WorldWideScience

Sample records for modern era retrospective-analysis

  1. Climate Data Guide - Modern Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2)

    Science.gov (United States)

    Cullather, Richard; Bosilovich, Michael

    2017-01-01

    The Modern-Era Retrospective analysis for Research and Applications, version 2 (MERRA-2) is a global atmospheric reanalysis produced by the NASA Global Modeling and Assimilation Office (GMAO). It spans the satellite observing era from 1980 to the present. The goals of MERRA-2 are to provide a regularly-gridded, homogeneous record of the global atmosphere, and to incorporate additional aspects of the climate system including trace gas constituents (stratospheric ozone), and improved land surface representation, and cryospheric processes. MERRA-2 is also the first satellite-era global reanalysis to assimilate space-based observations of aerosols and represent their interactions with other physical processes in the climate system. The inclusion of these additional components are consistent with the overall objectives of an Integrated Earth System Analysis (IESA). MERRA-2 is intended to replace the original MERRA product, and reflects recent advances in atmospheric modeling and data assimilation. Modern hyperspectral radiance and microwave observations, along with GPS-Radio Occultation and NASA ozone datasets are now assimilated in MERRA-2. Much of the structure of the data files remains the same in MERRA-2. While the original MERRA data format was HDF-EOS, the MERRA-2 supplied binary data format is now NetCDF4 (with lossy compression to save space).

  2. American Meteorological Society (AMS) - The Modern Era Retrospective-Analysis for Research and Applications (MERRA) Data and Accessibility

    Science.gov (United States)

    daSilva, Arlindo

    2009-01-01

    The AM Short Course on The Modern Era Retrospective-analysis for Research and Applications (MERRA) data and accessibility will be held on January 11, 2009 preceding the 89th Annual Meeting in Phoenix, Arizona. Preliminary programs, registration, hotel, and general information will be posted on the AMS Web site in mid-September 2008. Retrospective-analyses (or reanalyses) have been established as an important tool in weather and climate research over the last decade. As computer power increases, the data assimilation and modeling systems improve and become more advanced, the input data quality increases and so reanalyses become more reliable. In 2008, NASA Global Modeling and Assimilation Office began producing a new reanalysis called the Modem Era Retrospective-analysis for Research and Applications (MERRA). The initial data from the reanalysis has been made available to the community and should be complete through 30 years (1979-present) by Fall of 2009. MERRA has taken advantage of the advancement of computing resources to provide users more data than previously available. The native spatial resolution is nominally 1/2 degrees and the surface two dimensional data are one hourly frequency. In addition to the meteorological analysis data, complete mass, energy and momentum budget data and also stratospheric data are provided. The eventual data holdings will exceed 150Tb. In order to facilitate user accessibility to the data, it will be stored in online hard drives (not tape storage) and available through several portals. Subsetting tools will also be available to allow users to tailor their data requests. The goals of this short course are to provide hands on users of reanalyses instruction on MERRA systems and also interactive experience with the online data and access tools. The course is intended for students and research scientists who will be actively interested in accessing and applying MERRA data in their weather, climate or applications work. The course has

  3. METODE MUHADDITSIN DI ERA MODERN

    Directory of Open Access Journals (Sweden)

    Adriansyah Adriansyah

    2016-05-01

    Full Text Available After the era of tadwin, almost all disciplines of knowledge in the Islamic world, including the study of hadith, was considered “running on the spot.” Yet, attention and maintenance of the hadith was still favored by intellectuals. Similarly, in the modern era, the hadith remains the object of criticism by not only Muslim intellectuals but also outsiders, such as the West. Western imperialism against the Islamic world in the past was now the beginning of the history of how Muslims are only able to “survive” rather than “attack.” The emergence of defensive and reactive works against trends of the West in criticizing and blasphemed the hadith, then, such works became trends and supporting methodologies among Muslim observers of the hadith in today’s modern era

  4. Bremsstrahlung: an experimentalists personal perspective on the post modern era

    International Nuclear Information System (INIS)

    Quarles, C.A.

    2000-01-01

    In this brief review I will discuss the recent experimental work on the doubly differential cross section, i.e. the photon energy and angular distribution, for electron Bremsstrahlung from thin solid film and gas targets. Since the beginning of the modern era in the study of Bremsstrahlung with the publication of the 1971 paper by Ts eng and Pratt, Professor Pratt has been the dominant influence in Bremsstrahlung research. Most, if not all, experimental research during the modern era has been motivated by the interest in comparing data with the theory of Pratt and his coworkers. As Bremsstrahlung research has moved into its post modern era, new experiments with increasing precision are concentrating on determining under what conditions ordinary Bremsstrahlung theory needs to be supplemented by a contribution from polarization Bremsstrahlung. Efforts to improve the comparison of thin-target experiment with theory have also led to new experimental and modeling work on Bremsstrahlung from thick solid targets. Thick-target Bremsstrahlung is interesting in its own right, but we also want to understand it better since it is the ever-present background in the thin-target experiments and the limiting factor in the effort to distinguish the polarization contribution to the total Bremsstrahlung spectrum. Professor Pratt ushered in the modern era in Bremsstrahlung research and has recently guided the transition into the post modern era. It can be expected that he will continue to have a formative influence on the developments of Bremsstrahlung research into the foreseeable future.

  5. Modernity: A new axial (era culture?

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    Wolfgang Schluchter

    2017-10-01

    Full Text Available The proposition of an axial age, lasting roughly from 800 to 200 B.C. and occurring in major civilizations (China, India, Near East independent of each other, first introduced by Alfred Weber and Karl Jaspers, then further developed by Robert Bellah and S. N. Eisenstadt among others, implied from the outset the question whether there has been a second axial age, leading to modernity, and if so, whether this second axial age consists in a secularization of the achievements of the first axial age. In this article it is argued that the notion of a second axial age is meaningful, but that the emergence of modernity can›t be accounted for in terms of secularization of the achievements of the first axial age. Rather, a new axial principle was institutionalized which separates the modern from the premodern world. This new principle is spelled out with reference to Hans Blumenberg, Charles Taylor and especially Max Weber. The emphasis is on the dialectics of disenchantment and the place of religion in a secular age

  6. Outcome of oligodendroglioma treatment in the era of modern neuroimaging

    International Nuclear Information System (INIS)

    Kleinberg, Lawrence R.; Silverman, Edward; Brem, Henry; Wharam, Moody D.

    1997-01-01

    Purpose/Objective: The benefit of routine postoperative radiotherapy for low grade oligodendroglioma remains controversial. Most published series include many patients treated before the availability of CT or MRI scans which allow early diagnosis, guide surgery, detect residual disease, improve radiotherapy, and detect asymptomatic recurrences. The purpose of this analysis is to determine whether observation rather than radiation continues to be an appropriate option for selected patients with the availability of modern neuroimaging. Materials and Methods: 58 patients (age 2-67 years, 6 pts. =2 poor prognostic factor (p=.04). Results: Two and five year actuarial freedom from local progression was 93 +/- 4% and 75% +/- 8% whereas 2 and 5 year overall survival was 94% +/- 3% and 80% +/- 7%. Despite the imbalance of prognostic factors, there was no significant difference whether or not postoperative RT was given. With RT, 2 and 4 year actuarial freedom from progression was 94% +/- 4% and 78% +/- 8%, whereas without RT it was 94% +/- 6% at 2 and 4 years. Similarly, 2 and 4 year actuarial survival was 94% +/- 4% and 78% +/- 8% with RT and was 91% +/- 8% without RT. (5(10)) recurrences were detected radiologically without new or progressive clinical symptoms. Conclusion: These data support the hypothesis that, in the era of modern neuroimaging, the initial observation of good risk patients and immediate irradiation of poor risk patients is an appropriate treatment approach which results in good medium term control and survival for low grade oligodendroglioma patients. A policy of treatment vs. observation based on selected prognostic factors will be tested prospectively in an intergroup trial for low grade glioma histologies

  7. Pola Komunikasi Adat Berasan Suku Serawai di Era Modern

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    Vethy Octaviani

    2017-05-01

    Full Text Available This study aims to get a comprehensive picture of the pattern of communication on Berasan local customary in Bengkulu City in experiencing a cultural shift. This study uses phenomenological method by describing the phenomenon of Berasan traditions in modern era. Cultural communication pattern is social perception caused by cultural differences that affects the process of perception and including component of communication process. The result shows communication pattern of Berasan local customary of Serawai tribe with communities in Bengkulu city and the migrants has been seen form who will deal first with her parents. Communication pattern of Berasan local customary with urban community of Bengkulu, a man who came first to her house to meet directly with their parents, while communication pattern of Berasan local customary with migrants:  his deputy has to come first to the house of the women. This paper concludes that communication patterns of Berasan local customary between Serawai tribe with Bengkulu community and migrants has changed.

  8. Challenges of Judiciary Modernization in an Open Government Era

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    Carlos E. Jiménez Gómez

    2014-12-01

    Full Text Available In the modernization of public administrations, we are witnessing a phase of changes in an Open Government context. In any process of judiciary modernization, context is of great importance. The modernization of justice today requires major changes. This also implicates important challenges in the pursuit of judicial efficiency. Based on recent research on justice and ict´s, we find it necessary to talk about the modernization of administrations and the adoption of ict´s. In addition to this, we also discuss judicial efficiency. Furthermore, we take a step ahead to properly approach the modernization of the administration of justice to address challenges such as training, Big Data and the electronic judicial process, and finally the re-design, opening and innovation in the justice system.

  9. The incidence of biopsy-proven transformation in follicular lymphoma in the rituximab era. A retrospective analysis from the Czech Lymphoma Study Group (CLSG) database.

    Science.gov (United States)

    Janikova, Andrea; Bortlicek, Zbynek; Campr, Vit; Kopalova, Natasa; Benesova, Katerina; Hamouzova, Michaela; Belada, David; Prochazka, Vit; Pytlik, Robert; Vokurka, Samuel; Pirnos, Jan; Duras, Juraj; Mocikova, Heidi; Mayer, Jiri; Trneny, Marek

    2018-04-01

    The aim of this study is to assess the incidence, risk factors, and outcome of biopsy-proven transformation in follicular lymphoma (FL) patients in the rituximab era. Transformation was analyzed in 1233 patients with initially diagnosed FL grades 1-3A, identified between 2002 and 2012 in the prospectively maintained Czech Lymphoma Study Group database. Only patients with histologically proven transformation (HT) were included. HT occurred in 58 cases at a median of 3.0 years from the initial FL diagnosis; the HT rate was 4% at 5 years. Transformation occurred most frequently at the first relapse (84% patients). Median OS from the HT was 2.5 years (95% CI 0.4-4.6) and 6-year OS with HT was shorter compared to all FLs (60 vs. 83.9%; 95% CI). A bulky tumor (≥ 10 cm), increased lactate dehydrogenase, age ≥ 60 years, and International Prognostic Index (intermediate/high risk), but not Follicular Lymphoma International Prognostic Index, were associated with transformation (p transformation rate at 5 years of 4.23% (95% CI 2.52-5.93); subsequent rituximab maintenance (n = 276) vs. observation (n = 153) was associated with a lower transformation rate (p.033; HR 3.29; CI 1.10-9.82). The transformation rate seems to be lower than in previous series, which may be influenced by broad use of rituximab, but prognosis of HT developed during therapy continues to be poor.

  10. Teaching the Past in the Early Modern Era: Two Different Ways to Make Use of History

    Science.gov (United States)

    Bruter, Annie

    2012-01-01

    Were teachers, of the early modern era not longing for the present? Most colleges of that time did not offer a history course. Still, they did teach a lot about the past since the teaching consisted in the reading of the works of ancient writers. This is because ancient science and literature were considered much more advanced than the science and…

  11. Utility of Hippocrates' prognostic aphorism to predict death in the modern era: prospective cohort study.

    Science.gov (United States)

    St John, Philip D; Montgomery, Patrick R

    2014-12-15

    To determine if one of Hippocrates' aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. Secondary analysis of an existing population based cohort study. Manitoba Study of Health and Aging. 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. Time to death. We recreated the hippocratic prognosticator using an item that measures appetite drawn from the Center for Epidemiologic Studies-depression subscale, and the mini-mental state examination, with a score of >25 being considered as normal. People with normal cognition and appetite were compared with those with either poor cognition or poor appetite. We constructed Cox regression models, adjusted for age, sex, education, and functional status. The prognostic aphorism predicted death, with an unadjusted hazard ratio of 2.37 (95% confidence interval 1.93 to 2.88) and a hazard ratio of 1.71 (1.37 to 2.12) adjusted for age, sex, and education. Both poor appetite and poor cognition predicted death. The sensitivity and specificity were not, however, sufficient for the measure to be used alone. An aphorism devised by Hippocrates millennia ago can predict death in the modern era. © St John et al 2014.

  12. Utility of Hippocrates’ prognostic aphorism to predict death in the modern era: prospective cohort study

    Science.gov (United States)

    Montgomery, Patrick R

    2014-01-01

    Objective To determine if one of Hippocrates’ aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. Design Secondary analysis of an existing population based cohort study. Setting Manitoba Study of Health and Aging. Participants 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. Main outcome measure Time to death. Methods We recreated the hippocratic prognosticator using an item that measures appetite drawn from the Center for Epidemiologic Studies-depression subscale, and the mini-mental state examination, with a score of >25 being considered as normal. People with normal cognition and appetite were compared with those with either poor cognition or poor appetite. We constructed Cox regression models, adjusted for age, sex, education, and functional status. Results The prognostic aphorism predicted death, with an unadjusted hazard ratio of 2.37 (95% confidence interval 1.93 to 2.88) and a hazard ratio of 1.71 (1.37 to 2.12) adjusted for age, sex, and education. Both poor appetite and poor cognition predicted death. The sensitivity and specificity were not, however, sufficient for the measure to be used alone. Conclusion An aphorism devised by Hippocrates millennia ago can predict death in the modern era. PMID:25512328

  13. Symptomatic Perihepatic Fluid Collections After Hepatic Resection in the Modern Era.

    Science.gov (United States)

    Konstantinidis, Ioannis T; Mastrodomenico, Pedro; Sofocleous, Constantinos T; Brown, Karen T; Getrajdman, George I; Gönen, Mithat; Allen, Peter J; Kingham, T Peter; DeMatteo, Ronald P; Fong, Yuman; Jarnagin, William R; D'Angelica, Michael I

    2016-04-01

    Improvements in liver surgery have led to decreased mortality rates. Symptomatic perihepatic collections (SPHCs) requiring percutaneous drainage remain a significant source of morbidity. A single institution's prospectively maintained hepatic resection database was reviewed to identify patients who underwent hepatectomy between January 2004 and February 2012. Data from 2173 hepatectomies performed in 2040 patients were reviewed. Overall, 200 (9%) patients developed an SPHC, the majority non-bilious (75.5%) and infected (54%). Major hepatic resections, larger than median blood loss (≥360 ml), use of surgical drains, and simultaneous performance of a colorectal procedure were associated with an SPHC on multivariate analysis. Non-bilious, non-infected (NBNI) collections were associated with lower white blood cell (WBC) counts, absence of a bilio-enteric anastomosis, use of hepatic arterial infusion pump (HAIP), and presence of metastatic disease, and resolved more frequently with a single interventional radiology (IR) procedure (85 vs. 46.5%, p < 0.001) more quickly (15 vs. 30 days, p = 0.001). SPHCs developed in 9% of patients in a modern series of hepatic resections, and in one third were non-bilious and non-infected. In the era of modern interventional radiology, the need for re-operation for SPHC is exceedingly rare. A significant proportion of minimally symptomatic SPHC patients may not require drainage, and strategies to avoid unnecessary drainage are warranted.

  14. When and how should we manage thoracic aortic injuries in the modern era?

    Science.gov (United States)

    Bottet, Benjamin; Bouchard, François; Peillon, Christophe; Baste, Jean-Marc

    2016-12-01

    A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was what are the optimum treatment modality and timing of intervention for blunt thoracic aortic injury (BTAI) in the modern era? Of the 697 papers found using the reported search, 14 (5 meta-analyses, 2 prospective and 7 retrospective studies) represented the best evidence to answer the clinical question. The author, journal, country, date of publication, patient group studied, study type, relevant outcomes, results and weakness of these papers are tabulated. All five meta-analyses reported a reduction in mortality with thoracic endovascular aortic repair (TEVAR) compared with open repair (OR), but only four found the same benefit on paraplegia rate. Similarly, the two prospective and four retrospective studies showed significantly lower mortality with TEVAR than with OR. Only one study (a meta-analysis) reported a significantly lower stroke rate with TEVAR than with OR, whereas the 13 others reported a similar or even higher stroke rate. Other complication rates were identical. Four studies demonstrated that non-operative management (NOM) as a treatment option for BTAI was associated with increased mortality, even if it has declined in recent years. One study emphasized that some cases with minimal aortic injuries (Grade I and II on CT scan) could benefit from NOM. Regarding the timing of repair, only three studies analysed outcomes of delayed repair and reported significantly lower mortality than for early repair. We conclude that with lower mortality and similar overall complications including paraplegia but higher stroke rate, TEVAR is the most suitable treatment for BTAI in the modern era, where expertise exists, especially for cases of multiple associated injuries and in the older age group. Delayed aortic repair can be proposed based on CT scan analysis, but emergent repair should still be advocated for imminent free aortic rupture. NOM

  15. Resolving an 80-yr-old controversy: the beginning of the modern era of renal physiology.

    Science.gov (United States)

    Jamison, Rex L

    2014-12-01

    Marcello Malpighi discovered the glomerulus that bears his name in the 17th century, but it was not until the middle of the 19th century, in 1842, that William Bowman in London published his studies of the histological structure of the glomerulus and proposed that urine formation begins with glomerular secretion. At nearly the same time in Marburg, Carl Ludwig, unaware of Bowman's findings, proposed that urine formation begins with glomerular filtration followed by tubule reabsorption. The controversy lasted 80 yr. Prominent investigators weighed in on both sides. Rudolph Heidenhain's findings in 1874 swung the pendulum toward Bowman's theory until Arthur Cushny published his book, The Secretion of Urine, in 1917, in which he found the evidence insufficient to prove either theory. In 1921, a young physician, Joseph Wearn, began his postresidency training in the laboratory of Alfred N. Richards. He read Cushny's book and learned how to expose the glomerulus of a living frog. Richards proposed that Wearn use that experimental preparation to inject epinephrine into the glomerulus. Wearn proposed a different experiment: instead of using injection, collect fluid from the glomerulus and analyze it. Richards agreed, and the landmark results of that experiment, published in 1924, settled the controversy. The modern era of renal physiology was born. Copyright © 2014 The American Physiological Society.

  16. Vestibular schwannomas in the modern era: epidemiology, treatment trends, and disparities in management.

    Science.gov (United States)

    Babu, Ranjith; Sharma, Richa; Bagley, Jacob H; Hatef, Jeffrey; Friedman, Allan H; Adamson, Cory

    2013-07-01

    There are a variety of treatment options for the management of vestibular schwannomas (VSs), including microsurgical resection, radiotherapy, and observation. Although the choice of treatment is dependent on various patient factors, physician bias has been shown to significantly affect treatment choice for VS. In this study the authors describe the current epidemiology of VS and treatment trends in the US in the modern era. They also illustrate patient and tumor characteristics and elucidate their effect on tumor management. Patients diagnosed with VS were identified through the Surveillance, Epidemiology, and End Results database, spanning the years 2004-2009. Age-adjusted incidence rates were calculated and adjusted using the 2000 US standard population. The chi-square and Student t-tests were used to evaluate differences between patient and tumor characteristics. Multivariate logistic regression was performed to determine the effects of various patient and tumor characteristics on the choice of tumor treatment. A total of 6225 patients with VSs treated between 2004 and 2009 were identified. The overall incidence rate was 1.2 per 100,000 population per year. The median age of patients with VS was 55 years, with the majority of patients being Caucasian (83.16%). Of all patients, 3053 (49.04%) received surgery only, with 1466 (23.55%) receiving radiotherapy alone. Both surgery and radiation were only used in 123 patients (1.98%), with 1504 patients not undergoing any treatment (24.16%). Increasing age correlated with decreased use of surgery (OR 0.95, 95% CI 0.95-0.96; pmanagement (OR 1.04, 95% CI 1.04-1.05; pmanaged conservatively despite presenting with larger tumors. Further studies are needed to elucidate the reasons for treatment disparities and investigate the nationwide trend of resection for the treatment of small VSs.

  17. Traumatic diaphragmatic hernias: Retrospective analysis

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    J.P.A. Sousa

    2006-05-01

    Full Text Available Aims: This study classifies cases of traumatic diaphragmatic hernias (TDH in patients admitted to the Intensive Care Unit (ICU of the Coimbra University Hospitals (HUC from 1990 to 2004. Methods: Retrospective analysis of 34 cases of TDH, studying anatomical location, place and time of diagnosis, complementary tests aiding diagnosis, herniated organs, associated traumatism, morbidity and mortality. Results: Twenty-eight male and six female patients with an average age of 40.5 years ± 20.5, average SAPS score 38.8. Average lenght of stay was 19.1 ± 13.6 days, all suffered from closed traumatism and were put on artificial ventilation. The left-side diaphragm was more frequently affected (94.1% then the right. Diagnosis in 19 cases was made up in the first six hours following the diagnosis of traumatism, in four cases within 12 hours and in the remaining cases between 48 hours and 16 years after traumatism. In 13 patients the diagnosis was established intra-operatively. The stomach was typically one of the herniated organs. The most frequently associated lesions at the thoracic level were pulmonary contusion, haemothorax and pneumothorax, and at the abdominal level, haemoperitoneum and splenic lesion. The rates for complications and mortality were 55.8% and 11.7% respectively. Conclusions: TDH mainly occurs on the left side through closed thoraco-abdominal trauma following road traffic accidents. This group of patients, on average younger than others admitted to ICU, presents a longer average hospitalisation period, but has lower rates of mortality and lower SAPS severity scores. The most commonly herniated organ was the stomach and the most frequently encountered lesions were cranial-encephalic, splenic and pleural traumatisms. Pre-operative diagnosis of diaphragmatic injuries is difficult and a high index of clinical suspicion is needed after thoracoabdominal trauma. This diagnosis should always be considered a possibility in

  18. The Italian Middle School in a Deregulation Era: Modernity through Path-Dependency and Global Models

    Science.gov (United States)

    Mincu, Monica E.

    2015-01-01

    In the current context of intensified moves towards educational deregulation, the configuration of the Italian middle school and its relationship to education governance is an interesting case. Historically, it represents a unique example of the successful "decision-making" model of the welfarist era. Despite some internal constraints,…

  19. The world goes modern: new globalized framings of the postwar era in the contemporary exhibitions After Year Zero and The World Goes Pop

    Directory of Open Access Journals (Sweden)

    Kristian Handberg

    2016-04-01

    Full Text Available The article analyzes the contemporary art historical focus on multiple modernities through two significant exhibitions: After Year Zero at Haus der Kulturen der Welt, Berlin 2013/Museum of Modern Art, Warsaw 2015 and The World Goes Pop, Tate Modern, London (2015. These different exhibitions are aimed at re-reading the post-1945 era in a global context, discussing how arts and culture responded to a global modernity. The article emphasizes the overlapping interests in this by academic art history and criticism as well as museal and curatorial efforts and discusses the idea of curatorial research in these different approaches.

  20. Understanding Political Influence in Modern-Era Conflict:A Qualitative Historical Analysis of Hassan Nasrallah’s Speeches

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    Reem Abu-Lughod

    2012-09-01

    Full Text Available Understanding Political Influence in Modern-Era Conflict: A Qualitative Historical Analysis of Hassan Nasrallah’s Speeches 'Abstract' 'This research examines and closely analyzes speeches delivered by Hezbollah’s secretary general and spokesman, Hassan Nasrallah, from a content analysis perspective. We reveal that several significant political phenomena that have occurred in Lebanon were impacted by the intensity of speeches delivered by Nasrallah; these three events being the 2006 War, the Doha Agreement, and the 2008 prisoner exchange. Data has been collected from transcribed speeches and analyzed using a qualitative historical analysis. Furthermore, we use latent analysis to assess Nasrallah’s underlying implications of his speeches and identify the themes he uses to influence his audience.'

  1. Prolonged survival of patients with non-small-cell lung cancer with leptomeningeal carcinomatosis in the modern treatment era.

    Science.gov (United States)

    Riess, Jonathan W; Nagpal, Seema; Iv, Michael; Zeineh, Michael; Gubens, Matthew A; Ramchandran, Kavitha; Neal, Joel W; Wakelee, Heather A

    2014-05-01

    Leptomeningeal carcinomatosis (LM) is a severe complication of non-small-cell lung cancer (NSCLC) historically associated with poor prognosis. New chemotherapeutic and targeted treatments could potentially affect the natural history of LM. Patients with a pathologic diagnosis of NSCLC with LM treated at Stanford between 2003 and 2011 were identified via institutional databases and medical records. LM was defined by cerebrospinal fluid (CSF) that was positive for malignant cells or by LM enhancement on magnetic resonance imaging with gadolinium contrast. Retrospective, landmark analyses were performed to estimate survival. Statistical analyses were performed using SAS Enterprise Guide, version 4.3. LM was identified in 30 patients. All cases were adenocarcinoma; 60% of patients had a known or suspected driver mutation. The mean age was 58 years. Of the 30 patients, 67% were women; 70% were nonsmokers; 27% initially presented with LM; 84% received systemic treatment at or after development of LM; and 53% of these patients received modern systemic therapy for their LM, defined as a regimen containing pemetrexed, bevacizumab, or a tyrosine kinase inhibitor. Mean overall survival after LM diagnosis was 6 months (95% CI, 3-12). Patients who received modern systemic therapy for LM had decreased hazard of death (hazard ratio [HR], 0.24; P = .007). In this retrospective, single-institution analysis, median survival with LM was higher compared with historical experience. Patients who received modern systemic therapy for their LM had particularly good outcomes. These data provide evidence for improving survival outcomes in the modern treatment era for this difficult-to-treat complication. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. The Lunar Potential Determination Using Apollo-Era Data and Modern Measurements and Models

    Science.gov (United States)

    Collier, Michael R.; Farrell, William M.; Espley, Jared; Webb, Phillip; Stubbs, Timothy J.; Webb, Phillip; Hills, H. Kent; Delory, Greg

    2008-01-01

    Since the Apollo era the electric potential of the Moon has been a subject of interest and debate. Deployed by three Apollo missions, Apollo 12, Apollo 14 and Apollo 15, the Suprathermal Ion Detector Experiment (SIDE) determined the sunlit lunar surface potential to be about +10 Volts using the energy spectra of lunar ionospheric thermal ions accelerated toward the Moon. More recently, the Lunar Prospector (LP) Electron Reflectometer used electron distributions to infer negative lunar surface potentials, primarily in shadow. We will present initial results from a study to combine lunar surface potential measurements from both SIDE and the LP/Electron Reflectometer to calibrate an advanced model of lunar surface charging which includes effects from the plasma environment, photoemission, secondaries ejected by ion impact onto the lunar surface, and the lunar wake created downstream by the solar wind-lunar interaction.

  3. John Rawls and the theory of modernization. A retrospective analysis John Rawls y la teoría de la modernización. Una retrospectiva analítica

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    Bula Jorge Iván

    1994-12-01

    Full Text Available This work discusses the value of the theory of modernization and describes the scope and limitations of Rawls' Theory of Justice. The theory of modernization has a strong darwinist legacy: the biological evolution from simple to complex forms is applied to the social context and the transition from traditional to modern forms becomes a linear process. Rawls' most recent work link the concept of justice to that of social order, and his principIes become relevant when the principle of difference become the principIe of the least difference, as the basis of all political freedoms. The author holds that there are a number of roads to modernization and, following Bidet, he states that different models of society may come to exist within the matrix of modernization, including capitalism, socialism and all points between.En este trabajo se discute la validez de la teoría de la modernización y se identifican los alcances y las limitaciones de la Teoría de la Justicia de Rawls. La teoría de la modernización tiene una profunda herencia darwinistas: la evolución biológica de lo simple a lo complejo se traslada a lo social como un paso de lo tradicional a lo moderno y, en últimas, lleva a imitar a las sociedades más desarrolladas. Los nuevos enfoques critican la distinción entre lo tradicional y lo moderno y la visión unilineal del proceso de modernización. Los últimos trabajos de Rawls vinculan el concepto de la justicia al concepto de orden social y sus principios adquieren pertenencia cuando el principio de la diferencia se transforma en el de la menor diferencia, fundamento de todas las libertades políticas. El autor sostiene que hay varios caminos para la modernización y, siguiendo a Bidet, afirma que dentro de la matriz de la modernidad pueden desarrollarse distintos modelos de sociedad: capitalismo, socialismo o cualquier otra solución intermedia.

  4. The Bright Face of Dark Tourism - Military Conflicts and World Travel in the Modern Era

    OpenAIRE

    Mihály Miklós Nagy

    2016-01-01

    In the history of modern culture, besides its primary task of imposing political will, the military has also served as a major travel institution. The geographical dimensions of wars and the increasingly greater military forces involved have resulted in millions of people being compelled to get to know foreign lands and cultures as soldiers. Thus, military forces have become agents of developing societies’ geographical culture. This phenomenon is the bright face of dark tourism. Still, dark t...

  5. Public health in New York City, 2002-2007: confronting epidemics of the modern era.

    Science.gov (United States)

    Frieden, Thomas R; Bassett, Mary T; Thorpe, Lorna E; Farley, Thomas A

    2008-10-01

    Long after the leading causes of death in the United States shifted from infectious diseases to chronic diseases, many public health agencies have not established effective policies and programmes to prevent current health problems. Starting in 2002, the New York City health department, an agency with a long history of innovation, undertook initiatives to address chronic disease prevention and control, as well as to modernize methods to address persistent health problems. All the initiatives relied on an expansive use of epidemiology; actions to prevent disease were based on policy change to create health-promoting environments as well as engagement with the health care system to improve its focus on prevention. Examples of policy-based initiatives are: a multi-component tobacco control programme that included a tax increase, a comprehensive smoke-free air law, hard-hitting anti-tobacco advertising and cessation services; elimination of trans fats from restaurants and a mandate that restaurants post-calorie information on menu boards. Examples of health care initiatives are public health 'detailing' to primary care providers, creation of a city-wide diabetes registry and development of a public health-oriented electronic health record. The infrastructure needed by local health departments to prevent chronic diseases and other modern health problems includes strong information technology systems, skillful epidemiology, expertise in communications using modern media, policy-making authority and, most importantly, political support.

  6. Antara Makkah, Basrah dan Kemerdekaan Studi Konstruksi Historis Pendidikan Islam Era Klasik hingga Modern

    Directory of Open Access Journals (Sweden)

    M. Mujab

    2013-09-01

    Full Text Available Islamic Education at first period was showed its superiority. It was proved by the emergency of superior, dinamic and creative generation. The generation from companions of the prophet, tabi’in and tabi’it tabiin are a sturdy generation, have a high comitment for moral values of Islam. Whereas on the pre-modern, Islam was suffered a decrease. Its quite alarming setback. Its period of deteriorate. This periode was identified as time of the demise of the Islamic struggle. So, education was not incised achievement then previous generations.

  7. The Bright Face of Dark Tourism - Military Conflicts and World Travel in the Modern Era

    Directory of Open Access Journals (Sweden)

    Mihály Miklós Nagy

    2016-11-01

    Full Text Available In the history of modern culture, besides its primary task of imposing political will, the military has also served as a major travel institution. The geographical dimensions of wars and the increasingly greater military forces involved have resulted in millions of people being compelled to get to know foreign lands and cultures as soldiers. Thus, military forces have become agents of developing societies’ geographical culture. This phenomenon is the bright face of dark tourism. Still, dark tourism has another positive aspect as well: the scientific exploration of certain landscapes and regions. Modern military forces have launched numerous scientific explorations to learn about the Earth. There are two types of such explorations: exploratory trips related to military campaigns and endeavors of purely scientific purposes. At the same time, scientific knowledge accumulated in the military has also played important roles in geographic research. The transportation of large numbers of personnel and the scientific expeditions of military forces have led to the development of military travel literature, whose significance goes beyond the framework of military geography and which has become an organic part of academic geographical literature.

  8. Survival of Idiopathic Pulmonary Arterial Hypertension Patients in the Modern Era in Australia and New Zealand.

    Science.gov (United States)

    Strange, Geoff; Lau, Edmund M; Giannoulatou, Eleni; Corrigan, Carolyn; Kotlyar, Eugene; Kermeen, Fiona; Williams, Trevor; Celermajer, David S; Dwyer, Nathan; Whitford, Helen; Wrobel, Jeremy P; Feenstra, John; Lavender, Melanie; Whyte, Kenneth; Collins, Nicholas; Steele, Peter; Proudman, Susanna; Thakkar, Vivek; Keating, Dominic; Keogh, Anne

    2017-09-20

    Epidemiology and treatment strategies continue to evolve in pulmonary arterial hypertension (PAH). We sought to define the characteristics and survival of patients with idiopathic, heritable and drug-induced PAH in the current management era. Consecutive cases of idiopathic, heritable and drug-induced PAH were prospectively enrolled into an Australian and New Zealand Registry. Between January 2012 and December 2016, a total of 220 incident cases were enrolled (mean age 57.2±18.7years, female 69.5%) and followed for a median duration of 26 months (IQR17-39). Co-morbidities were common such as obesity (34.1%), systemic hypertension (30.5%), coronary artery disease (16.4%) and diabetes mellitus (19.5%). Initial combination therapy was used in 54 patients (dual, n=50; triple, n=4). Estimated survival rates at 1-year, 2-years and 3-years were 95.6% (CI 92.8-98.5%), 87.3% (CI 82.5-92.4%) and 77.0% (CI 70.3-84.3%), respectively. Multivariate analysis showed that male sex and lower 6-minute distance at diagnosis independently predicted worse survival, whereas obesity was associated with improved survival. Co-morbidities other than obesity did not impact survival. Initial dual oral combination therapy was associated with a trend towards better survival compared with initial oral monotherapy (adjusted HR=0.27, CI 0.06-1.18, p=0.082) CONCLUSIONS: The epidemiology and survival of patients with idiopathic PAH in Australia and New Zealand are similar to contemporary registries reported in Europe and North America. Male sex and poorer exercise capacity are predictive of mortality whereas obesity appears to exert a protective effect. Despite current therapies, PAH remains a life-threatening disease associated with significant early mortality. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

  9. Subsequent primary malignancies after diffuse large B-cell lymphoma in the modern treatment era.

    Science.gov (United States)

    Tao, Li; Clarke, Christina A; Rosenberg, Aaron S; Advani, Ranjana H; Jonas, Brian A; Flowers, Christopher R; Keegan, Theresa H M

    2017-07-01

    With the addition of rituximab and other treatment advances, survival after diffuse large B-cell lymphoma (DLBCL) has improved, but subsequent primary malignancies (SPMs) have emerged as an important challenge for DLBCL survivorship. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for SPMs among 23 879 patients who survived at least 1 year after a first primary DLBCL diagnosed during 1989-2012, compared to the general population in California. Cumulative incidence (CMI) of SPMs, accounting for the competing risk of death, also was calculated. We found that the incidence of acute myeloid leukaemia (AML) nearly doubled in the post-rituximab era [SIR (95% CI) 4·39 (2·51-7·13) pre- (1989-2000) and 8·70 (6·62-11·22) post-rituximab (2001-2012)]. Subsequent thyroid cancer was rare pre-rituximab, but increased substantially after 2001 [0·66 (0·08-2·37) vs. 2·27(1·44-3·41)]. The 5-year CMI for all SPMs (4·77% pre- vs. 5·41% post-rituximab, P = 0·047), AML (0·15% vs. 0·41%, P = 0·003), thyroid cancer (0·03% vs. 0·15%, P = 0·003) and melanoma (0·25% vs. 0·42%, P = 0·020) were greater in DLBCL patients diagnosed in the post- versus pre-rituximab period. This study provides insight into the changing pattern of SPM occurrence after the introduction of rituximab, which may elucidate the aetiology of SPMs and should guide future cancer surveillance efforts among DLBCL patients. © 2017 John Wiley & Sons Ltd.

  10. EVIDENCES OF SCIENTIFIC MIRACLE OF AL-QUR’AN IN THE MODERN ERA

    Directory of Open Access Journals (Sweden)

    Dwi Sukmanila Sayska

    2016-05-01

    Full Text Available One of the miracles of al-Qur’an is i’jaz ilmi, it’s meant the information of al-Qur’an about science which is then able revealed and proven in accordance with the development of science. I’jaz ilmi does not present itself, but should be explored and researched, so that the evidence of i’jaz ilmi can be more and more and grow over time. Scientists gave the parable is like a spring that never runs dry. Every time always comes new discoveries and scientific provisions which already hinted at al-Qur’an for 14 centuries ago as evidence of i’jaz. I’jaz ilmi later became a effective propaganda media, especially among scientists. Many cases found confession of scientists when they were able to prove the truth of which is informed by al-Qur’an. In addition, evidence of ilmi i’jaz is able to ward off external oblique view of Islam that al-Qur’an is man work, because when they know that what is described by al- Qur’an has been proved by modern scientific discoveries, and eventually they acknowledges that al-Qur’an is really the word of God

  11. The modern CIO: forging a new role in the managed care era.

    Science.gov (United States)

    Griffin, J

    1997-05-01

    The advent of managed care has helped forge new roles for healthcare professionals. Competitive pressures, the profile of the member community, and provider network design drive healthcare delivery via the managed care model. Careful analysis and design of the managed care model charts the success or failure of the health care delivery system--usually an integrated delivery system (IDS). Therefore, those healthcare organizations that have chosen to get on the managed care bandwagon must re-invent themselves, both culturally and technologically. The chief information officer (CIO) leads this technological revolution. To work effectively, the technological infrastructure of the IDS must be closely in line with enterprise goals and objectives. In the managed care environment the old information system (IS) approach of supporting the operational needs of individual departments simply will not work. The CIO's new role will be to master the concept of managed care to ensure that enterprise-wide needs for operational, clinical, and financial information are met, and that IS and enterprise goals are aligned. CIOs who have an intuitive grasp of the managed care environment--although their numbers are growing as managed care mushrooms--make up a minority group. They are a special breed with clearly definable qualities such as business savvy and an affinity for big-picture thinking. To an IDS, a CIO with these qualities is a rare gem indeed. This article introduces Don Winschel, the associate administrator and CIO of Johnson City Medical Center (Johnson City, TN) as an example of one such modern CIO.

  12. Radiation therapy for Ewing's sarcoma: Results from Memorial Sloan-Kettering in the modern era

    International Nuclear Information System (INIS)

    La, Trang H.; Meyers, Paul A.; Wexler, Leonard H.; Alektiar, Kaled M.; Healey, John H.; Laquaglia, Michael P.; Boland, Patrick J.; Wolden, Suzanne L.

    2006-01-01

    Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority of primary tumors were centrally located (72%): spine (n = 18), pelvis (n = 15), extremities (n 12), chest wall (n = 5), head and neck (n = 5), and other (n = 5). Thirty-eight percent of patients presented with metastatic disease, and 52% of primary tumors were ≥8 cm. Actuarial 3-year local control was 77%. The presence of metastases at diagnosis was an adverse prognostic factor for local control (84% vs. 61%, p = 0.036). No other predictive factors for local failure were identified. In patients without metastatic disease, 3-year disease-free and overall survival rates were 70% and 86%, respectively, whereas in patients with metastases they were both 21%. Follow-up of surviving patients was 6-178 months (median, 41 months). Conclusion: In this unfavorable cohort of ESFT patients, radiation therapy was an effective modality for local control, especially for patients without metastases. The presence of metastases at diagnosis is a predictive factor not only for death but also for local failure

  13. Modernizing Earth and Space Science Modeling Workflows in the Big Data Era

    Science.gov (United States)

    Kinter, J. L.; Feigelson, E.; Walker, R. J.; Tino, C.

    2017-12-01

    Modeling is a major aspect of the Earth and space science research. The development of numerical models of the Earth system, planetary systems or astrophysical systems is essential to linking theory with observations. Optimal use of observations that are quite expensive to obtain and maintain typically requires data assimilation that involves numerical models. In the Earth sciences, models of the physical climate system are typically used for data assimilation, climate projection, and inter-disciplinary research, spanning applications from analysis of multi-sensor data sets to decision-making in climate-sensitive sectors with applications to ecosystems, hazards, and various biogeochemical processes. In space physics, most models are from first principles, require considerable expertise to run and are frequently modified significantly for each case study. The volume and variety of model output data from modeling Earth and space systems are rapidly increasing and have reached a scale where human interaction with data is prohibitively inefficient. A major barrier to progress is that modeling workflows isn't deemed by practitioners to be a design problem. Existing workflows have been created by a slow accretion of software, typically based on undocumented, inflexible scripts haphazardly modified by a succession of scientists and students not trained in modern software engineering methods. As a result, existing modeling workflows suffer from an inability to onboard new datasets into models; an inability to keep pace with accelerating data production rates; and irreproducibility, among other problems. These factors are creating an untenable situation for those conducting and supporting Earth system and space science. Improving modeling workflows requires investments in hardware, software and human resources. This paper describes the critical path issues that must be targeted to accelerate modeling workflows, including script modularization, parallelization, and

  14. A retrospective analysis of acute organophosphorus poisoning ...

    African Journals Online (AJOL)

    A retrospective analysis of acute organophosphorus poisoning cases admitted to the tertiary care teaching hospital in South India. ... Young adult males were more commonly involved than females (M:F 2.5:1). The mean age of the patients was 28 years (range 2-72 years, SD ± 14.3 years). Mean time to receive treatment ...

  15. Mortality among people living with HIV/AIDS with non-small-cell lung cancer in the modern HAART Era.

    Science.gov (United States)

    Smith, Danielle M; Salters, Kate A; Eyawo, Oghenowede; Franco-Villalobos, Conrado; Jabbari, Shahab; Wiseman, Sam M; Press, Natasha; Montaner, Julio S G; Man, S F Paul; Hull, Mark; Hogg, Robert S

    2018-02-07

    People living with HIV (PLWHA) with adequate access to modern combination antiretroviral therapy (cART) are living longer and experiencing reduced AIDS-related morbidity and mortality. However, increases in non-AIDS related conditions, such as certain cancers, have accompanied these therapeutic advances over time. As such, our study objective was to determine the impact of HIV on all-cause and lung cancer-specific mortality amongst PLWHA with diagnoses of non-small-cell lung cancer (NSCLC) and HIV-negative individuals with NSCLC. This analysis was inclusive of PLWHA on and off cART over the age of 19 years and a 10% comparison sample from the BC population ≥19 years, over a 13-year period (2000-2013). Kaplan-Meier estimates, Cox PH models, and competing risk analysis for all-cause and cause-specific mortality (respectively) compared PLWHA to HIV-negative individuals, controlling for age, gender, cancer stage, co-morbidities; and nadir CD4 count, viral load, and injection drug use for a HIV-positive specific analysis. We identified 71 PLWHA and 2463 HIV-negative individuals diagnosed with NSCLC between 2000 and 2013. PLWHA with NSCLC were diagnosed at a significantly younger age than HIV-negative individuals (median age 57 vs 71 years, p cancer-specific mortality. However, in multivariate analysis, HIV was associated with greater all-cause mortality (adjusted hazard ratio [aHR]:1.44; 95% confidence interval [CI]: 1.08-1.90), with median survival of 4 months for PLWHA, and 10 months for HIV-negative. Higher nadir CD4 count was protective against mortality (aHR: 0.33, 95% CI: 0.17-0.64) amongst PLWHA in multivariate analysis. Our analysis suggests that PLWHA in the modern cART era experience similar lung cancer survival outcomes compared to the general BC population with NSCLC. However, we also observed significantly higher all-cause mortality among PLWHA with NSCLC, which may warrant further inquiry into the role of HIV in exacerbating mortality among PLWHA with

  16. Retrospective analysis of the Spitak earthquake

    Directory of Open Access Journals (Sweden)

    A. K. Tovmassian

    1995-06-01

    Full Text Available Based on the retrospective analysis of numerous data and studies of the Spitak earthquake the present work at- tempts to shed light on different aspects of that catastrophic seismic event which occurred in Northern Arme- nia on December 7, 1988. The authors follow a chronological order of presentation, namely: changes in geo- sphere, atmosphere, biosphere during the preparation of the Spitak earthquake, foreshocks, main shock, after- shocks, focal mechanisms, historical seismicity; seismotectonic position of the source, strong motion records, site effects; the macroseismic effect, collapse of buildings and structures; rescue activities; earthquake conse- quences; and the lessons of the Spitak earthquake.

  17. Modern scientific evidence pertaining to criminal investigations in the Chosun dynasty era (1392-1897 A.C.E.) in Korea.

    Science.gov (United States)

    Nam, Yun Sik; Won, Sung-Ok; Lee, Kang-Bong

    2014-07-01

    A guidebook detailing the process of forensic investigation was written in 1440 A.C.E. It outlines the fundamentals and details of each element of criminal investigation during the era of the Chosun dynasty in Korea. Because this old guidebook was written in terms of personal experience rather than on scientific basis, it includes many fallacies from the perspective of modern forensic science. However, the book describes methods to form a scientific basis for the experiments performed. We demonstrate the modern scientific basis for ancient methods to monitor trace amounts of blood and detect lethal arsenic poisoning from a postmortem examination as described in this old forensic guidebook. Traces of blood and arsenic poisoning were detected according to the respective color changes of brownish red, due to the reaction of ferric ions in blood with acetic ions of vinegar, and dark blue, due to the reaction of silver with arsenic sulfide. © 2014 American Academy of Forensic Sciences.

  18. Modern

    Directory of Open Access Journals (Sweden)

    A.V. Bagrov

    2014-06-01

    Full Text Available The article gives an overview of the most important problems of modern meteoric astronomy and briefly describes ways and methods of their solutions. Particular attention is paid to the construction and arrangement of meteoric video cameras intended for registration of the meteoric phenomena as the main method of obtaining reliable and objective observational data on the basis of which the solution of the described tasks is possible.

  19. Revisiting Mathematical Problem Solving and Posing in the Digital Era: Toward Pedagogically Sound Uses of Modern Technology

    Science.gov (United States)

    Abramovich, S.

    2014-01-01

    The availability of sophisticated computer programs such as "Wolfram Alpha" has made many problems found in the secondary mathematics curriculum somewhat obsolete for they can be easily solved by the software. Against this background, an interplay between the power of a modern tool of technology and educational constraints it presents is…

  20. Expert Coaching in Weight Loss: Retrospective Analysis.

    Science.gov (United States)

    Painter, Stefanie Lynn; Ahmed, Rezwan; Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2018-03-13

    Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Participant's one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. ©Stefanie Lynn Painter, Rezwan Ahmed, Robert F Kushner, James O Hill, Richard Lindquist, Scott

  1. Expert Coaching in Weight Loss: Retrospective Analysis

    Science.gov (United States)

    Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2018-01-01

    Background Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. Objective The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. Methods A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Conclusions Participant’s one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. PMID:29535082

  2. [Retrospective analysis of 44 childhood drowning accidents].

    Science.gov (United States)

    Brüning, Caroline; Siekmeyer, Werner; Siekmeyer, Manuela; Merkenschlager, Andreas; Kiess, Wieland

    2010-07-01

    Worldwide, drowning is the second leading cause of unintentional death and the leading cause of cardiovascular failure for children [1-3]. The number of near-drownings, where the incident is survived for at least 24 hours, is assumed to be four times as high [5]. In the years 1994 until 2008 there were 44 cases of drowning treated at the children's department of the University of Leipzig. This number shows that even in a medical centre drowning incidents are only occasional incidents. Therefore it is important to know the sequelae and handlings to be able to react in case of an emergency. A total of 44 children suffering a drowning accident within the last 48 hours who were treated during the period of 01.01.1994 through 30.06.2008 at the Children's Centre at the University of Leipzig. A retrospective analysis using a structured questionnaire was done. Social demographic data, accident progress, clinical results and progress as well as outcome of the cases were investigated. During the analysed period in the median three children were treated each year after drowning incidents. Clustering in the summer and winter months and on the weekends was recognizable. The median age was 3.33 years and the group of high risk were children aged 1-3 years, especially boys. Sixty percent of the children came from stable social backgrounds. Half of the children suffered from drowning in created swimming pools or ponds, the rest in natural waters, public pools and sources of water in the household. The median submersion lasted 2 minutes. Correlation of submersions below 1 minute with a good, and submersions above 10 minutes with a negative outcome was shown. A Glasgow Coma Scale (GCS) of 3 points (n = 15) and pupils without light reaction (n = 14) were associated with a lethal outcome or residual neurological deficits. Looking at the laboratory values, correlation between severe acidotic pH-values with a very low base excess, high blood sugar as well as high lactate values and a

  3. Risk of second malignancies in patients with early-stage classical Hodgkin's lymphoma treated in a modern era

    International Nuclear Information System (INIS)

    LeMieux, Melissa H; Solanki, Abhishek A; Mahmood, Usama; Chmura, Steven J; Koshy, Matthew

    2015-01-01

    Second malignancies remain an issue affecting morbidity and mortality in long-term survivors of early stage Hodgkin's lymphoma (HL). We undertook this study to determine if treatment in the modern era resulted in decreased second malignancies. Patients diagnosed with stage I–II cHL between 1988 and 2009 who received radiation therapy (RT) were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Freedom from second malignancy (FFSM) was estimated using the Kaplan–Meier method. Univariate analysis (UVA) was performed using the Log-Rank test, and included age, gender, year of diagnosis, and stage. Multivariable analysis (MVA) was performed using Cox Proportional Hazards modeling. The study cohort included 8807 patients. The median age at diagnosis was 32 years (range: 2–85). The majority of patients had stage II disease (n = 6044, 69%), 597 (7%) had extranodal involvement (ENI), and 1925 (22%) had B symptoms. Median follow-up for the entire cohort was 7.2 years (range: 0–22). Five hundred twenty-three (6%) patients developed a second malignancy. Median latency to second malignancy was 5.8 years (range: 0.1–21.5). Of the 523 patients that developed a second malignancy, 228 (44%) occurred in the first 5 years, 139 (27%) were diagnosed between years 5–10, and 156 (30%) beyond 10 years. The 10 year FFSM for patients treated between 1988 and 1999 was 93.0% versus 95.1% for patients treated between 2000 and 2009 (P = 0.04), On MVA, treatment between 2000 and 2009 was associated with a HR for second malignancy of 0.77 (95% Confidence Interval: 0.62–0.96, P = 0.02) compared to the treatment between 1988 and 1999. Our analysis suggests that in patients treated with RT for stage I or II cHL, treatment prior to 2000 had a slightly higher risk of second malignancy compared to treatment in 2000 and later. Further studies, with longer follow-up of patients treated in the modern era are needed to confirm these findings

  4. 'He plays on the pillory'. The use of musical instruments for punishment in the Middle Ages and the Early Modern Era.

    Science.gov (United States)

    Herzfeld-Schild, Marie Louise

    2013-01-01

    Illustrations by the Dutch renaissance artists Pieter Bruegel the Elder and Jan Wierix both show a man imprisoned on a pillory, a former place of enforcement of judicial sentences, and playing a musical instrument. Taken as legal iconographic sources, these illustrations of the old saying 'He plays on the pillory' can be understood as references to a specific kind of punishment used in the Middle Ages and the Early Modern Era. Specifically, delinquents had to wear wooden or iron 'neck violins' or 'neck flutes' while being pilloried or chased through the streets in order to be humiliated in public. As well as this historical fact, there also exists an interpretation that takes the illustrations by Bruegel and Wierix literally. It suggests that these punishment practices originally date back to a more ancient use of real instruments in a penal system that was applied and understood as a 'healing punishment' (poena medicinalis) to banish the ill and re-establish the good in the delinquent, the community and the world as a whole due to musical sounds. By means of legal iconographical and historical methods, this article explores the different nuances of punishment that employed real or symbolic musical instruments. Thus, it examines a historical aspect of 'music in detention' where the (symbolic) sounds do not emanate from the punisher but from the punished themselves.

  5. RETROSPECTIVE ANALYSIS OF COMMUNICATIVE COMPETENCE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Alla A. Isakova

    2017-03-01

    Full Text Available Introduction: the article outlines the concepts of communicative competence and cross-cultural communication. The authors highlight their place in higher education institutions based on a case-study of Tyumen region (Russia. The increased interest in the process of cross-cultural communication determines the relevance of the research.. Materials and Methods: during the research process the authors used descriptive method, observation and learning with consulting of relevant literature. The methodological basis of the research is a philosophical concept of the relationship between culture and morality, communication, inter-ethnic and ecological culture and others. Results: this communicative education system should be continuous, comprehensive, interdisciplinary and integrated to promote personal development of students with differentiation depending on professional orientation. Teaching should be consistent with cultural traditions and ethical values as the basis of person’s physical and mental health, knowledge of the world and their pl ace in it. Discussion and Conclusions: the development of communicative competence takes place in the educational process. The communication will be successful in the new changed reality of professional activity. The research of verbal and nonverbal communication is useful for commercial and government institutions. It is necessary to study the communicative process in the educational environment promoting personal development of the students. The conditions of integration processes demonstrate some significant changes. The main priorities of modern higher education are full-fledged formation and development of the student’s abilities. It is possible to assume that communicative competence will be the link and the basis of the interaction of all educational forms. The article touches upon the philosophical, literary and cultural problems; the topic determines the choice of Integration of Education.

  6. In the Modern Treatment Era, Is Breast Conservation Equivalent to Mastectomy in Women Younger Than 40 Years of Age? A Multi-Institution Study

    Energy Technology Data Exchange (ETDEWEB)

    Frandsen, Jonathan; Ly, David [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah School of Medicine, Salt Lake City, Utah (United States); Cannon, George [Department of Radiation Oncology, Intermountain Medical Center, Murray, Utah (United States); Suneja, Gita [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah School of Medicine, Salt Lake City, Utah (United States); Matsen, Cindy [Department of General Surgery, Huntsman Cancer Hospital, University of Utah School of Medicine, Salt Lake City, Utah (United States); Gaffney, David K. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah School of Medicine, Salt Lake City, Utah (United States); Wright, Melissa [Oncology Clinical Program, Intermountain Healthcare, Salt Lake City, Utah (United States); Kokeny, Kristine E. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah School of Medicine, Salt Lake City, Utah (United States); Poppe, Matthew M., E-mail: matthew.poppe@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah School of Medicine, Salt Lake City, Utah (United States)

    2015-12-01

    Purpose: Mastectomy is often recommended for women ≤40 years of age with breast cancer, as young women were under-represented in the landmark trials comparing breast conservation therapy (BCT) to mastectomy. We hypothesized that, in the modern treatment era, BCT and mastectomy result in equivalent local control rates in young women. Methods and Materials: Breast cancer cases arising between 1975 and 2013 in women ≤40 years old were collected from the tumor registries of 2 large healthcare systems in Utah. Kaplan-Meier estimates and Cox proportional hazards models were used to analyze freedom from locoregional recurrence (FFLR), overall survival (OS), and relapse-free survival (RFS). Results: This analysis identified 853 BCT candidates. A comparison of BCT to mastectomy after 2000 showed FFLR, RFS, and OS were all similar. Rate for FFLR at 10 years was 94.9% versus 92.1% for BCT and mastectomy, respectively (P=.57). For women whose cancer was diagnosed after 2000, who received BCT, FFLR and RFS rates were improved compared to those whose cancer was diagnosed prior to 2000 (P<.05), whereas OS (P=.46) rates were similar. Among those who underwent mastectomy, FFLR, OS, and RFS were significantly improved (P<.05) with diagnosis after 2000. Conclusions: FFLR rates for young women, ≤40 years of age, have significantly improved for BCT and mastectomy over time. If patients were treated after 2000, BCT appears to be safe and equivalent to mastectomy at 10 years in terms of FFLR, OS, and RFS.

  7. SOCIAL SECURITY IN MODERN ERA

    African Journals Online (AJOL)

    2018-03-28

    Mar 28, 2018 ... Lecturer, Department of Social Work, Bindura University of Science Education; Email. ... Lecturer, School of Social Work, University of Zimbabwe, Mount ... There are two types of informal social security: traditional or family ...

  8. Nutrigenomics in the modern era.

    Science.gov (United States)

    Mathers, John C

    2017-08-01

    The concept that interactions between nutrition and genetics determine phenotype was established by Garrod at the beginning of the 20th century through his ground-breaking work on inborn errors of metabolism. A century later, the science and technologies involved in sequencing of the human genome stimulated development of the scientific discipline which we now recognise as nutritional genomics (nutrigenomics). Much of the early hype around possible applications of this new science was unhelpful and raised expectations, which have not been realised as quickly as some would have hoped. However, major advances have been made in quantifying the contribution of genetic variation to a wide range of phenotypes and it is now clear that for nutrition-related phenotypes, such as obesity and common complex diseases, the genetic contribution made by SNP alone is often modest. There is much scope for innovative research to understand the roles of less well explored types of genomic structural variation, e.g. copy number variants, and of interactions between genotype and dietary factors, in phenotype determination. New tools and models, including stem cell-based approaches and genome editing, have huge potential to transform mechanistic nutrition research. Finally, the application of nutrigenomics research offers substantial potential to improve public health e.g. through the use of metabolomics approaches to identify novel biomarkers of food intake, which will lead to more objective and robust measures of dietary exposure. In addition, nutrigenomics may have applications in the development of personalised nutrition interventions, which may facilitate larger, more appropriate and sustained changes in eating (and other lifestyle) behaviours and help to reduce health inequalities.

  9. 69-74 A Retrospective Analysis of Prescribing Prac

    African Journals Online (AJOL)

    user

    A Retrospective Analysis of Prescribing Practice Based on WHO Prescribing Indicators at Four. Selected Hospitals of West ... Key words: World Health Organization, prescribing indicators, rational drug use. INTRODUCTION. Indicators of ... factors, the risk of irrational prescribing could raise several folds. Irrational use of ...

  10. Prevalence of breast tuberculosis: Retrospective analysis of 65 ...

    African Journals Online (AJOL)

    Prevalence of breast tuberculosis: Retrospective analysis of 65 patients attending a tertiary hospital in Durban, South Africa. ... Breast tuberculosis (BTB) is uncommon, but not rare. Knowledge of the ways in which it can ... Fine-needle aspiration cytology had sensitivity of only 28% compared with 94% for histology. Of those ...

  11. A retrospective analysis of ultrasound-guided large core needle ...

    African Journals Online (AJOL)

    A retrospective analysis of ultrasound-guided large core needle biopsies of breast lesions at a regional public hospital in Durban, KwaZulu-Natal, South Africa. ... Objective: To assess the influence of technical variables on the diagnostic yield of breast specimens obtained by using US-LCNB, and the sensitivity of detecting ...

  12. Breast cancer metastasis to thyroid: a retrospective analysis.

    African Journals Online (AJOL)

    Objective: Retrospective analysis of data from breast cancer patients with thyroid metastasis (TM). Methods: The ... parenchyma with gathering of calcification that reduced in size, revealing the sensitiveness of TM to chemotherapy. Conclusion: US ..... patients.16-18. Most common sites of primary tumors are renal cell car-.

  13. A retrospective analysis of blood gases with two different insulin ...

    African Journals Online (AJOL)

    A retrospective analysis of blood gases with two different insulin infusion protocols in patients undergoing cardiovascular surgery. ... In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb). Materials and Methods: We collected data from ...

  14. Shoulder injuries in professional rugby: a retrospective analysis

    OpenAIRE

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-01-01

    Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set a...

  15. Retrospective Analysis of Studying Psychological Nature of Creativity

    Directory of Open Access Journals (Sweden)

    N V Artjushkina

    2013-12-01

    Full Text Available The creativity phenomenon analysis in the works of the domestic and foreign scientists is presented in this article. The authors focus their special attention on the factors of creativity manifestation during the various periods of ontogenesis and on the characteristic of the conditions necessary for the formation of a creative personality. On the basis of the retrospective analysis and the synthesis of the conceptual approaches to studying the parameters of creativity, the criteria by which it is possible to determine the level of the development of the creative personality are revealed.

  16. The Modern Value of Early Writings in Medicine and Dentistry.

    Science.gov (United States)

    Peck, Sheldon

    2016-01-01

    This article illustrates three examples supporting the modern value of early writings in dentistry and medicine. First, by studying cases described in works published long before the era of genetic science, we are able to develop new hypotheses about familial conditions and their genetic roots. Tooth transposition is presented as an example. Second, old writings may lead us to valuable historical insights and perspectives in medicine that can be revealed only in retrospective analysis. An example of this kind of historical analysis uncovers why dentistry became unnaturally separated from mainstream medicine in the 19th century. Third, early writings become keys to unlocking forgotten knowledge that enriches our understanding of historically significant people and events. The discovery of Norman Kingsley's long forgotten pyrographic paintings after Rembrandt portraits is used as an example. Libraries, the traditional custodians of these valued old texts, must continue to be supported, and not undermined by the paperless digital revolution. Copyright American Academy of the History of Dentistry.

  17. Book review of 'Mass-media, modernitate tendentiala si europenizare in era Internetului' [Mass-media, tendential modernity and Europeanization in the Internet era] by Constantin Schifirnet, Bucharest: Tritonic, 2014, 356 pages

    Directory of Open Access Journals (Sweden)

    Mălina Ciocea

    2016-08-01

    Full Text Available A strong voice in the Romanian sociology of communication, Constantin Schifirneþ has published extensively in the fields of cultural anthropology and Romanian philosophical and sociological thinking, re-editing fundamental works by Spiru Haret (vol. I-XI, 2009-2010, C. Rãdulescu-Motru, A.D. Xenopol and other significant authors. His most recent papers analyze phenomena and processes in Romanian society: modernization and Europeanization, with a special focus on the role played by mass-media in these developments.

  18. NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

    Science.gov (United States)

    Thomas, D.; Wear, M.; VanBaalen, M.; Lee, L.; Fitts, M.

    2011-01-01

    As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future

  19. A Retrospective Analysis of Neonatal Encephalocele Predisposing Factors and Outcomes.

    Science.gov (United States)

    Yucetas, Seyho Cem; Uçler, Necati

    2017-01-01

    This study evaluates the predisposing factors and outcomes of surgical management of encephaloceles at our institution. A retrospective analysis of 32 occipital encephaloceles managed operatively at the Neurosurgery Department Clinics of the Faculty of Medicine, Adıyaman University, was performed between 2011 and 2015. Among the study population, 19 mothers had been exposed to TORCH infections (toxoplasma, rubella, cytomegalovirus, herpes simplex virus), 18 were in consanguineous marriages, and 3 had regular prenatal screening. Associated congenital anomalies were common. Eight infants required reoperation, and 9 died during follow-up. The study identified key areas for prevention. Knowledge of the intracranial and associated anomalies can guide management. © 2016 S. Karger AG, Basel.

  20. [A retrospective analysis of 97 drunk driving cases].

    Science.gov (United States)

    Cheng, Xiang-Wei; Chu, Yun; Zong, Xiong-Xin; Wang, Zi-Wei; Chu, Jian-Xin

    2013-04-01

    Based on a retrospective analysis of the drunk driving cases, to explore the drunk drivers' personnel composition, occurrence time and psychology. As a result of punishment of the drunk driving by criminal law for one year from May 1st, 2011 to April 30th, 2012, 91 drunk driving cases were statistically analyzed the easy-happening time of drunk driving, the drunk drivers' age, gender, occupational characteristics, domicile and psychological factors. In 97 drunk driving cases, 26-40 years old, non-local domiciled and non-professional male drivers were prone to drunk driving at night from 22:00 to 5:00. The behavior of drunk driving is relevant to time, age, genders and occupation. The psychological characteristics of most drivers are fluky, making-life-easy, competitive and peacockish.

  1. Crop Management as an Agricultural Adaptation to Climate Change in Early Modern Era: A Comparative Study of Eastern and Western Europe

    Directory of Open Access Journals (Sweden)

    Qing Pei

    2016-07-01

    Full Text Available Effective adaptation determines agricultural vulnerability to climate change, especially in the pre-industrial era. Crop management as an agricultural adaptation to climate change in recent human history, however, has rarely been systematically evaluated. Using Europe as our study area, we statistically compared yield ratio of wheat, rye, barley, and oats (an important performance indicator of an agrarian economy between Eastern and Western Europe in AD 1500–1800. In particular, a statistical comparison was made of crop yield ratio in the two regions during the warm agricultural recovery period AD 1700–1800. The general trend of crop yield in Eastern and Western Europe basically followed the alternation of climatic epochs, in which the extreme cooling period in AD 1560–1660 drastically reduced the crop yield ratio. The yield ratio of rye in Eastern and Western Europe was very similar throughout the entire study period. However, the yield ratio of wheat, barley, and oats showed different patterns in the two regions and increased drastically in Western Europe in the warm agricultural recovery period, which might have contributed to rapid socio-economic development in Western Europe and eventually the East–West Divide in Europe in the following centuries.

  2. Esophageal achalasia: retrospective analysis of treatment during 2000–2010

    Directory of Open Access Journals (Sweden)

    Tomaž Štupnik

    2011-10-01

    Full Text Available BACKGROUND Esophageal achalasia (EA is a primary esophageal motility disorder of unclear aetiology. Standard treatments of EA are: pneumatic balloon dilation (PBD of the lower esophageal sphyncter (LES and surgical cleaving of the muscle by Heller myotomy. Although the treatment effectively cures dysphagia, the symptoms recur in about a half of the patients. Our point of interest was long-term effectiveness of EA treatment at our department. METHODSWe made a retrospective analysis of EA patients treated at our department of thoracic surgery during the 2000–2010 period.RESULTSIn 11 years we performed 187 PBD and 22 laparoscopic myotomies (LM in 148 patients. Three years after the procedure 65 % of patients after PBD and 90 % of patients after LM showed no signs of disease. The risk of recurrence was 3.56-times greater (p = 0.03 after PBD (in comparison to LM, whereas patients older than 50 years bear 0.51-times lower risk (p = 0.02. The most significant complicatios were esophageal perforation in 3 patients (1.6 % after PBD and gastroesophageal reflux in 3 patients (15 % after LM.CONCLUSIONSPBD is a fast, simple, inexpensive and very efficient method of EA treatment, which can be safely performed in almost every patient. LM is far more expensive and a more complicated method that is more suitable for younger patients, in whom PBD is less effective.

  3. Retrospective analysis of paediatric achalasia in India: Single centre experience

    Directory of Open Access Journals (Sweden)

    Sunita Singh

    2012-01-01

    Full Text Available Background: Developing countries at tertiary referral centre. The aim of this study was to share our experience of paediatric achalasia in Indian scenario. Materials and Methods: This was a retrospective analysis of children <16 years, operated for achalasia at our centre, from December 1998 to December 2011. Results: Total 40 patients (mean age 39 ± 4.29 months, including 1 patient of megaesophagus were operated over 13 years of period; 17 patients (associated congenital H-type tracheoesophageal fistula in one patient, non- responders/ lost follow-up for minimum of 3 years in 16 patients were excluded from the study. The response rate of parents in follow-up was 60.0%. Mean symptoms duration was 27.88 ± 2 months. Most common symptoms were regurgitation and failure to thrive (78.2%. Mean symptom scoring in follow-up after 3 year was 1 ± 0.7 compared to 5 ± 0.51 at the time of admission (P < 0.012. One infant expired (mediastenitis, one developed adhesive intestinal obstruction and one needed posterior re-myotomy (for megaesophagus. There were no treatment failures in mean follow-up of 40.2 ± 5.07 months. Conclusions: Cardiomyotomy with partial fundoplication is the best modality of treatment for paediatric achalasia cardia, even from parents′ perspective.

  4. Occipitocervical fusions in children. Retrospective analysis and technical considerations.

    Science.gov (United States)

    Rodgers, W B; Coran, D L; Emans, J B; Hresko, M T; Hall, J E

    1999-07-01

    This report presents a retrospective analysis of the authors' experience with occipitocervical fusions in children and adolescents during the last 2 decades. A description of an operative technique devised by the senior author (JEH), and a comparison of the results using this and other methods of fusion are given. Twenty-three patients underwent occipitocervical fusion. Fifteen of the patients were operated on using the authors' technique. To achieve stable fixation of the distal cervical vertebra a threaded Kirschner wire was passed transversely through the spinous process; occipital fixation was achieved by the traditional method of wiring corticocancellous bone graft to the skull through burr holes. The occipital wires then were wrapped around the Kirschner wire and the graft was cradled in the resulting nest. Halo immobilization was used in 10 patients for an average of 12.5 weeks (range, 6-24 weeks). Twenty-two patients achieved successful fusion at an average followup of 5.8 years (range, 1-14.33 years). Several complications, including transient quadriplegia in one patient, pseudarthrosis in two (one of which persists), hardware fixation failure in one, unintended distal extension of the fusion, pneumonia, wound infection, halo pin infection, skin breakdown under the halo vest, hydrocephalus, cerebrospinal fluid leak, and traumatic fusion fracture were encountered. Results using the technique described herein are comparable with or better than the results reported in the previous literature, and the results of the patients in this series in whom the technique was not used.

  5. Ambivalência, gênero e modernidade capitalista: a França na era da flexibilidade Ambivalence, gender and capitalist modernity: France in an era of flexibility

    Directory of Open Access Journals (Sweden)

    Isabelle Berrebi-Hoffman

    2009-06-01

    Full Text Available Tanto a situação na França quanto os quadros de referência teóricos usados para analisar a flexibilidade evoluíram consideravelmente nos últimos vinte anos. Nosso artigo pretende descrever essa transformação e defender uma tese específica. O mundo moderno pós-Ford apresenta dois novos aspectos quando comparado ao que fora descrito na análise funcionalista tradicional: por um lado, as tensões inerentes à natureza ambivalente da flexibilidade são vistas hoje como questões mais pessoais; por outro, a ambivalência não é mais encarada como puramente disfuncional, mas tem um aspecto positivo. À luz desse novo quadro de referência, apresentaremos inicialmente o cenário dos vários debates sobre flexibilidade na França, e mostraremos, em seguida, as relações entre flexibilidade e ambivalência sociológica, antes de apresentarmos os dados empíricos que sustentam nossa tese.Both the situation of employment in France and the frameworks used to analyse flexibility have evolved considerably over the last twenty years. The paper aims to describe this transformation and defend a particular thesis. Our post-Ford modern world has two new aspects when compared with the traditional functionalist analysis: on the one hand, the tensions inherent in the ambivalent nature of flexibility are today seen as more personal issues, and on the other, ambivalence is no longer seen as purely dysfunctional, but to have a possible positive aspect. Given this new framework, the paper first presents the background to the various debates on flexibility in France, and then shows the links between flexibility and sociological ambivalence before presenting empirical data in support of the thesis.

  6. ERA-40

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — ERA-40 project was to produce and promote the use of a comprehensive set of global analysis describing the state of the atmosphere and land and ocean-wave conditions...

  7. [Profile of Shohei Ninomiya (pharmacist), the first Japanese medical representative to practice modern European-style propaganda in the late Meiji era].

    Science.gov (United States)

    Nishikawa, Takashi

    2007-01-01

    A Swiss pharmaceutical company (F-Hoffmann-La Roche Ltd.), first introduced the profession of "propagandist" in Japan in 1912. At the time, Shohei Ninomiya was a chief hospital pharmacist, but he changed his vocation to become the first "propah" (Japanese abbreviation for propagandist). The German physician Dr. Rudolf Ebering initiated Dr. Ninomiya in the methods and principles of "propah," and he faithfully practiced them. The defining principle of a modern European propagandist is one who is far from sales-centered. From the late 1970s through 1980s, however, Japanese pharmaceutical companies indulged in pursuing sales and neglected this principle, resulting in numerous abuses and adverse effects. Today, use of the description "medical representative" (MR) is more common than "propah." Even with this different description, pharmaceutical companies and MRs should never neglect the founding principle to avoid repeating such abuses.

  8. Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    James C. Anderson

    2017-07-01

    Full Text Available IntroductionRestless legs syndrome (RLS is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS.MethodsForty-two patients completed VAS scales (0–10 for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14. The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001 and the individual VAS scores (all P < 0.01, such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

  9. Retrospective analysis of RF heating measurements of passive medical implants.

    Science.gov (United States)

    Song, Ting; Xu, Zhiheng; Iacono, Maria Ida; Angelone, Leonardo M; Rajan, Sunder

    2018-05-09

    The test reports for the RF-induced heating of metallic devices of hundreds of medical implants have been provided to the U.S. Food and Drug Administration as a part of premarket submissions. The main purpose of this study is to perform a retrospective analysis of the RF-induced heating data provided in the reports to analyze the trends and correlate them with implant geometric characteristics. The ASTM-based RF heating test reports from 86 premarket U.S. Food and Drug Administration submissions were reviewed by three U.S. Food and Drug Administration reviewers. From each test report, the dimensions and RF-induced heating values for a given whole-body (WB) specific absorption rate (SAR) and local background (LB) SAR were extracted and analyzed. The data from 56 stents were analyzed as a subset to further understand heating trends and length dependence. For a given WB SAR, the LB/WB SAR ratio varied significantly across the test labs, from 2.3 to 11.3. There was an increasing trend on the temperature change per LB SAR with device length. The maximum heating for stents occurred at lengths of approximately 100 mm at 3 T, and beyond 150 mm at 1.5 T. Differences in the LB/WB SAR ratios across testing labs and various MRI scanners could lead to inconsistent WB SAR labeling. Magnetic resonance (MR) conditional labeling based on WB SAR should be derived from a conservative estimate of global LB/WB ratios. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  10. Retrospective Analysis of Lophodermium seditiosum Epidemics in Estonia

    Directory of Open Access Journals (Sweden)

    HANSO, MÄRT

    2007-01-01

    Full Text Available The needle trace method (NTM, created and developed by the Finnish forest pathologists prof. T. Kurkela, dr. R. Jalkanen and T. Aalto during the last decade of the XX century, has been already used by several researchers of different countries for retrospective analysis of needle diseases (Hypodermella sulcigena, by R. Jalkanen et al. in Finland or herbivorous insect pests of Scots pine (Diprion pini, by T. Kurkela et al. in Finland; Bupalus piniaria, by H. Armour et al. in Scotland, but as well of pests of Sitka spruce (Gilpinia hercyniae, by D.T. Williams et al. in England. Scots pine in forest nurseries and young plantations of Estonia is often but irregularly suffering from the epidemics of the needle cast fungus Lophodermium seditiosum. Current environmental regulations exclude from the regulatory (control measures all the others except of well-argued prophylactic systems, built up on reliable prognoses. The last is inconceivable without the availability of a reliable, as well, and long-lasting retrospective time-series of L. seditiosum epidemics, which, as it is known from the last half of the XX century, are occupying large forest areas, usually not least than a half of (the small Estonia. An appropriate time-series would be useful, as well, for the more basic understanding of the accelerated mortality processes during the stand formation in early pole-age Scots pine plantations. Methodological principles of the use of NTM in an appropriate investigation together with the preliminary results of our research work, looking back for more than a century, are introduced and discussed in this investigation.

  11. Fournier's gangrene: A retrospective analysis of 25 patients.

    Science.gov (United States)

    Yücel, Metin; Özpek, Adnan; Başak, Fatih; Kılıç, Ali; Ünal, Ethem; Yüksekdağ, Sema; Acar, Aylin; Baş, Gürhan

    2017-09-01

    Fournier's gangrene is a surgical emergency that progresses rapidly and insidiously and results in high morbidity and mortality rates unless it is immediately diagnosed and managed. Here we analyze the outcomes of patients who were followed up and treated for Fournier's gangrene. We conducted a retrospective analysis of the medical data of 25 patients operated on for Fournier's gangrene between January 2010 and June 2015. The diagnosis of Fournier's gangrene was made by performing a physical examination. Patients who had genital, perineal, and perianal tenderness; induration; cyanosis; gangrene; and subcutaneous crepitation were considered as having Fournier's gangrene. Following resuscitation, aggressive surgical debridement was performed and vacuum-assisted closure (VAC) was conducted in addition to debridement in select patient. Repeat debridements were performed as requirement. This study included 25 patients. Fourteen patients (56%) were females and 11 (44%) were males. The mean age of the patients was 54.3 years (range: 27-82 years). The mean duration of hospital stay was 21.4 days; the mean number of debridements performed was 2.4. Thirteen patients (52%) had perianal abscesses, and 20 (80%) had diabetes mellitus. All patients underwent extensive debridement; 16 patients (64%) underwent VAC in addition to debridement. Patients undergoing VAC had significantly longer durations of hospital stay and a higher mean number of debridements performed (p=0.004 and p=0.048, respectively). An ostomy was made in one patient, and one patient died. In Fournier's gangrene, early diagnosis, effective resuscitation, aggressive debridement, and VAC application in suitable cases may reduce the morbidity and mortality rates and the need for an ostomy.

  12. Retrospective Analysis of Low Flows at Headwater Watersheds in Wyoming

    Science.gov (United States)

    Voutchkova, D. D.; Miller, S. N.

    2016-12-01

    Understanding summer low-flow variability and change in the mountainous West has important implications for water allocations downstream and for maintaining water availability for drinking water supply, reservoir storage, industrial, agricultural, and ecological needs. Wildfires and insect infestations are classical disturbance hydrology topics. It is unclear, however, what are their effects on streamflow and in particular low-flows, when vegetation disturbances are overlapping in time and combined with highly variable and potentially changing local climate. The purpose of this study, therefore, is to quantify changes in low-flows resulting from disturbance in headwater streams. Here we present a retrospective analysis based on: (1) 49-75 complete water years (wy) of daily streamflow data (USGS) for 14 high-elevation headwater watersheds with varying areas (60-1730 km2, 86-100% of watershed area >2000masl) and evergreen forest cover (15-82%), (2) 25-36 complete wy of daily snow-water equivalent accumulation (SWE) and precipitation data from Wyoming SNOTEL stations, (3) burned area boundaries for 20wy (MTBS project), (4) aerial surveys by R1, R2, R4 Forest Service Regions for 18wy (data on tree mortality). We quantify the change in various low-flow characteristics (e.g. post-snowmelt baseflow, Q90 and Q95, 3-,7-, 30- and 90-day annual minima etc.) while accounting for local inter- and multi-annual climate variability by using SWE accumulation data, as it integrates both temperature and precipitation changes. Our approach differs from typical before-after field-based investigation for paired watersheds, as it provides a synthesis over large temporal and spatial scales, resulting in spectrum of possible hydrologic responses due to varying disturbance severity. Quantifying the changes in low-flows and low-flow variability will improve our understanding and will facilitate water management and planning at local state-wide level.

  13. Retrospective analysis of 'gamma distribution' based IMRT QA criteria

    International Nuclear Information System (INIS)

    Wen, C.; Chappell, R.A.

    2010-01-01

    Full text: IMRT has been implemented into clinical practice at Royal Hobart Hospital (RHH) since mid 2006 for treating patients with Head and Neck (H and N) or prostate tumours. A local quality assurance (QA) acceptance criteria based on 'gamma distribution' for approving IMRT plan was developed and implemented in early 2007. A retrospective analysis of such criteria over 194 clinical cases will be presented. The RHH IMRT criteria was established with assumption that gamma distribution obtained through inter-comparison of 2 D dose maps between planned and delivered was governed by a positive-hail' normal distribution. A commercial system-MapCheck was used for 2 D dose map comparison with a built-in gamma analysis tool. Gamma distribution histogram was generated and recorded for all cases. By retrospectively analysing those distributions using curve fitting technique, a statistical gamma distribution can be obtained and evaluated. This analytical result can be used for future IMRT planing and treatment delivery. The analyses indicate that gamma distribution obtained through MapCheckTM is well under the normal distribution, particularly for prostate cases. The applied pass/fail criteria is not overly sensitive to identify 'false fails' but can be further tighten-up for smaller field while for larger field found in both H and N and prostate cases, the criteria was correctly applied. Non-uniform distribution of detectors in MapCheck and experience level of planners are two major factors to variation in gamma distribution among clinical cases. This criteria derived from clinical statistics is superior and more accurate than single-valued criteria for lMRT QA acceptance procedure. (author)

  14. Sources for the study of the history of the dominican studium generale in Krakow in the modern era. The state of research and research perspectives

    Directory of Open Access Journals (Sweden)

    Wiktor Szymborski

    2012-12-01

    Full Text Available Main objective of the essay under consideration was investigation and characterized most important source materials stocked at the Archive of the Cracow’s Dominican Province to present the history of their studium generale during the Modern period. Also, the current knowledge of a.m. period of studium generale was screened- out and some searching hypothesis were proposed concerning the history of the Cracow’s Dominican studium generale. The searching time frame have been limited to XVI up to XVII century. Taken into consideration, the current status of research works performed so far, one ought to stated that the Modern Epoch has not been searched out with the same consciousness compare to the Medieval one. As the most important printed source materials, one ought to account the documents issued by the general and provincial chapters of the Convent. The documents of the provincial chapters have been listed and screened by Father Fabian Madura, and were stocked as the typescript formats at the Cracow’s Dominican Convent Library. Based on the searched source materials of General Chapter of Dominican Convent at Cracow, it is possible to present the general overview of the convent education system and its changes in due time. Due to the records found it would be possible to identify – position and name – the Dominicans nominated to the Convent stadium generale. The most important manuscript stocked at the Cracow’s Dominican Convent Archive as the education system is concern, is so called Liber Studii Generalis cracoviensis (rkps 20. This manuscript covers the list of friars who have been nominated to work at stadium generale. A.m. document has to verify and compare with other sources. Taken into consideration above mention facts, it seems to be as most important searching activities to describe the convent society of the Cracow’s Dominicans. At the essay some detailed searching hypothesis were presented, such as searching and reviewing

  15. A Retrospective Analysis of Factors Affecting Early Stoma Complications.

    Science.gov (United States)

    Koc, Umit; Karaman, Kerem; Gomceli, Ismail; Dalgic, Tahsin; Ozer, Ilter; Ulas, Murat; Ercan, Metin; Bostanci, Erdal; Akoglu, Musa

    2017-01-01

    Despite advances in surgical techniques and products for stoma care, stoma-related complications are still common. A retrospective analysis was performed of the medical records of 462 consecutive patients (295 [63.9%] female, 167 [36.1 %] male, mean age 55.5 ± 15.1 years, mean body mass index [BMI] 25.1 ± 5.2) who had undergone stoma creation at the Gastroenterological Surgery Clinic of Turkiye Yuksek İhtisas Teaching and Research Hospital between January 2008 and December 2012 to examine the incidence of early (ie, within 30 days after surgery) stoma complications and identify potential risk factors. Variables abstracted included gender, age, and BMI; existence of malignant disease; comorbidities (diabetes mellitus, hypertension, coronary artery disease, chronic respiratory disease); use of neoadjuvant chemoradiotherapy; permanent or temporary stoma; type of stoma (loop/end stoma); stoma localization; and the use of preoperative marking of the stoma site. Data were entered and analyzed using statistical software. Descriptive statistics, chi-squared, and Mann-Whitney U tests were used to describe and analyze all variables, and logistic regression analysis was used to determine independent risk factors for stoma complications. Ostomy-related complications developed in 131 patients (28.4%) Of these, superficial mucocutaneous separation was the most frequent complication (90 patients, 19.5%), followed by stoma retraction (15 patients, 3.2%). In univariate analysis, malignant disease (P = .025), creation of a colostomy (P = .002), and left lower quadrant stoma location (P toma complication. Only stoma location was an independent risk factor for the development of a stoma complication (P = .044). The rate of stoma complications was not significantly different between patients who underwent nonemergent surgery (30% in patients preoperatively sited versus 28.4% not sited) and patients who underwent emergency surgery (27.1%). Early stoma complication rates were higher

  16. Retrospective Analysis of Inflight Exercise Loading and Physiological Outcomes

    Science.gov (United States)

    Ploutz-Snyder, L. L.; Buxton, R. E.; De Witt, J. K.; Guilliams, M. E.; Hanson, A. M.; Peters, B. T.; Pandorf, M. M. Scott; Sibonga, J. D.

    2014-01-01

    Astronauts perform exercise throughout their missions to counter the health declines that occur as a result of long-term exposure to weightlessness. Although all astronauts perform exercise during their missions, the specific prescriptions, and thus the mechanical loading, differs among individuals. For example, inflight ground reaction force data indicate that subject-specific differences exist in foot forces created when exercising on the second-generation treadmill (T2) [1]. The current exercise devices allow astronauts to complete prescriptions at higher intensities, resulting in greater benefits with increased efficiency. Although physiological outcomes have improved, the specific factors related to the increased benefits are unknown. In-flight exercise hardware collect data that allows for exploratory analyses to determine if specific performance factors relate to physiological outcomes. These analyses are vital for understanding which components of exercise are most critical for optimal human health and performance. The relationship between exercise performance variables and physiological changes during flight has yet to be fully investigated. Identifying the critical performance variables that relate to improved physiological outcomes is vital for creating current and future exercise prescriptions to optimize astronaut health. The specific aims of this project are: 1) To quantify the exercise-related mechanical loading experienced by crewmembers on T2 and ARED during their mission on ISS; 2) To explore relationships between exercise loading variables, bone, and muscle health changes during the mission; 3) To determine if specific mechanical loading variables are more critical than others in protecting physiology; 4) To develop methodology for operational use in monitoring accumulated training loads during crew exercise programs. This retrospective analysis, which is currently in progress, is being conducted using data from astronauts that have flown long

  17. Shoulder injuries in professional rugby: a retrospective analysis.

    Science.gov (United States)

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-04-26

    In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. This study is a retrospective analysis set at a university sports medicine clinic. Eighty-seven professional rugby players, referred by their professional medical team since they could no longer play, underwent shoulder arthroscopy between June 2001 and October 2007 due to persistent shoulder pain and dysfunction. All were full-time professional male rugby union and rugby league players. They all had failed conservative treatment for their complaint, and the diagnosis was unclear. Arthroscopic findings were used as a measure of main outcome. The primary mechanism of injury was reported as direct tackling (56%; n = 49) followed in succession by falling onto the arm (10%; n = 8). However, in 30% of the cases, no definite injury could be recalled. The main operative finding was that most patients exhibited multiple shoulder pathologies, with 75% of cases presenting with two or more pathologies. A superior labrum anterior to posterior (SLAP) lesion was evident at arthroscopy in 72 of the 87 cases (83%), while rotator cuff tears were evident in 43% of cases (n = 37). One-third of all cases had a Bankart tear (n = 29), despite none of them reporting previous dislocations, while other labral tears, excluding SLAP tears, to the inferior or posterior labrum were present in 34% (n = 30) of the cohort. Repeated tackling, which is clearly rugby specific, is most likely to be responsible for most of these shoulder injuries, which upon arthroscopic examination, showed signs of mixed pathology. We suggest that an early arthroscopic investigation is valuable in

  18. Odontoid fractures: A retrospective analysis of 53 cases

    Directory of Open Access Journals (Sweden)

    Shetty Arjun

    2009-01-01

    Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

  19. Retrospective Analysis of Mosh-Pit-Related Injuries.

    Science.gov (United States)

    Milsten, Andrew M; Tennyson, Joseph; Weisberg, Stacy

    2017-12-01

    . Milsten AM , Tennyson J , Weisberg S , Retrospective analysis of mosh-pit-related injuries. Prehosp Disaster Med. 2017;32(6):636-641.

  20. Artifact in Pediatric Oculomotor Findings during Videonystagmography: A Retrospective Analysis.

    Science.gov (United States)

    Doettl, Steven M; Plyler, Patrick N; McCaslin, Devin L

    2017-04-01

    Accurate measurement of oculomotor function using videonystagmography (VNG) is imperative for diagnosis and management of patients with reported dizziness. The oculomotor evaluation during VNG utilizes video-oculography providing valuable information regarding the central structures and pathways that control eye movements. Artifact may have an effect on the overall validity and reliability of VNG oculomotor tracings and can result from patient and/or recording errors. It is postulated that artifact could occur more frequently in the pediatric population due to both patient and equipment factors. The purpose of this study was to systematically evaluate the occurrence and impact of artifact on saccades, smooth pursuit, and optokinetic (OPK) testing in normal pediatric and adult subjects using commercially available clinical VNG equipment and standard clinical protocols for oculomotor testing. The present study utilized a retrospective analysis of a repeated measures design. Oculomotor results from a total of 62 participants were analyzed. Portions of these data have been presented in a previous research study. Group 1 consisted of twenty-nine 4- to 6-yr-olds with an average age of 4.86 (SD = 0.88) yr. Group 2 consisted of thirty-three 22- to 44-yr-olds with an average age of 25.2 (SD = 5.34) yr. Raw oculomotor recordings were analyzed "offline" by a single masked, trained investigator. Each tracing was evaluated for instances of artifact including eye blinks, eye closure, eyes moving in opposite direction of the target, eye tracking software problems, and overall poor morphology. The number of instances of artifact were noted and recorded for each participant in both groups. Individual eye movements not affected by artifact were included for final analysis. Artifact rejection techniques were also compared. The results indicated increased artifact for the pediatric group for saccade and smooth pursuit testing. Additionally, a significant decrease in instances of

  1. Globalization in the early modern era

    NARCIS (Netherlands)

    Zwart, de Pim

    2016-01-01

    This article contributes to the ongoing debate on the origins of globalization. It examines the process of commodity price convergence, an indicator of globalization, between Europe and Asia on the basis of newly obtained price data from the Dutch East India Company (VOC) archives. Prices for

  2. Modern biogeochemistry environmental risk assessment

    CERN Document Server

    Bashkin, Vladimir N

    2006-01-01

    Most books deal mainly with various technical aspects of ERA description and calculationsAims at generalizing the modern ideas of both biogeochemical and environmental risk assessment during recent yearsAims at supplementing the existing books by providing a modern understanding of mechanisms that are responsible for the ecological risk for human beings and ecosystem

  3. Dakwah di Era Digital

    Directory of Open Access Journals (Sweden)

    Wahyu Budiantoro

    2018-04-01

    Full Text Available These days dakwah is not only interpreted as transformation of a pure religious value, but also transformation of a more relevant value including many aspects in digital era. Digital era is when society succumbed into the flow of information causing cultural shock and difficulties on synthesizing meaning from those scattered information. Dakwah on Digital age must accommodate societal needs which tend to move into a mass society. It results in strategy and more humane and innovative dakwah methods. One of innovative dakwah methods is conducted dakwah activities through digital media,with the consequences of this is that da’i must developed soft skill and technological capabilities. Another beneficial comes from this is that dakwah could become more modern and practical in terms of methods and material. On the other hand, citizen Journalism as a mass cultural product and the results of technological development, gives an opportunity for da’i to able to record the entire activities, including the dynamics of islamic life. In terms of learning curriculum, dakwah in digital format must be included, so then the intellectual and cultural spirit which flourished in pesantren could be adapted and competed in a global world.

  4. The phenomenon of social assistance in the humanities: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    I. S. Lazarenko

    2016-08-01

    Full Text Available The article analyzes the phenomenon of social assistance in humanitarian schools. Such as: 1 Philosophy; 2 Cultural Studies; 3 Law; 3 Socio-pedagogical science. Retrospective analysis allowed revealing the research principles of social assistance analysis, functional features and differences of this phenomenon. Established that the theoretical basis of social assistance study incorporated in works of ancient philosophers (Socrates, Plato, Aristotle. Analyzed influence on the formation of social assistance scientific research by religious philosophers of the Middle Ages (F. Aquinas, A. Blessed. Deals the transformation of social assistance understanding from a part of society moral to forms of social interaction. Civilizational approach outlined in the cultural mainstream schools (B. Malinowski, C. Polanyi. It was determined that the cultural research traditions of social assistance understood this phenomena as a repeater of cultural heritage through the traditions of the community. Outlined scientific approach to social assistance in Law sciences. It was found that representatives of Socio-pedagogical and Political Science have used theoretical developments sociologists (M. Weber, J. Mead, H. Blumer, T. Parsons, R. Merton, E Giddens. Demonstrated that in Political Science social assistance acts as a functional tool for implementation of social policy. Characterized the role of social assistance within different models of social policy and its positions in state and international organization. Deals with the fundamental difference between the concepts of «social assistance» and «social work». Outlined limits the use of these concepts in humanitarian studies. The analysis allows us to formulate research strategies study the phenomenon of social assistance in modern society. In particular sociological perspective updated study of the phenomenon of social assistance. Actually, applied achievements of classic theory of social capital in the

  5. El fenómeno de los rosarios públicos en España durante la época moderna. Estado actual de la cuestión (The Phenomenon of Public Rosaries in Spain During the Modern Era. Current Status of the Question

    Directory of Open Access Journals (Sweden)

    Carlos José Romero Mensaque

    2012-12-01

    Full Text Available Resumen: Este artículo es un estado de la cuestión sobre el origen y primer desarrollo histórico del fenómeno de los Rosarios públicos o de la Aurora en España durante la época moderna, todo un acontecimiento de la religiosidad popular del Barroco.Absatract: This article is a state of the question on the origin and early development of the phenomenon of historical public Rosaries or Aurora in Spain during the modern era, an event of Baroque popular religiosity.

  6. Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases

    NARCIS (Netherlands)

    Raber-Durlacher, J. E.; Weijl, N. I.; Abu Saris, M.; de Koning, B.; Zwinderman, A. H.; Osanto, S.

    2000-01-01

    The incidence and the severity of chemotherapy-associated oral mucositis were determined in a retrospective analysis of 150 patients with various solid tumors. In addition, possible risk factors for the development of mucositis were identified. Patients were treated with chemotherapeutic regimens

  7. Retrospective analysis of the treatment of psoriasis of the palms and soles

    NARCIS (Netherlands)

    Spuls, P. I.; Hadi, S.; Rivera, L.; Lebwohl, M.

    2003-01-01

    In this retrospective analysis, the effect of currently used treatments in 26 patients with psoriasis of the palms and soles were analyzed. In general, patients are treated initially with topical medications including superpotent topical corticosteroids in combination with calcipotriene ointment or

  8. Comparisons of the tropospheric specific humidity from GPS radio occultations with ERA-Interim, NASA MERRA, and AIRS data

    Science.gov (United States)

    Vergados, Panagiotis; Mannucci, Anthony J.; Ao, Chi O.; Verkhoglyadova, Olga; Iijima, Byron

    2018-03-01

    We construct a 9-year data record (2007-2015) of the tropospheric specific humidity using Global Positioning System radio occultation (GPS RO) observations from the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) mission. This record covers the ±40° latitude belt and includes estimates of the zonally averaged monthly mean specific humidity from 700 up to 400 hPa. It includes three major climate zones: (a) the deep tropics (±15°), (b) the trade winds belts (±15-30°), and (c) the subtropics (±30-40°). We find that the RO observations agree very well with the European Centre for Medium-Range Weather Forecasts Re-Analysis Interim (ERA-Interim), the Modern-Era Retrospective Analysis for Research and Applications (MERRA), and the Atmospheric Infrared Sounder (AIRS) by capturing similar magnitudes and patterns of variability in the monthly zonal mean specific humidity and interannual anomaly over annual and interannual timescales. The JPL and UCAR specific humidity climatologies differ by less than 15 % (depending on location and pressure level), primarily due to differences in the retrieved refractivity. In the middle-to-upper troposphere, in all climate zones, JPL is the wettest of all data sets, AIRS is the driest of all data sets, and UCAR, ERA-Interim, and MERRA are in very good agreement, lying between the JPL and AIRS climatologies. In the lower-to-middle troposphere, we present a complex behavior of discrepancies, and we speculate that this might be due to convection and entrainment. Conclusively, the RO observations could potentially be used as a climate variable, but more thorough analysis is required to assess the structural uncertainty between centers and its origin.

  9. Nuclear power and modern society

    International Nuclear Information System (INIS)

    Komarek, A.

    1999-01-01

    A treatise consisting of the following sections: Development of modern society (Origin of modern society; Industrial society; The year 1968; Post-industrial society; Worldwide civic society); Historic breaks in the development of the stationary power sector (Stationary thermal power; Historic breaks in the development of nuclear power); Czech nuclear power engineering in the globalization era (Major causes of success of Czech nuclear power engineering; Future of Czech nuclear power engineering). (P.A.)

  10. Modernity after Modernity

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2007-08-01

    Full Text Available A strategy for the second modernization raises, beyond objectives, a series of epistemicresponsibilities. It is known that modernization stemming from the Enlightment had, among other things,the pretense that it is a project which is self-legitimating. Its profound rationales are the only justification.Referential self-centering proved to be the one that made possible a practice of the new. Modernizationhaving the function of renouncing myth – meaning an eliminatory formula for the past – and thefixation in the opportunity and potentiality of the present, seemed to close an insoluble but extremelyengrossing problem: that of a propensity towards utopia, of the risky escape towards the future. Thetraditionalization of the new constitutes a support for the daring to break out of the captivity of themoment.Modernization becomes the experience of combining the new which, thus, creates a succession ofpresent times. The future is no longer the result of fantasy, but a system’s direct expression to combine thenew. Therefore the future is an option for one or another model of the present, often tested previouslysomewhere else. In a non-metaphysical way, the future can be seen, touched, tried, lived by simplegeographical movement. The sense of evolution has de-temporalized taking the form of the concomitant,parallel, enclosed, neighboring space. We just have to be in the trend, to evolve in the context.Globalization defines the context and its conception – as a project of the second modernity – showsus the trends. The problem is how to understand the context in order to find the sense of the trend. Are wethe load the sense with the values of the first modernity or will we have to turn to the values of anothermodernity? Why do we have to move away from the significance of the processes which made up the firstmodernity? How do we relate to the content of the new context in which the structural trends of today’sworld are taking place? What is the

  11. Modern teaching for modern education

    OpenAIRE

    Mirascieva, Snezana

    2016-01-01

    Carrying the epithet of being contemporary education today means modern teaching. If modern education is a state in the field of education of all its elements, then teaching will also be a state with its own special features defining it as modern. The main issues of concern in this paper relate to what constitutes modern teaching, which features determine it as being modern, and how much is teaching today following the trend of modernization.

  12. Retrospective analysis of dengue specific IgM reactive serum samples

    OpenAIRE

    Nemai Bhattacharya; Bhaswati Bandyopadhyay; Indranil Bhattacharjee; Hiranmoy Mukherjee; Srabani Talukdar; Ruby Mondal; Netai Pramanick; Goutam Chandra; Amiya K. Hati

    2013-01-01

    Objective: To conduct a retrospective analysis of dengue cases in Kolkata, on the basis of presence of anti-dengue IgM in their sera and presence or absence of anti-dengue IgG and dengue specific Non structural 1 (NS1) antigen in each of the serum sample. Methods: Sample was tested quantitatively employing ELISA technique, using Biorad test kits, with a view to get a more comprehensive picture of dengue in an urban endemic area and also to evaluate individual cases. Results: Th...

  13. Ecological Modernization and the Global Economy

    NARCIS (Netherlands)

    Mol, A.P.J.

    2002-01-01

    This paper explores what an ecological modernization perspective has to offer in an era marked by globalization. Globalization processes and dynamics are mostly seen as detrimental to the environment. The point that an ecological modernization perspective puts on the research agenda is that,

  14. TEORI - TEORI DALAM DUNIA PENDIDIKAN MODERN

    Directory of Open Access Journals (Sweden)

    I Nyoman Temon Astawa

    2016-02-01

    Full Text Available The theories in education are reflections of both the Renaissance and modern era. In the history of science the discrepancy between the epistemology of the Rationalism, Empiricism, Positivism, and Saintism have become the major interest. The first theory of modern education is the Humanismand the post classical ones which include Behaviorism, Cognitivism, Humanismand Cybernetics.

  15. Sustainable renewal of the everyday Modern

    NARCIS (Netherlands)

    de Jonge, W.

    2017-01-01

    Listed or not, many Modern-era buildings deserve our appreciation for their architectural merit, whether it be for the social developments that these buildings represent or for the innovative technologies applied and used in their making. Early preservation projects of Modern ‘icons’ carried out

  16. Colorectal cancer with intestinal perforation - a retrospective analysis of treatment outcomes.

    Science.gov (United States)

    Banaszkiewicz, Zbigniew; Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2014-01-01

    Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates.

  17. Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: a comparison of Australian series

    International Nuclear Information System (INIS)

    Wilcox, Shea W.; Last, Andrew J.; Aherne, Noel J.; McLachlan, Craig S.; McKay, Michael J.; Shakespeare, Thomas P.

    2015-01-01

    We compare the results of modern external-beam radiotherapy (EBRT), using combined androgen deprivation and dose-escalated intensity-modulated radiotherapy with MRI-CT fusion and daily image guidance with fiducial markers (DE-IG-IMRT), with recently published Australian series of brachytherapy and surgery. Five-year actuarial biochemical disease-free survival (bDFS), metastasis-free survival (MFS) and prostate cancer-specific survival (PCaSS) were calculated for 675 patients treated with DE-IG-IMRT and androgen deprivation therapy (ADT). Patients had intermediate-risk (IR) and high-risk (HR) disease. A search was conducted identifying Australian reports from 2005 onwards of IR and HR patients treated with surgery or brachytherapy, reporting actuarial outcomes at 3 years or later. With a median follow-up of 59 months, our 5-year bDFS was 93.3% overall: 95.5% for IR and 91.3% for HR disease. MFS was 96.9% overall (99.0% IR, 94.9% HR), and PCaSS was 98.8% overall (100% IR, 97.7% HR). Prevalence of Grade 2 genitourinary and gastrointestinal toxicity at 5 years was 1.3% and 1.6%, with 0.3% Grade 3 genitourinary toxicity and no Grade 3 gastrointestinal toxicity. Eight reports of brachytherapy and surgery were identified. The HDR brachytherapy series' median 5-year bDFS was 82.5%, MFS 90.0% and PCaSS 97.9%. One surgical series reported 5-year bDFS of 65.5% for HR patients. One LDR series reported 5-year bDFS of 85% for IR patients. Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option.

  18. Ethnic Entrepreneurship in the Russian Empire in the Era of Economic Modernization in the Second Half of the 19th – Early 20th Century (as Illustrated in the Example of Siberia

    Directory of Open Access Journals (Sweden)

    Vladimir N. Shaidurov

    2016-09-01

    Full Text Available The second half of the 19th century brought about the modernization reforms in the Russian political system, which accelerated the development of the country's capitalist economy. The abolition of segregationist regulations contributed to the development of bourgeois relations in industry and agriculture. The pace of economic modernization was faster in European Russia, while the country’s frontier regions in the Asiatic part of the Russian Empire seriously lagged behind the center. The role of agents for capitalist change in industry and agriculture was accepted by the members of non-Russian ethnic groups, such as Jews, Germans, Poles and others. They became new bourgeois who were former government officials who had required connections to establish factories, and traders, who accumulated significant capital. In the 2nd half of the 19th century, a major role was performed by individual entrepreneurship inside ethnic communities. Its scope comprised the sectors which generated no economic interest among Russians living in Siberia, and which required large capital investments (distilling, shipping companies. In the early 20th century the social composition of communities was blurry thanks to peasants who formed a key component in migratory flows to Siberia. This shifted emphasis to small and medium-sized enterprises in the agricultural sector. The purpose of the paper is to use specific examples to show how ethnic entrepreneurship depended on a community's social composition, and determine its place in the regional economy in the conditions of ongoing political modernization and initial steps to industrialization. The foundation for the study is built on the archival documents, statistical digests and current research. The work is based on comparativism.

  19. Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: a comparison of Australian series.

    Science.gov (United States)

    Wilcox, Shea William; Aherne, Noel J; McLachlan, Craig Steven; McKay, Michael J; Last, Andrew J; Shakespeare, Thomas P

    2015-02-01

    We compare the results of modern external-beam radiotherapy (EBRT), using combined androgen deprivation and dose-escalated intensity-modulated radiotherapy with MRI-CT fusion and daily image guidance with fiducial markers (DE-IG-IMRT), with recently published Australian series of brachytherapy and surgery. Five-year actuarial biochemical disease-free survival (bDFS), metastasis-free survival (MFS) and prostate cancer-specific survival (PCaSS) were calculated for 675 patients treated with DE-IG-IMRT and androgen deprivation therapy (ADT). Patients had intermediate-risk (IR) and high-risk (HR) disease. A search was conducted identifying Australian reports from 2005 onwards of IR and HR patients treated with surgery or brachytherapy, reporting actuarial outcomes at 3 years or later. With a median follow-up of 59 months, our 5-year bDFS was 93.3% overall: 95.5% for IR and 91.3% for HR disease. MFS was 96.9% overall (99.0% IR, 94.9% HR), and PCaSS was 98.8% overall (100% IR, 97.7% HR). Prevalence of Grade 2 genitourinary and gastrointestinal toxicity at 5 years was 1.3% and 1.6%, with 0.3% Grade 3 genitourinary toxicity and no Grade 3 gastrointestinal toxicity. Eight reports of brachytherapy and surgery were identified. The HDR brachytherapy series' median 5-year bDFS was 82.5%, MFS 90.0% and PCaSS 97.9%. One surgical series reported 5-year bDFS of 65.5% for HR patients. One LDR series reported 5-year bDFS of 85% for IR patients. Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option. © 2015 The Royal Australian and New Zealand College of Radiologists.

  20. Recent Reanalysis Activities at ECMWF: Results from ERA-20C and Plans for ERA5

    Science.gov (United States)

    Dragani, R.; Hersbach, H.; Poli, P.; Pebeuy, C.; Hirahara, S.; Simmons, A.; Dee, D.

    2015-12-01

    This presentation will provide an overview of the most recent reanalysis activities performed at the European Centre for Medium-Range Weather Forecasts (ECMWF). A pilot reanalysis of the 20th-century (ERA-20C) has recently been completed. Funded through the European FP7 collaborative project ERA-CLIM, ERA-20C is part of a suite of experiments that also includes a model-only integration (ERA-20CM) and a land-surface reanalysis (ERA-20CL). Its data assimilation system is constrained by only surface observations obtained from ISPD (3.2.6) and ICOADS (2.5.1). Surface boundary conditions are provided by the Hadley Centre (HadISST2.1.0.0) and radiative forcing follows CMIP5 recommended data sets. First-guess uncertainty estimates are based on a 10-member ensemble of Data Assimilations, ERA-20C ensemble, run prior to ERA-20C using ten SST and sea-ice realizations from the Hadley Centre. In November 2014, the European Commission entrusted ECMWF to run on its behalf the Copernicus Climate Change Service (C3S) aiming at producing quality-assured information about the past, current and future states of the climate at both European and global scales. Reanalysis will be one of the main components of the C3S portfolio and the first one to be produced is a global modern era reanalysis (ERA5) covering the period from 1979 onwards. Based on a recent version of the ECMWF data assimilation system, ERA5 will replace the widely used ERA-Interim dataset. This new production will benefit from a much improved model, and better characterized and exploited observations compared to its predecessor. The first part of the presentation will focus on the ERA-20C production, provide an overview of its main characteristics and discuss some of the key results from its assessment. The second part of the talk will give an overview of ERA5, and briefly discuss some of its challenges.

  1. ERA`s Ranger uranium mine

    Energy Technology Data Exchange (ETDEWEB)

    Davies, W. [Energy Resources of Australia Ltd., Sydney, NSW (Australia)

    1997-12-31

    Energy Resource of Australia (ERA) is a public company with 68% of its shares owned by the Australian company North Limited. It is currently operating one major production centre - Ranger Mine which is 260 kilometres east of Darwin, extracting and selling uranium from the Ranger Mine in the Northern Territory to nuclear electricity utilities in Japan, South Korea, Europe and North America. The first drum of uranium oxide from Ranger was drummed in August 1981 and operations have continued since that time. ERA is also in the process of working towards obtaining approvals for the development of a second mine - Jabiluka which is located 20 kilometres north of Ranger. The leases of Ranger and Jabiluka adjoin. The Minister for the Environment has advised the Minister for Resources and Energy that there does not appear to be any environmental issue which would prevent the preferred Jabiluka proposal from proceeding. Consent for the development of ERA`s preferred option for the development of Jabiluka is being sought from the Aboriginal Traditional Owners. Ranger is currently the third largest producing uranium mine in the world producing 4,237 tonnes of U{sub 3}O{sub 8} in the year to June 1997.

  2. Integration and Cooperation in the Next Golden Age of Human Space Flight Data Repositories: Tools for Retrospective Analysis and Future Planning

    Science.gov (United States)

    Thomas, D.; Fitts, M.; Wear, M.; VanBaalen, M.

    2011-01-01

    As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health Repository (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning

  3. The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

    Science.gov (United States)

    Friedman, M H; Weisberg, J

    2000-07-01

    Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely.

  4. A retrospective analysis of health systems in Denmark and Kaiser Permanente

    DEFF Research Database (Denmark)

    Frølich, Anne; Schiøtz, Michaela L; Strandberg-Larsen, Martin

    2008-01-01

    ABSTRACT: BACKGROUND: To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. METHODS: Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million...... citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase...... comparability. RESULTS: A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100...

  5. Identification of Design Work Patterns by Retrospective Analysis of Work Sheets

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp

    1999-01-01

    project is carried out where we seek to identify design work patterns by retrospective analysis of documentation created during design projects.An elements to satisfy the wish for an efficient design process could be to identify work patterns applied by engineering designers, evaluate these patterns...... with respect to their efficiency, and reuse the most efficient in future projects. Thus, the objective of this research is to analyse design projects in order to identify the work patterns applied. Based on an evaluation of identified work patterns we expect a recommendation of work patterns supporting...... an efficient design process can be established.In this paper we describe the analysis method, and present observations from analyses of three projects....

  6. Kinetic therapy reduces complications and shortens hospital stay in patients with cardiogenic shock - a retrospective analysis.

    Science.gov (United States)

    Simonis, Gregor; Flemming, Kerstin; Ziegs, Enrico; Haacke, Katrin; Rauwolf, Thomas; Strasser, Ruth H

    2007-03-01

    Kinetic therapy (KT) has been shown to reduce complications and to shorten hospital stay in trauma patients. Data in non-surgical patients are inconclusive, and kinetic therapy has not been tested in patients with cardiogenic shock. The present analysis compares KT with standard care in patients with cardiogenic shock. A retrospective analysis of 133 patients with cardiogenic shock admitted to 1 academic heart center was performed. Patients with standard care (SC, turning every 2 h by the staff) were compared with kinetic therapy (KT, using oscillating air-flotation beds). 68 patients with KT were compared with 65 patients with SC. Length of ventilator therapy was 11 days in KT and 18 days in SC (p=0.048). The mortality was comparable in both groups. Pneumonia occurred in 14 patients in KT and 39 patients in SC (ppatients treated with kinetic therapy. The use of KT shortens hospital stay and reduces rates of pneumonia and pressure ulcers as compared to SC.

  7. Evolution of Canadian nursing curricula: a critical retrospective analysis of power and caring.

    Science.gov (United States)

    Anthony, Susan E; Landeen, Janet

    2009-01-01

    The evolution of Canadian nursing curricula has mutually influenced and reflected nursing's historical course: nursing practice and education are inextricably linked. This paper is a critical retrospective analysis of the evolution of nursing curricula in Canada from the 20th century to the present. Falk Rafael's (1996) dialectic exploration of power and caring in nursing guides the analysis. An ordered, assimilated, and empowered curriculum development framework results. Foucault's (1980) work in the sociology of knowledge and Belenky, Clinchy, Goldberger, and Tarule's (1986) epistemological conceptualization of women's knowledge development are incorporated. The intricacies of the relationship between nursing curriculum development and Canadian history, the navigation of societal paradoxes that mutually drive and inform education and practice, and the instrumental need for nursing education research are considered. A fourth and new dialectic layer is suggested that places nursing on the inter-professional team of architects of a co-constructed emancipatory curriculum.

  8. Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Carpenter, Alberta [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heath, Garvin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-01-06

    This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular, the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.

  9. Retrospective Analysis of Communication Events - Understanding the Dynamics of Collaborative Multi-Party Discourse

    Energy Technology Data Exchange (ETDEWEB)

    Cowell, Andrew J.; Haack, Jereme N.; McColgin, Dave W.

    2006-06-08

    This research is aimed at understanding the dynamics of collaborative multi-party discourse across multiple communication modalities. Before we can truly make sig-nificant strides in devising collaborative communication systems, there is a need to understand how typical users utilize com-putationally supported communications mechanisms such as email, instant mes-saging, video conferencing, chat rooms, etc., both singularly and in conjunction with traditional means of communication such as face-to-face meetings, telephone calls and postal mail. Attempting to un-derstand an individual’s communications profile with access to only a single modal-ity is challenging at best and often futile. Here, we discuss the development of RACE – Retrospective Analysis of Com-munications Events – a test-bed prototype to investigate issues relating to multi-modal multi-party discourse.

  10. [Retrospective analysis of 24 recurrent glioblastoma after chemoradiation and treated with nitrosoureas or irinotecan and bevacizumab].

    Science.gov (United States)

    Vauleon, Elodie; Mesbah, Habiba; Gedouin, Daniel; Lecouillard, Isabelle; Louvel, Guillaume; Hamlat, Abderrahmane; Riffaud, Laurent; Carsin, Béatrice; Quillien, Véronique; Audrain, Odile; Lesimple, Thierry

    2012-02-01

    Despite progress in the initial management of glioblastoma (GB), the vast majority of patients will experience recurrence within 2-3 years. The medical treatment of these recurrences is being modified by the use of antiangiogenic therapies. Twenty-four patients, who relapsed from GB after chemoradiation followed by adjuvant temozolomide in Rennes, were treated by conventional chemotherapy (nitrosourea) or by the combination of irinotecan and bevacizumab. In this retrospective analysis, overall survival from diagnosis of recurrence was significantly longer in patients treated with the combination of bevacizumab and irinotecan than with nitrosourea (5 months versus 11.5 months). The combination of irinotecan and bevacizumab appeared to provide clinical benefit to patients with recurrent GB.

  11. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis.

    Science.gov (United States)

    Azmi, NA; Razak, HRA; Vinjamuri, S.

    2017-05-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population.

  12. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis

    International Nuclear Information System (INIS)

    Azmi, NA; Razak, HRA; Vinjamuri, S

    2017-01-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population. (paper)

  13. Retrospective analysis of patients clinical manifestations before and after pheochromocytoma surgery.

    Science.gov (United States)

    Balazovjech, I; Davidova, H; Breza, J

    2004-01-01

    A retrospective analysis of presurgical clinical picture and blood pressures of 34 patients with histologically verified pheochromocytoma. Assessment of clinical state, blood pressure and prognosis in the course of patients control hospitalizations from 2001 to 2002. The study was designed as a synoptic one, based on a retrospective analysis of 34 patients records with histologically verified pheochromocytoma (26 women and 8 men). Our assessments of clinical symptomatology, maximum paroxysmal hypertension values, average blood pressure values in patients with persistent arterial hypertension, arterial hypertension grade and circadian index were based on patients records. Patients epinephrectomies were followed during their control hospitalizations to assess their clinical state. Their blood pressures were evaluated by means of their circadian monitoring. From the 34 patients, 21 were diagnosed with solitary pheochromocytomas. The circadian index persistence analysis prior to the surgery was associated with circadian blood pressure monitoring in 21 patients. It was lost in 57% of patients. During their control hospitalization as many as 82% of patients preserved their circadian blood pressure variability with a more than 10% decrease in the night time, 5 patients did not preserve their circadian blood pressure variability. Seven from the original 34 patients died: Three of them died from their primary disease, one 63-year old man died from shock following tumour extirpation. The death of other 3 patients was not associated with their primary disease. Long-lasting survival of patients with pheochromocytoma after surgical treatment--except for those with malignant disease--was demonstrated. Although our assessment of the resulting treatment effects was positive, a long-term follow-up is inevitable because of a difficult pathologic-anatomical verification of the malignant nature of the disease as well as of the risk of tumour relapse assessment. (Tab. 1, Fig. 5, Ref 36.)

  14. Colorectal cancer with intestinal perforation – a retrospective analysis of treatment outcomes

    Science.gov (United States)

    Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2014-01-01

    Aim of the study Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. Material and methods A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Results Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). Conclusions In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates. PMID:25784840

  15. International Orders in the Early Modern World

    DEFF Research Database (Denmark)

    This book challenges the Eurocentric foundations of modern International Relations scholarship. Its primary empirical focus is the early modern era, when European primacy had yet to develop in many parts of the globe. It presents a series of regional case studies from experts on East Asia, the Mi...... and scholars of international relations, international relations theory, international history, early modern history and sociology.......This book challenges the Eurocentric foundations of modern International Relations scholarship. Its primary empirical focus is the early modern era, when European primacy had yet to develop in many parts of the globe. It presents a series of regional case studies from experts on East Asia......, the Middle East, Africa and Latin America, and Russia to explore patterns of cross-cultural exchange and civilizational encounters. The authors analyze a series of regional international orders which were primarily defined by local interests, agendas and institutions, with European interlopers often playing...

  16. A Escola Médica de Pádua: medicina e filosofia no período moderno The Paduan School of Medicine: medicine and philosophy in the modern era

    Directory of Open Access Journals (Sweden)

    Regina Andrés Rebollo

    2010-06-01

    Full Text Available Trata-se de contribuição parcial ao entendimento da história da recepção e transmissão dos textos clássicos hipocráticos e galênicos na Itália do período moderno. Observando-se rotuli e puncti da Escola Médica da Universidade de Pádua, que registram as disciplinas e os conteúdos ministrados no período compreendido entre 1500 e 1600, pode-se conhecer o currículo oficial dessa famosa escola. A consulta a tais documentos mostra o compromisso da formação médica oficial com a tradição, em especial com Hipócrates, Galeno, Avicena e Aristóteles.This is a partial contribution to an understanding of the history of the reception and transmission of classical Hippocratic and Galenic texts in Italy's modern period. By examining rotuli and puncti of the School of Medicine of Padua University, which record the subjects and content taught in the period between 1500 and 1600, one can study the official curriculum of this famous school. Perusal of these documents shows the commitment of official medical training to tradition, especially with respect to Hippocrates, Galen, Avicenna and Aristotle

  17. Dakwah di Era Digital

    OpenAIRE

    Budiantoro, Wahyu

    2018-01-01

    These days dakwah is not only interpreted as transformation of a pure religious value, but also transformation of a more relevant value including many aspects in digital era. Digital era is when society succumbed into the flow of information causing cultural shock and difficulties on synthesizing meaning from those scattered information. Dakwah on Digital age must accommodate societal needs which tend to move into a mass society. It results in strategy and more humane and innovative dakwah me...

  18. A retrospective analysis on the relationship between intraoperative hypothermia and postoperative ileus after laparoscopic colorectal surgery

    OpenAIRE

    Choi, Ji-Won; Kim, Duk-Kyung; Kim, Jin-Kyoung; Lee, Eun-Jee; Kim, Jea-Youn

    2018-01-01

    Postoperative ileus (POI) is an important factor prolonging the length of hospital stay following colorectal surgery. We retrospectively explored whether there is a clinically relevant association between intraoperative hypothermia and POI in patients who underwent laparoscopic colorectal surgery for malignancy within the setting of an enhanced recovery after surgery (ERAS) program between April 2016 and January 2017 at our institution. In total, 637 patients were analyzed, of whom 122 (19.2%...

  19. Sequencing chemotherapy and radiotherapy in locoregional advanced breast cancer patients after mastectomy – a retrospective analysis

    International Nuclear Information System (INIS)

    Piroth, Marc D; Pinkawa, Michael; Gagel, Bernd; Stanzel, Sven; Asadpour, Branka; Eble, Michael J

    2008-01-01

    Combined chemo- and radiotherapy are established in breast cancer treatment. Chemotherapy is recommended prior to radiotherapy but decisive data on the optimal sequence are rare. This retrospective analysis aimed to assess the role of sequencing in patients after mastectomy because of advanced locoregional disease. A total of 212 eligible patients had a stage III breast cancer and had adjuvant chemotherapy and radiotherapy after mastectomy and axillary dissection between 1996 and 2004. According to concerted multi-modality treatment strategies 86 patients were treated sequentially (chemotherapy followed by radiotherapy) (SEQgroup), 70 patients had a sandwich treatment (SW-group) and 56 patients had simultaneous chemoradiation (SIM-group) during that time period. Radiotherapy comprised the thoracic wall and/or regional lymph nodes. The total dose was 45–50.4 Gray. As simultaneous chemoradiation CMF was given in 95.4% of patients while in sequential or sandwich application in 86% and 87.1% of patients an anthracycline-based chemotherapy was given. Concerning the parameters nodal involvement, lymphovascular invasion, extracapsular spread and extension of the irradiated region the three treatment groups were significantly imbalanced. The other parameters, e.g. age, pathological tumor stage, grading and receptor status were homogeneously distributed. Looking on those two groups with an equally effective chemotherapy (EC, FEC), the SEQ- and SW-group, the sole imbalance was the extension of LVI (57.1 vs. 25.6%, p < 0.0001). 5-year overall- and disease free survival were 53.2%/56%, 38.1%/32% and 64.2%/50%, for the sequential, sandwich and simultaneous regime, respectively, which differed significantly in the univariate analysis (p = 0.04 and p = 0.03, log-rank test). Also the 5-year locoregional or distant recurrence free survival showed no significant differences according to the sequence of chemo- and radiotherapy. In the multivariate analyses the sequence had no

  20. Retrospective Analysis of Patient Presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014.

    Science.gov (United States)

    Crabtree, Nathan; Mo, Shirley; Ong, Leon; Jegathees, Thuvarahan; Wei, Daniel; Fahey, David; Liu, Jia Jenny

    2017-04-01

    Introduction Comprehensive studies on the relationship between patient demographics and subsequent treatment and disposition at a single mass-gathering event are lacking. The Sydney Royal Easter Show (SRES; Sydney Olympic Park, New South Wales, Australia) is an annual, 14-day, agricultural mass-gathering event occurring around the Easter weekend, attracting more than 800,000 patrons per year. In this study, patient records from the SRES were analyzed to examine relationships between weather, crowd size, day of week, and demographics on treatment and disposition. This information would help to predict factors affecting patient treatment and disposition to guide ongoing training of first responders and to evaluate the appropriateness of staffing skills mix at future events. Hypothesis Patient demographics, environmental factors, and attendance would influence the nature and severity of presentations at the SRES, which would influence staffing requirements. A retrospective analysis of 4,141 patient record forms was performed for patients who presented to St John Ambulance (Australian Capital Territory, Australia) at the SRES between 2012 and 2014 inclusive. Presentation type was classified using a previously published minimum data set. Data on weather and crowd size were obtained from the Australian Bureau of Meteorology (Melbourne, Victoria, Australia) and the SRES, respectively. Statistical analyses were performed using SPSS v22 (IBM; Armonk, New York USA). Between 2012 to 2014, over 2.5 million people attended the SRES with 4,141 patients treated onsite. As expected, the majority of presentations were injuries (49%) and illnesses (46%). Although patient demographics and presentation types did not change over time, the duration of treatment increased. A higher proportion of patients were discharged to hospital or home compared to the proportion of patients discharged back to the event. Patients from rural/regional locations (accounting for 15% of all patients) were

  1. Surgical treatment of acute pulmonary embolism--a 12-year retrospective analysis

    DEFF Research Database (Denmark)

    Lehnert, Per; Møller, Christian H; Carlsen, Jørn

    2012-01-01

    Surgical embolectomy for acute pulmonary embolism (PE) is considered to be a high risk procedure and therefore a last treatment option. We wanted to evaluate the procedures role in modern treatment of acute PE....

  2. Modernity: Are Modern Times Different?

    Directory of Open Access Journals (Sweden)

    Lynn Hunt

    2014-12-01

    Full Text Available “Modernity” has recently been the subject of considerable discussion among historians. This article reviews some of the debates and argues that modernity is a problematic concept because it implies a complete rupture with “traditional” ways of life. Studies of key terms are undertaken with the aid of Google Ngrams. These show that “modernity,” “modern times,” and “traditional” —in English and other languages— have a history of their own. A brief analysis of the shift from a self oriented toward equilibrium to a self oriented toward stimulation demonstrates that modernity is not necessary to historical analysis.

  3. Injection therapy for chronic prostatitis: A retrospective analysis of 77 cases

    Directory of Open Access Journals (Sweden)

    Attila Toth

    2018-03-01

    Full Text Available Objective: To compare pre- and post-therapy symptom scores reported on the National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI after trans-rectal antibiotic injections therapy for men suffering from chronic prostatitis. Materials and methods: Retrospective analysis of NIHCPSI symptom scores obtained from chart reviews of 77 treated males suffering from chronic prostatitis before and after trans rectal injections for the treatment of chronic prostatitis. Results: Most patients reported a 40% to 60% improvement in symptom scores. In subgroups comparing scores in patients with less than 5 injections, the improvement was less than in patients who received 10 or more injections. Patients’ responses after a shorter (3 months follow up showed better pain scores than patient’s scores after longer, over one-year or more, follow- up periods. Conclusion: Our findings show that direct antibiotic injection for chronic prostatitis is a viable addition to standard therapies. Improvements in symptom scores are long lasting. Discomfort is minimal and side effects are rare and avoidable

  4. A retrospective analysis of antimicrobial resistance in bacterial pathogens in an equine hospital (2012-2015).

    Science.gov (United States)

    van Spijk, J N; Schmitt, S; Fürst, A E; Schoster, A

    2016-06-01

    Antimicrobial resistance has become an important concern in veterinary medicine. The aim of this study was to describe the rate of antimicrobial resistance in common equine pathogens and to determine the occurrence of multidrug-resistant isolates. A retrospective analysis of all susceptibility testing results from bacterial pathogens cultured from horses at the University of Zurich Equine Hospital (2012-2015) was performed. Strains exhibiting resistance to 3 or more antimicrobial categories were defined as multidrug-resistant. Susceptibility results from 303 bacterial pathogens were analyzed, most commonly Escherichia coli (60/303, 20%) and Staphylococcus aureus (40/303, 13%). High rates of acquired resistance against commonly used antimicrobials were found in most of the frequently isolated equine pathogens. The highest rate of multidrug resistance was found in isolates of Acinetobacter baumannii (23/24, 96%), followed by Enterobacter cloacae complex (24/28, 86%) and Escherichia coli (48/60, 80%). Overall, 60% of Escherichia coli isolates were phenotypically ESBL-producing and 68% of Staphylococcus spp. were phenotypically methicillin-resistant. High rates of acquired antimicrobial resistance towards commonly used antibiotics are concerning and underline the importance of individual bacteriological and antimicrobial susceptibility testing to guide antimicrobial therapy. Minimizing and optimizing antimicrobial therapy in horses is needed.

  5. Results of radiotherapy in recurrent endometrial carcinoma: A retrospective analysis of 51 patients

    International Nuclear Information System (INIS)

    Kuten, A.; Grigsby, P.W.; Perez, C.A.; Fineberg, B.; Garcia, D.M.; Simpson, J.R.

    1989-01-01

    A retrospective analysis was performed of 51 patients with locoregional recurrence of endometrial carcinoma, treated by radiotherapy between 1959 and 1986. There were 17 patients (33%) with isolated vaginal recurrence, 12 patients (24%) with vaginal recurrence with pelvic extension, 7 patients (14%) with pelvic recurrence only, and 15 patients (29%) with simultaneous locoregional and distant failure. Eighty percent of the recurrences occurred within 3.5 years from primary treatment; time to relapse was shorter in patients with advanced-stage, high-grade malignancy at original diagnosis. Locoregional control was achieved in 18 patients (35%). Complete tumor regression in the vagina, irrespective of extravaginal pelvic disease status or distant metastasis, occurred in 28 of 34 patients with vaginal involvement (82%). The 5- and 10-year overall actuarial survivals for all patients were 18 and 12.5%, respectively. The 5- and 10-year progression-free survivals of patients with isolated vaginal recurrences were 40% and 29%, respectively; the 5-year progression-free survival of patients with vaginal recurrence with pelvic extension was 20%. There were no survivors beyond 1.5 years among patients with pelvic recurrence (p = 0.02). All patients with simultaneous locoregional and distant failure were dead by 3.5 years. Stage at original diagnosis, time to relapse from primary treatment, histologic pattern, and grade of malignancy were prognosticators of survival. Five patients (10%) developed a total of ten radiation-related sequelae

  6. Hospital stay as a proxy indicator for severe injury in earthquakes: a retrospective analysis.

    Science.gov (United States)

    Zhao, Lu-Ping; Gerdin, Martin; Westman, Lina; Rodriguez-Llanes, Jose Manuel; Wu, Qi; van den Oever, Barbara; Pan, Liang; Albela, Manuel; Chen, Gao; Zhang, De-Sheng; Guha-Sapir, Debarati; von Schreeb, Johan

    2013-01-01

    Earthquakes are the most violent type of natural disasters and injuries are the dominant medical problem in the early phases after earthquakes. However, likely because of poor data availability, high-quality research on injuries after earthquakes is lacking. Length of hospital stay (LOS) has been validated as a proxy indicator for injury severity in high-income settings and could potentially be used in retrospective research of injuries after earthquakes. In this study, we assessed LOS as an adequate proxy indicator for severe injury in trauma survivors of an earthquake. A retrospective analysis was conducted using a database of 1,878 injured patients from the 2008 Wenchuan earthquake. Our primary outcome was severe injury, defined as a composite measure of serious injury or resource use. Secondary outcomes were serious injury and resource use, analysed separately. Non-parametric receiver operating characteristics (ROC) and area under the curve (AUC) analysis was used to test the discriminatory accuracy of LOS when used to identify severe injury. An 0.7earthquake survivors. However, LOS was found to be a proxy for major nonorthopaedic surgery and blood transfusion. These findings can be useful for retrospective research on earthquake-injured patients when detailed hospital records are not available.

  7. Consumer concerns about paracetamol: a retrospective analysis of a medicines call centre.

    Science.gov (United States)

    Lau, Stephanie M; McGuire, Treasure M; van Driel, Mieke L

    2016-06-08

    To identify consumer information needs about paracetamol, the most commonly used analgesic and antipyretic worldwide. Retrospective analysis of medicines questions from the public. Australian consumer medicines call centre. Callers to National Prescribing Service Medicines Line between September 2002 and June 2010 (n=123 217). Enquiry profile: demographics, enquiry type and concurrent medicines included in paracetamol calls; question themes derived from subset of call narratives. Paracetamol comprised part of the enquiry in 5.2% of calls (n=6367). The caller age distribution for paracetamol calls was skewed towards a younger cohort, with 45.2% made by those aged 25-44 vs 37.5% in 'rest of calls'. Significantly more paracetamol-related calls were made for a child (23.7%) compared with 'rest of calls' (12.7%, pConsumers have many concerns about the use of paracetamol that may be under-recognised by healthcare providers, with the nature of enquiries differing across life stages. These concerns are not adequately addressed by available consumer information. Improving access to targeted information about paracetamol would promote the safe and effective use of this common medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Vascular access in lipoprotein apheresis: a retrospective analysis from the UK's largest lipoprotein apheresis centre.

    Science.gov (United States)

    Doherty, Daniel J; Pottle, Alison; Malietzis, George; Hakim, Nadey; Barbir, Mahmoud; Crane, Jeremy S

    2018-01-01

    Lipoprotein apheresis (LA) has proven to be an effective, safe and life-saving therapy. Vascular access is needed to facilitate this treatment but has recognised complications. Despite consistency in treatment indication and duration there are no guidelines in place. The aim of this study is to characterise vascular access practice at the UK's largest LA centre and forward suggestions for future approaches. A retrospective analysis of vascular access strategies was undertaken in all patients who received LA treatment in the low-density lipoprotein (LDL) Apheresis Unit at Harefield Hospital (Middlesex, UK) from November 2000 to March 2016. Fifty-three former and current patients underwent 4260 LA treatments. Peripheral vein cannulation represented 79% of initial vascular access strategies with arteriovenous (AV) fistula use accounting for 15%. Last used method of vascular access was peripheral vein cannulation in 57% versus AV fistula in 32%. Total AV fistula failure rate was 37%. Peripheral vein cannulation remains the most common method to facilitate LA. Practice trends indicate a move towards AV fistula creation; the favoured approach receiving support from the expert body in this area. AV fistula failure rate is high and of great concern, therefore we suggest the implementation of upper limb ultrasound vascular mapping in all patients who meet treatment eligibility criteria. We encourage close ties between apheresis units and specialist surgical centres to facilitate patient counselling and monitoring. Further prospective data regarding fistula failure is needed in this expanding treatment field.

  9. Clinical nutrition counselling service in the veterinary hospital: retrospective analysis of equine patients and nutritional considerations.

    Science.gov (United States)

    Vergnano, D; Bergero, D; Valle, E

    2017-06-01

    Nutrition plays a very important role in the healthy and in the ill horse. Although research in this field clearly shows that incorrect nutritional practices may lead to severe pathologies, inappropriate feeding plans often continue to be used. A clinical nutrition counselling (CNC) service could thus be of great use to both horse owners and veterinarians. The aim of this study was to provide information on equine patients referred to the CNC service of the University of Turin and to provide standard dietary protocols as used in our Veterinary Teaching Hospital for the most common nutrition-related pathologies. The data were obtained by retrospective analysis of the nutritional records of referred equine patients. The data collected included information about anamnesis, nutritional assessment, current diet, referring person and follow-up of each patient. Sixty-one horses were included in the study. The majority were adult males. The most common breeds were the Italian Saddle Horse and the Friesian Horse. Old horses (>19 years) had a statistically lower BCS than brood mares or other adult horses (p equine gastric ulcer syndrome. All horses received first-cut meadow hay; 85% also ate concentrates. Young horses (equine population. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

  10. Gandhi and Mao on manual labour in the school: A retrospective analysis

    Science.gov (United States)

    Zachariah, Mathew; Hoffman, Arlene

    1985-12-01

    Mahatma Gandhi's views on relating the world of formal education to the world of work were developed first in his experimental `Tolstoy Farm' in South Africa. On his return to India, Gandhi insisted that a required manual labour component in the curriculum would help regenerate India's village economy, develop in India's children a deeper understanding of India's cultural roots, motivate children to relate `book learning' to life in society, and destroy invidious caste distinctions. The major proposals and suggestions in Gandhi's writing will be discussed in the context of his hopes for using schooling as an agent of progress in India. Mao Ze-Dong's views, on the other hand, were developed in the context of his Yenan experience in the 1930s, i.e. the decision to consolidate a power base in the interior of China before waging a class war against the landlords and capitalists of China. Mao's views were also, to some extent, rooted in the Chinese reality of stagnant, poverty-stricken rural areas. But, Mao's writings indicate that Marxist hopes to relate theory and practice (as understood in dialectical materialism) and to ensure that everyone participated in mental as well as manual labour in a socialist society had led him to formulate his proposals. Both Gandhi's and Mao's views and proposals have been more or less abandoned in India and China respectively. The similar and dissimilar reasons which led to such a fate are examined in this retrospective analysis.

  11. Real-world Outcomes of Multiple Myeloma: Retrospective Analysis of the Czech Registry of Monoclonal Gammopathies.

    Science.gov (United States)

    Hájek, Roman; Jarkovsky, Jiri; Maisnar, Vladimír; Pour, Ludek; Špička, Ivan; Minařík, Jiri; Gregora, Evžen; Kessler, Petr; Sýkora, Michal; Fraňková, Hana; Campioni, Marco; DeCosta, Lucy; Treur, Maarten; Gonzalez-McQuire, Sebastian; Bouwmeester, Walter

    2018-06-01

    Real-world data on patient outcomes and treatment patterns in multiple myeloma (MM) are limited. The present noninterventional, observational, retrospective analysis of prospectively collected Czech patient medical record data from the Registry of Monoclonal Gammopathies estimated real-world outcomes in adults with a diagnosis of symptomatic MM made between May 2007 and June 2014. In total, 2446 patients had initiated first-line treatment. The median overall survival since the diagnosis (primary endpoint) was 50.3 months (95% confidence interval, 46.1-54.5 months) and decreased with each successive treatment line. A similar trend was observed for progression-free survival and the depth of response. In line with European guidelines and clinical practice, bortezomib-, thalidomide-, and lenalidomide-based regimens were most commonly used across all treatment lines (42.3%, 28.9%, and 18.4%, respectively). In the first line, bortezomib and thalidomide were used most often, with lenalidomide the most commonly used agent in the relapse setting (second to fourth lines). Exploratory analyses revealed that younger age (≤ 65 years), lower international staging system stage, and previous stem cell transplantation were associated with significant improvements in overall and progression-free survival, especially in the early treatment lines. The present study is the first analysis of Czech data from the Registry of Monoclonal Gammopathies, and it provides important insights into the real-world management of MM for physicians and healthcare providers. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Retrospective analysis of dengue specific IgM reactive serum samples

    Directory of Open Access Journals (Sweden)

    Nemai Bhattacharya

    2013-04-01

    Full Text Available Objective: To conduct a retrospective analysis of dengue cases in Kolkata, on the basis of presence of anti-dengue IgM in their sera and presence or absence of anti-dengue IgG and dengue specific Non structural 1 (NS1 antigen in each of the serum sample. Methods: Sample was tested quantitatively employing ELISA technique, using Biorad test kits, with a view to get a more comprehensive picture of dengue in an urban endemic area and also to evaluate individual cases. Results: This reconstructed study revealed that of those 91 dengue cases, 70.3% (64 and 29.7% (27 were suffering from secondary and primary dengue respectively, showing that number of secondary dengue cases were much more than that of primary dengue cases with a possibility of emergence of DHF. A small proportion of cases 18.7% (17 were reactive for NS1. The duration of fever in NS1 antigen positive cases varied between 5 and 7 days. Of 17 NS1 reactive cases, 10 (10.9% and 7 (7.7% were suffering from secondary and primary dengue respectively. Conclusions: Early detection of primary and secondary dengue cases would be facilitated by utilizing all three parameters (NS1 antigen, anti-dengue IgM and IgG helping to evaluate, monitor and treat a dengue case effectively.

  13. Spatial Distribution and a Retrospective Analysis of the Herpetofauna in the City of Plovdiv, Bulgaria

    Directory of Open Access Journals (Sweden)

    Ivelin A. Mollov

    2010-12-01

    Full Text Available The current study presents the contemporary status and distribution of theamphibians and reptiles in the city of Plovdiv. To track changes in the status ofamphibians and reptiles in the research area through time, a retrospective analysis wasmade based on available literary data. During the past 100 years four species ofamphibians (Triturus karelinii, Lissotriton vulgaris, Bombina bombina, B. variegata and fourspecies of reptiles (Coronella austriaca, Zamenis longissimus, Elaphe sauromates, Viperaammodytes probably have disappeared from the study area; one amphibian species (Bufobufo and one reptile (Natrix natrix have not changed their status, one amphibian(Pelobates syriacus and two reptile species (Ablepharus kitaibelii, Podarcis muralis havereduced their localities and four amphibian species (Epidalea viridis, Rana dalmatina,Pelophylax ridibundus, Hyla arborea and seven species of reptiles (Mediodactylus kotschyi,Lacerta trilineata, Lacerta viridis, Podarcis tauricus, Emys orbicularis, Dolichophis caspius,Natrix tessellata have increased their localities and frequency of occurrence. The recordsof the two tortoise species (Testudo hermanni and T. graeca in the city, and the presence ofthe Red-eared slider (Trachemys scripta elegans should be considered as accidental.Important Herpetological Areas (IHA in the study region are also identified.

  14. Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island (China)

    Science.gov (United States)

    Titlyanov, Eduard A.; Titlyanova, Tamara V.; Xia, Bangmei; Bartsch, Inka

    2016-09-01

    Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island in the period 1933-1992 is presented in this paper. There are two extensive sample collection periods of benthic macroalgae: the early collection (EC) covers a period between the early 1930s and the 1980s before considerable urbanization and reef degradation took place and a late collection (LC) was performed in 1990/1992 during a phase of rapid urbanization. Analysis of data also including an earlier published inventory of green algae covering the same collection sites (Titlyanov et al. 2011a) revealed that the marine flora of the island comprises 426 taxa in total, with 59% red algae, 18% brown algae and 23% green algae. In total 59 species of red algae, 11 species of brown algae and 37 species of green algae sampled during the LC are new records for Hainan Island. Considerable floristic changes between EC and LC became evident. In the LC there were significantly more filamentous, tubular or fine blade-like, and often epiphytic, green and red algae with a high surface-to-volume ratio. Additionally a reduction of green, brown and red algal species with larger fleshy or foliose thalli and a low surface-to-volume ratio was observed. It is assumed that the changes reflect the degradation of the coral reef ecosystem around Hainan, which was damaged by human activities especially in the 1950s-1970s.

  15. Risk factors of extubation failure in extremely low birth weight infants: a five year retrospective analysis.

    Science.gov (United States)

    Lee, Chao-Yi; Su, Bai-Horng; Lin, Tsung-Wen; Lin, Hung-Chih; Li, Tsai-Chung; Wang, Nai-Phon

    2002-01-01

    Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation therapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3 +/- 140.4 gm. The mean gestational age was 25.8 +/- 1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistant staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent post-extubation atelectasis and nosocomial pneumonia.

  16. A RETROSPECTIVE ANALYSIS OF ARTHROSCOPIC ACL RECONSTRUCTION WITH HAMSTRING TENDON GRAFT

    Directory of Open Access Journals (Sweden)

    Ashish R. Agarwal

    2017-08-01

    Full Text Available BACKGROUND ACL reconstruction is one of the commonest knee surgeries done. Young adults are the commonest patients; thus, this injury has a large impact on socioeconomic status of the family. The aim of the study is to study the outcome of arthroscopic ACL reconstruction with hamstring tendon graft. MATERIALS AND METHODS 50 patients following up in the OPD who had undergone ACL reconstruction with hamstring tendon graft are evaluated. Patients who had other lesions, such meniscal injuries or collateral injuries were discarded. These patients were evaluated by using Tegner and Lysholm score of 6 months, 12 months and 24 months. Settings- It is a retrospective analysis of the data collected from the patients who were opiated at Nair Hospital. RESULTS 90% of patients in the study were males. Mean age of the study population is 30.7 years. All the patients in the study had instability as a symptom, while 80% of them also had pain. Six months after surgery, according to Tegner and Lysholm score, 52% patients had good outcome, while 48% had fair outcome. At 2 years, 98% of study population had excellent outcome. CONCLUSION Arthroscopic ACL reconstruction with hamstring graft is an effective way of treating ACL tear.

  17. Hypophosphatemia. From retrospective analysis to the analysis of the potential role of phosphatemia in panic disorders

    Directory of Open Access Journals (Sweden)

    Alessandro Riccardi

    2010-09-01

    Full Text Available The detection of a low serum phosphate level is not unusual in an Emergency Department, especially in clinical conditions linked to hyperventilation and subsequent respiratory alkalosis, asthma, sepsis, severe pain, anxiety. Symptoms of hypophosphatemia are typically not specific when the imbalance is not particularly severe, but if hyphophosphatemia does not resolve rhabdomyolisis, hemolysis, decreased tissue oxygenation and respiratory failure can be observed. Only recently some authors have pointed out that the level of serum phosphate in patient with anxiety and panic disorders can give information on the severity of the attacks as well on the clinical course of the disease. In a retrospective analysis on 599 case of hypophosphatemia observed in our ED, the percentage of case of panic disorders was particularly high among patients with lower phosphatemia. Therefore, we decided to examine this aspect closely, assessing if the determination of serum phosphate could be useful in the management of panic attacks at first approach in emergency room. Our observation are consistent with the statement that hypophosphatemia is one of the main clinical aspect of panic attack, and strongly support the hypothesis that hypophosphatemia correlates with the most severe symptoms of panic attack and should be itself considered as one of the most important aspect of this syndrome. Serum phosphate levels appear to mirror its clinical course, and can be used in the clinical setting of an Emergency Department, for the confirmation of a diagnosis of anxiety-panic disorder and as marker of the response to therapy

  18. Performance evaluation of phage-displayed synthetic human single-domain antibody libraries: A retrospective analysis.

    Science.gov (United States)

    Henry, Kevin A; Tanha, Jamshid

    2018-05-01

    Fully human synthetic single-domain antibodies (sdAbs) are desirable therapeutic molecules but their development is a considerable challenge. Here, using a retrospective analysis of in-house historical data, we examined the parameters that impact the outcome of screening phage-displayed synthetic human sdAb libraries to discover antigen-specific binders. We found no evidence for a differential effect of domain type (V H or V L ), library randomization strategy, incorporation of a stabilizing disulfide linkage or sdAb display format (monovalent vs. multivalent) on the probability of obtaining any antigen-binding human sdAbs, instead finding that the success of library screens was primarily related to properties of target antigens, especially molecular mass. The solubility and binding affinity of sdAbs isolated from successful screens depended both on properties of the sdAb libraries (primarily domain type) and the target antigens. Taking attrition of sdAbs with major manufacturability concerns (aggregation; low expression) and sdAbs that do not recognize native cell-surface antigens as independent probabilities, we calculate the overall likelihood of obtaining ≥1 antigen-binding human sdAb from a single library-target screen as ~24%. Successful library-target screens should be expected to yield ~1.3 human sdAbs on average, each with average binding affinity of ~2 μM. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Myeloperoxidase mRNA detection for lineage determination of leukemic blasts: retrospective analysis.

    Science.gov (United States)

    Crisan, D; Anstett, M J

    1995-07-01

    Myeloperoxidase (MPO) mRNA is an early myeloid marker; its detection in the morphologically and immunophenotypically primitive blasts of acute undifferentiated leukemia (AUL) establishes myeloid lineage and allows reclassification as acute myelogenous leukemia with minimal differentiation (AML-MO). We have previously reported a procedure for MPO mRNA detection by RT-PCR (reverse transcription-polymerase chain reaction) and an adaptation for use of routine hematology smears. This variant procedure allows retrospective analysis of mRNA and is used in the present study to evaluate the lineage of leukemic blasts in seven cases with morphology and cytochemistry consistent with AUL. All hematology smears used in this study were air-dried, unstained or Wright-stained and stored at room temperature for periods varying between 3 days and 2 years. MPO mRNA was detected in six cases, establishing the myeloid lineage of the blasts and the diagnosis of AML-MO. In the remaining case, the blasts were MPO mRNA negative, confirming the diagnosis of AUL. The RT-PCR procedure for retrospective mRNA analysis is useful in the clinical setting, due to its high specificity and sensitivity, speed (less than 24 h), safety (no radioactivity) and convenient use of routine hematology smears; it is particularly attractive in clinical situations when fresh or frozen specimens are no longer available at the time when the need for molecular diagnostics becomes apparent.

  20. Retrospective analysis of co-occurrence of congenital aortic stenosis and pulmonary artery stenosis in dogs.

    Science.gov (United States)

    Kander, M; Pasławska, U; Staszczyk, M; Cepiel, A; Pasławski, R; Mazur, G; Noszczyk-Nowak, A

    2015-01-01

    The study has focused on the retrospective analysis of cases of coexisting congenital aortic stenosis (AS) and pulmonary artery stenosis (PS) in dogs. The research included 5463 dogs which were referred for cardiological examination (including clinical examination, ECG and echocardiography) between 2004 and 2014. Aortic stenosis and PS stenosis were detected in 31 dogs. This complex defect was the most commonly diagnosed in Boxers - 7 dogs, other breeds were represented by: 4 cross-breed dogs, 2 Bichon Maltais, 3 Miniature Pinschers, 2 Bernese Mountain Dogs, 2 French Bulldogs, and individuals of following breeds: Bichon Frise, Bull Terrier, Czech Wolfdog, German Shepherd, Hairless Chinese Crested Dog, Miniature Schnauzer, Pug, Rottweiler, Samoyed, West Highland White Terrier and Yorkshire Terrier. In all the dogs, the murmurs could be heard, graded from 2 to 5 (on a scale of 1-6). Besides, in 9 cases other congenital defects were diagnosed: patent ductus arteriosus, mitral valve dysplasia, pulmonary or aortic valve regurgitation, tricuspid valve dysplasia, ventricular or atrial septal defect. The majority of the dogs suffered from pulmonary valvular stenosis (1 dog had supravalvular pulmonary artery stenosis) and subvalvular aortic stenosis (2 dogs had valvular aortic stenosis). Conclusions and clinical relevance - co-occurrence of AS and PS is the most common complex congenital heart defect. Boxer breed was predisposed to this complex defect. It was found that coexisting AS and PS is more common in male dogs and the degree of PS and AS was mostly similar.

  1. Open access to MRI for general practitioners: 12 years' experience at one institution -- a retrospective analysis.

    Science.gov (United States)

    Gough-Palmer, A L; Burnett, C; Gedroyc, W M

    2009-08-01

    The aim of this study was to evaluate 12 years of general practitioner (GP) use of open access MRI services at a single London teaching hospital. A retrospective analysis of reports from all GP requests for MRI scans between 1994 and 2005 was performed. The date, scanned body part, and requester details from 1798 scans requested by 209 individual GPs over a continuous 12-year period were recorded. All scans were then graded into four categories based on the severity of reported findings from normal to gross abnormality. Over the study period, GP requests as a percentage of the total (MRI) department workload remained low at approximately 2.6%. Spine, knee and brain requests constituted 86% (n = 1546) of requested scans. 48% (n = 868) of scans were reported as normal or minor degenerative changes only. 26% (n = 466) of scans demonstrated serious pathology that was likely to warrant hospital consultant referral. There was a wide range of scans requested per requester, from 1 to 240 over the period, with an average of 8.5 scans per GP. In conclusion, any department wishing to set up open access to MRI services for GPs could cover the majority of requests by offering spine, knee and brain imaging. The percentage of normal report rates for GP requests is comparable with previous studies of outpatient referrals. A large variation in requesting patterns between GPs suggests the need for increased communication between GPs and imaging departments to optimise use of the service.

  2. A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department.

    Science.gov (United States)

    Fawcett, Richard John; Kernohan, George

    2017-09-12

    To discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law. A retrospective analysis of patients' notes who were assigned an FGM code during the period of May 2015 to August 2016. Single-centre, large UK major trauma centre offering a tertiary FGM clinic. Any woman coded during the study period as having undergone FGM. Number of FGM cases identified by the ED. Mean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status. 34 patients were identified as having undergone FGM, 19 had previously attended ED and none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation. This study demonstrates that the identification of FGM victims by an ED is very poor, and more work needs to be done to increase awareness of the subject by front-line staff. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

    Science.gov (United States)

    Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

    2009-01-01

    The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

  4. An audit of the outcome of amblyopia treatment: a retrospective analysis of 322 children.

    Science.gov (United States)

    Awan, M; Proudlock, F A; Grosvenor, D; Choudhuri, I; Sarvanananthan, N; Gottlob, I

    2010-08-01

    Little is known about the effectiveness of occlusion therapy in hospital settings. A retrospective analysis was conducted to assess modalities, outcome and hospital costs of children treated for amblyopia with patching in a UK clinic. Notes of 322 children with amblyopia discharged after occlusion treatment were selected consecutively and reviewed. Data collated included age at presentation, amblyopia type, visual acuity (VA; before/after occlusion and at discharge), number of prescribed hours of occlusion, duration of patching treatment, number of glasses prescribed and number of visits attended or failed to attend. Hospital treatment costs were estimated. Mixed amblyopes were prescribed the longest amount of patching (mean 2815 h over 23 months) followed by strabismic (1984 h) and anisometropic (1238 h) amblyopes. 319 amblyopes received glasses and five atropine treatment. The percentage of patients reaching VA of 6/12 was best in the anisometropic and strabismic groups (>75%) and worse in mixed amblyopia (64%). Average hospital costs were estimated at pound1365. Although the mean duration of treatment was long, involving many hospital visits, the visual outcome was variable, unsatisfactory (amblyopia treatment are needed, possibly by using educational/motivational intervention.

  5. Prevalence of multidrug resistant pathogens in children with urinary tract infection: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Srinivasan S, Madhusudhan NS

    2014-11-01

    Full Text Available Urinary tract infection (UTI is one of the commonest medical problems in children. It can distress the child and may cause kidney damage. Prompt diagnosis and effective treatment can prevent complications in the child. But treatment of UTI in children has now become a challenge due to the emergence of multidrug resistant bacteria. Aims & Objectives: To know the bacteriological profile and susceptibility pattern of urinary tract infections in children and to know the prevalence of multidrug resistant uropathogens. Materials & Methods: A retrospective analysis was done on all paediatric urine samples for a period of one year. A total of 1581 samples were included in the study. Antimicrobial susceptibility testing was done on samples showing significant growth by Kirby-Bauer disc diffusion method. Statistical analysis: Prevalence and pattern were analyzed using proportions and percentages. Results: E.coli was the most predominant organism (56% causing UTI in children followed by Klebsiella sp (17%. Fifty three percent of gram negative organisms isolated from children were found to be multidrug resistant. Majority of E. coli isolates were found to be highly resistant to Ampicillin (91% and Cotrimoxazole (82% and highly sensitive to Imipenem (99% and Amikacin (93%. Conclusion: Paediatric UTI was common in children less than 5 years of age. Gram negative bacteria (E. coli and Klebsiella sp were more common than gram positive bacteria. Our study revealed that multidrug resistance was higher in E.coli.

  6. Sudden illness while driving a vehicle--a retrospective analysis of commercial drivers in Japan.

    Science.gov (United States)

    Hitosugi, Masahito; Gomei, Sayaka; Okubo, Takao; Tokudome, Shogo

    2012-01-01

    We performed a retrospective analysis of commercial drivers to clarify the background of incidents of sudden illness while driving. The analysis used reports submitted by employers to the Japan Ministry of Land, Infrastructure, Transport, and Tourism regarding commercial drivers who had been ordered to stop driving owing to health problems. Of 211 cases with an average work history of 15.2 years, there were 88 bus drivers, 70 taxi drivers, and 53 truck drivers, 36.0% of who had died as a result of their disease. Among taxi and truck drivers, more than 70% of incidents were due to cardiac, aortic, and cerebrovascular disease. More than 80% of these were unable to avoid traffic accidents caused by sudden illness. However, among bus drivers, cardiac, aortic, and cerebrovascular disease accounted for only 23.5% of incidents, and accidents were avoided in more than half of the cases. The duration between starting work and the incident time was significantly shorter among bus drivers [mean 3.3 hours, standard deviation (SD) 3.1] than taxi (7.7 hours, SD 5.8) and truck (7.2 hours, SD 6.3) drivers (Pprevent disabling events while driving. As a precaution, physicians should advise commercial drivers to stop driving as soon as they detect slight discomfort. To prevent accidents, more assertive health promotion aimed at professional drivers is needed.

  7. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan

    NARCIS (Netherlands)

    Bekolo, C.E.; Loenhout, J.A. van; Rodriguez-Llanes, J.M.; Rumunu, J.; Ramadan, O.P.; Guha-Sapir, D.

    2016-01-01

    OBJECTIVE: To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. METHODS: The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South

  8. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014 : retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H|info:eu-repo/dai/nl/304824755; Tijdink, Joeri K; Otte, Willem M

    2015-01-01

    OBJECTIVE: To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. DESIGN: Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. METHODS: The yearly frequencies of positive, negative, and

  9. The Rejuvenation of Cartography in ICT Era

    Directory of Open Access Journals (Sweden)

    GUO Renzhong

    2017-10-01

    Full Text Available With the impetus of ICT, cartography faces the unprecedented challenges. The paper discusses the problems and changes of cartography facing the digital technology, analyzes the constraints of traditional cartography that are mainly delimited by 2D physical paper map. Diverseness of modern cartography shows various map products, and the paper illustrates the digital freedom in information space of modern cartography from eight aspects, including physical reality VS virtual reality, paper map VS digital map, superficial visualization VS inner visualization and so on. Modern cartography encounters the new development opportunities and fresh demands in digital era, and it's necessary to extend the framework of cartography and to assimilate newly sprouted things to promote the rejuvenation of cartography.

  10. Modern cosmology

    International Nuclear Information System (INIS)

    Zeldovich, Y.B.

    1983-01-01

    This paper fives a general review of modern cosmology. The following subjects are discussed: hot big bang and periodization of the evolution; Hubble expansion; the structure of the universe (pancake theory); baryon asymmetry; inflatory universe. (Auth.)

  11. Ecological recovery in ERA

    DEFF Research Database (Denmark)

    EFSA Scientific Committee (Scientific Committee); Topping, Christopher John

    2016-01-01

    knowledge and data retrieved from the literature. Finally, the information presented in this opinion was reviewed by experts from the relevant EFSA Panels, European risk assessment bodies and through an open consultation requesting input from stakeholders. A conceptual framework was developed to address...... recognises the importance of more integrated ERAs considering both the local and landscape scales, as well as the possible co-occurrence of multiple potential stressors that fall under the remit of EFSA, which are important when addressing ecological recovery. In this scientific opinion, the Scientific...... Committee gathered scientific knowledge on the potential for the recovery of non-target organisms for the further development of ERA. Current EFSA guidance documents and opinions were reviewed on how ecological recovery is addressed in ERA schemes. In addition, this scientific opinion is based on expert...

  12. Retrospective analysis of the recovery of orientation and memory during posttraumatic amnesia.

    Science.gov (United States)

    Roberts, Caroline M; Spitz, Gershon; Ponsford, Jennie L

    2015-07-01

    Prospective monitoring of posttraumatic amnesia (PTA) is recommended following moderate to severe traumatic brain injury (TBI). However, few studies have examined the typical order in which items recover on PTA scales. Different methods have been used to define recovery, and the order reported is not consistent across the literature. The purpose of this study was to improve understanding of the progression of PTA by reporting the duration to recovery of items and categories on the Westmead Post-Traumatic Amnesia Scale (WPTAS) according to different criteria. A retrospective analysis was conducted of 66 patients with TBI who were administered the WPTAS during hospital admission. The duration to recovery of items and categories was determined according to 3 criteria: first correct, correct 3 times in a row, and consistently correct. On the basis of the sample mean, date of birth (DOB), year, age, place, month, day, name, and memory for the 3 pictures recovered in this order according to all 3 criteria. However, the significance of differences between items and the order of recovery of categories depended on the criterion adopted. Although DOB recovered first in 74% of cases and the 3 pictures last in 63% of cases, there was a high degree of individual variability in the precise sequence of recovery. The traditional view of PTA recovering in the order of person, place, time, and memory does not adequately describe the profile of recovery on the WPTAS. Considering the recovery of individual items is necessary to understand and account for individuals differences in the order of recovery. (c) 2015 APA, all rights reserved).

  13. Self-expanding Y stents in the treatment of central airway stenosis: a retrospective analysis.

    Science.gov (United States)

    Gompelmann, Daniela; Eberhardt, Ralf; Schuhmann, Maren; Heussel, Claus P; Herth, Felix J F

    2013-10-01

    Central airway obstruction (CAO) is a life-threatening situation. Stent insertion re-establishes patency of the central airways. Self-expanding metallic Y stents have been available since 2005, widening the spectrum of interventional bronchoscopic techniques. Retrospective analysis of all patients treated for CAO with a self-expanding metallic Y stent at the Thoraxklinik Heidelberg between May 2005 and January 2009. A total of 43 patients aged 26-81 had a metallic Y stent inserted endoscopically for the treatment of CAO; 39 of these patients (90.7%) had CAO due to malignant disease, four patients (9.3%) due to benign disease. In all 43 patients, the Y stent was deployed without any complications. A longitudinal follow up was possible in 32 of the 43 patients. The stents remained in situ for an average of 107.1 days (range 1-640 days). In 29 patients with malignant CAO the stenosis was successfully overcome with a Y stent; 11 of these patients died within 6 weeks following stent insertion. On follow up the remaining 18 patients showed immediate improvement of dyspnoea. Eight out of the 18 patients (44.4%) tolerated the stent without problems, two (11.1%) required further stenting, six (33.3%) had complications such as increased secretions, cough, dyspnoea or granulation tissue formation. The stent was removed in one patient (5.6%) due to increased secretions, and in another (5.6%) as the stent was no longer required due to successful tumour-specific therapy. Placement of Y stents in symptomatic CAO allows for quick relief of symptoms. Severe complications are rare. Stent removal is possible after successful treatment of the primary tumour. However, the prognostic indicator for survival is the underlying malignancy.

  14. A retrospective analysis of endoscopic treatment outcomes in patients with postoperative bile leakage.

    Science.gov (United States)

    Sayar, Suleyman; Olmez, Sehmus; Avcioglu, Ufuk; Tenlik, Ilyas; Saritas, Bunyamin; Ozdil, Kamil; Altiparmak, Emin; Ozaslan, Ersan

    2016-01-01

    Bile leakage, while rare, can be a complication seen after cholecystectomy. It may also occur after hepatic or biliary surgical procedures. Etiology may be underlying pathology or surgical complication. Endoscopic retrograde cholangiopancreatography (ERCP) can play major role in diagnosis and treatment of bile leakage. Present study was a retrospective analysis of outcomes of ERCP procedure in patients with bile leakage. Patients who underwent ERCP for bile leakage after surgery between 2008 and 2012 were included in the study. Etiology, clinical and radiological characteristics, and endoscopic treatment outcomes were recorded and analyzed. Total of 31 patients (10 male, 21 female) were included in the study. ERCP was performed for bile leakage after cholecystectomy in 20 patients, after hydatid cyst operation in 10 patients, and after hepatic resection in 1 patient. Clinical signs and symptoms of bile leakage included abdominal pain, bile drainage from percutaneous drain, peritonitis, jaundice, and bilioma. Twelve (60%) patients were treated with endoscopic sphincterotomy (ES) and nasobiliary drainage (NBD) catheter, 7 patients (35%) were treated with ES and biliary stent (BS), and 1 patient (5%) was treated with ES alone. Treatment efficiency was 100% in bile leakage cases after cholecystectomy. Ten (32%) cases of hydatid cyst surgery had subsequent cystobiliary fistula. Of these patients, 7 were treated with ES and NBD, 2 were treated with ES and BS, and 1 patient (8%) with ES alone. Treatment was successful in 90% of these cases. ERCP is an effective method to diagnose and treat bile leakage. Endoscopic treatment of postoperative bile leakage should be individualized based on etiological and other factors, such as accompanying fistula.

  15. Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

    International Nuclear Information System (INIS)

    Vignali, Claudio; Bargellini, Irene; Lazzereschi, Michele; Cioni, Roberto; Petruzzi, Pasquale; Caramella, Davide; Pinto, Stefania; Napoli, Vinicio; Zampa, Virna; Bartolozzi, Carlo

    2005-01-01

    Purpose. To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting. Methods. From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22±12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter. Results. Comparing group A and B patients (χ 2 test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was ≥6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents). Conclusion. Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 15-20 mm

  16. Injuries in Collegiate Women’s Volleyball: A Four-Year Retrospective Analysis

    Science.gov (United States)

    Sole, Christopher J.; Kavanaugh, Ashley A.; Stone, Michael H.

    2017-01-01

    A four-year retrospective analysis of injury data was conducted on a collegiate (NCAA Division I) women’s volleyball team. Twenty athletes (Year 1: age = 19.4 ± 0.9 y, height = 175.2 ± 5.1 cm, body mass = 70.5 ± 10.2 kg; Year 2: age = 20.1 ± 1.0 y, height = 175.7 ± 4.7 cm, body mass = 69.5 ± 10.1 kg; Year 3: age = 20.1 ± 1.4 y, height = 173.8 ± 6.3 cm, body mass = 69.9 ± 10.8 kg; Year 4: age = 19.5 ± 1.4 y, height = 174.4 ± 8.6 cm, body mass = 72.7 ± 10.8 kg) participated in this study, accounting for 1483 total training exposures. Injury was defined as any damage to a body part, incurred during volleyball or strength and conditioning-related activities, which interfered with training and/or competition. Injury rate was normalized to the number of athletes and exposure and expressed as injuries per 1000 exposures. A total of 133 injuries were recorded. The most common injury was to the knee (left = 7.5%, right = 12.0%). Injuries occurred most often in volleyball practice (75.2%), followed by competition (20.3%), and strength and conditioning-related activities (4.5%). Non-contact injuries (upper body = 26.3%, lower body = 53.4%) were more common than contact injuries (upper-body = 13.5%, lower-body = 6.8%). An examination of injury rates relative to the training year revealed patterns in injury occurrence. Specifically, spikes in injury rate were consistently observed during periods of increased training volume that were preceded by breaks in organized training, such as the early pre-season and off-season training periods.

  17. Infectious complications in chronic lymphocytic leukemia- a retrospective analysis: single institution experience.

    Science.gov (United States)

    Demitrovicova, L; Mikuskova, E; Oravcova, I; Cingelova, S; Drgona, L; Mladosievicova, B

    2017-01-01

    The aim of this study was to evaluate the incidence of a variety of infectious complications in patients with CLL regarding the duration of CLL and the type of treatment. We present the retrospective analysis of patients with CLL treated at our institution in years 2004-2016. We collected data about the type of infection, pathogenes, treatment and severity of infections surpassed in connection with administration treatment. In the study one hundred and ten patients were evaluated. The average age of patients was 61.7 years (range 34.5-91.9 years). Fludarabine was the most widely used regimen, followed by bendamustine and alemtuzumab. We recorded 393 episodes of infections, of which 114 (29%) were severe and life threatening of degree 3-5, and 279 (71%) of degree 2. The most common infections were the upper respiratory tract infections together with sinusitis (45.03%), pneumonia (26.20%), CMV reactivation occured in 8.14%, infections of the skin was in 7.6 %. Most infections have occurred with the administration of monoclonal antibody alemtuzumab, these patients were at significantly higher risk of infection [RR 2.59 (1.30 to 5.17)] than patients receiving obinutuzumab [RR 0.63 (0.48 to 0.82)] (p = 0.0001). On the contrary, the safety profile of BCR signaling pathway inhibitors was very acceptable [RR 1.17 (0.70 - 1.96)]. The number of infections have decreased during the first 12 months of treatment with ibrutinib. In the study group we recorded 19 deaths, 8 (7.27%) of them were of infectious etiology. The risk of infectious complications is lifelong in patients with CLL, it can be minimized by early detection and aggressive management. Novel targeted agents used in therapy of CLL have a good safety profile, even the risk of infection is decreased during administration.

  18. Single Center Retrospective Analysis of Conventional and Radial TIG Catheters for Transradial Diagnostic Coronary Angiography.

    Science.gov (United States)

    Vorpahl, Marc; Koehler, Till; Foerst, Jason; Panagiotopoulos, Spyridon; Schleiting, Heinrich; Koss, Klaus; Ziegler, Gunda; Brinkmann, Hilmar; Seyfarth, Melchior; Tiroch, Klaus

    2015-01-01

    Current guidelines favor the radial approach for coronary angiography. Therefore, specialty radial diagnostic catheters were designed to engage both coronary arteries with a single device. However, it is unclear if single catheters are superior to conventional catheters. A retrospective analysis was performed of consecutive right radial coronary angiographies to determine catheter use, fluoroscopy time, radiation dosage, and consumption of contrast. Procedures were performed with a single TIG catheter or conventional catheters (CONV). Procedures with coronary artery bypass grafts or ventricular angiographies were excluded. 273 transradial procedures were performed successfully. 95 procedures were performed with CONV and 178 procedures with a TIG. Crossover to additional catheters was higher in TIG (15.2%) compared to CONV (5.3%, p = 0.02). Fluoroscopy time was comparable between CONV and TIG, without crossover (2.2 ± 1.2 min versus 2.3 ± 1.2 min; n.s.), however, greater in the case of crossover for CONV (5.8 ± 0.7) and TIG (7.6 ± 3.0; p = 0.0001). Radiation dosage was similar in CONV and the TIG, without crossover (1419 ± 1075, cGy∗cm(2) versus 1690 ± 1138; n.s.), however, greater for CONV (2374 ± 620) and TIG (3733 ± 2281, p = 0.05) with crossover. Overall, the amount of contrast was greater in TIG (56 ± 13 mL) versus CONV (48 ± 3 mL; p = 0.0003). CONV femoral catheters may be the primary choice for radial approach.

  19. Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population.

    Science.gov (United States)

    Mahajan, R; Chhabra, H S; Srivastava, A; Venkatesh, R; Kanagaraju, V; Kaul, R; Tandon, V; Nanda, A; Sangondimath, G; Patel, N

    2015-05-01

    This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS). Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay. Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013). Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.

  20. [Tics in children and adolescents: a retrospective analysis of 78 cases].

    Science.gov (United States)

    Catarina Prior, A; Tavares, S; Figueiroa, S; Temudo, T

    2007-02-01

    Tics are the most frequent abnormal movement in children. A familial history of tics and a personal and familial history of neurobehavioral disturbances are common in children with this abnormality. Tics may seriously compromise daily activities in affected individuals. To identify the characteristics of tics in children and adolescents followed-up in the Neuropediatric Unit of the Hospital Geral de Santo António. We performed a retrospective analysis of patients with tics based on information collected from medical records. The diagnostic criteria of the DSM IV-TR 2000 of the American Psychiatric Association were used. The medical records of 78 children were analyzed, 84.6 % of whom were boys. More than one third of the patients were aged 4 to 8 years old. In 5.1 % of the patients tics developed before the age of 2 years. A familial history of tics, depression and obsessive disorder traits was found in approximately 30 % of patients. The most frequent comorbidity was attention deficit hyperactivity disorder (67.9 %). The occurrence of pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection (PANDAS) was suggested in five patients. In all patients, motor tics occurred before vocal tics. In more than two thirds of the patients, tics were simple. In 59.0 % of the patients, tics were chronic, and in 45.7 % of these met the criteria for Tourette's syndrome. A total of 43.1 % of the patients with chronic tics received pharmacotherapy, risperidone being the most frequently used drug. In general the results of the present study are in agreement with those of previous studies, underlining the need to consider a diagnosis of tics in young children and highlighting the importance of identification and appropriate treatment of comorbidities.

  1. Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Ashley Branham, PharmD

    2010-01-01

    Full Text Available Objective: To determine if pharmacist-provided medication therapy management (MTM improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient’s prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR. Design: Retrospective analysis of medication adherence, pre-post comparison. Setting: Three independent pharmacies in North Carolina. Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR. Intervention: MTM services provided by community pharmacists. Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC and change in medication costs for patients and third party payers. Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8. Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43. However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08 following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR. Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.

  2. [Tracheobronchial stents: a retrospective analysis of indications, results and in particular complications].

    Science.gov (United States)

    Tonn, H; Mall, W; Schneider, K-D; Schönhofer, B

    2008-10-01

    Tracheobronchial stents are inserted mainly in cases of malignant and benign airway stenosis. Further indications are esophago-tracheal fistulas, mediastinal fistulas and tracheomalacia. A retrospective analysis was conducted on patients' records, information provided by the general practitioners and relatives of the patients from July 1993 to December 2006 in the Department of Pneumology of the Heidehaus Hospital Hannover (since 6/05 Department of Pneumology and Internal Intensive Care Medicine, Oststadt-Heidehaus Hospital). During the observation period of 13 years a total of 269 stents (177 permanent, 92 temporary) were implanted in 207 patients (1.3 stents per patient). The vast majority of patients (173/207) suffered from an underlying malignancy. About half of the stents were deployed in the trachea. The median length of placement was 116 days in patients with malignancies and 313 days in patients with benign diseases. In about 40 % of the patients notable complications were observed which were directly or indirectly associated with the stents. These findings show the importance of a critical indication for stent implantation. In benign diseases a stent can remain for years inside the tracheobronchial system, if it is well tolerated in the beginning. In malignant diseases the result depends decisively on the stage of the tumour: has the stent been implanted before any other tumour therapy is started or is it an end-stage tumor with no other therapeutic option? In general, complications of stents occur quite frequently. The analysis of stent data leads to some aspects for the prevention of stent-related complications. There should be a strict indication and appropriate choice of stent material. Nevertheless, there remains an ethical dilemma in patients with end-stage disease as to whether to implant a stent or to do nothing against the tumor, because the benefit immediately after stent insertion vanishes with progression of the tumour, so causing extra

  3. Retrospective analysis of necropsy reports suggestive of abuse in dogs and cats.

    Science.gov (United States)

    Almeida, Daniel C; Torres, Sheila M F; Wuenschmann, Arno

    2018-02-15

    OBJECTIVE To identify historical and necropsy findings suggestive of neglect or abuse of dogs and cats by retrospective analysis of necropsy reports from a veterinary diagnostic laboratory. DESIGN Retrospective cohort study. SAMPLE 119 necropsy reports of dogs and cats. PROCEDURES Necropsy reports from February 2001 to May 2012 were electronically searched to identify potential animal abuse or neglect cases. Cases were selected and categorized according to a previously proposed method for classification of animal abuse. Inclusion criteria included signs of neglect, nonaccidental injury (NAI; blunt-force or sharp-force trauma, gunshot, burns, drowning, asphyxiation, and suspicious intoxications), and sexual abuse. Poor preservation of cadavers, age abuse cases, determined on the basis of all necropsies performed in the study period, was 73 of 8,417 (0.87%) in dogs and 46 of 4,905 (0.94%) in cats. Neglect and NAI were commonly identified in cats; NAI was most commonly found in dogs. Gunshot and blunt-force trauma were the most common NAIs in dogs and cats, respectively. Pit bull-type dogs (29/73 [40%]) were overrepresented in several abuse categories. Most cats (29/46 [63%]) were domestic shorthair, but no breed association was found. Most (41/71 [58%]) affected animals with age data available were ≤ 2 years old. CONCLUSIONS AND CLINICAL RELEVANCE Approximately 1% of dogs and cats necropsied in the study period had signs suggestive of abuse. Medical findings alone are not necessarily indicative of abuse, but some findings can increase the index of suspicion.

  4. Predictors of sustained response to rivastigmine in patients with Alzheimer's disease: a retrospective analysis.

    Science.gov (United States)

    Sadowsky, Carl H; Grossberg, George T; Somogyi, Monique; Meng, Xiangyi

    2011-01-01

    The cholinesterase inhibitor rivastigmine is approved for the treatment of mild to moderate Alzheimer's disease. However, it is not possible to predict which individuals will benefit from treatment. This retrospective analysis of an international, 24-week, randomized, double-blind trial aimed to identify the percentage of persons with Alzheimer's disease who have a sustained response with rivastigmine patch, rivastigmine capsules, or placebo; to determine the magnitude of the sustained treatment response; and to investigate baseline patient characteristics predictive of the observed sustained response. Patients who improved on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL) at week 16 and maintained at least the week 16 improvement at week 24 were identified as sustained responders. Treatment differences and baseline predictive factors were assessed in patients demonstrating a 1-, 2-, 3-, 4-, or 5-point sustained improvement. The first patient was screened in November 2003 and the last patient completed the study in January 2006. More persons with Alzheimer's disease had sustained improvements on the ADAS-cog and ADCS-ADL with rivastigmine versus placebo. Sustained improvements of 4 or 5 points on the ADAS-cog or ADCS-ADL were demonstrated in the 9.5-mg/24-h rivastigmine patch (24% and 36% of patients, respectively) and 12-mg/d capsule groups (28% on both outcome measures). Factors predictive of a sustained response to treatment included baseline Mini-Mental State Examination, ADAS-cog, and ADCS-ADL scores and treatment, country of treatment, and time since first symptom was diagnosed by a physician. Understanding factors predictive of sustained cholinesterase inhibitor treatment response should help to optimize Alzheimer's disease management and encourage compliance by allowing more realistic expectations of treatment effects.

  5. Retrospective analysis of factors affecting the progression of Chronic Renal Failure in Adult Polycystic Kidney Disease

    International Nuclear Information System (INIS)

    Ahmed, E.R.; Tashkandi, Muhammed A.; Nahrir, S.; Maulana, A.

    2006-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is the commonest congenital cystic renal disease. Factors such as hypertension, urinary tract infection, hematuria and proteinuria may effect the progression to chronic renal failure in ADPKD patients. Therapeutic interventions, such as the use of angiotensin converting enzyme inhibitors (ACEI) or diet modification, may impact the natural progression of the disease. We aim in this study to review a registry of ADPKD patients in order to compare the slow and fast progressors and identify possible predictors of progression and interventions that slow the progression of this disease. Sheffield Kidney Institute (SKI), one of the largest kidney institutes in Northern Europe, has registered a large number of ADPKD patients since 1981. SKI's computer network contains a wide range of information on these patients. We selected 94 adult polycystic patients from the SKI for retrospective analysis of factors affecting progression to chronic renal failure. Patients who doubled their s. creatinine in 3 6 months were considered fast progressors (FP), while those who doubled their s. creatinine in > 36 months were regarded as slow progressors (SP). There 70 patients in the FP group and 24 patients in the SP group. A third group of 137 patients consisted of non-progressors (NP) who ha d stable s. creatinine levels during the same period. We found that the incidence of hypertension, UTI, macroscopic and microscopic hematuria, and overt proteinuria in the FP group was higher than in SP and NP groups. Modification of some factors, such as hypertension and UTI, may decrease the rate of the deterioration of renal function. (author)

  6. A retrospective analysis on the relationship between intraoperative hypothermia and postoperative ileus after laparoscopic colorectal surgery.

    Science.gov (United States)

    Choi, Ji-Won; Kim, Duk-Kyung; Kim, Jin-Kyoung; Lee, Eun-Jee; Kim, Jea-Youn

    2018-01-01

    Postoperative ileus (POI) is an important factor prolonging the length of hospital stay following colorectal surgery. We retrospectively explored whether there is a clinically relevant association between intraoperative hypothermia and POI in patients who underwent laparoscopic colorectal surgery for malignancy within the setting of an enhanced recovery after surgery (ERAS) program between April 2016 and January 2017 at our institution. In total, 637 patients were analyzed, of whom 122 (19.2%) developed clinically and radiologically diagnosed POI. Overall, 530 (83.2%) patients experienced intraoperative hypothermia. Although the mean lowest core temperature was lower in patients with POI than those without POI (35.3 ± 0.5°C vs. 35.5 ± 0.5°C, P = 0.004), the independence of intraoperative hypothermia was not confirmed based on multivariate logistic regression analysis. In addition to three variables (high age-adjusted Charlson comorbidity index score, long duration of surgery, high maximum pain score during the first 3 days postoperatively), cumulative dose of rescue opioids used during the first 3 days postoperatively was identified as an independent risk factor of POI (odds ratio = 1.027 for each 1-morphine equivalent [mg] increase, 95% confidence interval = 1.014-1.040, P POI within an ERAS pathway, in which items other than thermal measures might offset its negative impact on POI. However, as it was associated with delayed discharge from the hospital, intraoperative maintenance of normothermia is still needed.

  7. LIBRARIES, SCHOOLS AND MODERN AGE

    Directory of Open Access Journals (Sweden)

    Borjanka Trajković

    2016-04-01

    Full Text Available For centuries the role of the library was defined as a warehouse of books. Now, in the 21st century, the library is facing perhaps the biggest challenge – its physical survival. The role of librarians is re-branded to reflect their expertise as curators of content and reliable navigators in an evergrowing ocean of information - in any format they might exist. The future libraries shall be open to all the new ideas on how to work better and accept the new technologies. On the one hand, they must recognize the need to change their methods, but on the other hand - to preserve the continuity of their objectives and mission. The new era requires modern models of learning and the attractiveness of the curricula, that is, a modern education system that shall adapt the curricula to the needs of modern society and reconcile centuries of man's need for knowledge, reading books and education in general with the new technologies.

  8. ERA: Adverse Consequences

    Science.gov (United States)

    Martin, Brian

    2011-01-01

    Excellence in Research for Australia has a number of limitations: inputs are counted as outputs, time is wasted, disciplinary research is favoured and public engagement is discouraged. Most importantly, by focusing on measurement and emphasising competition, ERA may actually undermine the cooperation and intrinsic motivation that underpin research…

  9. Energy: a new era

    International Nuclear Information System (INIS)

    Moore, Curtis.

    1995-01-01

    The world appears on the verge of a new era of advanced technologies and new fuels. Although such a transformation is unlikely to take place overnight, change is clearly coming. The question is how much and how fast: Will energy transition amount to a technological revolution, or merely an evolution? A detailed evaluation of the various aspects is given. (author). 23 refs

  10. Pengaruh Tipografi pada Era Massimo Vignelli terhadap Tipografi Michael Bierut

    Directory of Open Access Journals (Sweden)

    Irwan Harnoko

    2011-10-01

    Full Text Available Massimo Vignelli is a senior graphic designer lived in New York, as a vocal modernism against post-modernism. His statement firmly opposing post-modernism in several occasions: interview in Helvetica the movie, typeradio, talkshow, and some articles in Looking Closer or AIGA Journal. Graphic design works of Massimo Vignelli reflected his characteristic, which is firmly choosing typeface. Typefaces of Vignelly are around 5 typefaces: Bodoni, Helvetica, Times Roman, Century, and Futura. The article uses formal analysis method. The writers collected materials about Michael Bierut, Massimo VIgnelli and Tibor Kalman from books and websites. The writers compare the typeface opinion of Massimo Vignelli (modernism designer, Michael Bierut designer (transition era designer from modernism to post-modernism, and Tibor Kalman (a designer in A Century of Graphic Design, as the influencer of Bierut’s betrayal over Vignelli. 

  11. Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis

    DEFF Research Database (Denmark)

    Runström, B; Hallböök, O; Nyström, P O

    2013-01-01

    AIM: To study factors that influenced healing and survival after attempted closure of enterocutaneous fistula. MATERIAL AND METHODS: Retrospective analysis of prospective data concerning 101 patients operated on 132 instances for 110 enterocutaneous fistulae at two hospitals. RESULTS: In all, 96 ...... is a negative factor that requires careful planning of the operation.......AIM: To study factors that influenced healing and survival after attempted closure of enterocutaneous fistula. MATERIAL AND METHODS: Retrospective analysis of prospective data concerning 101 patients operated on 132 instances for 110 enterocutaneous fistulae at two hospitals. RESULTS: In all, 96...... (87%) of the 110 fistulae healed and 92 (91%) patients survived. A total of 9 patients with unhealed fistula died. Multivariate analysis revealed jaundice as an independent factor for both death and failed closure and operation without anastomosis as an independent positive factor for healing. Failure...

  12. Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis.

    Science.gov (United States)

    Shearer, Freya M; Moyes, Catherine L; Pigott, David M; Brady, Oliver J; Marinho, Fatima; Deshpande, Aniruddha; Longbottom, Joshua; Browne, Annie J; Kraemer, Moritz U G; O'Reilly, Kathleen M; Hombach, Joachim; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S; Hay, Simon I; Golding, Nick; Reiner, Robert C

    2017-11-01

    Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. The Rhodes Trust, Bill & Melinda Gates Foundation, the

  13. A retrospective analysis of ethics knowledge in physical therapy (1970-2000).

    Science.gov (United States)

    Swisher, Laura Lee

    2002-07-01

    between clinical and ethical decision making, and the changing relationship with patients. Although knowledge of ethics grew steadily between 1970 and 2000, this retrospective analysis identified gaps in our current knowledge. Further research is needed to address the unique ethical problems commonly encountered in all 5 roles of the physical therapist; patient perspectives on ethical issues in physical therapy; variety in ethical approaches; factors affecting moral judgment, sensitivity, motivation, and courage; and cultural dimensions of ethical practice in physical therapy.

  14. [Lung abscess and thoracic empyema: retrospective analysis in an internal medicine department].

    Science.gov (United States)

    Monteiro, Rita; Alfaro, Tiago M; Correia, Lurdes; Simão, Adélia; Carvalho, Armando; Costa, J Nascimento

    2011-12-01

    Lung abscess is a collection of necrotic and suppurated tissue located at the pulmonary parenchyma. Empyema is defined as the presence of pus in the pleural space. To study the clinical and microbiological characteristics, treatment and prognosis of patients with lung abscess and/or empyema admitted to an Internal Medicine ward. A retrospective analysis of medical records was performed, including all patients admitted to an Internal Medicine ward for lung abscess or empyema, between 2000 and 2008. Thirty patients were included (22 males/ eight females), accounting for 0.18% of all patients admitted in this ward in the same period. Three patients had pulmonary abscess, 18 empyema, and nine both diseases. The average age was 68.5 years (31 to 90). The most frequent complaints were dyspnoea (90%), fever (73.3%), cough (66.7%), weight loss (60%) and chest pain (53.3%). The most frequent associated disorders were stroke associated disability (46.7%), heart failure (43.3%) and arterial hypertension (33.3%). Thoracentesis was performed in all patients with empyema. In one patient with lung abscess an anaerobic microorganism was identified. In patients with empyema, cultures were positive in 61.1% of cases, with a slight predominance of methicillin-resistant Staphylococcus aureus (27.3%) and Prevotella intermedia (18.2%). In patients with both abscess and empyema, cultures of the abscess were positive in 44.4% and of the pleural fluid in 33.3%, with no predominant microorganism. Empiric antimicrobial therapy was started in all patients and later adapted to the antibiotic sensitivity test results. Surgery was performed in three patients. Seven patients (23.3%) died during admission. The average age of the patients who died was 81.3 years and of those who survived was 64.5 years. Lung abscess and empyema are infrequent diseases in an Internal Medicine ward, affect mostly males and have unspecific clinical manifestations. The chest X-ray, computed tomography (CT) and

  15. Age trends in 30 day hospital readmissions: US national retrospective analysis

    Science.gov (United States)

    Berry, Jay G; Gay, James C; Joynt Maddox, Karen; Coleman, Eric A; Bucholz, Emily M; O’Neill, Margaret R; Blaine, Kevin; Hall, Matthew

    2018-01-01

    Abstract Objective To assess trends in and risk factors for readmission to hospital across the age continuum. Design Retrospective analysis. Setting and participants 31 729 762 index hospital admissions for all conditions in 2013 from the US Agency for Healthcare Research and Quality Nationwide Readmissions Database. Main outcome measure 30 day, all cause, unplanned hospital readmissions. Odds of readmission were compared by patients’ age in one year epochs with logistic regression, accounting for sex, payer, length of stay, discharge disposition, number of chronic conditions, reason for and severity of admission, and data clustering by hospital. The middle (45 years) of the age range (0-90+ years) was selected as the age reference group. Results The 30 day unplanned readmission rate following all US index admissions was 11.6% (n=3 678 018). Referenced by patients aged 45 years, the adjusted odds ratio for readmission increased between ages 16 and 20 years (from 0.70 (95% confidence interval 0.68 to 0.71) to 1.04 (1.02 to 1.06)), remained elevated between ages 21 and 44 years (range 1.02 (1.00 to 1.03) to 1.12 (1.10 to 1.14)), steadily decreased between ages 46 and 64 years (range 1.02 (1.00 to 1.04) to 0.91 (0.90 to 0.93)), and decreased abruptly at age 65 years (0.78 (0.77 to 0.79)), after which the odds remained relatively constant with advancing age. Across all ages, multiple chronic conditions were associated with the highest adjusted odds of readmission (for example, 3.67 (3.64 to 3.69) for six or more versus no chronic conditions). Among children, young adults, and middle aged adults, mental health was one of the most common reasons for index admissions that had high adjusted readmission rates (≥75th centile). Conclusions The likelihood of readmission was elevated for children transitioning to adulthood, children and younger adults with mental health disorders, and patients of all ages with multiple chronic conditions. Further attention to the

  16. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

    Energy Technology Data Exchange (ETDEWEB)

    Schlampp, Ingmar; Rieken, Stefan; Habermehl, Daniel; Foerster, Robert; Debus, Juergen; Rief, Harald [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-09-15

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.) [German] Die retrospektive Analyse untersuchte osteolytische Knochenmetastasen von Patienten mit Mammakarzinom der thorakalen und lumbalen Wirbelsaeule nach Radiotherapie (RT) hinsichtlich Stabilitaet anhand eines validierten Scores. Die Stabilitaet von 157 osteolytischen Metastasen bei 115 Patienten mit Brustkrebs, behandelt von Januar 2000 bis Januar 2012, wurde retrospektiv anhand des Taneichi-Scores evaluiert. Prognostische Faktoren bezueglich Stabilitaet und Ueberlebensraten wurden analysiert. Vor RT wurden 85 Laesionen (54 %) als instabil gewertet. Nach 3 und 6 Monaten wurden 109 (70 %) und 124 (79 %) Laesionen als stabil klassifiziert. Vor RT wurden 30 Frakturen gefunden, nach RT zeigten sich 7 weitere (4,5 %) pathologische Frakturen. Kein prognostischer

  17. Detecting medication errors in the New Zealand pharmacovigilance database: a retrospective analysis.

    Science.gov (United States)

    Kunac, Desireé L; Tatley, Michael V

    2011-01-01

    Despite the traditional focus being adverse drug reactions (ADRs), pharmacovigilance centres have recently been identified as a potentially rich and important source of medication error data. To identify medication errors in the New Zealand Pharmacovigilance database (Centre for Adverse Reactions Monitoring [CARM]), and to describe the frequency and characteristics of these events. A retrospective analysis of the CARM pharmacovigilance database operated by the New Zealand Pharmacovigilance Centre was undertaken for the year 1 January-31 December 2007. All reports, excluding those relating to vaccines, clinical trials and pharmaceutical company reports, underwent a preventability assessment using predetermined criteria. Those events deemed preventable were subsequently classified to identify the degree of patient harm, type of error, stage of medication use process where the error occurred and origin of the error. A total of 1412 reports met the inclusion criteria and were reviewed, of which 4.3% (61/1412) were deemed preventable. Not all errors resulted in patient harm: 29.5% (18/61) were 'no harm' errors but 65.5% (40/61) of errors were deemed to have been associated with some degree of patient harm (preventable adverse drug events [ADEs]). For 5.0% (3/61) of events, the degree of patient harm was unable to be determined as the patient outcome was unknown. The majority of preventable ADEs (62.5% [25/40]) occurred in adults aged 65 years and older. The medication classes most involved in preventable ADEs were antibacterials for systemic use and anti-inflammatory agents, with gastrointestinal and respiratory system disorders the most common adverse events reported. For both preventable ADEs and 'no harm' events, most errors were incorrect dose and drug therapy monitoring problems consisting of failures in detection of significant drug interactions, past allergies or lack of necessary clinical monitoring. Preventable events were mostly related to the prescribing and

  18. A retrospective analysis of the clinicopathological and molecular characteristics of pulmonary blastoma

    Directory of Open Access Journals (Sweden)

    Zhao YY

    2016-11-01

    Full Text Available Yuan-Yuan Zhao,1,* Lin Liu,1,2,* Ting Zhou,1,* Ning-Ning Zhou,1 Yun-Peng Yang,1 Xue Hou,1 Yong Li,3 Hong-Yun Zhao,1 Yan Huang,1 Li Zhang1 1Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 2Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, 3Department of Pathology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China *These authors contributed equally to this work Purpose: The aim of this study was to analyze and summarize the clinicopathological and molecular characteristics of classic biphasic pulmonary blastoma (PB to improve its diagnosis and treatment. Patients and methods: A retrospective analysis was performed in patients who were diagnosed with PB at Sun Yat-Sen University Cancer Center from March 1995 to March 2015. Genomic DNA was profiled using a capture-based targeted sequencing panel. Results: Sixteen patients with an average age of 40 years were included in this study. Accurate preoperative diagnosis was very challenging as surgically resected tissues with immunohistochemical staining were required for the diagnosis. Surgery was the optimal treatment for localized disease and there was no standard management for metastatic disease. Mutations were detected among 9 out of the 56 genes profiled, including BRCA2, ERBB4, ALK, MET, BRAF, RAF1, PTEN, EGFR, and PIK3CA. Conclusion: Due to the low incidence rate and the reclassification of PB, no standard treatment is available. Although the numbers of cases are few with varying individual experiences, it is important to improve our understanding regarding this rare lung cancer. Targeted DNA sequencing may be of clinical use for molecular testing and the effects of targeted

  19. A retrospective analysis of the change in anti-malarial treatment policy: Peru

    Directory of Open Access Journals (Sweden)

    Vincent-Mark Arlene

    2009-04-01

    Full Text Available Abstract Background National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. Objectives To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru. Methods Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents, a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. Results The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b engaging in collaborative teamwork among nationals and between nationals and international collaborators, c respect for and inclusion of district-level staff in all phases of the process, d reliance on high levels of technical and scientific knowledge, e use of standardized protocols to collect data, and f transparency. Conclusion Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the

  20. THE RISKS OF DEVIANT BEHAVIOR ADOLESCENCE: EXPERIENCE IN A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Aminat Danjalovna Vislova

    2015-10-01

    Full Text Available The problem of the risks of drug abuse as a form of deviant behavior in the context of adolescence. In this study deviant behavior appears as actions (or willingness to commit them, contrary to the generally accepted cultural and moral values, as well as socio-psychological and legal norms, including the abuse of alcohol, drugs and other psychoactive substances Study prerequisites for the formation of drug addiction in adolescence age allows us to trace the link between awareness about drugs and those at risk of developing dependence on them, which are due to the age and psychological characteristics described L.S. Vygotsky and other scientists working in the paradigm of cultural-historical psychology. The article hypothesized that narcogene information can act as a factor of risk of drug use. It is argued that the basis of the commission of a narcotic substance samples is narcogene information and control over the sources that may contribute to the prevention of mass anesthesia teenagers. This assertion is supported by the results of a retrospective study of social and psychological factors in the emergence of drug abuse conducted in the Kabardino-Balkaria republic dispensary, which was attended by 24 active addict aged 18-28 who are registered with the method of questioning.Purpose. To study the role of information on drugs and drug addiction in the range of solutions «for» or «against» in a situation narcogene risk.Methodology. Questioning of active drug abusers.Results. Based on a retrospective analysis of risk factors for drug abuse as a form of deviant behavior found that narcogene information may lead to introduction to drugs. Lack of knowledge about the effects of drugs on the human body, and the temptation to create a stable, creates a high risk on narcotics debut. Drug use leads to a decrease of expression of fear and inadequate assessment of the degree of its danger. It creates a false impression that the drug is easy to give

  1. Percutaneous cryoablation of prostate cancer guided by rectal ultrasound: a retrospectively analysis of 42 cases

    International Nuclear Information System (INIS)

    Xing Wenge; Guo Zhi; Wang Haitao; Liu Fang; Li Baoguo; Yu Haipeng; Li Yong

    2008-01-01

    Objective: To evaluate the effectiveness and safety of rectal ultrasound-guided agon-hilium percutaneous cryoablation in treatment of patients with median and or late-stage prostate cancer patients. Methods: Retrospectively analysis of 42 cases of with stage C and D prostate cancer patients treated by rectal ultrasound-guided argon-hilium percutaneous cryoablation during the follow-up of 1-12 months. The prostate specific antigen (PSA), biochemical progression-free survival (bPFS), PSA objective response, transrectal ultrasound of the prostate (TRUS), TRUS-guided biopsy of the prostate, the maximum urinary flow rate(MFR), MRI examination at before, and 3,6,12 months after cryoablation were recorded and evaluated. The results were statistically evaluated by using variance analysis. Results: The PSA value at before and 3,6, 12 months after cryoablation were (4.48±1.35), (3.54±1.67), (3.18±1.76), (2.87±1.89) μg/L, respectively; TRUS-measured prostate volumes at before and 3, 6,12 months after cryoablation were (59.7± 8.2), (46.9±8.3), (26.2±3.9), (25.9±3.7) mm 3 , respectively; MFR before and 3, 6,12 months after cryoablation were (10.4±0.8), (14.3±1.2), (18.3±1.3), (18.9±1.3) ml/s, respectively; Compared with before cryoablation, the differences between before and after cryoablation was statistically significant (F= 53.93,747.92,3843.03, respectively, P<0.01). The bPFS rates in 3 months,6 months and 12 months were 95.2% (40/42), 95.2% (40/42), and 90.5% (38/42), respectively. According to the PSA response, the total effective rate (CR 16 cases, PR 15 cases) at 12 months was 73.8%, and SD was 16.7% (7/42), PD was 9.5% (4/42). Complications included temporary incontinence 2.4% (1/42), Penile tingling/numbness 2.4% (1/42), pelvic pain 4.9% (2/41) and Scrotum Edema 2.4% (1/42). There was no case with severe complications such as severe infection or urethrorectal fistula, etc. Conclusions: Rectal ultrasound-guided agon-hilium percutaneous cryoablation showed

  2. Retrospective analysis of cystic craniopharyngeomas after intracavital irradiation with yttrium-90 colloid

    International Nuclear Information System (INIS)

    Urbanova, E.; Vizda, J.; Netikova, M.; Kafka, P.; Jakubec, J.

    2002-01-01

    Aim: The authors report about follow up the patients after intracavitary irradiation for cystic craniopharyngeoma. Material and Methods: For retrospective analysis 15 patients were selected. The volume of the cyst was determined by CT or MRI. For dosimetry Backlund's formula was used. The cumulative dose to the inner surface of the cyst wall was about 250Gy. 90 Yttrium silicate colloid was administered directly during stereotactically (CT guided) surgery or through the Ommaya drainage system. Control scintigraphy was performed 2-3 hours after 90 Y injection with gamma camera to detect possible leakage of the radioisotope. None of our patients showed evidence of this. In addition to this, the patients were checked daily to pay attention to visual function, neurological condition and possible meningeal irritation. Results: Cyst shrinkage was monitored by repeated CT examinations. CT cyst volume measurement analysed all patients before and 1,2,3 and 5 years after the treatment. In our study 45% of cysts decreased in volume during 4 month, shrinkage of the initial cyst volume was 75% after 1 year. The cyst disappeared nearly totally in 5 patients. Only 3 cyst remain unchanged and 90 Y treatment was repeated. No patients developed a visual field defect or evidence of hypothalamic dysfunction after the treatment. The neuro-opthalmological state completely recovered in 2 patients and improved in 5 patients. The prognosis was good only when an intact optic discs in time of the treatment was present. In some cases the radioisotope was implanted at a late stage of the disease without the opthalmological and neurological improvement. One patient died due to pulmonary embolism one week after the procedure. One patient died within a one year of the treatment from complications related to a solid cystic recurrence. One of typical signs for recurrence was worsening of neuro-opthalmological state. Conclusion: From our results this intracavitary 90 Y therapy is minimally invasive

  3. Biobanks in the Era of Digital Medicine.

    Science.gov (United States)

    Jacobs, Gunnar; Wolf, Andreas; Krawczak, Michael; Lieb, Wolfgang

    2018-05-01

    Digitalization is currently permeating virtually all sectors of modern societies, including biomedical research and medical care. At the same time, biobanks engaged in the long-term storage of biological samples that are fit for purpose have become key drivers in both fields. The present article highlights some of the challenges and opportunities that biobanking is facing in the current proverbial "era of digitalization." © 2017 The Authors Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

  4. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014 : retrospective analysis

    OpenAIRE

    Vinkers, Christiaan H; Tijdink, Joeri K; Otte, Willem M

    2015-01-01

    OBJECTIVE: To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. DESIGN: Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. METHODS: The yearly frequencies of positive, negative, and neutral words (25 preselected words in each category), plus 100 randomly selected words were normalised for the total number of abstracts. Subanalyses included pattern quantification of individual wo...

  5. Italian Modernities

    DEFF Research Database (Denmark)

    Thomassen, Bjørn; Forlenza, Rosario

    assumptions that have substituted for thought and that have perpetuated prejudices both within and outside Italy’s borders. Grounded in meticulous historical and ethnological research, Italian Modernities deserves as wide an audience as its scholarship is deep.” (Michael Herzfeld, Ernest E. Monrad Professor...

  6. Montreal Modern

    DEFF Research Database (Denmark)

    Handberg, Kristian

    2015-01-01

    , and the space age modernism of the 1960s following the Expo 67 and Quebec’s Quiet Revolution. This is reflected in the city’s thriving retro culture through the study of two groups of retro shops. In circulating specific memories and objects in a specific context, retro is an important negotiation of the past...

  7. Intracranial meningiomas in the present era of modern neuroimaging

    African Journals Online (AJOL)

    Background: Intracranial meningioma is the most common primary, intracranial, extra-axial neoplasm. It is mesenchymal in origin and arises from meningothelial cells of arachnoid villi of meninges. Objectives: To re-emphasize the regional anatomic localisation and diagnostic radiological features of intracranial ...

  8. Dermatopathology education in the era of modern technology.

    Science.gov (United States)

    Shahriari, Neda; Grant-Kels, Jane; Murphy, Michael J

    2017-09-01

    Continuing technological advances are inevitably impacting the study and practice of dermatopathology (DP). We are seeing the transition from glass slide microscopy to virtual microscopy, which is serving both as an accessible educational medium for medical students, residents and fellows in the form of online databases and atlases, as well as a research tool to better inform us regarding the development of visual diagnostic expertise. Expansion in mobile technology is simplifying slide image attainment and providing greater opportunities for phone- and tablet-based microscopy, including teledermatopathology instruction and consultation in resource-poor areas with lack of specialists. Easily accessible mobile and computer-based applications ("apps"), including myDermPath and Clearpath, are providing an interactive medium for DP instruction. The Internet and social networking sites are enabling rapid global communication of DP information and image-sharing, promoting collaborative diagnostic research and scholastic endeavors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Organizations as professional communities in the post/modern era.

    NARCIS (Netherlands)

    drs. ing. Adriaan Oosterloo

    2011-01-01

    What is the meaning of social context for the connection between Psychologists and Social Workers with the organization they work for? Many professionals are searching for both professional space, and a fitting connectedness to the organization. This connection seems to be greatly influenced by

  10. The Digital Era: Challenges for the Modern Mind

    Directory of Open Access Journals (Sweden)

    Merlin Donald

    2014-05-01

    Full Text Available The digital media are the new interface between mind and world. They enable us to gain instant access to an infinitely expandable collective memory system. This is an indispensable breakthrough, but has the potential to seriously violate the ancient co-evolutionary pact between brain and culture which has kept the rate of cultural and technological change within tolerable limits. Traditional cultures, with all their flaws, stayed well within the adaptive capacities of the individual brain. However, the recent explosion of digital culture has placed all forms of traditional culture under serious challenge. The principal challenge is a cognitive one: the economic system is increasingly tethered to a machine-driven agenda that either ignores or downgrades the most basic needs of the human mind. The result is a governance system that is out of control, in which success depends upon fitting the individual mind to a largely machine-driven agenda, rather than vice versa. Three especially serious concerns stand out: (1 how to maintain the autonomy of the individual mind in the context of massive and sophisticated external programming; (2 how to construct networks of trust in an environment of anonymity and manipulation; and (3 how to place the most basic needs of the human mind at the top of our list of governance priorities.

  11. Prostatic abscess: Diagnosis and management in the modern antibiotic era

    Directory of Open Access Journals (Sweden)

    Punit Tiwari

    2011-01-01

    Full Text Available This retrospective study was aimed at analyzing the clinical findings and thera-peutic strategies in 24 patients who were admitted with prostatic abscess, during the period from 1999 to 2008. The diagnosis of prostatic abscesses was made clinically by digital rectal palpation based on the presence of positive fluctuation with tenderness. All cases were confirmed by trans-rectal ultrasound (TRUS, and only positive cases were included in this study. The diagnostic work-up included analysis of midstream urine and abscess fluid culture for pathogens. Therapeutic options included endoscopic trans-urethral incision or trans-perineal aspiration under ultrasound guidance, or conservative therapy. Of the 24 patients studied, 45.83% of the cases had a pre-di-posing factor, and diabetes mellitus (37.50% was the most common. Digital rectal palpation re-vealed fluctuation in 70.83% of the cases. Trans-abdominal ultrasonography missed the condition in 29.16% of the cases. On TRUS, all the study patients showed hypo-echoic zones, while nine others showed internal septations. In most of the cases, the lesion was peripheral. A causative pathogen could be identified in 70.83% of the cases. Surgical drainage of the abscess by trans-urethral deroofing was performed in 17 cases (including one with failed aspiration, trans-perineal aspiration under TRUS guidance was performed in three cases and conservative therapy was followed in five cases. Our data confirms the importance of predisposing factors in the patho-genesis of prostatic abscess. In most of the cases, the clue to diagnosis is obtained by digital rectal palpation. TRUS gives the definite diagnosis and also helps in follow-up of patients. Trans-urethral deroofing is the ideal therapy where the abscess cavity is more than 1 cm, although in some selected cases, TRUS-guided aspiration or conservative therapy does have a role in treatment.

  12. Metastatic prostate cancer in the modern era of PSA screening

    Directory of Open Access Journals (Sweden)

    Philip A. Fontenot Jr

    Full Text Available ABSTRACT Introduction To characterize initial presentation and PSA screening status in a contemporary cohort of men treated for metastatic prostate cancer at our institution. Materials and methods We reviewed records of 160 men treated for metastatic prostate cancer between 2008-2014 and assessed initial presentation, categorizing patients into four groups. Groups 1 and 2 presented with localized disease and received treatment. These men suffered biochemical recurrence late (>1 year or earlier (<1 year, respectively, and developed metastases. Groups 3 and 4 had asymptomatic and symptomatic metastases at the outset of their diagnosis. Patients with a first PSA at age 55 or younger were considered to have guideline-directed screening. Results Complete records were available on 157 men for initial presentation and 155 men for PSA screening. Groups 1, 2, 3 and 4 included 27 (17%, 7 (5%, 69 (44% and 54 (34% patients, respectively. Twenty (13% patients received guideline-directed PSA screening, 5/155 (3% patients presented with metastases prior to age 55 with their first PSA, and 130/155 (84% had their first PSA after age 55, of which 122/130 (94% had metastasis at the time of diagnosis. Conclusion Despite widespread screening, most men treated for metastatic prostate cancer at our institution presented with metastases rather than progressed after definitive treatment. Furthermore, 25 (16% patients received guideline-directed PSA screening at or before age 55. These data highlight that, despite mass screening efforts, patients treated for incurable disease at our institution may not have been a result of a failed screening test, but a failure to be screened.

  13. Metastatic prostate cancer in the modern era of PSA screening

    Science.gov (United States)

    Fontenot, Philip A.; Nehra, Avinash; Parker, William; Wyre, Hadley; Mirza, Moben; Duchene, David A.; Holzbeierlein, Jeffrey; Thrasher, James Brantley; Veldhuizen, Peter Van; Lee, Eugene K.

    2017-01-01

    ABSTRACT Introduction To characterize initial presentation and PSA screening status in a contemporary cohort of men treated for metastatic prostate cancer at our institution. Materials and methods We reviewed records of 160 men treated for metastatic prostate cancer between 2008-2014 and assessed initial presentation, categorizing patients into four groups. Groups 1 and 2 presented with localized disease and received treatment. These men suffered biochemical recurrence late (>1 year) or earlier (<1 year), respectively, and developed metastases. Groups 3 and 4 had asymptomatic and symptomatic metastases at the outset of their diagnosis. Patients with a first PSA at age 55 or younger were considered to have guideline-directed screening. Results Complete records were available on 157 men for initial presentation and 155 men for PSA screening. Groups 1, 2, 3 and 4 included 27 (17%), 7 (5%), 69 (44%) and 54 (34%) patients, respectively. Twenty (13%) patients received guideline-directed PSA screening, 5/155 (3%) patients presented with metastases prior to age 55 with their first PSA, and 130/155 (84%) had their first PSA after age 55, of which 122/130 (94%) had metastasis at the time of diagnosis. Conclusion Despite widespread screening, most men treated for metastatic prostate cancer at our institution presented with metastases rather than progressed after definitive treatment. Furthermore, 25 (16%) patients received guideline-directed PSA screening at or before age 55. These data highlight that, despite mass screening efforts, patients treated for incurable disease at our institution may not have been a result of a failed screening test, but a failure to be screened. PMID:28338310

  14. Outcomes of endovascular aortic repair in the modern era

    DEFF Research Database (Denmark)

    Budtz-Lilly, Jacob; Wanhainen, Anders; Mani, Kevin

    2018-01-01

    Monitoring outcomes following endovascular aortic repair (EVAR) is critical. Although evidence from randomized controlled trials has solidified the role of EVAR, the analysis of outcomes and "real-world" data has uncovered limitations, improved the selection of appropriate patients, and underscored...... the importance of instructions for use. Subsequent studies demonstrated the learning curve of EVAR and gradual improvement of outcomes over time. Outcomes analyses will continue to play an important role, particularly as technological growth of endovascular therapy has enabled treatment of more complex aneurysm...... pathologies and patients. The important analyses are herein reviewed, following the development of EVAR in the treatment of intact abdominal aortic aneurysms (AAA) to ruptured AAAs, and finally to complex aneurysms, including thoracoabdominal aortic aneurysms and mycotic aneurysms. This includes an overview...

  15. The Efficacy of Urban Insurgency in the Modern Era

    Science.gov (United States)

    2002-05-31

    name Tupac Amaru UDR Ulster Defense Regiment (Northern Ireland) UN United Nations US United States of America WWI World War I WWII World War II 1 CHAPTER...Tupamoros) urban insurgency campaign that was conducted in Montevideo, Uruguay, from 1963 to 1972. It took its popular name, Tupamoros, from an Incan, Tupac ...moniker, the Tupamoros, came from an Incan, Tupac Amaru, who was burned at the stake after leading an unsuccessful revolt against Spanish colonial rule

  16. ERA's Ranger uranium mine

    International Nuclear Information System (INIS)

    Davies, W.

    1997-01-01

    Energy Resource of Australia (ERA) is a public company with 68% of its shares owned by the Australian company North Limited. It is currently operating one major production centre - Ranger Mine which is 260 kilometres east of Darwin, extracting and selling uranium from the Ranger Mine in the Northern Territory to nuclear electricity utilities in Japan, South Korea, Europe and North America. The first drum of uranium oxide from Ranger was drummed in August 1981 and operations have continued since that time. ERA is also in the process of working towards obtaining approvals for the development of a second mine - Jabiluka which is located 20 kilometres north of Ranger. The leases of Ranger and Jabiluka adjoin. The Minister for the Environment has advised the Minister for Resources and Energy that there does not appear to be any environmental issue which would prevent the preferred Jabiluka proposal from proceeding. Consent for the development of ERA's preferred option for the development of Jabiluka is being sought from the Aboriginal Traditional Owners. Ranger is currently the third largest producing uranium mine in the world producing 4,237 tonnes of U 3 O 8 in the year to June 1997

  17. Retrospective analysis of icotinib neoadjuvant therapy of 63 lung cancer patients.

    Science.gov (United States)

    Wang, T; Liu, Y; Zhou, B; Hao, S; Wang, Z; Liang, N; Liu, J; Wang, S

    2017-01-01

    This study aims to explore the feasibility of icotinib neoadjuvant therapy for nonsmall cell lung cancer (NSCLC). This was a retrospective analysis of the clinical data for 63 NSCLC patients (61 cases of adenocarcinoma and two cases of squamous cell carcinoma) receiving surgical resection of lung lesions after oral intake of icotinib from December 2011 to November 2013 in the PLA General Hospital. Preoperative oral intake of the patients was icotinib 125 mg tid, drug side effects were evaluated according to the American National Cancer Institute Common Toxicity Criteria Version 4.0; computed tomography scan was done on the day taking medicine and 2 weeks later to determine tumor changes. After oral intake of Icotinib for 2 to 22 weeks (5 cases for 2 weeks,13 cases for 3 to 22 weeks), all patients receive surgical resection of lung cancer lesions, and testing of removed tumor to evaluate the epidermal growth factor receptor (EGFR) gene mutation status was performed by fluorescence polymerase chain reaction. The patients with sensitive EGFR mutations receive Icotinib as postoperative adjuvant therapy. Side effects of medication within 2 weeks included rash (44.4%, 28/63), dry skin (34.9%, 22/63), diarrhea (14.3%, 9/63), and oral ulcer (1.6%, 1/63); there were no icotinib-associated thoracic surgery complications during the perioperational period. 71.4% patients (45/63) achieve an average reduction of 23.5% ±10.7%(10%-53.5%) after 2 weeks medication of Icotinib(regressive tumor[RT]) .28.6% patients(18/63) achieve stable tumor(ST),enlargement of 8.7% to reduction of 8.7% of the maximum diameter of lung cancer after 2 weeks medication of Icotinib. Of the RT group, 68.9% (31/45) of the tumors were detected with EGFR-sensitive mutation (exon 19 or 21 mutation), 24.4% (11/45) with wild-type EGFR, and three cases of exon 20 mutation. Of the ST group, 77.8% (14/18) were detected with wild-type EGFR, three cases of exon 20 mutation, and one case of exon 19 deletion mutation

  18. [Treatment of mallet finger with dorsal nail glued splint: retrospective analysis of 270 cases].

    Science.gov (United States)

    Facca, S; Nonnenmacher, J; Liverneaux, P

    2007-11-01

    Management of mallet finger is both difficult and controversial. Sequelae are not uncommon, particularly after surgical treatment. Many authors advocate orthopedic treatment which is less invasive but requires greater patient participation to implement. Despite the large number of orthopedic methods proposed, none has proven superiority. We report here our experience with a dorsal adhesive splint which preserves digital pulp function and improves observance. This retrospective analysis included 270 mallet fingers presenting 153 tendon injuries and 117 bony injuries in 265 patients aged 42 years on average and treated from 2003 to 2005. Most of the tendon injuries involved the medius (38.7%) and most of the bony injuries involved the ring finger (35.4%). A splint was fashioned for the two distal phalanges and glued to the nail plate filed for this purpose. The splint was fashioned out of an L-shaped plastic sheet of thermo-malleable plastic dipped in hot water (60 degrees C). The L was molded to the dorsal aspect of the phalanges and rolled like a ring around the second phalanx, then glued to the nail. The splint was worn for eight weeks by patients with a tendon injury and six weeks for those with a bony injury. The splint was then worn at night for two weeks. Three criteria were used to analyze outcome: residual extension deficit, joint involvement, complications. Mean follow-up was 18 months. Mean time from trauma to definitive installation of the splint was six days. The complication rate for this orthopedic method was 14.3%, complications being observed in 6% of patients. All complications were transient except for one case of swan neck deformity and one case of painful osteoarthritis. Thirty splints (11%) became unglued but were all reinstalled using the same protocol. Thirty fingers (14%) presented residual deficit of active extension measuring less than 20 degrees. The quality of the result depended on the type of injury: tendon injuries led to extension

  19. Retrospective analysis of heavy metal contamination in Rhode Island based on old and new herbarium specimens.

    Science.gov (United States)

    Rudin, Sofia M; Murray, David W; Whitfeld, Timothy J S

    2017-01-01

    Herbarium specimens may provide a record of past environmental conditions, including heavy metal pollution. To explore this potential, we compared concentrations of copper, lead, and zinc in historical and new collections from four sites in Rhode Island, USA. We compared historical specimens (1846 to 1916) to congener specimens collected in 2015 at three former industrial sites in Providence, Rhode Island, and one nonindustrial site on Block Island. Leaf material was prepared by UltraWAVE SRC Microwave Digestion, and heavy metal concentrations were measured by inductively coupled plasma-atomic emission spectroscopy. Heavy metal concentrations in the historical and new specimens were measurable for all elements tested, and levels of copper and zinc were comparable in the historical and 2015 collections. By contrast, the concentration of lead declined at all sites over time. Significant variability in heavy metal concentration was observed between taxa, reflecting their varied potential for elemental accumulation. It seems clear that herbarium specimens can be used to evaluate past levels of pollution and assess local environmental changes. With careful sampling effort, these specimens can be a valuable part of environmental science research. Broadening the possible applications for herbarium collections in this way increases their relevance in an era of reduced funding for collections-based research.

  20. Institutions and Modernity

    Directory of Open Access Journals (Sweden)

    Witold Morawski

    2013-09-01

    Full Text Available Purpose: Modernity consists of many confl icting aspects: It brings many empty promises, yet has resulted in new institutions that create bridges between the values and interests of millions of people who seek freedom, prosperity, quality of life, strengthened democracy and social justice. In this paper I attempt to a gain and loss account against modernity, because institutional rules are not only conducive to cooperative interactions, but to hostile interactions as well. People are not always guided by moral commitment, but rather more often driven by cold calculation or coercion.Methodology: Modernity has at least three defi nitions. The fi rst defi nition is based on ideas that took over the imagination of the era. The second defi nition is based on an analysis of the behavior of people who respond to reason as well as emotion and believe that they act more rationally than their ancestors or the traditional “others”. The third defi nition is the one closest to my heart, consisting of the use of institutional categories. Institutions offer practical ways of connecting ideas and people. The challenge for them is the result of deepening local and national interdependencies, but increasingly often also regional (e.g. European and global. Interdependencies are the result of the scientifi c and technological revolution, global markets, global governance mechanisms, the emergence of new social forces and cultural confl icts (against the background of reconciling identity and differences.Conclusions: The most important task is to identify the mechanisms of complex systems so that people know how to act under conditions of uncertainty, risk and crisis. Hence, the expectations toward institutions often exceed their abilities. Even though new institutions are being created and old ones are being fixed, we are witnessing and participating in, institutional paralysis and the decay (e.g. corruption. In this situation, it is imperative not only to

  1. Modern Cosmology

    CERN Document Server

    Zhang Yuan Zhong

    2002-01-01

    This book is one of a series in the areas of high-energy physics, cosmology and gravitation published by the Institute of Physics. It includes courses given at a doctoral school on 'Relativistic Cosmology: Theory and Observation' held in Spring 2000 at the Centre for Scientific Culture 'Alessandro Volta', Italy, sponsored by SIGRAV-Societa Italiana di Relativita e Gravitazione (Italian Society of Relativity and Gravitation) and the University of Insubria. This book collects 15 review reports given by a number of outstanding scientists. They touch upon the main aspects of modern cosmology from observational matters to theoretical models, such as cosmological models, the early universe, dark matter and dark energy, modern observational cosmology, cosmic microwave background, gravitational lensing, and numerical simulations in cosmology. In particular, the introduction to the basics of cosmology includes the basic equations, covariant and tetrad descriptions, Friedmann models, observation and horizons, etc. The ...

  2. Modern bureaucracy

    OpenAIRE

    Toye, John

    2006-01-01

    Max Weber believed that bureaucracy could be understood by analysing its ideal-typical characteristics, and that these characteristics would become more pervasive as the modern age advanced. Weber’s horizontal account of bureaucracy can be criticised on various grounds, including its unrealistic notion of bureaucratic rationality. An alternative view is proposed, namely, that the development of state bureaucracies is driven by the trajectory of the highpower politics in which they are nested....

  3. Modern Biology

    OpenAIRE

    ALEKSIC, Branko

    2014-01-01

    The purpose of this course is to learn the philosophy, principles, and techniques of modern biology. The course is particularly designed for those who have not learned biology previously or whose major is other than biology, and who may think that they do not need to know any biology at all. The topics are covered in a rather general, overview manner, but certain level of diligence in grasping concepts and memorizing the terminology is expected.

  4. Modern maths

    CERN Multimedia

    Thom,R

    1974-01-01

    Le Prof. R. Thom expose ses vues sur l'enseignement des mathématiques modernes et des mathémathiques de toujours. Il est un grand mathématicien et était professeur à Strasbourg; maintenant il est professeur de hautes études scientifiques et était invité par le Prof. Piaget à Genève

  5. Modern control techniques for accelerators

    International Nuclear Information System (INIS)

    Goodwin, R.W.; Shea, M.F.

    1984-01-01

    Beginning in the mid to late sixties, most new accelerators were designed to include computer based control systems. Although each installation differed in detail, the technology of the sixties and early to mid seventies dictated an architecture that was essentially the same for the control systems of that era. A mini-computer was connected to the hardware and to a console. Two developments have changed the architecture of modern systems: the microprocessor and local area networks. This paper discusses these two developments and demonstrates their impact on control system design and implementation by way of describing a possible architecture for any size of accelerator. Both hardware and software aspects are included

  6. Charged particle counters in the pre-modern period

    International Nuclear Information System (INIS)

    Beringer, R.

    1979-01-01

    The history of nuclear particle and radiation counting techniques divides itself naturally into three epochs that may be labeled: Early, Pre-Modern, and Modern. The Pre-Modern era is designated as the period starting in the 1930's during which the several types of gas-ionization counters of the Early period were perfected and coupled to vacuum tube circuits and recording apparatus. These developments are briefly discussed. (Auth.)

  7. Retrospective and modern views on modernization and alternative modernization components of shinto and zen buddhism

    Directory of Open Access Journals (Sweden)

    Y. Y. Medviedieva

    2016-03-01

    Full Text Available The article is devoted to the ratio of modernization and counter modernizing key components of Japan and religions (partly introduced Christianity. The author concludes that the various components of the religious consciousness of the Japanese were kontratetycal on two main elements that form the basis of modern Western culture Japanese resistance and cause upgrade. First, science and technology, working on the basis of the laws of nature, which are opposed to the supernatural and the metaphysical world. Secondly, expressed individualism and atomism as hypertrophic respect for the human person, liberal nadzoseredzhenist to a person who undermines the consolidation of corporate social society. Japanese culture in the past was oriented toward modernization, but progress has been very slow. Moreover, in this process, Japan was much more conservative because in Japanese society regulatory institutions of the army, religion and industrial corporations can be considered a kind of constants which not only can be adapted to the modernization of Euro-American style, as suggested selection of authentic script compatible, especially with life values corporatism and solidarity. It is in this dimension of modernization projects related to Christian proselytism, as were «frustrated.» The reason for this breakdown can be considered inherence religion with social cohesion, its actual merging of social institutions, as well as hidden mahizm skepticism and religious outlook that combines Shinto, Confucian and Zen Buddhist elements. Since modernization in Christianity included the distinction darkened minds clerical era and «enlightened enlightenment» of consciousness era of modern times, it is this dichotomy allowed to oppose religious «ignorance» and scientific «enlightenment», the clergy and secular intellectuals, universities and intellectual clubs as a medium spreading the ideology of the bourgeoisie and monasteries as centers of religious clericalism

  8. Modern Cosmology

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Yuanzhong

    2002-06-21

    This book is one of a series in the areas of high-energy physics, cosmology and gravitation published by the Institute of Physics. It includes courses given at a doctoral school on 'Relativistic Cosmology: Theory and Observation' held in Spring 2000 at the Centre for Scientific Culture 'Alessandro Volta', Italy, sponsored by SIGRAV-Societa Italiana di Relativita e Gravitazione (Italian Society of Relativity and Gravitation) and the University of Insubria. This book collects 15 review reports given by a number of outstanding scientists. They touch upon the main aspects of modern cosmology from observational matters to theoretical models, such as cosmological models, the early universe, dark matter and dark energy, modern observational cosmology, cosmic microwave background, gravitational lensing, and numerical simulations in cosmology. In particular, the introduction to the basics of cosmology includes the basic equations, covariant and tetrad descriptions, Friedmann models, observation and horizons, etc. The chapters on the early universe involve inflationary theories, particle physics in the early universe, and the creation of matter in the universe. The chapters on dark matter (DM) deal with experimental evidence of DM, neutrino oscillations, DM candidates in supersymmetry models and supergravity, structure formation in the universe, dark-matter search with innovative techniques, and dark energy (cosmological constant), etc. The chapters about structure in the universe consist of the basis for structure formation, quantifying large-scale structure, cosmic background fluctuation, galaxy space distribution, and the clustering of galaxies. In the field of modern observational cosmology, galaxy surveys and cluster surveys are given. The chapter on gravitational lensing describes the lens basics and models, galactic microlensing and galaxy clusters as lenses. The last chapter, 'Numerical simulations in cosmology', deals with spatial and

  9. Modern plasmonics

    CERN Document Server

    Maradudin, Alexei A; Barnes, William L

    2014-01-01

    Plasmonics is entering the curriculum of many universities, either as a stand alone subject, or as part of some course or courses. Nanotechnology institutes have been, and are being, established in universities, in which plasmonics is a significant topic of research. Modern Plasmonics book offers a comprehensive presentation of the properties of surface plasmon polaritons, in systems of different structures and various natures, e.g. active, nonlinear, graded, theoretical/computational and experimental techniques for studying them, and their use in a variety of applications. Contains materia

  10. Modern spectroscopy

    CERN Document Server

    Hollas, J Michael

    2013-01-01

    The latest edition of this highly acclaimed title introduces the reader to a wide range of spectroscopies, and includes both the background theory and applications to structure determination and chemical analysis.  It covers rotational, vibrational, electronic, photoelectron and Auger spectroscopy, as well as EXAFs and the theory of lasers and laser spectroscopy. A  revised and updated edition of a successful, clearly written book Includes the latest developments in modern laser techniques, such as cavity ring-down spectroscopy and femtosecond lasers Provides numerous worked examples, calculations and questions at the end of chapters.

  11. Second Nuclear Era

    International Nuclear Information System (INIS)

    Weinberg, A.M.; Spiewak, I.; Barkenbus, J.N.; Livingston, R.S.; Phung, D.L.

    1984-03-01

    The Institute for Energy Analysis with support from The Andrew W. Mellon Foundation has studied the decline of the present nuclear era in the United States and the characteristics of a Second Nuclear Era which might be instrumental in restoring nuclear power to an appropriate place in the energy options of our country. The study has determined that reactors operating today are much safer than they were at the time of the TMI accident. A number of concepts for a supersafe reactor were reviewed and at least two were found that show considerable promise, the PIUS, a Swedish pressurized water design, and a gas-cooled modular design of German and US origin. Although new, safer, incrementally improved, conventional reactors are under study by the nuclear industry, the complete lack of new orders in the United States will slow their introduction and they are likely to be more expensive than present designs. The study recommends that supersafe reactors be taken seriously and that federal and private funds both be used to design and, if feasible, to build a prototype reactor of substantial size. 146 references, 8 figures, 2 tables

  12. Rework of the ERA software system: ERA-8

    Science.gov (United States)

    Pavlov, D.; Skripnichenko, V.

    2015-08-01

    The software system that has been powering many products of the IAA during decades has undergone a major rework. ERA has capabilities for: processing tables of observations of different kinds, fitting parameters to observations, integrating equations of motion of the Solar system bodies. ERA comprises a domain-specific language called SLON, tailored for astronomical tasks. SLON provides a convenient syntax for reductions of observations, choosing of IAU standards to use, applying rules for filtering observations or selecting parameters for fitting. Also, ERA includes a table editor and a graph plotter. ERA-8 has a number of improvements over previous versions such as: integration of the Solar system and TT xA1 TDB with arbitrary number of asteroids; option to use different ephemeris (including DE and INPOP); integrator with 80-bit floating point. The code of ERA-8 has been completely rewritten from Pascal to C (for numerical computations) and Racket (for running SLON programs and managing data). ERA-8 is portable across major operating systems. The format of tables in ERA-8 is based on SQLite. The SPICE format has been chosen as the main format for ephemeris in ERA-8.

  13. Modern thermodynamics

    CERN Document Server

    Ben-Naim, Arieh

    2017-01-01

    This textbook introduces thermodynamics with a modern approach, starting from four fundamental physical facts (the atomic nature of matter, the indistinguishability of atoms and molecules of the same species, the uncertainty principle, and the existence of equilibrium states) and analyzing the behavior of complex systems with the tools of information theory, in particular with Shannon's measure of information (or SMI), which can be defined on any probability distribution. SMI is defined and its properties and time evolution are illustrated, and it is shown that the entropy is a particular type of SMI, i.e. the SMI related to the phase-space distribution for a macroscopic system at equilibrium. The connection to SMI allows the reader to understand what entropy is and why isolated systems follow the Second Law of Thermodynamics. The Second Llaw is also formulated for other systems, not thermally isolated and even open with respect to the transfer of particles. All the fundamental aspects of thermodynamics are d...

  14. Modern electrodynamics

    CERN Document Server

    Zangwill, Andrew

    2013-01-01

    An engaging writing style and a strong focus on the physics make this comprehensive, graduate-level textbook unique among existing classical electromagnetism textbooks. Charged particles in vacuum and the electrodynamics of continuous media are given equal attention in discussions of electrostatics, magnetostatics, quasistatics, conservation laws, wave propagation, radiation, scattering, special relativity and field theory. Extensive use of qualitative arguments similar to those used by working physicists makes Modern Electrodynamics a must-have for every student of this subject. In 24 chapters, the textbook covers many more topics than can be presented in a typical two-semester course, making it easy for instructors to tailor courses to their specific needs. Close to 120 worked examples and 80 applications boxes help the reader build physical intuition and develop technical skill. Nearly 600 end-of-chapter homework problems encourage students to engage actively with the material. A solutions manual is availa...

  15. Alternative Modernities for Colonial Korea

    Directory of Open Access Journals (Sweden)

    Steven Lee

    2016-06-01

    Full Text Available Sunyoung Park. The Proletarian Wave: Literature and Leftist Culture in Colonial Korea, 1910–1945. Cambridge, MA: Harvard University Asia Center, 2015. 348 pp. $50 (cloth. Vladimir Tikhonov. Modern Korea and Its Others: Perceptions of the Neighbouring Countries and Korean Modernity. London: Routledge, 2016. 218 pp. $160 (cloth. It has become a global scholarly undertaking: how to rethink modernity so as to decouple it from Westernization (Chakrabarty 2000. Strategies have included foregrounding the plurality of history to disrupt linear progress; positing non-Western centers of modernity in, say, Moscow or Shanghai; and tracing anticolonial circuits connecting Asia to Africa to Latin America. The two recent books under review here add colonial-era Korea to such far-reaching discussions by situating the country across national boundaries. Interestingly, one connecting thread here is the alternative world system provided by the interwar, Soviet-oriented Left. The result is an unsettling of binaries that subsequently became entrenched during the Cold War: for example, north-south, socialist-nationalist, and, for literature, realist-modernist. But more broadly, pervading both books is the sense that history could have turned out differently—that revisiting northeast Asia’s porous borders in the early twentieth century reveals the Korean peninsula’s lost, internationalist potential...

  16. Acute herpes zoster neuralgia: retrospective analysis of clinical aspects and therapeutic responsiveness.

    Science.gov (United States)

    Haas, N; Holle, E; Hermes, B; Henz, B M

    2001-01-01

    Although the efficacy of modern antiviral agents for the treatment of herpes zoster is unquestioned, their ability to affect the associated pain remains controversial. We have therefore evaluated the inpatient hospital records of 550 patients with herpes zoster with regard to pain-related clinical aspects and therapeutic responsiveness. Intensity of pain was quantified by calculating a daily pain equivalence index (PEI) on the basis of different classes of pain medication and the number of tablets used in each category. The mean age of patients was 66.7 years, cranial segments were predominantly involved (55%), 64% of patients suffered from associated diseases and 77% experienced herpes-related pain. The PEI was 0.90 in the entire patient population, with significantly higher values in women and in patients with 3 or more associated diseases. It was lower in sacral and cranial nerve involvement, and it decreased rapidly in patients prior to discharge from hospital. Although there were significant differences in hospital stay between patients who received aciclovir and those who did not (mean 20.3 vs. 23.8 days), and for high- versus low-dose oral or intravenous administration, no significant differences were noted between the two groups for initial PEI values and during the course of observation, irrespective of the route of administration or the dose of aciclovir and the individual patient's PEI value. The groups were otherwise closely similar with regard to basic demographic and clinical data. 23.3% predominantly aged female patients with more associated diseases than the total patient population had a persistently elevated PEI and stayed in hospital beyond 21 days (mean 35.1 days), representing patients who went on to postherpetic neuralgia. These data further delineate clinical aspects of acute herpes zoster neuralgia, underline the unsolved therapeutic problems associated with this condition despite otherwise effective antiviral treatment, and characterise a

  17. A Method for Exploring Program and Portfolio Affordability Tradeoffs Under Uncertainty Using Epoch-Era Analysis: A Case Application to Carrier Strike Group Design

    Science.gov (United States)

    2015-04-30

    design for affordability by augmenting Epoch-Era Analysis with aspects of Modern Portfolio Theory . The method is demonstrated through the design of a...introduces a method to conduct portfolio design for affordability by augmenting Epoch-Era Analysis with aspects of Modern Portfolio Theory . The method...through the integration of elements of Modern Portfolio Theory (MPT) and the SoS design literature. The proposed method is demonstrated in a case study

  18. Nasionalisme di Era Internet

    Directory of Open Access Journals (Sweden)

    Danu Widhyatmoko

    2015-04-01

    Full Text Available Nationalism and nationality of a country life are moving into the new phase. Internet has become a new medium that opens up so many opportunities to create a sense of nationalism for the country. This paper contains a review of nationalism in the age of the Internet. This paper begins with understanding nationalism, the character of the Internet, social media and nationalism in the era of the Internet. Research method used in this paper is literature study, continued with reflective data analysis. With reflective analysis method, the authors analyzed data from the data collection has been carried out for comparison between the existing literature by circumstances or phenomena that occur, so that the conclusions of rational and scientific data can be obtained. 

  19. [Overall digitalization: leading innovation of endodontics in big data era].

    Science.gov (United States)

    Ling, J Q

    2016-04-09

    In big data era, digital technologies bring great challenges and opportunities to modern stomatology. The applications of digital technologies, such as cone-beam CT(CBCT), computer aided design,(CAD)and computer aided manufacture(CAM), 3D printing and digital approaches for education , provide new concepts and patterns to the treatment and study of endodontic diseases. This review provides an overview of the application and prospect of commonly used digital technologies in the development of endodontics.

  20. Gravitational Physics: the birth of a new era

    Science.gov (United States)

    Sakellariadou, Mairi

    2017-11-01

    We live the golden age of cosmology, while the era of gravitational astronomy has finally begun. Still, fundamental puzzles remain. Standard cosmology is formulated within the framework of Einstein's General theory of Relativity. Notwithstanding, General Relativity is not adequate to explain the earliest stages of cosmic existence, and cannot provide an explanation for the Big Bang itself. Modern early universe cosmology is in need of a rigorous underpinning in Quantum Gravity.

  1. Modernization and Lynching in the New South

    Directory of Open Access Journals (Sweden)

    Mattias Smångs

    2016-09-01

    Full Text Available This article evaluates an emerging body of historical scholarship that challenges prevailing views of the primacy of rural conditions in southern lynching by positing that it was symbiotically associated with the processes of modernization underway in the region in the decades around 1900. Statistical analyses of lynching data that differentiate among events according to communal participation, support, and ceremony in Georgia and Louisiana from 1882 to 1930 and local-level indices of modernization (urbanization, rural depopulation, industrialization, agricultural commercialization, and dissolution of traditional family roles yield results that both support and contradict such a modernization thesis of lynching. The findings imply that the consequences of the social transformation in the South coinciding with the lynching era were not uniform throughout the region with regard to racial conflict and violence and that broad arguments proposing an intrinsic connection between modernization and lynchings therefore are overstated.

  2. Pengaruh Revolusi Industri Terhadap Perkembangan Desain Modern

    Directory of Open Access Journals (Sweden)

    Yunida Sofiana

    2014-10-01

    Full Text Available The Industrial revolution of the second half of the eighteenth century in Britain was the beginning era of the design modern. Pros and Cons from these revolution happens to comes up with a new movement to art and design that called Art and Craft Movement and Art Nouveau that will be given a tremendous impacts on design modern. Different design approach will be contributed on developing design modern. The research method that has been used for this paper was desk-research method by collected secondary data and analyses to find conclusion about how did the industrial revolution contributed to modern design. The beauty of a design derived from the expertise in exploring new material and technology. The lack in artistic and decorative aspects set new structural and functional display of a design. 

  3. DEMONETIZATION A STEP TOWARDS MODERN FINANCIAL INCLUSION

    OpenAIRE

    Dharini Raje Sisodia; Akanksha Kapoor

    2017-01-01

    India creating a high expectation for the world to become economic leader. From quite a while Indian took Financial Inclusion as serious course of Business as a development tool and encouraging result are been observed. In order to have strong financial inclusion serious action are required. In this era of technology with largest youth population in India, this is the best time to strike the chords of modern financial inclusion. This paper will take up the issues related to demonetization and...

  4. The ERA-EDTA today and tomorrow: a progress document by the ERA-EDTA Council.

    Science.gov (United States)

    Zoccali, Carmine; Arici, Mustafa; Blankestijn, Peter J; Bruchfeld, Annette; Capasso, Giovambattista; Fliser, Danilo; Fouque, Denis; Goumenos, Dimitrios; Ketteler, Markus; Malyszko, Jolanta; Massy, Ziad; Rychlík, Ivan; Spasovski, Goce

    2018-05-23

    Scientific societies are increasingly seen as central to the advancement of information sharing and collaboration among scientists and clinical investigators for the progress of medical research and the promotion of education, professional competence, integrity and quality studies. To more effectively serve the practicing nephrologists and investigators dedicated to renal science, the Council of the European Renal Association and European Dialysis and Transplantation Association (ERA-EDTA) reorganized and integrated the various activities of the society into two branches, the Clinical Nephrology Governance branch and the Renal Science branch. New affordable initiatives to promote research, education and professional development and to advocate for the recognition of chronic kidney disease as a major public health issue at the European level will be put in place and/or potentiated in the new organizational frame. Educational initiatives will be espoused to Continuous Professional Development and, starting from 2019, 14 Education & Continuous Professional Development courses will be held covering the full range of knowledge areas of modern nephrology. Consolidation and development is the short- and medium-term mantra of the ERA-EDTA. The society has a rich portfolio of successful activities and brilliant, creative scientists among its members. Integrating the various activities of the ERA-EDTA and treasuring the expertise and wisdom of its most accomplished members will facilitate collaborative research, education and its public impact at large.

  5. Crititics to Metaphysics by Modern Philosophers (Discourse on Human Beings in Reality)

    OpenAIRE

    Frederikus Fios

    2016-01-01

    We have entered the 21st century that is popularly known as the era of the development of modern science and technology. Philosophy provides naming for contemporary era as postmodern era. But do we suddenly come to this day and age? No! Because humans are homo viator, persona that does pilgrimage in history, space and time. Philosophy has expanded periodically in the long course of history. Since the days of classical antiquity, philosophy comes with a patterned metaphysical paradigm. T...

  6. Mutual Influence of Institutional and Transport Factors of Economic Development: Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Dmitry A. Macheret

    2017-12-01

    . One of these key features were personalized relations as the basis of the institutions of the «closed access society». The dynamic expansion of the Russian railway network was carried out through a railway concessions. It is quite progressive institution of public-private partnership. But the low level of the country's fundamental institutions that supported the archaic «closed access society» had a negative impact on the development of railway transport. This resulted in corruption in decision-making related to the concessions assignment. In turn, it was the main reason for irrational choice of new lines, ineffective procedures for determining concessionaires, overestimated construction costs and costly operation of many railway lines. Despite this, the creation of the railway network had a significant impact on the development of the industrial economy and institutions of capitalism in Russia. The development of transport infrastructure in conjunction with the development of socio-economic and public institutions can provide a huge synergetic effect, a powerful impetus to the development of the economy and society within the framework of current institutional modernization.

  7. Retrospective analysis of cytopathology using gray level co-occurrence matrix algorithm for thyroid malignant nodules in the ultrasound imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeong Ju; Lee, Jin Soo [Dept. of Radiology, Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Kang, Se Sik; Kim, Chang Soo [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2017-06-15

    This study evaluated the applicability of computer-aided diagnosis by retrospective analysis of GLCM algorithm based on cytopathological diagnosis of normal and malignant nodules in thyroid ultrasound images. In the experiment, the recognition rate and ROC curve of thyroid malignant nodule were analyzed using 6 parameters of GLCM algorithm. Experimental results showed 97% energy, 93% contrast, 92% correlation, 92% homogeneity, 100% entropy and 100% variance. Statistical analysis showed that the area under the curve of each parameter was more than 0.947 (p = 0 .001) in t he ROC curve, which was s ignificant in the recognition of thyroid malignant nodules. In the GLCM, the cut-off value of each parameter can be used to predict the disease through analysis of quantitative computer-aided diagnosis.

  8. Engineering Education for a New Era

    Science.gov (United States)

    Ohgaki, Shinichiro

    Engineering education is composed of five components, the idea what engineering education ought to be, the knowledge in engineering fields, those who learn engineering, those who teach engineering and the stakeholders in engineering issues. The characteristics of all these five components are changing with the times. When we consider the engineering education for the next era, we should analyze the changes of all five components. Especially the knowledge and tools in engineering fields has been expanding, and advanced science and technology is casting partly a dark shadow on the modern convenient life. Moral rules or ethics for developing new products and engineering systems are now regarded as most important in engineering fields. All those who take the responsibility for engineering education should understand the change of all components in engineering education and have a clear grasp of the essence of engineering for sustainable society.

  9. Paclitaxel-Coated Balloons for the Treatment of Dysfunctional Dialysis Access. Results from a Single-Center, Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kitrou, Panagiotis M., E-mail: panoskitrou@gmail.com; Spiliopoulos, Stavros; Papadimatos, Panagiotis; Christeas, Nicolaos; Petsas, Theodoros; Katsanos, Konstantinos; Karnabatidis, Dimitris [Patras University Hospital, Interventional Radiology Department (Greece)

    2017-01-15

    PurposeTo investigate the safety and effectiveness of lutonix paclitaxel-coated balloon (PCB) for the treatment of dysfunctional dialysis access.Materials and MethodsThis was a single-center, single-arm, retrospective analysis of 39 patients (23 male, 59 %) undergoing 61 interventions using 69 PCBs in a 20-month period. There was a balance between arteriovenous fistulae (AVF) and grafts (AVG) (20 AVFs, 19AVGs), and the majority of lesions were restenotic (25/39, 64.1 %). Mean balloon diameter used was 6.6 mm and length 73.4 mm. Primary outcome measure was target lesion primary patency (TLPP) at 6 months, while secondary outcome measures included factors affecting TLPP and major complications. As there were lesions treated more than once with PCB, authors also compared patency results after first and second PCB angioplasty.ResultsTLPP was 72.2 % at 6 months with a median patency of 260 days according to the Kaplan–Meier survival analysis. No major complications occurred. TLPP between AVFs and AVGs (311 vs. 237 days, respectively; p = 0.29) and de novo and restenotic lesions was similar (270.5 vs. 267.5 days, respectively; p = 0.50). In 14 cases, in which lesions were treated with two PCB angioplasties, a statistically significant difference in TLPP after the second treatment was noted (first intervention 179.5 days vs. second intervention 273.5 days; p = 0.032).ConclusionIn this retrospective analysis, Lutonix PCB proved to be safe and effective in treating restenosis in dysfunctional dialysis access with results comparable to the literature available. Larger studies are needed to prove abovementioned results.

  10. Identitas Moral: Rekonstruksi Identitas Keindonesiaan pada Era Globalisasi Budaya

    Directory of Open Access Journals (Sweden)

    Leonardus Pandu Hapsoro

    2016-06-01

    Full Text Available Tulisan ini membahas mengenai proses rekonstruksi identitas keindonesiaan para aktor dalam komunitas Kultura Indonesia Star Society (KISS pada era globalisasi budaya. Dengan menggunakan metode penelitian kualitatif dan kerangka pemikiran Zygmunt Bauman antara modernitas cair dan agensi moral, tulisan ini menunjukkan bagaimana proses rekonstruksi identitas moral berawal dari keresahan aktor terhadap kondisi budaya tradisional pada era globalisasi. Penulis berpendapat bahwa ekspresi dari identitas aktor melalui gerakan sosial ini akan berperan menciptakan keberagaman budaya pada era globalisasi dan modernitas cair. Penulis ingin bergerak menjauh dari pandangan agentless dalam proses globalisasi dengan melihat dinamika agensi. Melalui agen dan bentuk agensi moral, penulis berpendapat bahwa di dalam proses dan dampak globalisasi, manusia tidak tertahan pada kondisi "adalah" atau tekanan struktural, melainkan terdapat optimisme untuk melihat suatu harapan atas kondisi yang "seharusnya" atau lebih baik melalui kesadaran identitas dan moral.This study discusses about the process of identity construction of actor  in the KISS community in an era of cultural globalization. This study will explain how the construction process of moral identity actor is formed in the era of cultural globalization. Moral identity construction of the actor in the era of globalization will be the anchor for agents to act and preserve the traditional culture with motivation, passion, and hope. This study used a qualitative approach by using the framework of Zygmunt Bauman concept of liquid modernity and moral agency. Through the framework of moral agency, this study shows how the construction of moral identity process begins with the actor disquite over the state of traditional culture in globalization era. Moral identity of the actor is capable of forming social practices agent in a daily life. First, by forming a community KISS. Second, as the cornerstone of actors to act

  11. Modern Supersymmetry

    International Nuclear Information System (INIS)

    Kulish, Petr P

    2006-01-01

    We have spent more than twenty years applying supersymmetry (SUSY) to elementary particle physics and attempting to find an experimental manifestation of this symmetry. Terning's monograph demonstrates the strong influence of SUSY on theoretical elaborations in the field of elementary particles. It gives both an overview of modern supersymmetry in elementary particle physics and calculation techniques. The author, trying to be closer to applications of SUSY in the real world of elementary particles, is also anticipating the importance of supersymmetry for rigorous study of nonperturbative phenomena in quantum field theory. In particular, he presents the 'exact' SUSY β function using instanton methods, phenomena of anomalies and dualities. Supersymmetry algebra is introduced by adding two anticommuting spinor generators to Poincare algebra and by presenting massive and massless supermultiplets of its representations. The author prefers to use mostly the component description of field contents of the theories in question rather than the superfield formalism. Such a style makes the account closer to physical characteristics. Relations required by SUSY among β functions of the gauge, Yukawa and quartic interactions are checked by direct calculations as well as to all orders in perturbation theory, thus demonstrating that SUSY survives quantization. A discussion is included of the hierarchy problem of different scales of weak and strong interactions and its possible solution by the minimal supersymmetric standard model. Different SUSY breaking mechanisms are presented corresponding to a realistic phenomenology. The monograph can also be considered as a guide to 'duality' relations connecting different SUSY gauge theories, supergravities and superstrings. This is demonstrated referring to the particular properties and characteristics of these theories (field contents, scaling dimensions of appropriate operators etc). In particular, the last chapter deals with the Ad

  12. VALUATION IN THE CONSTITUTIONAL ERA

    African Journals Online (AJOL)

    Brimer

    16 ..... stem from the pre-constitutional era, and the constitutional framework and its legitimate reform efforts. A decision on what is just ...... Carroll L Alice's Adventures in Wonderland (Digital Scanning Scituate MA. 2007). Dagan 1999 Va L Rev.

  13. Three eras of climate change

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul; Toulmin, Camilla

    2006-10-15

    Climate change as a global challenge has evolved through a series of stages in the last few decades. We are now on the brink of a new era which will see the terms of the debate shift once again. The different eras are characterised by the scientific evidence, public perceptions, responses and engagement of different groups to address the problem. In the first era, from the late 1980s to 2000, climate change was seen as an “environmental” problem to do with prevention of future impacts on the planet's climate systems over the next fifty to hundred years, through reductions in emissions of greenhouse gases, known as “mitigation”. The second era can be said to have started around the turn of the millennium, with the recognition that there will be some unavoidable impacts from climate change in the near term (over the next decade or two). These impacts must be coped with through “adaptation”, as well as mitigation, to prevent much more severe and possibly catastrophic impacts in the longer term. It has become clear that many of the impacts of climate change in the near term are likely to fall on the poorest countries and communities. The third era, which we are just about to enter, will see the issue change from tackling an environmental or development problem to a question of “global justice”. It will engage with a much wider array of citizens from around the world than previous eras.

  14. Synergetic Paradigm of Geopolitical Confrontation in the Postmodern Era

    Directory of Open Access Journals (Sweden)

    Sergey N. Teplyakov

    2014-01-01

    Full Text Available The article analyzes current state and mechanisms of geopolitical struggle in postmodern information age that has come. The author judges from assumption that entirely new postmodern society appeared with expansion of information technology, accompanied by cardinal changes in mechanisms of political power. Information technologies have become one of the most important factors contributing to the transformation of modern society from industrial to informational (post-industrial. In modern conditions, ensuring national and global security is a comprehensive process that includes not only measures to ensure information and economic security individually, but also such an integrated component as providing both information and economic security. The author suggests that modem geopolitical confrontation is carried out based on the synergetic paradigm. The main tool is information and energy influence on enemy system weaknesses using information space control, organizing negative information campaigns and applying economic sanctions. If the main focus of geopolitical struggle in modern era was forced expansion of the territory, in information postmodern age control over economic and information space has become priority among forms of geopolitical struggle. Military expansion of modern era becomes substituted by information and economic expansionism of postmodern using synergetic paradigm of geopolitical confrontation in order to control and capture the opponent's political space.

  15. Creative class as the leading group of modern society

    Directory of Open Access Journals (Sweden)

    O. Y. Sakalo

    2015-06-01

    Full Text Available In the article one of the modern approaches to the social structure of the society is considered. The creative class is determined as the main driving force and as a leading social class of modern society. The author studies the history of the concept of creative class, and R. Florida’s concept in particular, and determines its characteristics and peculiarities. The influence of the creative class on the society, on its transformation processes, and the system of social values is analyzed. The role of creative class in developing creative and innovative economy of the post­industrial society era is found out. The author considers the relationship between the creative class and the other social classes of modern society. The essence of the concept of creativity is defined, and one of the most important problems of the modern era that is a constant conflict between creativity and organization is examined. The comparative historical analysis of the so­called «institutional»/ «industrial» and «creative»/ «post­industrial» era is made. The role of the creative class in developing and social changing the modern American society is studied. The questions of forming and developing creative class in modern Ukrainian society are analyzed, and the peculiarities and problems of this process are figured out. The need of state support for forming national creative class, for its strengthening and growth is emphasized.

  16. Modern control techniques for accelerators

    International Nuclear Information System (INIS)

    Goodwin, R.W.; Shea, M.F.

    1984-05-01

    Beginning in the mid to late sixties, most new accelerators were designed to include computer based control systems. Although each installation differed in detail, the technology of the sixties and early to mid seventies dictated an architecture that was essentially the same for the control systems of that era. A mini-computer was connected to the hardware and to a console. Two developments have changed the architecture of modern systems: (a) the microprocessor and (b) local area networks. This paper discusses these two developments and demonstrates their impact on control system design and implementation by way of describing a possible architecture for any size of accelerator. Both hardware and software aspects are included

  17. Multiple modernities, modern subjectivities and social order

    DEFF Research Database (Denmark)

    Jung, Dietrich; Sinclair, Kirstine

    2015-01-01

    to modern subjectivity formation. In combining conceptual tools from these strands of social theory, we argue that the emergence of multiple modernities should be understood as a historical result of idiosyncratic social constructions combining global social imaginaries with religious and other cultural......Taking its point of departure in the conceptual debate about modernities in the plural, this article presents a heuristic framework based on an interpretative approach to modernity. The article draws on theories of multiple modernities, successive modernities and poststructuralist approaches...... traditions. In the second part of the article we illustrate this argument with three short excursions into the history of Islamic reform in the 19th and 20th centuries. In this way we interpret the modern history of Muslim societies as based on cultural conflicts between different forms of social order...

  18. Politics, Society and Communication in the Constitution of Modern Society: Early Modern England

    Directory of Open Access Journals (Sweden)

    Devrim ÖZKAN

    2014-12-01

    Full Text Available The inception of Modern England comprises a hundred and fifty years between sixteenth and mid eighteenth centuries. The structural qualities of modern societies of this day occur in this era. The political and economic changes and transformations that England experienced in this period of time are in enormous scale. In this period all social structure and institutions experienced structural change in terms of cultural, economic and political processes. In addition to this in this period the framework of the international system regarding economy and politics is established too. Important qualities of current modern societies are the speed of communication and interaction between its elements, its transformational capacity and the extent of its scope. In this, it is possible to apprehend the basic cornerstones of today’s information and communication age by analyzing the early modern period of England

  19. MEAD retrospective analysis report

    DEFF Research Database (Denmark)

    Hasager, Charlotte Bay; Carstensen, J.; Frohn, L.M.

    2003-01-01

    the bottom waters. Yet the cumulative atmospheric deposition is always larger than the marine deep-water flux. The mixing of nutrient-rich water from belowthe pycnocline into the euphotic zone is also a process of highly episodic character and provides sufficient nitrogen to the euphotic zone to sustain...... larger algae blooms. The two nitrogen loading processes are correlated - mainly because both are to someextent related to the wind velocity - and the nitrogen input from both processes enables the build-up of algae blooms. Furthermore, the nitrogen supplied on a single day cannot sustain a bloom...

  20. [Retrospective analysis of the use of the Spanish words severo and severidad in CIRUGIA ESPANOLA during 2007].

    Science.gov (United States)

    Martínez-Ramos, David

    2008-12-01

    The Spanish words severo (severe) and severidad (severity) are usually used as a synonyms of grave (serious) and gravedad (seriousness), although the Spanish Royal Academy of Language (Real Academia Española [RAE]) specifically recommends not to use them in this sense. A retrospective analysis to evaluate the use of the words severo and severidad in Cirugía Española during 2007 was performed. All the articles published in Cirugía Española during 2007 were reviewed. The articles in which severo and/or severidad were present were selected. For each article, the month of publication, the type of article, the geographic origin and the exact sentence containing these words were analyzed. Correctness and incorrectness of their use was studied according to the RAE normative. A total of 33 articles were selected. Every month (except for January) had, at least, 2 articles. Thirty-one of the articles were from Spain whereas 2 were from Hispano-America. Eleven cases were original articles, 7 reviews, 6 case reports, 3 editorials, 3 special articles and 3 letters to the editor. The Spanish words severo and severidad are inadequately used too often in scientific texts. It must be avoided using them as a synonym of grave, importante or serio, incorrect translations of the English word severe.

  1. Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

    Directory of Open Access Journals (Sweden)

    Eun-Kyung Woo

    2013-09-01

    Full Text Available Background This paper discusses the treatment protocol for patients with frostbite.Methods We performed a retrospective analysis of a series of 17 patients with second- andhigher-degree frostbite who had been treated at our medical institution between 2010 and2012.Results Our clinical series of patients (n=17 included 13 men and four women, whosemean age was 42.4±11.6 years (range, 22-67 years. The sites of injury include the foot in sixpatients (35.3%, the hand in six patients (35.3% and the facial region in five patients (29.4%.Seven patients with second-degree frostbite were completely cured with only conservativetreatment during a mean period of 12.7±3.3 days (range, 8-16 days. Of the five patients withthird-degree frostbite, two underwent skin grafting following debridement, and the remainingthree achieved a complete cure with conservative treatment during a mean period of 35±4.3days (range, 29-39 days. Five patients with fourth-degree frostbite were treated with surgicalprocedures including amputation.Conclusions With the appropriate conservative management in the early stage of onset,surgeons should decide on surgery after waiting for a sufficient period of time until thedemarcation of the wound. Continuous management of patients is also needed to achievefunctional recovery after a complete cure has been achieved. This should also be accompaniedby patient education for the avoidance of re-exposure to cold environments.

  2. [Italian physician's needs for medical information. Retrospective analysis of the medical information service provided by Novartis Pharma to clinicians].

    Science.gov (United States)

    Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

    2013-10-01

    The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.

  3. Platinum-based chemotherapy followed by radiation therapy of locally advanced nasopharyngeal cancer; A retrospective analysis of 39 cases

    Energy Technology Data Exchange (ETDEWEB)

    Fountzilas, G.; Danilidis, J.; Kosmidis, P.; Srihar, K.S.; Kalogera-Fountzila, A.; Nicolaou, A.; Makrantonakis, P.; Banis, K.; Dimitriadis, A.; Sombolos, K.; Zaramboukas, T.; Themelis, C.; Vritsios, A.; Tourkantonis, A. (Ahepa Univ. Hospital, Thessaloniki (Greece) Metaxa Cancer Hospital, Piraeaus (Greece) Miami School of Medicine and VA Hospital, FL (United States). Sylvester Comprehensive Cancer Center)

    1991-01-01

    A retrospective analysis was performed of 39 patients with locally advanced nasopharyngeal cancer treated with combined chemotherapy and radiation therapy during the last five years at our departments. There were 26 men and 13 women with median age 55 (24-75) years. Histology was squamous cell carcinoma in 6 patients and undifferentiated carcinoma in the remaining 33 patients. Induction chemotherapy consisted of either regimen A (cisplating 100 mg/m{sup 2} day 1, 5-FU 1000 mg/m{sup 2} days 2-6 as continuous infusion, bleomycin 15 mg days 15 and 29 i.m., mitomycin 4 mg/m{sup 2} day 22 and hydroxyurea 1000 mg/m{sup 2} daily days 23-27) or regimen B (carboplatin 300 mg/m{sup 2} day 1, 5-FU 1000 mg/m{sup 2} days 1-5 as continuous infusion and methotrexate 1.2 g/m{sup 2} day 14 with leucovorin rescue). After completion of induction chemotherapy 13 patients (33%) had complete remission (CR) and 19 (49%) partial remission (PR). The CR rate was increased after radiation therapy to 72%. Survival rates were 88% at 12 and 78% at 24 months. Median time to progression was 29.5 months. In conclusion, induction chemotherapy with a platinum-based regimen followed by radiation therapy achieved a high rate of local control. If the treatment also prolongs survival must, however, be studied by randomized trials. (orig.).

  4. Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis.

    Science.gov (United States)

    Wang, Kaiwen; Zhong, Shuang; Wang, Xiaoye; Wang, Zhe; Yang, Lianping; Wang, Qiong; Wang, Suhan; Sheng, Rongrong; Ma, Rui; Lin, Shao; Liu, Wenyu; Zu, Rongqiang; Huang, Cunrui

    2017-10-10

    (1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing's Center for Disease Control and Prevention (CDC) and Funing People's Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.

  5. Technician Consistency in Specular Microscopy Measurements: A "Real-World" Retrospective Analysis of a United States Eye Bank.

    Science.gov (United States)

    Rand, Gabriel M; Kwon, Ji Won; Gore, Patrick K; McCartney, Mitchell D; Chuck, Roy S

    2017-10-01

    To quantify consistency of endothelial cell density (ECD) measurements among technicians in a single US eye bank operating under typical operating conditions. In this retrospective analysis of 51 microscopy technicians using a semiautomated counting method on 35,067 eyes from July 2007 to May 2015, technician- and date-related marginal ECD effects were calculated using linear regression models. ECD variance was correlated with the number of specular microscopy technicians. Technician mean ECDs ranged from 2386 ± 431 to 3005 ± 560 cells/mm. Nine technicians had statistically and clinically significant marginal effects. Annual mean ECDs adjusted for changes in technicians ranged from 2422 ± 433 to 2644 ± 430 cells/mm. The period of 2007 to 2009 had statistically and clinically significant marginal effects. There was a nonstatistically significant association between the number of technicians and ECD standard deviation. There was significant ECD variability associated with specular microscopy technicians and with the date of measurement. We recommend that eye banks collect data related to laboratory factors that have been shown to influence ECD variability.

  6. Do Surgeons React?: A Retrospective Analysis of Surgeons' Response to Harassment of a Colleague During Simulated Operating Theatre Scenarios.

    Science.gov (United States)

    Gostlow, Hannah; Vega, Camila Vega; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

    2017-07-24

    To assess and report on surgeons' ability to identify and manage incidences of harassment. The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the workplace. To eradicate these behaviors, it is first critical to understand how the current workforce responds to these actions. A retrospective analysis of video data of an operating theatre simulation was conducted to identify how surgeons, from a range of experience levels, react to instances of harassment. Thematic analysis was used to categorize types of harassment and participant response characteristics. The frequency of these responses was assessed and reported. The type of participant response depended on the nature of harassment being perpetuated and the seniority of the participant. In the 50 instances of scripted harassment, active responses were enacted 52% of the time, acknowledgment responses 16%, and no response enacted in 30%. One senior surgeon also perpetuated the harassment (2%). Trainees were more likely to respond actively compared with consultants. It is apparent that trainees are more aware of instances of harassment, and were more likely to intervene during the simulated scenario. However, a large proportion of harassment was unchallenged. The hierarchical nature of surgical education and the surgical workforce in general needs to enable a culture in which the responsibility to intervene is allowed and respected. Simulation-based education programs could be developed to train in the recognition and intervention of discrimination, bullying, harassment and sexual harassment.

  7. [Peribulbar block combined with general anesthesia in babies undergoing laser treatment for retinopathy of prematurity: a retrospective analysis].

    Science.gov (United States)

    Pinho, Daniela Filipa Rodrigues; Real, Cátia; Ferreira, Leónia; Pina, Pedro

    2018-03-12

    Currently there is no agreement regarding which one is the most adequate anesthetic technique for the treatment of retinopathy of prematurity. Peribulbar block may reduce the incidence of oculocardiac reflex and postoperative apnea. The goal of this study was to report the outcomes of peribulbar block, when combined with general anesthesia, for the laser treatment for retinopathy of prematurity, in premature babies. A retrospective analysis of anesthetic records of all babies who underwent laser treatment for retinopathy of prematurity from January 2008 through December 2015 in a tertiary hospital was performed. During that period a total of six babies was submitted to laser treatment for retinopathy of prematurity, all under peribulbar block combined with general anesthesia. A single infratemporal injection of 0.15mL.kg -1 per eye ropivacaine 1% or 0.75% was performed. At the end of the procedure, all babies resumed spontaneous ventilation. No perioperative complications were reported. Peribulbar block was a safe anesthetic technique in our sample considered. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Kaiwen Wang

    2017-10-01

    Full Text Available (1 Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2 Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing’s Center for Disease Control and Prevention (CDC and Funing People’s Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3 Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33 and injury (RR = 31.80; 95% CI = 17.26, 58.61, and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29. Of the 337 injuries, 274 injuries (81% were minor. Most deaths occurred indoors (87% and the head (74% was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4 Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.

  9. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis.

    Science.gov (United States)

    Lubbes, Stefanie; Rustemeyer, Thomas; Sillevis Smitt, Johannes H; Schuttelaar, Marie Louise; Middelkamp-Hup, Maritza A

    2017-03-01

    Allergic contact dermatitis is known to occur in children with and without atopic dermatitis, but more data are needed on contact sensitization profiles in these two groups. To identify frequent allergens in children with and without atopic dermatitis suspected of having allergic contact dermatitis. A retrospective analysis of children aged 0-17 years patch tested between 1996 and 2013 was performed. Of all 1012 children tested because of suspected contact dermatitis, 46% developed one or more positive reactions, the proportions for children with (n = 526) and without (n = 395) atopic dermatitis being 48% and 47%, respectively. Children with atopic dermatitis reacted more often to lanolin alcohol (30% pet., p = 0.030), Amerchol L-101 (p = 0.030), and fragrances [fragrance mix I (p = 0.048) and Myroxylon pereirae (p = 0.005)]. Allergens outside the European baseline series that frequently gave positive reactions in these groups included cocamidopropyl betaine and Amerchol L-101. Reactivity to these allergens was significantly more common in atopic dermatitis children. Sensitization prevalences in children with and without atopic dermatitis were similar, but children with atopic dermatitis reacted significantly more often to lanolin alcohol and fragrances. Testing with additional series besides the European baseline series may be necessary, as reactions to, for example, cocamidopropyl betaine and Amerchol L-101 may otherwise be missed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. A Retrospective Analysis of Cyanoacrylate Injection versus Hemoclip Placement for Bleeding Dieulafoy’s Lesion in Duodenum

    Directory of Open Access Journals (Sweden)

    Yu Jiang

    2018-01-01

    Full Text Available Background. Duodenal Dieulafoy’s lesion (DL is a rare disease that may lead to lethal hemorrhage in the upper gastrointestinal tract. The best technique for endoscopic intervention still remains unclear. In the present study, we performed a retrospective analysis of cyanoacrylate injection versus hemoclip placement for treating bleeding DLs. Materials and Methods. We retrospectively analyzed eighteen patients from three medical centers between October 2008 and February 2016; six patients received cyanoacrylate injection, while hemoclips were placed in 12 patients during the upper gastrointestinal endoscopy. Results. All patients received first endoscopic examination and/or endotherapy within 12 hours of admission to hospital. No difference was observed in the primary hemostasis rate or the recurrent hemorrhage rate between the cyanoacrylate injection (CI group and the hemoclip placement (HP group, except that in one patient from the HP group melena was found three days after the first endotherapy. This patient received cyanoacrylate injection once again. Conclusion. Both cyanoacrylate injection and hemoclip placement are effective in treating duodenal DL, and neither of them causes significant side effects.

  11. The prognostic value of time parameters in adjuvant radiotherapy of head and neck cancer. A retrospective analysis of 138 patients

    International Nuclear Information System (INIS)

    Dietl, B.; Schaefer, C.; Koelbl, O.

    2005-01-01

    Purpose: to answer the question, how the parameters waiting time, radiation treatment time and overall treatment time (OTT) influenced the endpoints overall (OS), event-free (EFS) and local recurrence-free survival (LRFS) in patients with locally advanced head-and-neck cancer, who had received postoperative radiotherapy. Patients and methods: 138 patients were included into a retrospective analysis from 10/1993 to 05/2000. Besides the time parameters waiting time, radiation treatment time and OTT, tumor- and therapy-related parameters (T-, N-, R-status, grading, tumor site, surgical technique, and postoperative hemoglobin < 12 g/dl) with potential impact on the endpoints were investigated in the univariate analysis (Kaplan-Meier log-rank test). Individual parameters with a significant impact (p = 0.05) were subjected to a multivariate Cox regression analysis. Results: besides a postoperative hemoglobin value < 12 g/dl, in the univariate analysis an OTT ≥ 105 days negatively influenced all endpoints, as well as a radiation treatment time ≥ 60 days. On multivariate Cox regression analysis, postoperative hemoglobin < 12 g/dl and an OTT ≥ 105 days were identified as independent negative prognostic factors for all endpoints. Conclusion: the waiting time should be managed according to the ASARA (as short as reasonably achievable) recommendation, radiation treatment should not be protracted exceeding an overall treatment of 105 days. Generally, time parameters should be routinely included in the standard tumor documentation, thus facilitating further evaluation of these prognostically relevant factors. (orig.)

  12. CHRISTMAS 2015 : THE PUBLICATION GAME Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H.; Tijdink, Joeri K.; Otte, Wim

    2015-01-01

    Objective To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. Design Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. Methods The yearly frequencies of positive, negative, and

  13. Sports in postmodern era

    Directory of Open Access Journals (Sweden)

    Paul Miron

    2009-06-01

    Full Text Available The present study tries to make a resume from a socio-cultural point of view of the sportiv peisage analized in the evolutionof society trying to answer some questions such as: What is the place of sports in our modern society? How does sportinfluence social and cultural evolutions? What are the cultural tendencies which can be distinguished in the sports practice?These are a few questions which could lead to establishing raports between sports, culture and society. Sport is more andmore amrked by the charactersitics of postmoderinsm. New social values are being vehiclated by current generations whichinfluence sportive behaviours. The popularity of sports has a big influence in the process of globalisation of politics,economics and culture. In our days we observe the fact that some contradictions are being manifested: globalisation andindividualisation, „sportivisation” and „desportivisation”, a culture of health and a culture of amusement and finally,spontaneity and fragmentation compared to the security and autentification of the individual.

  14. Social Darwinism in modern China

    Institute of Scientific and Technical Information of China (English)

    XU Jilin; XIAO Zhiwei

    2012-01-01

    After evolutionary theory was introduced in China,Herbert Spencer's interpretation of it in the form of social Darwinism persuaded the Chinese that if they wanted to strengthen their nation,they would have to accept the brutal truth of natural selection,in which the principle of survival of the fittest rules.This version of evolutionary theory,when combined with the pragmatic thrust of Confucianism and the realpolitik of legalism from China's indigenous tradition,started a storm of materialism and utilitarianism in modern China.In the process,the traditional social order based on the rule of propriety (li) was completely subverted and replaced by a new order predicated on the rule of competition and power.This development produced a new mental outlook that privileged power over everything else,seriously undermined the rules of ethics and caused serious political consequences in the late Qing and early Republican period.This intellectual development may have contributed to ending the dynastic rule in China,but it was also responsible for ruining the newborn Republican China.The Chinese intellectuals of the May Fourth era critically reflected on this problematic legacy.While still believing in the notion of progress,they abandoned social Darwinism and embraced the idea of evolution through mutual assistance.Thus began a historical shift in modern China from focusing on wealth and power to focusing on civilization as China's salvation.

  15. Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data.

    Science.gov (United States)

    O'Keeffe, Colin; Mason, Suzanne; Jacques, Richard; Nicholl, Jon

    2018-01-01

    The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E) data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014). Data was collected on all adult (>16 years) ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups. There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%). Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, Paged 16-44) compared to those aged 45-64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, Puse the ED to obtain healthcare that could be provided in a less urgent setting and also more likely to do this out of hours. Alternative services are required to manage non-urgent demand, currently being borne by the ED and the ambulance service, particularly in out of hours.

  16. Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

    Directory of Open Access Journals (Sweden)

    Eun-Kyung Woo

    2013-09-01

    Full Text Available BackgroundThis paper discusses the treatment protocol for patients with frostbite.MethodsWe performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012.ResultsOur clinical series of patients (n=17 included 13 men and four women, whose mean age was 42.4±11.6 years (range, 22-67 years. The sites of injury include the foot in six patients (35.3%, the hand in six patients (35.3% and the facial region in five patients (29.4%. Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7±3.3 days (range, 8-16 days. Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35±4.3 days (range, 29-39 days. Five patients with fourth-degree frostbite were treated with surgical procedures including amputation.ConclusionsWith the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

  17. Benzodiazepine Consumption Is Associated With Lower Blood Pressure in Ambulatory Blood Pressure Monitoring (ABPM): Retrospective Analysis of 4938 ABPMs.

    Science.gov (United States)

    Mendelson, Nitsan; Gontmacher, Bella; Vodonos, Allina; Novack, Victor; Abu-AjAj, Muhammad; Wolak, Arik; Shalev, Haddar; Wolak, Talya

    2018-03-10

    The effect of chronic benzodiazepine use on blood pressure has not been documented. We aimed to evaluate whether regular benzodiazepine use can be associated to the results of ambulatory blood pressure monitoring (ABPM). A retrospective analysis of the ABPM database between 2009 and 2015 was performed. The study groups were divided according to benzodiazepine treatment at least 3 months before ABPM. Generalized estimating equation (GEE) model analysis was conducted to estimate the association between benzodiazepine treatment and ABPM test measurements. Multivariable COX regression survival analysis model for mortality and cardiovascular (CV) events was performed. A total of 4,938 ABPM studies were included in final analysis, 670 ABPMs of benzodiazepine-treated patients, and 4,268 of untreated patients. The benzodiazepine-treated group was significantly older, with a predominance of female patients, comprised more diabetic patients and consumed more antihypertensive medications. Adjustment for age, gender, diabetes mellitus, and number of antihypertensive medications, showed an association between benzodiazepine treatment and significantly lower ABPM measurements. When the analysis was split into those ≥60 years old and the other ABPM measurements only among ≥60 years old. Multivariable Cox regression survival analysis showed that regular benzodiazepine consumption was not associated with increased mortality or CV events (mean follow-up period of 42.4 ± 19.8 and 42.1 ± 20.0 months, respectively). Long-term use of benzodiazepines by ≥60 years old was independently associated with lower diastolic and systolic blood pressure in all parameters of ABPM, but not among younger patients.

  18. Sporadic and genetic forms of paediatric somatotropinoma: a retrospective analysis of seven cases and a review of the literature

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    Nozières Cécile

    2011-10-01

    Full Text Available Abstract Background Somatotropinoma, a pituitary adenoma characterised by excessive production of growth hormone (GH, is extremely rare in childhood. A genetic defect is evident in some cases; known genetic changes include: multiple endocrine neoplasia type 1 (MEN1; Carney complex; McCune-Albright syndrome; and, more recently identified, aryl hydrocarbon receptor-interacting protein (AIP. We describe seven children with somatotropinoma with a special focus on the differences between genetic and sporadic forms. Methods Seven children who presented in our regional network between 1992 and 2008 were included in this retrospective analysis. First-type therapy was somatostatin (SMS analogues or transsphenoidal surgery. Control was defined as when insulin-like growth factor-1 (IGF-1 levels were within the normal range for the patient's age at 6 months after therapy, associated with decreasing tumour volume. Results Patients were aged 5-17 years and the majority (n = 6 were male. Four patients had an identified genetic mutation (McCune-Albright syndrome: n = 1; MEN1: n = 1; AIP: n = 2; the remaining three cases were sporadic. Accelerated growth rate was reported as the first clinical sign in four patients. Five patients presented with macroadenoma; invasion was noted in four of them (sporadic: n = 1; genetic: n = 3. Six patients were treated with SMS analogues; normalisation of IGF-1 occurred in one patient who had a sporadic intrasellar macroadenoma. Multiple types of therapy were necessary in all patients with an identified genetic mutation (4 types: n = 1; 3 types: n = 2; 2 types: n = 1, whereas two of the three patients with sporadic somatotropinoma required only one type of therapy. Conclusions This is the first series that analyzes the therapeutic response of somatotropinoma in paediatric patients with identified genetic defects. We found that, in children, genetic somatotropinomas are more invasive than sporadic somatotropinomas. Furthermore

  19. The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases

    International Nuclear Information System (INIS)

    Rief, Harald; Bischof, Marc; Bruckner, Thomas; Welzel, Thomas; Askoxylakis, Vasileios; Rieken, Stefan; Lindel, Katja; Combs, Stephanie; Debus, Jürgen

    2013-01-01

    The objective of this retrospective analysis is to systematically assess osseous lesions on the basis of a validated scoring system in terms of stability and fractures prior to and following radiotherapy in 338 lung cancer patients with bone metastases in the vertebral column. The stability of 338 patients with 981 osteolytic metastases in the thoracic and lumbar spine was evaluated retrospectively on the basis of the Taneichi-Score between January 2000 and January 2012. 64% (215 patients) were classified stable prior to radiotherapy. Of the stable osseous metastases, none were rated unstable in the further course (p < 0.001, McNemar test). Of the 123 patients in whom the metastases were classified unstable prior to radiotherapy, 21 patients (17%) were classified stable after three months, and 30 patients (24%) stable after six months. A pathological fracture was diagnosed in 62 patients (18%) prior to radiotherapy. Regarding cases of osteolytic metastases of the vertebral bodies in which no fractures could be detected prior to the start of therapy, fractures occurred in 2% of all patients (n = 7) within six months following radiotherapy. Our analysis demonstrated that pathological fractures following radiotherapy occur in the very minority of vertebral lesions for patients with a favorable outcome. The use of a systematic radiological scoring system to classify osteolytic metastases of the vertebral column has shown to be feasible in daily routine. Prospective clinical trials are warranted in order to analyse, to what extent patients with osseous metastases can be mobilized by physiotherapy for strengthening the paravertebral muscles before radiotherapy effects can be measured by means of radiological recalcification

  20. Safety of pull-type and introducer percutaneous endoscopic gastrostomy tubes in oncology patients: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Pelckmans Paul A

    2011-03-01

    Full Text Available Abstract Background Percutaneous endoscopic gastrostomy (PEG allows long-term tube feeding. Safety of pull-type and introducer PEG placement in oncology patients with head/neck or oesophageal malignancies is unknown. Methods Retrospective analysis of 299 patients undergoing PEG tube placement between January 2006 and December 2008 revealed 57 oncology patients. All patients with head/neck or oesophageal malignancy were treated with chemo- and radiotherapy. In case of high-grade stenosis introducer Freka® Pexact PEG tube was placed (n = 24 and in all other patients (n = 33 conventional pull-type PEG tube. Short-term complications and mortality rates were compared. Results Patients' characteristics and clinical status were comparable in both groups. Short-term complications were encountered in 11/24 (48% introducer PEG patients as compared to only 4/33 (12% pull-type PEG patients (P vs. 0/33 (0%, P vs. 3/33 (9%, NS. Finally, 3/24 gastrointestinal perforations (12% resulted from a difficult placement procedure vs. 1/33 (3%, leading to urgent surgical intervention and admission to ICU. Two introducer PEG patients died at ICU, resulting in an overall mortality rate of 8% vs. 0% (P = 0.091. Conclusion The introducer Freka® Pexact PEG procedure for long-term tube feeding may lead to significantly higher complication and mortality rates in patients with head/neck or oesophageal malignancies treated with chemo- and radiotherapy. It is suggested to use the conventional pull-type PEG tube placement in this group of patients, if possible.

  1. [Acute ethanol intoxication among children and adolescents. A retrospective analysis of 173 patients admitted to a university children hospital].

    Science.gov (United States)

    Schöberl, S; Nickel, P; Schmutzer, G; Siekmeyer, W; Kiess, W

    2008-01-01

    In the last time the alcohol consumption among children and adolescents is a big theme in all kind of media. The ethanol consumption among children and adolescents has risen during the last years, but also new hazardous drinking patterns like "binge-drinking" are increasing. These drinking episodes are responsible for many hospital presentations of children and adolescents with acute ethanol intoxication. This study is a retrospective analysis of 173 patients admitted to the university children hospital of Leipzig due to acute ethanol intoxication during the period 1998-2004. Investigated parameters were: socio-demographic factors, clinical presentation and management as well as quantity and type of alcohol. During the years 1998-2004 the rate of alcohol intoxicated patients in this study increased, from 1998-2003 at about 171.4%. Totally 173 patients with an average age of 14.5 years were admitted to the university children hospital. There were significantly more boys than girls. The mean blood alcohol concentration of these patients was 1.77%. Some of the patients had severe symptoms. 62 were unconscious, 2 were in coma and at least 3 patients had to be ventilated. A difference between socioeconomic groups could be observed by comparing the different school types. 44.8% of the patients went to the middle school. Furthermore 17 patients of this study had mental disorders or psychosocial problems and were therefore in psychological or psychiatric treatment. In this study a significant influence of social classes or psychosocial problems on alcohol consumption such as binge-drinking leading to acute ethanol intoxication could not be found. Alarming is the increasing number of ethanol intoxicated patients, the young age, the high measured blood ethanol concentrations and the severe symptoms of these patients. This is the reason why early and intensive prevention strategies are required.

  2. Mucocutaneous manifestations of HIV infection: a retrospective analysis of 145 cases in a Chinese population in Malaysia.

    Science.gov (United States)

    Jing, W; Ismail, R

    1999-06-01

    Mucocutaneous lesions directly related to human immunodeficiency virus (HIV) infection usually present as initial manifestations of immune deficiency. The most common mucocutaneous lesions are Kaposi's sarcoma, histoplasmosis, oro-esophageal candidiasis, oral hairy leukoplakia, and, in Asia, Penicillium marneffei infection. Non-HIV-related skin lesions, such as psoriasis, seborrheic dermatitis, and nodular prurigo, may be the initial presentation among HIV infected patients attending outpatient clinics. A retrospective analysis was performed on 145 HIV-positive Malaysians of Chinese descent from two centers at the University Hospital Kuala Lumpur (UHKL) and the General Hospital Kuala Lumpur (GHKL) from March 1997 to February 1998. Demographic data and clinical data were analyzed. The analysis showed that 104 out of 145 patients had mucocutaneous disorders (71.7%). In the study, there were 100 men (96.2%) and four women (3.8%). The majority of patients were in the age group 20-50 years. The patients who presented with mucocutaneous disease also had low CD4+ T-lymphocyte counts and most had acquired immunodeficiency syndrome (AIDS) defining illness. The number of cases with generalized hyperpigmentation was very high in the group (35.9%), followed by nodular prurigo (29.7%) and xerosis (27.6%). Seborrheic dermatitis was seen in 20.7% of cases, with psoriasis in 8.3%. The most common infections were oral candidiasis (35.9%), tinea corporis and onychomycosis (9.7%), and herpes infection (5.5%); however, mucocutaneous manifestations of Kaposi's sarcoma were rare. The results suggest that mucocutaneous findings are useful clinical predictors of HIV infection or signs of the presence of advanced HIV infection.

  3. Retrospective analysis of the utility of multiparametric MRI for differentiating between benign and malignant breast lesions in women in China.

    Science.gov (United States)

    Fan, Wei Xiong; Chen, Xiao Feng; Cheng, Feng Yan; Cheng, Ya Bao; Xu, Tai; Zhu, Wen Biao; Zhu, Xiao Lei; Li, Gui Jin; Li, Shuai

    2018-01-01

    We explored the utility of time-resolved angiography with interleaved stochastic trajectories dynamic contrast-enhanced magnetic resonance imaging (TWIST DCE-MRI), readout segmentation of long variable echo-trains diffusion-weighted magnetic resonance imaging- diffusion-weighted magnetic resonance imaging (RESOLVE-DWI), and echo-planar imaging- diffusion-weighted magnetic resonance imaging (EPI-DWI) for distinguishing between malignant and benign breast lesions.This retrospective analysis included female patients with breast lesions seen at a single center in China between January 2016 and April 2016. Patients were allocated to a benign or malignant group based on pathologic diagnosis. All patients received routine MRI, RESOLVE-DWI, EPI-DWI, and TWIST DCE-T1WI. Variables measured included quantitative parameters (K, Kep, and Ve), semiquantitative parameters (rate of contrast enhancement for contrast agent inflow [W-in], rate of contrast decay for contrast agent outflow [W-out], and time-to-peak enhancement after contrast agent injection [TTP]) and apparent diffusion coefficient (ADC) values for RESOLVE-DWI (ADCr) and EPI-DWI (ADCe). Receiver-operating characteristic (ROC) curve analysis was used to evaluate the diagnostic utility of each parameter for differentiating malignant from benign breast lesions.A total of 87 patients were included (benign, n = 20; malignant, n = 67). Compared with the benign group, the malignant group had significantly higher K, Kep and W-in and significantly lower W-out, TTP, ADCe, and ADCr (all P benign and malignant lesions. Combining 3 parameters (Kep, W-out, and ADCr) had a higher diagnostic efficiency (AUC, 0.965) than any individual parameter and distinguished between benign and malignant lesions with high sensitivity (91.0%), specificity (95.0%), and accuracy (91.9%).An index combining Kep, W-out, and ADCr could potentially be used for the differential diagnosis of breast lesions.

  4. Which subtype of functional dyspepsia patients responses better to acupuncture? A retrospective analysis of a randomized controlled trial.

    Science.gov (United States)

    Ma, Tingting; Zeng, Fang; Li, Ying; Wang, Chieh-Mei; Tian, Xiaoping; Yu, Shuyuan; Zhao, Ling; Wu, Xi; Yang, Min; Wang, Dejun; Liang, Fanrong

    2015-01-01

    Whether subgroups of functional dyspepsia (FD) should be treated with different approaches is controversially discussed in research. As our previous study has demonstrated the effect of acupuncture in FD treatment, we now further analyze the therapeutic effect of acupuncture in the treatment of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). A retrospective analysis was conducted in 465 eligible PDS patients and 241 EPS patients. 4 acupuncture groups (group A: specific acupoints along the stomach meridian; group B: non-specific acupoints along the stomach meridian; group C: alarm and transport acupoints; group D: specific acupoints along the gallbladder meridian) were compared with a non-acupoint sham acupuncture group and an itopride group. The patients were treated in 5 consecutive sessions per week for 4 weeks and were followed-up for 12 weeks afterwards. Primary outcome of the study was defined as response rate and symptom improvement as measured by the Symptom Index of Dyspepsia, while secondary outcome was designated as improvement in quality of life (QoL) as determined by the Nepean Dyspepsia Index. Symptoms of dyspepsia and QoL were improved from baseline in all groups. In EPS patients, no statistically significant differences could be observed in response rate (p = 0.239) and symptoms improvement (p = 0.344 for epigastric pain; p = 0.465 for epigastric burning). In contrast, PDS patients of the acupuncture group A showed higher response rate (53.2% vs. 19.7%, pitopride group. FD patients with PDS responded better to the acupuncture therapies, especially at the specific acupoints along the stomach meridian. The positive therapeutic effect of acupuncture on PDS was correlated with the improvement in postprandial fullness. ClinicalTrial.gov NCT00599677. © 2015 S. Karger GmbH, Freiburg.

  5. Prolonged methylprednisolone therapy after the pulse treatment for patients with moderate-to-severe paraquat poisoning: A retrospective analysis.

    Science.gov (United States)

    Gao, Jie; Feng, ShunYi; Wang, Jian; Yang, SiYuan; Li, Yong

    2017-06-01

    This retrospective study aims to evaluate the effect of prolonged methylprednisolone (MP) therapy on the mortality of patients with moderate-to-severe paraquat (PQ) poisoning after the pulse treatment.We performed a retrospective analysis of patients with acute moderate-to-severe PQ poisoning that were admitted to the emergency department from May 2012 to August 2016. Out of 138 patients, 60 were treated with pulse treatment (15 mg kg day MP for 3 days) and 78 were treated with prolonged MP therapy after pulse treatment (15 mg kg day MP for 3 days; afterward, the dosage was reduced in half every 2 days, and the MP therapy was terminated until 0.47 mg kg day). Kaplan-Meier method was used to compare the mortality between the 2 groups. Cox proportional hazard models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI).The mortality of the prolonged MP therapy after pulse treatment group was lower than that of the pulse group (47.4% vs 63.3%; log-rank tests, P  =  .003). According to the multivariate Cox analysis, the prolonged MP therapy after pulse treatment was significantly associated with a lower mortality risk (HR: 0.31, 95% CI: 0.19-0.52, P treatment caused more incidences of leucopenia than the pulse treatment alone (25.6% vs 11.7%, P  =  .04).The prolonged MP therapy after pulse treatment can reduce the mortality of moderate-to-severe PQ poisoning patients.

  6. Cost of placement and complications associated with osseointegrated bone-conducting hearing prostheses: a retrospective analysis of medicare billing data.

    Science.gov (United States)

    Pross, Seth E; Layton, Andrew; Tong, Kuo; Lustig, Lawrence R

    2014-03-01

    To report the cost of placement and complications related to osseointegrated bone-conducting hearing prostheses (OBHPs) in a Medicare population. We performed a retrospective analysis of nationwide Medicare claims data for operative and nonoperative complications associated with the placement of percutaneous OBHPs between the first quarter of 2007 and the second quarter of 2009 for which there were 6 subsequent quarters of follow-up. We used Medicare Standard Analytical Files (SAF), which contain a 5% random sample of Medicare fee-for-service beneficiaries, excluding those that also were enrolled in a managed-care organization. We identified 118 patients who had OBHPs placed in the requisite period. Their complication billing data were analyzed for the six-quarters after initial placement. Seventy patients (59%) had no billing codes for complications or repeat procedures after receiving the implant, whereas 48 patients (41%) had such codes. The total adjusted mean cost with repeat/revision operations or complications was $7,812 per patient compared with $6,733 for those without these issues, an increase of $1,079 or 16%. We estimate that complications associated with the implantation of percutaneous OBHPs led to $417,616 in additional costs in the entire Medicare fee-for-service population during the study period and that the total cost of placement of these devices together with the cost of their complications totaled $6,789,248. In conclusion, the Medicare SAF database suggests that complications associated with OBHP increased the overall cost of placement by 16%. Like all surgical procedures, these complications and their associated costs should be taken into account when considering treatment options for patients who experience hearing loss.

  7. Assessment of Various Risk Factors for Success of Delayed and Immediate Loaded Dental Implants: A Retrospective Analysis.

    Science.gov (United States)

    Prasant, M C; Thukral, Rishi; Kumar, Sachin; Sadrani, Sannishth M; Baxi, Harsh; Shah, Aditi

    2016-10-01

    Ever since its introduction in 1977, a minimum of few months of period is required for osseointegration to take place after dental implant surgery. With the passage of time and advancements in the fields of dental implant, this healing period is getting smaller and smaller. Immediate loading of dental implants is becoming a very popular procedure in the recent time. Hence, we retrospectively analyzed the various risk factors for the failure of delayed and immediate loaded dental implants. In the present study, retrospective analysis of all the patients was done who underwent dental implant surgeries either by immediate loading procedure or by delayed loading procedures. All the patients were divided broadly into two groups with one group containing patients in which delayed loaded dental implants were placed while other consisted of patients in whom immediate loaded dental implants were placed. All the patients in whom follow-up records were missing and who had past medical history of any systemic diseases were excluded from the present study. Evaluation of associated possible risk factors was done by classifying the predictable factors as primary and secondary factors. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Kaplan-Meier survival analyses and chi-square test were used for assessment of level of significance. In delayed and immediate group of dental implants, mean age of the patients was 54.2 and 54.8 years respectively. Statistically significant results were obtained while comparing the clinical parameters of the dental implants in both the groups while demographic parameters showed nonsignificant correlation. Significant higher risk of dental implant failure is associated with immediate loaded dental implants. Tobacco smoking, shorter implant size, and other risk factors play a significant role in predicting the success and failure of dental implants. Delayed loaded dental implant placement should be preferred

  8. CAN A SPECIFIC NECK STRENGTHENING PROGRAM DECREASE CERVICAL SPINE INJURIES IN A MEN'S PROFESSIONAL RUGBY UNION TEAM? A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Robert Naish

    2013-09-01

    Full Text Available Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009 or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009. However, a significant (p = 0.03 reduction in the number of match injuries was evident from 2007-2008 (n = 11 to 2008-09 (n = 2. Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes

  9. A retrospective analysis of surgical site infections after chlorhexidine-alcohol versus iodine-alcohol for pre-operative antisepsis.

    Science.gov (United States)

    Charehbili, Ayoub; Swijnenburg, Rutger-Jan; van de Velde, Cornelis; van den Bremer, Jephta; van Gijn, Willem

    2014-06-01

    Surgical site infection (SSI) is the most common hospital-acquired infection in the Netherlands. There is little evidence in regard to differences in the efficacy of pre-operative topical antisepsis with iodine-alcohol as compared with chlorhexidine-alcohol for preventing SSI. We conducted a retrospective analysis at a single center, involving all patients who underwent breast, colon, or vascular surgery in 2010 and 2011, in which pre-operative disinfection of the skin was done with iodine-alcohol in 2010 and with chlorhexidine-alcohol in 2011. Demographic characteristics, surgical parameters, and rates of SSI were compared in the two groups of patients. Subgroup analyses were done for wound classification, wound type, and type of surgery performed. Associations of patient characteristics with SSI were also investigated. Data were analyzed with χ(2) tests, Student t-tests, and logistic regression analysis. No statistically significant difference was found in the rates of SSI in the two study groups, at 6.1% for the patients who underwent antisepsis with iodine-alcohol and 3.8% for those who underwent disinfection with chlorhexidine-alcohol (p=0.20). After multivariable analysis, an odds ratio (OR) of 0.68 (95% confidence interval [CI] 0.30-1.47) in favor of chlorhexidine-alcohol was found. Male gender, acute surgery, absence of antibiotic prophylaxis, and longer hospital length of stay (LOS) were all associated with SSI after pre-operative topical antisepsis. In this single-center study conducted over a course of one year with each of the preparations investigated, no difference in the rate of SSI was found after an instantaneous protocol change from iodine-alcohol to chlorhexidine-alcohol for pre-operative topical antisepsis.

  10. Adult "termination-of-resuscitation" (TOR)-criteria may not be suitable for children - a retrospective analysis.

    Science.gov (United States)

    Rotering, Victoria Maria; Trepels-Kottek, Sonja; Heimann, Konrad; Brokmann, Jörg-Christian; Orlikowsky, Thorsten; Schoberer, Mark

    2016-12-07

    Only a small number of patients survive out-of-hospital-cardiac-arrest (OHCA). The duration of CPR varies considerably and transportation of patients under CPR is often unsuccessful. Termination-of-resuscitation (TOR)-criteria aim to preclude futile resuscitation efforts. Our goal was to find out to which extent existing TOR-criteria can be transferred to paediatric OHCA-patients with special regard to their prognostic value. We performed a retrospective analysis of an eleven-year single centre patient cohort. 43 paediatric patients admitted to our institution after emergency-medical-system (EMS)-confirmed OHCA from 2003 to 2013 were included. Morrison's BLS- and ALS-TOR-rules as well as the Trauma-TOR-criteria by the American Association of EMS Physicians were evaluated for application in children, by calculating sensitivity, specificity, negative and positive predictive value for death-, as well as survival-prediction in our cohort. 26 patients achieved ROSC and 14 were discharged alive (n = 7 PCPC 1/2, n = 7 PCPC 5). Sensitivity for BLS-TOR-criteria predicting death was 48.3%, specificity 92.9%, the PPV 93.3% and the NPV 46.4%. ALS-TOR-criteria for death had a sensitivity of 10.3%, specificity of 100%, a PPV of 100% and an NPV of 35%. Retrospective application of the BLS-TOR-rule in our patient cohort identified the resuscitation of one later survivor as futile. ALS-TOR-criteria did not give false predictions of death. The proportion of CPRs that could have been abandoned is 48.2% for the BLS-TOR and only 10.3% for the ALS-TOR-rule. Both rules therefore appear not to be transferable to a paediatric population.

  11. Train-of-four recovery precedes twitch recovery during reversal with sugammadex in pediatric patients: A retrospective analysis.

    Science.gov (United States)

    Vieira Carlos, Ricardo; Luis Abramides Torres, Marcelo; de Boer, Hans Donald

    2018-04-01

    After reversal of a rocuronium-induced neuromuscular blockade with sugammadex, the recovery of train-of-four ratio to 0.9 is faster than recovery of first twitch of the train-of-four to 90% in adults. These findings after reversal of neuromuscular blockade with sugammadex have not yet been investigated in pediatric patients. The aim of this retrospective analysis was to investigate the relationship of the recovery of first twitch of the train-of-four height and train-of-four ratio after reversal of rocuronium-induced neuromuscular blockade with sugammadex in pediatric patients. Patients ASA I-III, aged 2-11 years, and who underwent abdominal and/or perineal surgery were included in the analysis. After extracting the necessary data from the hospital database, the patients were divided into 2 groups based on the dose of sugammadex received: group A: 2 mg.kg -1 for reversal of moderate neuromuscular blockade and group B: 4 mg.kg -1 for reversal of deep neuromuscular blockade. The relationship of the recovery of first twitch of the train-of-four height and train-of-four ratio in these 2 groups were analyzed. Data from 43 pediatric patients aged 2-11 years could be analyzed. The first twitch of the train-of-four height at the recovery of train-of-four ratio to 0.9 in group B was statistically significantly lower compared with group A. This height 3 and 5 minutes after the train-of-four ratio reached 0.9 showed no statistically significant differences between groups. The results were in line with the results found in adults and showed that the train-of-four ratio recovered to 0.9 was faster than first twitch of the train-of-four height recovered to the same level. © 2018 John Wiley & Sons Ltd.

  12. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan.

    Science.gov (United States)

    Bekolo, Cavin Epie; van Loenhout, Joris Adriaan Frank; Rodriguez-Llanes, Jose Manuel; Rumunu, John; Ramadan, Otim Patrick; Guha-Sapir, Debarati

    2016-09-01

    To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South Sudan on patients who developed cholera disease between 23 April and 20 July 2014 during a large outbreak, a few months after a pre-emptive oral vaccination campaign. Patients who developed severe dehydration were regarded as having a severe cholera infection. Vaccinated and unvaccinated patients were compared and multivariate logistic regression analysis was used to identify factors associated with developing severe disease or death. In total, 4115 cholera patients were treated at the 41 facilities: 1946 (47.3%) had severe disease and 62 (1.5%) deaths occurred. Multivariate analysis showed that patients who received two doses of oral cholera vaccine were 4.5-fold less likely to develop severe disease than unvaccinated patients (adjusted odds ratio, aOR: 0.22; 95% confidence interval, CI: 0.11-0.44). Moreover, those with severe cholera were significantly more likely to die than those without (aOR: 4.76; 95% CI: 2.33-9.77). Pre-emptive vaccination with two doses of oral cholera vaccine was associated with a significant reduction in the likelihood of developing severe cholera disease during an outbreak in South Sudan. Moreover, severe disease was the strongest predictor of death. Two doses of oral cholera vaccine should be used in emergencies to reduce the disease burden.

  13. SOUTHEAST ASIA: HISTORY, MODERNITY, AND RELIGIOUS CHANGE

    Directory of Open Access Journals (Sweden)

    Sumanto Al Qurtuby

    2015-11-01

    Full Text Available Southeast Asia or Southeastern Asia, with more than six hundred million populations, is home to millions of Buddhists, Muslims, Confucians, Protestants, Catholics, and now Pentecostals, as well as many followers of local religions and spiritual beliefs. Notwithstanding its great historical, political, cultural legacies, however, the region has long been neglected as a site for religious studies in the Western academia. Aiming at filling the gap in Asian and religious studies as well as exploring the richness of Southeast Asian cultures, this article discusses the dynamics, diversity, and complexity of Southeast Asian societies in their response to the region’s richly political, cultural, and religious traditions spanning from pre-modern era to modern one. The article also examines the “integrative revolutions” that shaped and reshaped warfare, state organization and economics of Southeast Asia, particularly in the pre-European colonial era. In addition, the work discusses the wave of Islamization, particularly since the nineteenth century, as well as the upsurge of religious resurgence that shift the nature of religiosity and the formation of religious groupings in the area. The advent of Islam, with some interventions of political regimes, had been an important cause for the decline of Hindu-Buddhist traditions in some areas of Southeast Asia, especially Indonesia, the coming of Pentecostalism has challenged the well-established mainstream Protestantism and Catholicism, especially in Indonesia and the Philippines. Keywords: history, modernity, religious change, Southeast Asia

  14. Ten Sins Challenging Education in the Contemporary Global Era: A Philosophical Essay

    Science.gov (United States)

    Sinagatullin, Ilghiz M.

    2004-01-01

    According to this author, the modern epoch is characterized by a decrease of vital spirituality and an increase of materialistic values and virtues. This article discusses what the author views as the ten sins challenging education in the contemporary global era. These are: (1) the shrinking of spiritual values; (2) corruption; (3) sexual…

  15. Evaluation of a 12-km Satellite-Era Reanalysis of Surface Mass Balance for the Greenland Ice Sheet

    Science.gov (United States)

    Cullather, R. I.; Nowicki, S.; Zhao, B.; Max, S.

    2016-12-01

    The recent contribution to sea level change from the Greenland Ice Sheet is thought to be strongly driven by surface processes including melt and runoff. Global reanalyses are potential means of reconstructing the historical time series of ice sheet surface mass balance (SMB), but lack spatial resolution needed to resolve ablation areas along the periphery of the ice sheet. In this work, the Modern-Era Retrospective analysis for Research and Applications, version 2 (MERRA-2) is used to examine the spatial and temporal variability of surface melt over the Greenland Ice Sheet. MERRA-2 is produced for the period 1980 to the present at a grid spacing of ½° latitude by ⅝° longitude, and includes snow hydrology processes including compaction, meltwater percolation and refreezing, runoff, and a prognostic surface albedo. The configuration of the MERRA-2 system allows for the background model - the Goddard Earth Observing System model, version 5 (GEOS-5) - to be carried in phase space through analyzed states via the computation of analysis increments, a capability referred to as "replay". Here, a MERRA-2 replay integration is conducted in which atmospheric forcing fields are interpolated and adjusted to sub- atmospheric grid-scale resolution. These adjustments include lapse-rate effects on temperature, humidity, precipitation, and other atmospheric variables that are known to have a strong elevation dependency over ice sheets. The surface coupling is performed such that mass and energy are conserved. The atmospheric forcing influences the surface representation, which operates on land surface tiles with an approximate 12-km spacing. This produces a high-resolution, downscaled SMB which is interactively coupled to the reanalysis model. We compare the downscaled SMB product with other reanalyses, regional climate model values, and a second MERRA-2 replay in which the background model has been replaced with a 12-km, non-hydrostatic version of GEOS-5. The assessment

  16. Survival of Er(a+) red cells in a patient with allo-anti-Era

    International Nuclear Information System (INIS)

    Thompson, H.W.; Skradski, K.J.; Thoreson, J.R.; Polesky, H.F.

    1985-01-01

    51 Chromium-labeled Er(a+) red cells survived nearly normally (T1/2 of 21 days) in a patient with allo-anti-Era. Transfusion of Er(a+) blood was without significant reaction and did not affect the anti-Era titer

  17. BIMBINGAN KONSELING AGAMA UNTUK MASYARAKAT MODERN

    Directory of Open Access Journals (Sweden)

    Darwis Darwis

    2016-01-01

    Full Text Available Tulisan ini  bertujuan untuk  memberikan informasi tentang kondisi masyarakat yang masuk pada era modern. Ciri modern yaitu cepatnya akses informasi karena kecanggihan  teknologi serta wawasan yang luas karena ada kebebasan berpikir (padahal manusia memiliki  keterbatasan kondisi fisik. Meskipun pemahaman tentang tentang perubahan senantiasa terjadi dalam kehidupan masyarakat, karena individu wajib mengikuti perubahan (yang membuat individu “dipaksa” untuk mengikuti dengan mengoptimalkan seluruh  potensi  yang  ada  pada manusia, yang tidak boleh berubah adalah keyakinan. Namun bagi individu yang “kurang tegas” dalam mengambil sikap di era modern ini akan menimbulkan penyimpangan dalam berbagai aspek kehidupan, sebagai akibat negatif  dari laju modernism yang memiliki kecenderungan meninggalkan nilai-nilai spiritual berdampak pada “kehampaan”  dan keterasingan dengan diri sendiri. Sehingga untuk mengembalikan manusia pada fitrahnya maka butuh konseling  agama yaitu membantu manusia agar mencapai derajat “kecerdasan qalbiah”, artinya: menggambarkan sejumlah kemampuan diri secara cepat dan sempurna untuk mengenali kalbu  dan  aktivitas-aktivitasnya,   mengelola   dan mengekspresikan jenis-jenis kalbu secara benar,  memotivasi kalbu untuk membina hubungan moralitas dengan orang lain dan hubungan ubudiyah dengan Tuhan agar kebutuhan manusia yaitu bio-psiko-sosio-religius terpenuhi secara seimbang untuk mendapatkan kebahagiaan dunia-akherat. RELIGIOUS  COUNSELING   GUIDANCE   TO MODERN SOCIETY. This paper aims to provide information about the condition of the people who entered the modern era. Modern characteristic is the speed of access to information because of technological sophistication and broad insight as freedom of thought (even though humans have limited physical condition.   Although understanding of the changes always occur in people’s lives, because the individual  is obliged to follow the

  18. International Orders in the Early Modern World

    DEFF Research Database (Denmark)

    a secondary role. These perspectives emphasise the central role of non-European agency in shaping global history, and stand in stark contrast to conventional narratives revolving around the ‘Rise of the West’, which tend to be based upon a stylized contrast between a dynamic West and a passive and static East....... Focusing on a crucial period of global history that has been neglected in the field of International Relations, the book reveals profound differences between the early modern era and the more familiar colonial conquests of the second half of the nineteenth century. It will be interest to students...

  19. Sugammadex for reversal of neuromuscular blockade: a retrospective analysis of clinical outcomes and cost-effectiveness in a single center.

    Science.gov (United States)

    Carron, Michele; Baratto, Fabio; Zarantonello, Francesco; Ori, Carlo

    2016-01-01

    The aim of the study is to evaluate the clinical and economic impact of introducing a rocuronium-neostigmine-sugammadex strategy into a cisatracurium-neostigmine regimen for neuromuscular block (NMB) management. We conducted a retrospective analysis of clinical outcomes and cost-effectiveness in five operating rooms at University Hospital of Padova. A clinical outcome evaluation after sugammadex administration as first-choice reversal drug in selected patients (rocuronium-sugammadex) and as rescue therapy after neostigmine reversal (rocuronium-neostigmine-sugammadex) compared to control was performed. A cost-analysis of NMB management accompanying the introduction of a rocuronium-neostigmine-sugammadex strategy into a cisatracurium-neostigmine regimen was carried out. To such purpose, two periods were compared: 2011-2012, without sugammadex available; 2013-2014, with sugammadex available. A subsequent analysis was performed to evaluate if sugammadex replacing neostigmine as first choice reversal drug is cost-effective. The introduction of a rocuronium-neostigmine-sugammadex strategy into a cisatracurium-neostigmine regimen reduced the average cost of NMB management by 36%, from €20.8/case to €13.3/case. Patients receiving sugammadex as a first-choice reversal drug (3%) exhibited significantly better train-of-four ratios at extubation (Psugammadex as first-choice reversal drug has been estimated to be €2.9/case. Patients receiving sugammadex as rescue therapy after neostigmine reversal (3.2%) showed no difference in time to discharge to the surgical ward (P=0.44) compared to controls. No unplanned intensive care unit (ICU) admissions with rocuronium-neostigmine-sugammadex strategy were observed. The potential economic benefit in avoiding postoperative residual curarization (PORC)-related ICU admission in the 2013-2014 period was estimated at an average value of €13,548 (€9,316-€23,845). Sugammadex eliminated PORC and associated morbidities. In our center

  20. Sugammadex for reversal of neuromuscular blockade: a retrospective analysis of clinical outcomes and cost-effectiveness in a single center

    Directory of Open Access Journals (Sweden)

    Carron M

    2016-02-01

    Full Text Available Michele Carron, Fabio Baratto, Francesco Zarantonello, Carlo Ori Department of Medicine, Anesthesiology and Intensive Care, University of Padova, Padova, Italy Objective: The aim of the study is to evaluate the clinical and economic impact of introducing a rocuronium–neostigmine–sugammadex strategy into a cisatracurium–neostigmine regimen for neuromuscular block (NMB management. Methods: We conducted a retrospective analysis of clinical outcomes and cost-effectiveness in five operating rooms at University Hospital of Padova. A clinical outcome evaluation after sugammadex administration as first-choice reversal drug in selected patients (rocuronium–sugammadex and as rescue therapy after neostigmine reversal (rocuronium–neostigmine–sugammadex compared to control was performed. A cost-analysis of NMB management accompanying the introduction of a rocuronium–neostigmine–sugammadex strategy into a cisatracurium–neostigmine regimen was carried out. To such purpose, two periods were compared: 2011–2012, without sugammadex available; 2013–2014, with sugammadex available. A subsequent analysis was performed to evaluate if sugammadex replacing neostigmine as first choice reversal drug is cost-effective. Results: The introduction of a rocuronium–neostigmine–sugammadex strategy into a cisatracurium–neostigmine regimen reduced the average cost of NMB management by 36%, from €20.8/case to €13.3/case. Patients receiving sugammadex as a first-choice reversal drug (3% exhibited significantly better train-of-four ratios at extubation (P<0.001 and were discharged to the surgical ward (P<0.001 more rapidly than controls. The cost-saving of sugammadex as first-choice reversal drug has been estimated to be €2.9/case. Patients receiving sugammadex as rescue therapy after neostigmine reversal (3.2% showed no difference in time to discharge to the surgical ward (P=0.44 compared to controls. No unplanned intensive care unit (ICU

  1. Correlation between Condylar Fracture Pattern after Parasymphyseal Impact and Condyle Morphological Features: A Retrospective Analysis of 107 Chinese Patients.

    Science.gov (United States)

    Han, Lu; Long, Ting; Tang, Wei; Liu, Lei; Jing, Wei; Tian, Wei-Dong; Long, Jie

    2017-02-20

    The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics. We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional (3D) reconstruction mandible models through the Mimics 16.0 (Materialize Leuven, Belgium) anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups. The results showed that the differences of condylar head width (M1), condylar neck width (M3), the ratio of condylar head width to condylar anteroposterior diameter (M1/M2), the ratio of condylar head width to condylar neck width (M1/M3), the ratio of condylar height to ramus height (M8/M7), and mandibular angle (M10) were statistically significant (p fractures were positively associated with M1 (compared to Type B: OR =1.627, 95% CI: 1.123, 2.359; compared to Type C: OR = 1.705, 95% CI: 1.170, 2.484) and M1/M2 (compared to Type B: OR =1.034, 95% CI: 0.879, 2.484). Type B condylar head fractures were negatively associated with M10 (compared to Type C: OR = 0.909, 95% CI: 0.821, 1.007). Condylar neck fractures were negatively associated with M3 (compared to condylar head: OR = 0.382, CI: 0.203, 0.720 ; compared to condylar base: OR = 0.436, 95% CI: 0.218, 0.874), and positively associated with M1/M3 (compared to condylar head: OR = 1.229, 95% CI: 1.063, 1.420 compared to condylar base: OR = 1.223, 95% CI: 1.034, 1.447). Condylar base fractures were positively associated with M10 (OR = 1.095, 95% CI: 1.008, 1.189) and

  2. Can a Specific Neck Strengthening Program Decrease Cervical Spine Injuries in a Men's Professional Rugby Union Team? A Retrospective Analysis

    Science.gov (United States)

    Naish, Robert; Burnett, Angus; Burrows, Sally; Andrews, Warren; Appleby, Brendyn

    2013-01-01

    Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase) was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009) or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009). However, a significant (p = 0.03) reduction in the number of match injuries was evident from 2007-2008 (n = 11) to 2008-09 (n = 2). Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes. Key Points While many authors have proposed that neck strengthening could be an effective strategy in preventing cervical spine injuries in

  3. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis.

    Science.gov (United States)

    Vinkers, Christiaan H; Tijdink, Joeri K; Otte, Willem M

    2015-12-14

    To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. The yearly frequencies of positive, negative, and neutral words (25 preselected words in each category), plus 100 randomly selected words were normalised for the total number of abstracts. Subanalyses included pattern quantification of individual words, specificity for selected high impact journals, and comparison between author affiliations within or outside countries with English as the official majority language. Frequency patterns were compared with 4% of all books ever printed and digitised by use of Google Books Ngram Viewer. Frequencies of positive and negative words in abstracts compared with frequencies of words with a neutral and random connotation, expressed as relative change since 1980. The absolute frequency of positive words increased from 2.0% (1974-80) to 17.5% (2014), a relative increase of 880% over four decades. All 25 individual positive words contributed to the increase, particularly the words "robust," "novel," "innovative," and "unprecedented," which increased in relative frequency up to 15,000%. Comparable but less pronounced results were obtained when restricting the analysis to selected journals with high impact factors. Authors affiliated to an institute in a non-English speaking country used significantly more positive words. Negative word frequencies increased from 1.3% (1974-80) to 3.2% (2014), a relative increase of 257%. Over the same time period, no apparent increase was found in neutral or random word use, or in the frequency of positive word use in published books. Our lexicographic analysis indicates that scientific abstracts are currently written with more positive and negative words, and provides an insight into the evolution of scientific writing. Apparently scientists look on the bright side of research

  4. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

    Science.gov (United States)

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-06-01

    The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more

  5. Treatment adherence and persistence with long-acting somatostatin analog therapy for the treatment of acromegaly: a retrospective analysis.

    Science.gov (United States)

    Gurel, Michelle H; Han, Yi; Stevens, Andrea L; Furtado, Aaron; Cox, David

    2017-04-04

    Many patients with acromegaly require medical treatment that includes somatostatin analogs (SSAs). Long-acting SSA formulations are widely used, due in part to increased patient convenience and increased treatment adherence vs daily medications. Although medication compliance can be poor in patients with chronic conditions, adherence and persistence with these SSAs in patients with acromegaly has not been evaluated. This analysis utilized claims data to estimate treatment adherence and persistence for lanreotide depot and long-acting octreotide in this population. This retrospective analysis used the MarketScan® database (~100 payors, 500 million claims in the US), which was searched between January 2007 and June 2012 to identify patients with acromegaly taking either lanreotide depot or long-acting octreotide. Patients switching treatments were excluded. Treatment adherence was assessed using medication possession ratio (MPR; number of doses dispensed in relation to dispensing period; ≥80% is considered adherent), injection count, and treatment time. Persistence was estimated by Kaplan-Meier analyses and Cox proportional hazards modeling. A washout period, defined as no acromegaly-related prescription activity 180 days prior to the index date, was employed to minimize effects of prior therapy and focus on patients more likely to be treatment-naïve. Altogether 1308 patients with acromegaly receiving a single SSA for treatment (1127 octreotide, 181 lanreotide) who had not switched treatments were identified. Mean MPR in patients with a 180-day washout (n = 663) was 89% for those receiving octreotide (n = 545) and 87% for those receiving lanreotide (n = 118). Median number of days on therapy was 169 (95% CI 135-232) for octreotide patients and 400 (95% CI 232-532) for lanreotide patients. The point estimate of the Cox proportional hazard ratio for stopping treatment was 1.385 for octreotide vs lanreotide (95% CI 1.079-1.777), suggesting a 38

  6. Efficiency of spinal anesthesia versus general anesthesia for lumbar spinal surgery: a retrospective analysis of 544 patients

    Directory of Open Access Journals (Sweden)

    Pierce JT

    2017-10-01

    Full Text Available John T Pierce,1 Guy Kositratna,2 Mark A Attiah,1 Michael J Kallan,3 Rebecca Koenigsberg,1 Peter Syre,1 David Wyler,4 Paul J Marcotte,1 W Andrew Kofke,1,2 William C Welch1 1Department of Neurosurgery, 2Department of Anesthesiology and Critical Care, 3Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 4Department of Anesthesiology and Critical Care, Neurosurgery, Jefferson Hospital of Neuroscience, Thomas Jefferson University, Philadelphia PA, USA Background: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU, incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons. Materials and methods: A retrospective analysis was performed by querying the electronic medical record database for surgeries performed by a single surgeon between 2007 and 2011 using procedural codes 63030 for diskectomy and 63047 for laminectomy: 544 lumbar laminectomy and diskectomy surgeries were identified, with 183 undergoing general anesthesia and 361 undergoing spinal anesthesia (SA. Linear and multivariate regression analyses were performed to identify differences in blood loss, operative time, time from entering the operating room (OR until incision, time from bandage placement to exiting the OR, total anesthesia time, PACU time, and total hospital stay. Secondary outcomes of interest included incidence of postoperative spinal hematoma and death, incidence of paraparesis, plegia, post-dural puncture headache, and paresthesia, among the SA patients. Results: SA was associated with significantly lower operative time, blood loss, total anesthesia time, time

  7. Clinical usefulness of Tc-99m hexakis 2-methoxybutyl isonitrile gated SPECT in patients with dilated cardiomyopathy: retrospective analysis

    International Nuclear Information System (INIS)

    Khan, Z.R.; Khan, A.Z.

    2010-01-01

    Background: In Dilated cardiomyopathy the heart is enlarged and ventricles are dilated. Gated myocardial perfusion single photon emission computed tomography is considered state of the art for myocardial perfusion imaging. A retrospective analysis was conducted to evaluate patients with dilated cardiomyopathy with Tc-99m sestamibi gated myocardial perfusion single photon emission computed tomography to evaluate its clinical utility. Methods: A 10 year retrospective medical record review was done from 1991 to 2001 at Wake Forest University, North Carolina, USA. Eligibility criteria included a diagnosis of dilated cardiomyopathy and availability of coronary angiography and Tc-99m sestamibi cardiac imaging results. 26 cases were selected for the final review and inclusion in the study. The study was done with standard protocols for cardiac sestamibi imaging. Results: A total of 26 cases were included in the final analysis. Cases were divided into two main groups. Group-A included 16 patients with no correlation between Tc-99m sestamibi and cardiac catheterisation reports. Group-B included 10 patients with good correlation between the above tests. There were no significant differences between the left ventricular ejection fraction, angina history, sex distribution and diabetic status between the two groups. We applied Wilcoxon Signed Rank Test and z-test to quantify the difference between the two groups. Data was tabulated and z-test was performed. The calculated p value was <0.0001. This is significantly less than the tabulated p-value at 5% level of significance, i.e., 1.96. Significant differences exist between Group-A and Group-B. Conclusion: Tc-99m sestamibi is an excellent agent for investigating myocardial perfusion in dilated cardiomyopathy. The reversible and fixed perfusion defects (small to medium sized) seen in dilated cardiomyopathy after performance of Tc-99m sestamibi gated single photon emission computed tomography imaging may not be due to coronary

  8. Are we ready for the ERAS protocol in colorectal surgery?

    Science.gov (United States)

    Kisielewski, Michał; Rubinkiewicz, Mateusz; Pędziwiatr, Michał; Pisarska, Magdalena; Migaczewski, Marcin; Dembiński, Marcin; Major, Piotr; Rembiasz, Kazimierz; Budzyński, Andrzej

    2017-01-01

    Modern perioperative care principles in elective colorectal surgery have already been established by international surgical authorities. Nevertheless, barriers to the introduction of routine evidence-based clinical care and changing dogmas still exist. One of the factors is the surgeon. To assess perioperative care trends in elective colorectal surgery among general surgery consultants in surgical departments in Malopolska Voivodeship, Poland. An anonymous standardized 20-question questionnaire was developed based on ERAS principles and sent out to Malopolska Voivodeship general surgery departments. Answers of general surgery consultants showed the level of acceptance of elements of perioperative care. The overall response rate was 66%. Several elements (antibiotic and antithrombotic prophylaxis, postoperative oxygen therapy, no nasogastric tubes) had quite a high acceptance rate. On the other hand, most crucial surgical perioperative elements (lack of mechanical bowel preparation, preoperative oral carbohydrate loading, use of laparoscopy and lack of drains, early fluid and oral diet intake, early mobilization) were not followed according to evidence-based ERAS protocol recommendations. Surgeons were not willing to change their practice, but were supportive of changes in anesthesiologist-dependent elements of perioperative care, such as restrictive fluid therapy, use of transversus abdominis plane blocks, etc. Many elements of perioperative care in elective colorectal surgery in Malopolska Voivodeship are still dictated by dogma and are not evidence-based. The level of acceptance of many important ERAS protocol elements is low. Surgeons are ready to accept only changes that do not interfere with their practice.

  9. General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis.

    Science.gov (United States)

    Tsiachristas, Apostolos; McDaid, David; Casey, Deborah; Brand, Fiona; Leal, Jose; Park, A-La; Geulayov, Galit; Hawton, Keith

    2017-10-01

    Self-harm is an extremely common reason for hospital presentation. However, few estimates have been made of the hospital costs of assessing and treating self-harm. Such information is essential for planning services and to help strengthen the case for investment in actions to reduce the frequency and effects of self-harm. In this study, we aimed to calculate the costs of hospital medical care associated with a self-harm episode and the costs of psychosocial assessment, together with identification of the key drivers of these costs. In a retrospective analysis, we estimated hospital resource use and care costs for all presentations for self-harm to the John Radcliffe Hospital (Oxford, UK), between April 1, 2013, and March 31, 2014. Episode-related data were provided by the Oxford Monitoring System for Self-harm and we linked these with financial hospital records to quantify costs. We assessed time and resources allocated to psychosocial assessments through discussion with clinical and managerial staff. We then used generalised linear models to investigate the associations between hospital costs and methods of self-harm. Between April 1, 2013, and March 31, 2014, 1647 self-harm presentations by 1153 patients were recorded. Of these, 1623 (99%) presentations by 1140 patients could be linked with hospital finance records. 179 (16%) patients were younger than 18 years. 1150 (70%) presentations were for self-poisoning alone, 367 (22%) for self-injury alone, and 130 (8%) for a combination of methods. Psychosocial assessments were made in 75% (1234) of all episodes. The overall mean hospital cost per episode of self-harm was £809. Costs differed significantly between different types of self-harm: self-injury alone £753 (SD 2061), self-poisoning alone £806 (SD 1568), self-poisoning and self-injury £987 (SD 1823; p<0·0001). Costs were mainly associated with the type of health-care service contact such as inpatient stay, intensive care, and psychosocial assessment. Mean

  10. Characterising non-urgent users of the emergency department (ED: A retrospective analysis of routine ED data.

    Directory of Open Access Journals (Sweden)

    Colin O'Keeffe

    Full Text Available The pressures of patient demand on emergency departments (EDs continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings.We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014. Data was collected on all adult (>16 years ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups.There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%. Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, P<0.001. The odds of a non-urgent attendance were significantly higher for younger patients (aged 16-44 compared to those aged 45-64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, P<0.001 and the over 65's (odds ratio: 3.81, 95% CI: 3.78 to 3.85, P<0.001. Younger patients were significantly more likely to attend non-urgently out of hours compared to the 45-64's (OR = 1.24, 95% CI: 1.22 to 1.25, P<0.001 and the 65+'s (OR = 1.38, 95% CI: 1.35 to 1.40, P<0.001. 110,605/554,564 (19.9% of the non-urgent attendances arrived by ambulance, increasing significantly out of hours versus in hours (OR = 2

  11. Retrospective analysis of heavy metal contamination in Rhode Island based on old and new herbarium specimens1

    Science.gov (United States)

    Rudin, Sofia M.; Murray, David W.; Whitfeld, Timothy J. S.

    2017-01-01

    Premise of the study: Herbarium specimens may provide a record of past environmental conditions, including heavy metal pollution. To explore this potential, we compared concentrations of copper, lead, and zinc in historical and new collections from four sites in Rhode Island, USA. Methods: We compared historical specimens (1846 to 1916) to congener specimens collected in 2015 at three former industrial sites in Providence, Rhode Island, and one nonindustrial site on Block Island. Leaf material was prepared by UltraWAVE SRC Microwave Digestion, and heavy metal concentrations were measured by inductively coupled plasma–atomic emission spectroscopy. Results: Heavy metal concentrations in the historical and new specimens were measurable for all elements tested, and levels of copper and zinc were comparable in the historical and 2015 collections. By contrast, the concentration of lead declined at all sites over time. Significant variability in heavy metal concentration was observed between taxa, reflecting their varied potential for elemental accumulation. Discussion: It seems clear that herbarium specimens can be used to evaluate past levels of pollution and assess local environmental changes. With careful sampling effort, these specimens can be a valuable part of environmental science research. Broadening the possible applications for herbarium collections in this way increases their relevance in an era of reduced funding for collections-based research. PMID:28090410

  12. Hérnias diafragmáticas traumáticas: Revisão casuística Traumatic diaphragmatic hernias: Retrospective analysis

    Directory of Open Access Journals (Sweden)

    JPA Sousa

    2006-05-01

    dificuldade de diagnóstico pré-operatória continua a requerer elevado grau de suspeição, exigindo-se sempre a colocação desta hipótese de diagnóstico no contexto de traumatismos toraco-abdominais fechados.Aims: This study classifies cases of traumatic diaphragmatic hernias (TDH in patients admitted to the Intensive Care Unit (ICU of the Coimbra University Hospitals (HUC from 1990 to 2004. Methods: Retrospective analysis of 34 cases of TDH, studying anatomical location, place and time of diagnosis, complementary tests aiding diagnosis, herniated organs, associated traumatism, morbidity and mortality. Results: Twenty-eight male and six female patients with an average age of 40.5 years ± 20.5, average SAPS score 38.8. Average lenght of stay was 19.1± 13.6 days, all suffered from closed traumatism and were put on artificial ventilation. The left-side diaphragm was more frequently affected (94.1% then the right. Diagnosis in 19 cases was made up in the first six hours following the diagnosis of traumatism, in four cases within 12 hours and in the remaining cases between 48 hours and 16 years after traumatism. In 13 patients the diagnosis was established intra-operatively. The stomach was typically one of the herniated organs. The most frequently associated lesions at the thoracic level were pulmonary contusion, haemothorax and pneumothorax, and at the abdominal level, haemoperitoneum and splenic lesion. The rates for complications and mortality were 55.8% and 11.7% respectively. Conclusions: TDH mainly occurs on the left side through closed thoraco-abdominal trauma following road traffic accidents. This group of patients, on average younger than others admitted to ICU, presents a longer average hospitalisation period, but has lower rates of mortality and lower SAPS severity scores. The most commonly herniated organ was the stomach and the most frequently encountered lesions were cranial-encephalic, splenic and pleural traumatisms. Pre-operative diagnosis of

  13. Understanding Social Media Network Structure AS A Strategic Way Of Advertising In Digital Economy Era (Memahami Struktur Jaringan Media Sosial sebagai Cara Strategis Periklanan di Era Ekonomi Digital)

    OpenAIRE

    Juditha, Christiany

    2017-01-01

    Advertising in online media is now a modern business phenomenon, along with the growing e-commerce in the era of digital economy. The penetration of social media is so high provides an opportunity for manufacturers to promote products/services through social media. Still not directly drive the purchase intentions of social media users themselves to a product due to some problems that arise, among others, issues of privacy and trus and incomprehension manufacturer of the structure of social me...

  14. CAPITALISM EMERGING ERA TAX SYSTEMS OF THE EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Tsokova Viktoria Aleksandrovna

    2013-04-01

    Full Text Available Three phases should be distinguished in the development of tax systems: I. The Ancient World and Middle Ages (from the IV - III centuries. BC. till. XVII - XVIII centuries AD. II. The new time (from the XVII - XVIII centuries till the end of XIX century. - the era of the emerging capitalism. III. Modern History (from the XX century and up to the present time. The capitalism emerging era scientific ideas and tax systems research relevance (importance is caused by the emergence of the main distinct characteristics of any state, that is by the permanently increasing demand of that institution for money. This fact, in its turn, contributes to the formation of the state tax system, and, of course, the evolution of scientific views on taxation. Nowadays, some theoretical ideas in the field of taxation, clarifying the nature and the role of taxes in the European countries budget formation begin to appear in Europe, especially in the UK. The development of tax systems in England, France and Germany have been analyzed; and , basing on the dialectical, historical and logical approaches, and the method of scientific abstraction, the authors identify the following common features of the capitalism emerging era tax systems in the European countries: the taxation on a regular (permanent basis, the expansion of the tax-payers range – all citizens of the state are becoming tax payers, the introduction of the income tax and the abolishment of the revenue leasing – creation of government agencies system responsible for the administration of taxes, to establishing and collecting taxes only with the Parliament approval and permission. Classical theoretical and practical approaches to creation of tax systems of the states have been formulated in Europe in the era of nascent capitalism and they haven’t lost the relevance yet.

  15. Er Rousseau moderne?

    DEFF Research Database (Denmark)

    Dupont, Søren

    1985-01-01

    Artiklen analyserer på hvilken måde Rousseau kan siges at være moderne, og den diskuterer på hvilken måde Rouseau har været medvirkende til at opbygge den moderne civilisation, og på hvilken måde han var kritisk i forhold til den gryende og moderne kapitalisme.......Artiklen analyserer på hvilken måde Rousseau kan siges at være moderne, og den diskuterer på hvilken måde Rouseau har været medvirkende til at opbygge den moderne civilisation, og på hvilken måde han var kritisk i forhold til den gryende og moderne kapitalisme....

  16. Late-Modern Symbolism

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2015-01-01

    Through analysis of key texts, I seek to demonstrate the explanative potential of Durkheim’s sociology of religion in the present context. I critically readdress the idea, found in his early work, that modernity is characterized by a rupture with pre-modern forms of solidarity. First, I investigate...... the ways in which Durkheim sets up a stark distinction between the pre-modern and the modern in his early work, and how this distinction is further cemented by his orthodox critique of the modern economy and its negative effects on social life. Second, I show how another timeless and positive understanding...... of “mechanical” solidarity is to be found behind the “symbolist” template crystalizing in Durkheim’s late work. Third, I develop this template for a modern context by critically addressing and removing other obstacles and prejudices on Durkheim’s part....

  17. MERRA-Land 2d land surface diagnostics, Time Average 1-hourly (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The Modern-Era Retrospective Analysis for Research and Applications (MERRA) is a state-of-the-art reanalysis data product that provides, in addition to atmospheric...

  18. MERRA-Land 2d land surface diagnostics, Monthly (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The Modern-Era Retrospective Analysis for Research and Applications (MERRA) is a state-of-the-art reanalysis data product that provides, in addition to atmospheric...

  19. Spatial Structure of Modern Moscow

    Directory of Open Access Journals (Sweden)

    Daria V. Goloukhova

    2015-01-01

    Full Text Available The article is focused on the spatial structure of modern Moscow and features distinguishing it from the cities of Western Europe and the US. The city has hybrid spatial structure combining elements which emerged on different stages of the city development. In the 14th century two tendencies appeared: the prestige of the city centre and opposition of Western districts as more prestigious to Eastern districts as less prestigious. Crucial spatial characteristics emerged in the Soviet era and up to now they define the image of Moscow. Firstly, it's a peculiar density profile. Population density in post-socialist cities tends to increase as we move further from the city centre while in Western European cities population density is the highest in central districts. Secondly, elementary units of Moscow spatial structure are so called micro-districts (neighbourhoods. The concept of a microdistrict was very popular with Soviet urban planners and widely applied in the residential construction. Another peculiarity of Moscow spatial structure is social heterogeneity of districts and absence of ethnic quarters or ghettos. Furthermore, significant part of the city area is occupied by former industrials zones which are not used anymore and need to be reconstructed. With transition to market economy a number of spatial changes emerged. They were partly related to the large-scale privatization, infill construction and lack of effective urban planning policy. In conclusion the article states the need for the new model of spatial organization which would take into account the specifics of Russian reality.

  20. Pediatric Acute Otitis Media in the Era of Pneumococcal Vaccination.

    Science.gov (United States)

    Tawfik, Kareem O; Ishman, Stacey L; Altaye, Mekibib; Meinzen-Derr, Jareen; Choo, Daniel I

    2017-05-01

    Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals. Subjects and Methods To determine annual prevalence of admission for AOM/CAOM, nationally weighted frequencies of children aged otitis media, acute mastoiditis, suppurative labyrinthitis, and/or acute petrositis were collected. The frequency of coexisting pneumococcal meningitis diagnoses among these patients was also collected. Trend analysis of prevalences of admission for AOM/CAOM and for pneumococcal meningitis occurring in the setting of AOM/CAOM from 2000 to 2012 was performed. Results Between 2000 and 2012, annual prevalence of admission for AOM/CAOM decreased from 3.956 to 2.618 per 100,000 persons ( P < .0001) (relative risk reduction 34%). Declines in admission prevalence were most pronounced in children <1 year of age (from 22.647 to 8.715 per 100,000 persons between 2000 and 2012, P < .0001) and 1 to 2 years of age (from 13.652 to 5.554 per 100,000 persons between 2000 and 2012, P < .0001). For all ages, the admission prevalence for pneumococcal meningitis and concomitant AOM/CAOM decreased (from 1.760 to 0.717 per 1,000,000 persons, P < .0001) over the study period. Conclusions The prevalence of hospital admission for pediatric AOM/CAOM has declined since the advent of pneumococcal vaccination. Admission rates for pneumococcal meningitis with AOM/CAOM have similarly declined.

  1. Indonesia - Procurement Modernization

    Data.gov (United States)

    Millennium Challenge Corporation — The evaluation seeks to establish evidence on the possible effects of an intervention designed to modernize public procurement: effects on cost savings, performance...

  2. Annals of Modern Education

    African Journals Online (AJOL)

    The Annals of Modern Education will be considered for publication publishes regular papers reporting ... Curriculum and Teaching, Students' Perspectives on Learning Environments, Environmental Education, ... AJOL African Journals Online.

  3. Nuclear weapons modernizations

    Energy Technology Data Exchange (ETDEWEB)

    Kristensen, Hans M. [Federation of American Scientists, Washington, DC (United States)

    2014-05-09

    This article reviews the nuclear weapons modernization programs underway in the world's nine nuclear weapons states. It concludes that despite significant reductions in overall weapons inventories since the end of the Cold War, the pace of reductions is slowing - four of the nuclear weapons states are even increasing their arsenals, and all the nuclear weapons states are busy modernizing their remaining arsenals in what appears to be a dynamic and counterproductive nuclear competition. The author questions whether perpetual modernization combined with no specific plan for the elimination of nuclear weapons is consistent with the nuclear Non-Proliferation Treaty and concludes that new limits on nuclear modernizations are needed.

  4. "Modern" Education Finance: How It Differs from the "Old" and the Analytic and Data Collection Changes It Implies

    Science.gov (United States)

    Guthrie, James W.

    2006-01-01

    This article contends that a new concept of education finance has emerged in response to substantial alterations in the U.S. education policy environment. The major distinction between modern and old is that the latter was principally concerned with arrangements of inputs in K-12 schooling. The former, modern-era education finance, is concerned…

  5. METAMORFOSIS PESANTREN DI ERA GLOBALISASI

    Directory of Open Access Journals (Sweden)

    Muhammad Jamaluddin

    2012-07-01

    Full Text Available Abstrak: Tulisan ini mendeskripsikan perkembangan peran dan fungsi pesantren sejak awal "kelahirannya" yang terjadi pada kehidupan masyarakat tradisional sampai pada perubahan model pesantren yang menyesuaikan dengan kemajuan teknologi informasi. Model pendidikan pesantren menjamur jauh sebelum lembaga pendidikan formal didirikan di Indonesia, sehingga kontribusinya sangat besar dalam pembangunan bangsa ini. Mempertahankan eksistensinya di tengah tren perkembangan masyarakat modern tentunya tidak mudah. Karena pesantren, di satu sisi, merupakan lembaga penguatan keagamaan dan moral, tetapi di sisi lain ia harus mampu beradaptasi dan bermetamorfosis sesuai dengan perkembangan masyarakat modern. Tantangan besar dalam masyarakat modern adalah dekadensi moral dan agama, lambatnya laju perkembangan ekonomi masyarakat, dan tingginya angka konsumerisme masyarakat. Berdasarkan tantangan ini, pesantren dapat melakukan revitalisasi peran dan fungsinya sebagai lembaga pendidikan dan pusat pemberdayaan masyarakat.     Abstract: This paper describes the development of the role and function of pesantren starting from the beginning of "its birth"  in traditional society to model of pesantren the advancement of information technology. Pesantren has flourished long before the formal educational institutions established in Indonesia. Thus, it has great contribution to the development of this nation. Maintaining its existency  in the middle of the development trend of modern society is certainly not easy for pesantren. In one side, it is an institution for strengthening of religious and moral issues but on the other hand it must be able to adapt and metamorphose in accordance with the development of modern society. The major challenges in modern society is the moral and religious decadence, the slow pace of economic development, and the high rate of consumerism. For these challenges, pesantren can revitalize its role and function as educational institutions

  6. Modernization of US Nuclear Forces: Costs in Perspective

    International Nuclear Information System (INIS)

    Tapia-Jimenez, D.

    2017-01-01

    This short research paper addresses two topics that have emerged in the debate about whether, when, and how to modernize U.S. nuclear forces.1 The first topic relates to the size and scale of the planned nuclear force, with some critics of the modernization plan arguing that the United States is simply replicating the Cold War force for a very different era. The second topic relates to the cost of the modernization effort, with some critics arguing that the cost is unaffordable.2 This paper begins with a review of the changes in the size and scale of U.S. nuclear forces since the Cold War. It then examines the expected costs of modernization in a comparative perspective.

  7. Modernization of US Nuclear Forces: Costs in Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Tapia-Jimenez, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-04-12

    This short research paper addresses two topics that have emerged in the debate about whether, when, and how to modernize U.S. nuclear forces.1 The first topic relates to the size and scale of the planned nuclear force, with some critics of the modernization plan arguing that the United States is simply replicating the Cold War force for a very different era. The second topic relates to the cost of the modernization effort, with some critics arguing that the cost is unaffordable.2 This paper begins with a review of the changes in the size and scale of U.S. nuclear forces since the Cold War. It then examines the expected costs of modernization in a comparative perspective.

  8. Tarbijalepingud rahvusvahelises eraõiguses / Margus Kingisepp

    Index Scriptorium Estoniae

    Kingisepp, Margus, 1969-

    1997-01-01

    Tarbijalepingute reguleerimisest erinevates riikides, 1955. a. Haagi konventsioonist ja 1980. a. Rooma konventsioonist, rahvusvahelisest jurisdiktsioonist tarbijalepingute puhul ning rahvusvahelise eraõiguse sätetest Eesti õiguses

  9. Distrofias retinianas da infância: análise retrospectiva Retinal dystrophies in childhood: retrospective analysis

    Directory of Open Access Journals (Sweden)

    Heloisa Andrade Maestrini

    2004-12-01

    distrofias retinianas da infância são um grupo heterogêneo de doenças que se manifestam por meio de sintomas inespecíficos. Uma análise cuidadosa dos sintomas, o exame oftalmológico completo e os exames complementares, principalmente ERG, testes de visão de cores e campo visual, podem ser úteis em seu diagnóstico.PURPOSE: To describe the clinical features and the results of diagnostic methods in all patients with diagnosis of one of the following retinal dystrophies: Leber congenital amaurosis (LCA, achromatopsia, cone distrophy or cone-rod distrophy, examined at the Low Vision Department of the Federal University of Minas Gerais, in the period of 1992 to 2003. METHODS: Retrospective analysis of charts of 40 patients. Ten had LCA, 17 had achromatopsia, 6 had cone distrophy and 7 had cone-rod distrophy. RESULTS: Visual acuity was extremely low in patients with LCA, ranging from 20/710 to light perception. The mean value for achromatopsia was 20/200, 20/280 for cone distrophy and 20/260 for cone-rod distrophy. High hyperopia was the most common refractional error in LCA patients. Hyperopia was more frequent in cases of achromatopsia and cone distrophy, while in cone-rod distrophy myopia predominated. Fundoscopy was altered in most cases of LCA, cone distrophy and rod-cone distrophy, and normal in most cases of achromatopsia. Oculodigital sign and enophtalmus were found only in LCA patients while photofobia and color vision defects prevailed in other groups. Nistagmus and strabismus were frequent findings in all groups. There was a high incidence of delayed neuro-psycho-motor development in LCA patients. Two of them had also associated genetic syndromes. Patients presented symptoms very early in life in LCA and achromatopsia, while in cone and cone-rod distrophies symptoms appeared later, but never after the age of 10. Consanguinity and positive familial history were strongly associated in all groups. The ERG was extinct in LCA, showed reduced photopic response in

  10. The New Era of Counterforce

    Science.gov (United States)

    Lieber, Keir

    Nuclear deterrence rests on the survivability of nuclear arsenals. For much of the nuclear age, counterforce disarming attacks those aimed at eliminating nuclear forces were nearly impossible because of the ability of potential victims to hide and protect their weapons. However, technological developments are eroding this foundation of nuclear deterrence. Advances rooted in the computer revolution have made nuclear forces around the world far more vulnerable than before. Specifically, two key approaches that countries have relied on to ensure arsenal survivability since the dawn of the nuclear age hardening and concealment have been undercut by leaps in weapons accuracy and a revolution in remote sensing. Various models, methods, and evidence demonstrate the emergence of new possibilities for counterforce disarming strikes. In short, the task of securing nuclear arsenals against attack is a far greater challenge than it was in the past. The new era of counterforce challenges the basis for confidence in contemporary deterrence stability, raises critical issues for national and international security policy, and sheds light on one of the enduring theoretical puzzles of the nuclear era: why international security competition has endured in the shadow of the nuclear revolution.

  11. The Study of the Technical Innovation of Agriculture and the Peasant's Activity in Landholder System, in Meiji-Taisyo Era

    OpenAIRE

    勝部, 眞人

    1997-01-01

    In this article, I analyzed the process of Japanese Modern Technical Innovation of Agriculture by many peasants in Meiji-Taisyo Era, for I think that analysis is the key to link between the study on Japanese Modern Landholder System and the historical study on agricultural technique. This study is made on Hiroshima Prefecture, that had so much population and therefore the smallest-scale farmers in Japan, and Akita Prefecture, that had less population and therefore the most extensive culti...

  12. Modern examples of extinctions

    DEFF Research Database (Denmark)

    Lövei, Gabor L

    2013-01-01

    No species lives forever, and extinction is the ultimate fate of all living species. The fossil record indicates that a recent extinction wave affecting terrestrial vertebrates was parallel with the arrival of modern humans to areas formerly uninhabited by them. These modern instances of extinction...

  13. Modern History of Tibet

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Authored by Xu Guangzhi, this book is a subsidiary project of Research Into Traditional Culture and History (of the PRC Ministry of Education) conducted by China Tibetology Research Institute of Tibet University. The book combines modern history of Tibet with modern history of China as a whole. It tells the close ties between various members of the Chinese nation.

  14. Adult learning in modernity

    DEFF Research Database (Denmark)

    Rasmussen, Palle

    2007-01-01

    The paper discusses the conditions for the growth of adult education in modern societies. It is argued that in modern adult life individual biographical reflection plays an increasing role, not only for educational and occupational choice but also in the process of identity formation and emotional...

  15. Liquid Modernity & Late Capitalism

    DEFF Research Database (Denmark)

    Hansen, Claus D.

    In Liquid Modernity, Bauman portrays Adorno and the rest of the early Frankfurt School as sociologists and thinkers belonging to the ‘heavy’ phase of modernity. In other words, they are deemed irrelevant to the discussion of current sociological time diagnoses and the purpose of critique under co...

  16. Understanding modern transparency

    NARCIS (Netherlands)

    Meijer, A.J.|info:eu-repo/dai/nl/172436729

    2009-01-01

    Proponents and opponents fiercely debate whether computer-mediated transparency has a positive effect on trust in the public sector. This article enhances our understanding of transparency by presenting three perspectives: a premodern, modern and post-modern perspective, and analyzing the basic

  17. Early Modern Philosophical Systems

    NARCIS (Netherlands)

    L. van Bunge (Wiep)

    2014-01-01

    textabstractThe occurrence of an entry on early modern philosophical systems in an encyclopaedia of Neo-Latin studies is fraught with complications, if only on account of the gradual disappearance during the early modern period of Latin as the main vehicle of philosophical communication. What

  18. Mod den moderne skole

    DEFF Research Database (Denmark)

    Vindum, Kjeld; Birk Morgen, Pernille

    2003-01-01

    Gennemgang af fem skoler som eksemplificerer væsentlige udviklingstrin i overgangen fra det sene 1800 tals etageskolebygninger til det moderne skolebyggeris gennemsalg i 1930erne.......Gennemgang af fem skoler som eksemplificerer væsentlige udviklingstrin i overgangen fra det sene 1800 tals etageskolebygninger til det moderne skolebyggeris gennemsalg i 1930erne....

  19. Spotting modern Copenhagen

    DEFF Research Database (Denmark)

    Ovesen, Hans; Bøgelund, Helle; Darger, Birgitte

    2002-01-01

    Med udgangspunkt i Københavns Rådhus og området omkring Banegårdspladsen analyseres Københavns indtræden i det moderne......Med udgangspunkt i Københavns Rådhus og området omkring Banegårdspladsen analyseres Københavns indtræden i det moderne...

  20. Productions, modern (Scandinavia)

    DEFF Research Database (Denmark)

    Lech, Marcel Lysgaard

    2017-01-01

    Greek comedy has never been as popular on the modern Scandinavian scene as Greek tragedy, but one play stands out among them all as a modern classic, Aristophanes’ Lysistrata, which has inspired many adaptations not only on the stage, but also in radio and cinema....

  1. The association of periodontal disease with kidney function decline: a longitudinal retrospective analysis of the MrOS dental study.

    Science.gov (United States)

    Grubbs, Vanessa; Vittinghoff, Eric; Taylor, George; Kritz-Silverstein, Donna; Powe, Neil; Bibbins-Domingo, Kirsten; Ishani, Areef; Cummings, Steven R

    2016-03-01

    Identifying modifiable risk factors for chronic kidney disease (CKD) is essential for reducing its burden. Periodontal disease is common, modifiable and has been implicated as a novel potential CKD risk factor, but evidence of its association with kidney function decline over time is limited. In a longitudinal retrospective cohort of 761 elderly men with preserved kidney function [estimated glomerular filtration rate > 60 mL/min/1.73 m(2) using a calibrated creatinine and cystatin C (eGFRcr-cys) equation] at baseline, we performed multivariable Poisson's regression to examine the association of severe periodontal disease with incident CKD, defined as incident eGFRcr-cys 5% annualized) eGFRcr-cys decline. Severe periodontal disease was defined in two ways: (i) ≥5 mm proximal attachment loss in 30% of teeth examined (European Workshop in Periodontology Group C, European Workshop); and (ii) 2+ interproximal sites with attachment loss ≥6 mm and 1+ interproximal sites with probing depth ≥5 mm (Centers for Disease Control/American Academy of Periodontology, CDC/AAP). At baseline, the mean age was 73.4 (SD 4.8) years, the median eGFRcr-cys was 82.4 mL/min/1.73 m(2), and 35.5 and 25.4% of participants had severe periodontal disease by European Workshop and CDC/AAP criteria, respectively. After a mean follow-up of 4.9 years (SD 0.3), 56 (7.4%) participants had incident CKD. Severe periodontal disease was associated with a 2-fold greater rate of incident CKD [incidence rate ratio (IRR) 2.01 (1.21-3.44), P = 0.007] after adjusting for confounders compared with not severe periodontal disease by European Workshop criteria but did not reach statistical significance by CDC/AAP criteria [IRR 1.10 (0.63-1.91), P = 0.9]. Severe periodontal disease may be associated with incident clinically significant kidney function decline among a cohort of elderly men. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  2. Modernism and Postmodernism: A Study of the Islamic Teachings with Special Reference to the Related Issues of Pakistani Society

    Directory of Open Access Journals (Sweden)

    Dr. Abdul Muhaimin

    2017-02-01

    Full Text Available Abstract This study elaborates the difference and connection between modernism and postmodernism eras while highlighting their backgrounds. The research highlights the teachings of Islam in terms of modernism and postmodernism. The research brings to light the influence of modernism and postmodernism on Muslim societies. What are the far reaching impacts of the modernism and postmodernism eras of Muslim societies and how well a common Muslim is equipped to address the issues related to postmodernism. The study primarily focuses on the related issues in Pakistani society and explains the role and the influence of religious scholars of their understanding of the terms modernism and postmodernism. The study focuses on the awareness of the ’Ulamā in addressing these global challenges and subsequently the future of Pakistani society. The study has an element of quantitative research and it indicates towards the on ground realities on the issue with the help of a latest survey on modernism and postmodernism.

  3. Retrospective analysis of mode survival, reliability of atrial sensing and incidence of atrial tachyarrhythmias in 307 single-lead VDD pacemaker patients.

    Science.gov (United States)

    Zupan, Igor; Lipar, Luka; Zizek, David; Boute, Wim; Vidmar, Masa; Gabrijelcic, Tone; Rakovec, Peter; Brecelj, Ales

    2006-10-01

    The aim of this retrospective analysis was to investigate VDD mode survival, development of atrial tachyarrhythmias (AT), and long-term atrial sensing performance of VDD pacing systems. We implanted single-lead VDD pacemakers in patients with isolated atrioventricular block and performed a retrospective analysis of 307 patients who had their devices implanted between May 1994 and September 2001. In 39 patients (12.7%), the pacing mode had to be reprogrammed to a single-chamber ventricular pacing mode, mostly due to permanent AT. In 16 of these patients, the atrial sensing safety margin was less than 150%. The atrial sensing safety margin was insufficient, i.e. less than 100% in only seven patients. Although only 12 (3.9%) of the patients had a history of paroxysmal AT at the time of pacemaker implantation, 200 (65%) patients presented with AT during follow-up. The mean AT burden at the last follow-up was 2.5%. These data illustrate that single-lead VDD pacemakers can be applied without serious complications in a highly selected group of patients. Our main concern is the development of AT in a large part of our population. Over a 10-year period, two thirds of our patients presented with AT.

  4. Entrepreneurship in the Digital Era

    Directory of Open Access Journals (Sweden)

    Nur Achmad

    2016-12-01

    Full Text Available This research aims to know about the entrepreneurship as one of the key issues related to many aspects, including its relevance to the economic, business and employment. The researches on entrepreneurship are the references to identify the success factors which supported the entrepreneurial success. The internet development in the digital age indirectly influenced the entrepreneurial ethos. It is not only influenced by the market potential and product innovation, but also by the commitments to entrepreneurship education and training model. Therefore, the studies on entrepreneurship in the industrial and developing countries are attractive. It is relevant to the internet era which provided opportunities for the development of entrepreneurial ethos, especially for the younger generation.

  5. TANTANGAN DAKWAH DI ERA POSMODERNISME

    Directory of Open Access Journals (Sweden)

    Elya Munfarida

    2016-11-01

    Full Text Available As a criticism to modemism, posmodemism has created new cultural realities different from the previous. Through its political acts and strategies, postmodernism has constructed cultural hypereality and complexity. This change becomes a chance and also threat that we need to be critical to anticipate the negative effects. One of its strategies is cultural deconstruction, which denies transcendental signs, meanings, and values, represents one of its negative effects. It will eliminate religious values which by contrast place transcendental values as its principle. For that reason, we need to contextualize Islamic teachings in order not to make postmodernism eliminate Muslims’ sense of religiousity. Da’wa, as a means of communication and transformation of Islamic values, plays a significantrole in this postmodernism era. Consequently, reconstruction of contextual da’wa strategy should be committed to balance the domination of postmodernism cultures.

  6. Spinal cord constraints in the era of high-precision radiotherapy. Retrospective analysis of 62 spinal/paraspinal lesions with possible infringements of spinal cord constraints within a minimal volume

    Energy Technology Data Exchange (ETDEWEB)

    Zschaeck, Sebastian; Wust, Peter; Graf, Reinhold; Wlodarczyk, Waldemar; Schild, Reinhard; Thieme, Alexander Henry; Weihrauch, Mirko; Budach, Volker; Ghadjar, Pirus [Charite Centrum Tumormedizin CC14, Klinik fuer Radioonkologie und Strahlentherapie, Berlin (Germany)

    2017-07-15

    Current constraints aim to minimize the risk of radiation myelitis by the use of restrictive maximal spinal cord doses, commonly 50 Gy. However, several studies suggested that a dose-volume effect could exist. Based on these observations, we evaluated patients receiving potentially excessive doses to the spinal cord within minimal volumes. Patients receiving radiotherapy between June 2010 and May 2015 using the Novalis trademark (Varian, Palo Alto, CA, USA; Brainlab, Heimstetten, Germany) radiosurgery system were retrospectively analyzed. A total of 56 patients with 62 treated lesions that had been prescribed radiation doses close to the spinal cord potentially higher than the common 50 Gy 2-Gy equivalent-dose (EQD2) constraint were selected for further analysis. Of these patients, 26 with 31 lesions had no history of previous irradiation, while 30 patients with 31 lesions had been previously irradiated within the treatment field. According to different dose evaluation approaches (spinal canal, spinal cord contour), 16 and 10 out of 31 primary irradiated lesions infringed constraints. For the 16 lesions violating spinal canal doses, the maximum doses ranged from 50.5 to 61.9 Gy EQD2. Reirradiated lesions had an average and median cumulative dose of 70.5 and 69 Gy, respectively. Dose drop-off was steep in both groups. Median overall survival was 17 months. No radiation myelitis or radiomorphological alterations were observed during follow-up. This study adds to the increasing body of evidence indicating that excessive spinal cord doses within a minimal volume, especially in a reirradiation setting with topographically distinct high-point doses, may be given to patients after careful evaluation of treatment- and tumor-associated risks. (orig.) [German] Um das Risiko einer radiogenen Myelitis zu minimieren, sind klinisch gebraeuchliche Dosisobergrenzen fuer das Rueckenmark mit 50-Gy-Maximaldosis sehr restriktiv. Einige Veroeffentlichungen deuten jedoch darauf hin, dass ein Dosis-Volumen-Effekt besteht. Unter diesem Aspekt wurden Patienten ausgewertet, die kleinstvolumig mit potenziell ueberhoehten Rueckenmarksdosen bestrahlt wurden. Retrospektiv ausgewertet wurden Patienten, die zwischen Juni 2010 und Mai 2015 mit dem Novalis trademark -Radiochirurgiesystem (Varian, Paulo Alto, CA, USA; Brainlab, Heimstetten, Deutschland) behandelt wurden. Fuer weitere Analysen wurden 62 Laesionen bei 56 Patienten mit potenziell ueberhoehter Rueckenmarksdosis (>50 Gy), berechnet als 2-Gy-Aequivalenzdosis (EQD2), ausgewaehlt. Von diesen waren 26 Patienten mit 31 Laesionen ohne Vorbestrahlung und 30 Patienten mit 31 Laesionen bereits im gleichen Bereich vorbestrahlt. Unter Verwendung verschiedener Dosisevaluationsverfahren (Spinalkanal, minimal konturierter Rueckenmarksbereich) ueberschritten 16 und 10 der 31 erstmalig bestrahlten Laesionen die Grenze. Bei den 16, die Maximaldosis ueberschreitenden Laesionen lag die maximale Myelondosis zwischen 50,5 und 61,9 Gy EQD2. Wiederbestrahlte Laesionen hatten eine durchschnittliche/mediane Kumulativdosis von 70,5 und 69 Gy. Der Dosisabfall war in beiden Gruppen sehr steil. Das mediane Gesamtueberleben betrug 17 Monate. Waehrend der Nachsorge wurden keine radiogene Myelitis oder roentgenmorphologische Veraenderungen beobachtet. Die Studie liefert Hinweise darauf, dass nach sorgsamem Abwaegen von Behandlungs- und tumorassoziierten Risiken eine kleinstvolumige Ueberdosierung des Myelons in Einzelfaellen moeglich erscheint, insbesondere bei Rebestrahlung mit topographisch unterschiedlich lokalisierten Maximaldosen. (orig.)

  7. DINAMISASI TRADISI ISLAM DI ERA GLOBALISASI: Studi atas Tradisi Keagamaan Kampung Jawa Tondano

    Directory of Open Access Journals (Sweden)

    Yusno Abdullah Otta

    2016-09-01

    Full Text Available There are signifiant relationship between modernization andm religion in the modernization and globalization era. In the context of Indonesia, religion, the teachings and traditions, preserved as a fundamental basis of morality to inflence the flw of modernization. Indonesian society, in general, divided into two groups of “modernist” and “traditional”. This grouping occurs because, from a historical perspective, the existence of Islam in Indonesia is experiencing a collision with various forms of local syncretic and, also, with Western civilization, especially, in the period of colonialism, the Christian religion, as happened in the village of Tondano Java, in particular, and other areas in Indonesia, in general. The result of research shows that all the tradition in this Tondano Javanese village today is still carried out consistently by the citizens. Flow of modernization and globalization were not many signifiant impacts for the implementation of these various religious traditions.

  8. Rituximab is associated with improved survival in Burkitt lymphoma: a retrospective analysis from two US academic medical centers.

    Science.gov (United States)

    Wildes, Tanya M; Farrington, Laura; Yeung, Cecilia; Harrington, Alexandra M; Foyil, Kelley V; Liu, Jingxia; Kreisel, Friederike; Bartlett, Nancy L; Fenske, Timothy S

    2014-02-01

    Burkitt lymphoma (BL) is a rare, highly aggressive B-cell malignancy treated most successfully with brief-duration, high-intensity chemotherapeutic regimens. The benefit of the addition of rituximab to these regimens remains uncertain. We sought to examine the effectiveness of chemotherapy with and without rituximab in patients with BL. This study is a retrospective cohort study of all adult patients with BL diagnosed and treated with modern, dose-intense chemotherapeutic regimens from 1998-2008 at two tertiary care institutions. All cases were confirmed by application of WHO 2008 criteria by hematopathologists. Medical records were reviewed for patient-, disease-, and treatment- related factors as well as treatment response and survival. Factors associated with survival were analyzed using Cox proportional hazards modeling. A total of 35 patients were analyzed: 18 patients received rituximab with chemotherapy (R-chemo) and 17 received chemotherapy (chemo) alone. The median age was 42 (range 20-74 years); 57% were male; 71% had Ann Arbor Stage IV disease; 33% had central nervous system involvement; 78% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. R-chemo was associated with significantly longer overall survival (OS) than chemo alone (5-year OS 70% and 29%, respectively, p = 0.040). On multivariate regression analysis, poor performance status and central nervous system involvement were associated with poorer survival. The addition of rituximab to chemotherapy was associated with improved OS in patients with Burkitt lymphoma. Poor performance status and central nervous system involvement were prognostically significant on multivariate analysis.

  9. God and religion in post-modern philosophers

    Directory of Open Access Journals (Sweden)

    José J. Queiroz

    2016-12-01

    Full Text Available This paper is an essay on the positions of some post-modern philosophers on religion, with the debate about post-modernity as a background. Its preliminary objective is to situate post-modernity taking a position between plain acceptance and categorical refusal in contemporary society. In this polemical field, the paper focuses on three important post-modern philosophers by pointing their contributions for a new thinking about religion today. The procedure consists in the reading of the authors´ texts looking for an interpretation of their discourses on God, religion and the sacred. The conclusion is that post-modernity is not as new era overcoming modernity, but that it is comprised of new themes  that are on the fringes  or even  in opposite directions of modernity´s parameters . One can find these themes in many fields of human knowledge including theology and science of religion. On Derrida´s position, who is the most focused philosopher, the text is still embryonic as it comes from ongoing research.  

  10. Modern technologies in Endodontics

    Directory of Open Access Journals (Sweden)

    Alfredo Iandolo

    2016-06-01

    Conclusions: The positive results highlighted by these clinical cases demonstrate how the use of modern technologies are essential to avoid iatrogenic injury, and guarantee, on the other hand, safe and reproducible results.

  11. Etymology and Modern Linguistics

    Science.gov (United States)

    Malkiel, Yakov

    1975-01-01

    Discusses the estrangement between etymology and modern linguistics, and concludes that a reconciliation between spatio-temporal linguistics and etymology must occur, because without it, both disciplines are doomed to inanition. (Author/AM)

  12. INFECTIVE ENDOCARDITIS: MODERN COURSE

    Directory of Open Access Journals (Sweden)

    T. L. Vinogradova

    2014-07-01

    Full Text Available The paper presents the characteristic features of the modern course of infective endocarditis. Unresolved questions of classification of diseaseand drug therapy are discussed. Clearly defined indications for surgical treatment of endocarditis.

  13. Anthropology and Multiple Modernities

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    “modernities” over the last 10 years, this paper wishes to address the analytical usefulness of this conceptual development. What is it about these concepts that make them useful as we try to capture the World today? Rather than providing any substantial definitions as to what those modernities are about (or...... what they are not about), anthropologists have used ethnographies to demonstrate how modernities are lived and constructed differently in different cultural contexts. To a very large extent, anthropologists intend these multiple modernities to refer to the interplay between local and global...... configurations. However, if the current pluralizing of modernity ultimately serves to describe the variety of cultural forms that co-exist in the World today, the analytical value of the concept risks being watered down, and little is gained in perspective. Arguably, other concepts would have served the purpose...

  14. Genealogies of Modern Technology

    DEFF Research Database (Denmark)

    Riis, Søren

    2008-01-01

    Does modern technology differ from ancient technology and does it have a unique essence? This twofold question opens one of Martin Heidegger's most influential philosophical inquiries, The Question Concerning Technology. The answer Heidegger offers has inspired various critiques and appraisals from...... a vast number of contemporary scholars of technology.1 Heidegger's answer is traditionally thought to suggest a great difference between ancient and modern technology. However, by re-examining Heidegger's text, it is possible to discover previously ignored or misunderstood lines of thoughts that affirm...... a multi-stable interpretation of the origin of modern technology. In what follows, we shall see how The Question Concerning Technology in fact supports three different genealogies of modern technology...

  15. Modern optimization with R

    CERN Document Server

    Cortez, Paulo

    2014-01-01

    The goal of this book is to gather in a single document the most relevant concepts related to modern optimization methods, showing how such concepts and methods can be addressed using the open source, multi-platform R tool. Modern optimization methods, also known as metaheuristics, are particularly useful for solving complex problems for which no specialized optimization algorithm has been developed. These methods often yield high quality solutions with a more reasonable use of computational resources (e.g. memory and processing effort). Examples of popular modern methods discussed in this book are: simulated annealing; tabu search; genetic algorithms; differential evolution; and particle swarm optimization. This book is suitable for undergraduate and graduate students in Computer Science, Information Technology, and related areas, as well as data analysts interested in exploring modern optimization methods using R.

  16. Modernizing Electricity Delivery

    Science.gov (United States)

    Explains how modern grid, or smart grid, investments can enable grid operators to respond faster to changes in grid conditions and allow for two-way communication between utilities and electricity end-users.

  17. Concepts in modern parenting

    OpenAIRE

    Dolenc, Anja

    2011-01-01

    The main focus of my dissertation represents changes in parenthood, which are a consequence of a wider specter of social changes. Besides, I am interested in modern trends of educational strategies and how parents deal with the demands of society and those of professional public for nothing less than a perfect parenthood. Theoretical cognitions are divided into three parts: in the first one, new forms of family and social changes which affected the development of the modern family are describ...

  18. Turbine maintenance and modernization

    Energy Technology Data Exchange (ETDEWEB)

    Unga, E. [Teollisuuden Voima Oy, Olkiluoto (Finland)

    1998-12-31

    The disturbance-free operation of the turbine plant plays an important role in reaching good production results. In the turbine maintenance of the Olkiluoto nuclear power plant the lifetime and efficiency of turbine components and the lifetime costs are taken into account in determining the turbine maintenance and modernization/improvement program. The turbine maintenance program and improvement/modernization measures taken in the plant units are described in this presentation. (orig.)

  19. Badges of modern slavery

    OpenAIRE

    Paz-Fuchs, Amir

    2016-01-01

    Notwithstanding the 19th century formal abolition of slavery as legal ownership of people, modern slavery and forced labour have not been consigned to the past. In fact, their existence is more widespread, and made more difficult to tackle due to the lack of formal, legal criteria. This article suggests that reference to the past, historical institutions reveals seven ‘badges of slavery’ that are helpful in identifying occurrences of modern slavery and forced labour. These are: humiliation, o...

  20. Turbine maintenance and modernization

    Energy Technology Data Exchange (ETDEWEB)

    Unga, E [Teollisuuden Voima Oy, Olkiluoto (Finland)

    1999-12-31

    The disturbance-free operation of the turbine plant plays an important role in reaching good production results. In the turbine maintenance of the Olkiluoto nuclear power plant the lifetime and efficiency of turbine components and the lifetime costs are taken into account in determining the turbine maintenance and modernization/improvement program. The turbine maintenance program and improvement/modernization measures taken in the plant units are described in this presentation. (orig.)

  1. A Modern Education

    OpenAIRE

    Macfarlane, Alan

    2015-01-01

    What is western modernity and how did education help to shape that modernity? Through an examination of schooling in elite British institutions, Alan Macfarlane tries to answer these question, particularly to explain the choices facing China and other emerging superpowers. One section looks at his English education; society and power, play and performance, head and heart, spirit and character. Another looks at education more widely: how it shaped the English world, English and Continental Eur...

  2. Modern mathematics made simple

    CERN Document Server

    Murphy, Patrick

    1982-01-01

    Modern Mathematics: Made Simple presents topics in modern mathematics, from elementary mathematical logic and switching circuits to multibase arithmetic and finite systems. Sets and relations, vectors and matrices, tesselations, and linear programming are also discussed.Comprised of 12 chapters, this book begins with an introduction to sets and basic operations on sets, as well as solving problems with Venn diagrams. The discussion then turns to elementary mathematical logic, with emphasis on inductive and deductive reasoning; conjunctions and disjunctions; compound statements and conditional

  3. Influences of Television Toward Modern Society Reflected in TV People by Haruki Murakami

    OpenAIRE

    KHIKMAH, ZIYAADATUL

    2014-01-01

    Khikmah, Ziyaadatul. 2014. Influences of Television toward Modern SocietyReflected in TV People By Haruki Murakami. Study Program of English,Department of Languages and Literature, Faculty of Cultural Studies, UniversitasBrawijaya. Supervisor: Juliati; Co-supervisor : Arcci Tusita. Keyword: Television, Mass Media, Effect, Construction, Culture, Influence. Television has become part of daily life in the society in modern era. Television functions as a medium of information and entertainment. ...

  4. Modern mammal origins: evolutionary grades in the Early Cretaceous of North America.

    OpenAIRE

    Jacobs, L L; Winkler, D A; Murry, P A

    1989-01-01

    Major groups of modern mammals have their origins in the Mesozoic Era, yet the mammalian fossil record is generally poor for that time interval. Fundamental morphological changes that led to modern mammals are often represented by small samples of isolated teeth. Fortunately, functional wear facets on teeth allow prediction of the morphology of occluding teeth that may be unrepresented by fossils. A major step in mammalian evolution occurred in the Early Cretaceous with the evolution of tribo...

  5. Modernization of credit relations

    Directory of Open Access Journals (Sweden)

    S.V. Volosovich

    2015-03-01

    Full Text Available Nowadays it is essential to modernize credit relations in the conditions of global economy transformations. This is due to the influence of integration processes on credit relations and transformation of the risks inherent in the credit field. The purpose of this article is to develop measures that help to improve the efficiency of interaction of credit relations’ participants. Modernization of credit relations is based on the interaction of its main and indirect subjects who belong to the subsystems of loans granting, deposits attraction and provision of related services. Its goal is to pass from extensive to intensive model of interaction between the subjects of credit relations. Components of the credit relations modernization are the following: institutional modernization, which is based on the interaction of credit relations’ subjects, and ensures the development of competition in all credit market’s segments, the creation of its corresponding infrastructure, qualitative change in the approaches of regulation and supervision; technological modernization, which involves the formation of joint products on the credit market and the formation of an integrated informational and analytical system. In the result of the credit relations’ modernization it is expected to achieve synergies between the subjects of credit relations, that will lead to changes in the business architecture of the financial market.

  6. Cecal intubation rates in different eras of endoscopic technological development.

    Science.gov (United States)

    Matyja, Maciej; Pasternak, Artur; Szura, Mirosław; Pędziwiatr, Michał; Major, Piotr; Rembiasz, Kazimierz

    2018-03-01

    Colonoscopy plays a critical role in colorectal cancer (CRC) screening and has been widely regarded as the gold standard. Cecal intubation rate (CIR) is one of the well-defined quality indicators used to assess colonoscopy. To assess the impact of new technologies on the quality of colonoscopy by assessing completion rates. This was a dual-center study at the 2 nd Department of Surgery at Jagiellonian University Medical College and at the Specialist Center "Medicina" in Krakow, Poland. The CIR and cecal intubation time (CIT) in three different eras of technological advancement were determined. The study enrolled 27 463 patients who underwent colonoscopy as part of a national CRC screening program. The patients were divided into three groups: group I - 3408 patients examined between 2000 and 2003 (optical endoscopes); group II - 10 405 patients examined between 2004 and 2008 (standard electronic endoscopes); and group III - 13 650 patients examined between 2009 and 2014 (modern endoscopes). There were statistically significant differences in the CIR between successive eras. The CIR in group I (2000-2003) was 69.75%, in group II (2004-2008) was 92.32%, and in group III (2009-2014) was 95.17%. The mean CIT was significantly reduced in group III. Our study shows that the technological innovation of novel endoscopy devices has a great influence on the effectiveness of the CRC screening program. The new era of endoscopic technological development has the potential to reduce examination-related patient discomfort, obviate the need for sedation and increase diagnostic yields.

  7. Politics of modern muslim subjectivities

    DEFF Research Database (Denmark)

    Jung, Dietrich; Petersen, Marie Juul; Sparre, Sara Lei

    Examining modern Muslim identity constructions, the authors introduce a novel analytical framework to Islamic Studies, drawing on theories of successive modernities, sociology of religion, and poststructuralist approaches to modern subjectivity, as well as the results of extensive fieldwork...

  8. [Modern aspects of epilepsy treatment].

    Science.gov (United States)

    Alajbegović, Azra; Kantardzić, Dzelaludin; Suljić, Enra; Alajbegović, Salem

    2003-01-01

    It is a general rule today, after a relevant diagnostics of an epilepsy, to start a monotherapy treatment, depending on a kind of a seizure, a life age and a general health condition. First line of monotherapy epilepsy drugs remain carbamazapine and sodium valproat. New drugs that are being introduced are: felbamat, gabapentin, lamotrigin, oxcarbazepin, tiagabin, topiramat, vigabatin and zanisamid. These are commonly used as add-on therapy, or as an addition for previously used antiepileptic. Their indicated areas are complex resistant partial seizures with or without generalization. Attention should be paid on proper dosage, interactions and toxicity. Regardless on the new epileptic era, according to reports of International League against epilepsy, most of the patients do not receive the drug that is the most appropriate for them concerning the price (cost-benefit). Neurosurgical methods in epilepsy treatment are: selective amygdalo-hyppocampotomy, temporal lobotomy, subpial resection, hemispherectomy, corpus callosotomy, removal of lesions like tumors or cysts provide encouraging results in reduction of epileptic seizures that can be followed by reduction of drug therapy. N. vagus stimulation is being wider introduced in resident epileptics. Treatment of epilepsy in women requires an approach to sexuality, conception, pregnancy, introduction of medicaments, antiepileptic terratogenity, contraception, motherhood and menopause. A special significance of modern approach to epilepsy is in treatment of elderly who have cerebrovascular and neurodegenerative disease as a cause of seizures. A complex treatment of epilepsy using pharmacological and neurosurgical approach requires supportive psychotherapy, socio-therapy, the work with a family, education about epilepsy and living a life with more quality having one.

  9. KASTRASI FREKUENSI PUBLIK: MEDIA LITERACY ERA BUDAYA POPULER

    Directory of Open Access Journals (Sweden)

    YULIANA RAHMAWATI

    2016-03-01

    Full Text Available Civilization change is a necessity. Culture as one formers also experienced dynamic civilization. Changes in form and content (content takes place not in a vacuum but in a variety of contextual quadrants. The era of modernity with the development of industry and capitalism climate has led to one part in cultural homogenization. Public spaces which in essence is a classless into an entity that has a value of commodities. Shift function of public spaces including public frequency in packs of popular culture has been a challenge for the creation of the public who have media literacy skills. With media literacy, public to understand what has been done for the public media and to the public .Keywords : public frequency , media literacy, cultural homogeneity, Castration

  10. Modern radiation therapy for primary cutaneous lymphomas

    DEFF Research Database (Denmark)

    Specht, Lena; Dabaja, Bouthaina; Illidge, Tim

    2015-01-01

    Primary cutaneous lymphomas are a heterogeneous group of diseases. They often remain localized, and they generally have a more indolent course and a better prognosis than lymphomas in other locations. They are highly radiosensitive, and radiation therapy is an important part of the treatment......, either as the sole treatment or as part of a multimodality approach. Radiation therapy of primary cutaneous lymphomas requires the use of special techniques that form the focus of these guidelines. The International Lymphoma Radiation Oncology Group has developed these guidelines after multinational...... meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the International Lymphoma Radiation Oncology Group steering committee on the use of radiation therapy in primary cutaneous lymphomas in the modern era....

  11. Modern Radiation Therapy for Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Specht, Lena; Yahalom, Joachim; Illidge, Tim

    2014-01-01

    Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced...... on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy......, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom...

  12. Revolution, modernity, and the potential of narratives

    DEFF Research Database (Denmark)

    Eriksson, Birgit

    2013-01-01

    The article investigates the impact of the French Revolution on Goethe’s narrative works in the mid-1790s. I argue that the reductive interpretation of Goethe’s attitude to the Revolution as distant and reluctant ignores the formal and thematic impact of the Revolution on his prose works. Similarly......, we lose important perspectives when reducing German intellectual life of the late eighteenth century to apolitical inwardness. The Revolution had an impact, also in the German context, and Goethe’s literary works were significantly affected by it. Working in various literary genres, he investigated...... and experimented with some of the fundamental challenges of the Revolution and the modern era, especially those regarding self-determination, community, and the nexus between individual and shared history. Following a brief sketch of how these issues looked from a German perspective, I will focus on Goethe’s...

  13. Nuclear energy and the new era

    International Nuclear Information System (INIS)

    Sefidvash, F.

    1992-01-01

    The problem of the utilization of nuclear energy is not only technical but also has important social, economic, political and ethical ramifications. Therefore, to discuss nuclear energy for the future, a vision of the new era needs to be identified. A model for the new era, as a natural consequence of growing interdependence among nations and the process of human evolution is described. The problems of inherent and passive safety, waste disposal, ecology, proliferation, economy and regulatory institutions in the new era are discussed. The particular role of small nuclear power reactors and their potential advantages are described. (author). 12 refs

  14. El lenguaje en la era digital

    Directory of Open Access Journals (Sweden)

    Juan Carlos Vergara Silva

    1998-02-01

    Con base en la interrelación entre lenguaje y pensamiento se plantea el papel fundamental que el lenguaje ocupa en el modelo económico, educativo y cultural generado por la aparición de la era digital o era del conocimiento. en este artículo se evidencian los retos que genera una era marcada por un esquema digital en el desarrollo y uso de habilidades comunicativas tanto en la docencia superior como en el ejercicio profesional eficiente.

  15. Retrospective Analysis of Clinical and Cost Outcomes Associated with Methicillin-Resistant Staphylococcus aureus Complicated Skin and Skin Structure Infections Treated with Daptomycin, Vancomycin, or Linezolid

    Directory of Open Access Journals (Sweden)

    Bradley M. Wright

    2011-01-01

    Full Text Available Objective. The objective of this analysis was to compare clinical and cost outcomes associated with patients who had suspected or documented methicillin-resistant Staphylococcus aureus (MRSA infections treated with daptomycin, vancomycin, or linezolid in complicated skin and skin structure infections (cSSSIs. Design. This was a retrospective analysis conducted from February to June of 2007. Appropriate data was collected, collated, and subsequently evaluated with the purpose of quantifying length of stay, antibiotic therapy duration, clinical cure rates, adverse drug events, and cost of hospitalization. Results. All 82 patients included in the analysis experienced clinical cure. The duration of antibiotic therapy was similar among the three groups yet the length of hospitalization was slightly shorter in the daptomycin group. Conclusions. The incidence of resistant staphylococcal infections is increasing; therefore, judicious use of MRSA active agents is paramount. Future studies are necessary to determine if MRSA treatment options can be stratified based on the severity of the infectious process.

  16. Trends in Life Expectancy of Cystic Fibrosis Patients in Moscow and their Connection with the Treatment Received: Retrospective Analysis for 1993–2013

    Directory of Open Access Journals (Sweden)

    N. Yu. Kashirskaya

    2015-01-01

    Full Text Available Cystic fibrosis is multiple organ pathology that requires a complex treatment. Its standardization and pharmacoeconomic analysis are absolutely necessary. We performed a retrospective analysis of the trends in life expectancy of cystic fibrosis patients who lived inMoscow in 1993, 1998, 2003, 2008, and 2013. It was found that the survival rate of these patients depended on the choice of drug therapy (pancreatic enzymes, dornase alfa, intravenous and inhaled antipseudomonal antibiotics, changes in diet, active dispensary observation at a specialized center for cystic fibrosis, and neonatal screening. We determined the cost of drug therapy per patient. From 1993 to 2013, the survival rate of patients who lived in Moscow increased by more than 20 years (from 16 to 39 years, respectively. The average cost of therapy increased more than 10 times (from USD 1.8 to 21.9 thousand, respectively.

  17. Perinatal complications and neonatal outcomes of twin pregnancies conceived by assisted reproductive techniques and those conceived spontaneously: A retrospective analysis of 811 cases

    Directory of Open Access Journals (Sweden)

    Jin YU

    2017-11-01

    Full Text Available Objective To investigate the general situations of gravida, pregnancy complications, childbirth and neonatal outcomes of twin pregnancies conceived by assisted reproductive techniques (ART and those conceived spontaneously. Methods A retrospective analysis was carried out on the basic information, perinatal complications, delivery information and neonatal outcomes of twin pregnancies received by ART (ART group, n=518 and those conceived spontaneously (SC group, n=293. Results Gravida age was older in ART group than in SC group (P0.05. Conclusion Twin pregnancy conceived by ART may lead to higher incidences of gestational diabetes mellitus and abnormal placenta and more postpartum hemorrhage, but no significant difference existed in the neonatal outcomes between twin pregnancies conceived by ART and those conceived spontaneously. DOI: 10.11855/j.issn.0577-7402.2017.11.12

  18. Periodistas para la era digital

    Directory of Open Access Journals (Sweden)

    Fernando Villalobos G.

    2014-12-01

    Full Text Available La formación de los periodistas del siglo XXI en la era digital se concibe como un reto y el mayor desafío. Los medios digitales demandan especialización y dominio de las nuevas tecnologías. Las universidades, principales gestores de este cambio, en la sociedad del conocimiento, requieren trabajar en la reformulación de nuevos pensum y en tres terrenos fundamentales: el perfil del egresado, el estilo pedagógico y el nuevo modo de relacionarse con el mundo exterior. Se necesita de una oferta académica referida al ciberperiodismo y a la cibercomunicación. La profesión periodística, y específicamente la formación de los comunicadores registra cambios importantes debido a las nuevas tecnologías, ahora el aula es el mundo globalizado e interconectado por la gran autopista de la información, por ello, la formación del comunicador social, demanda renovadas prácticas educativas. Las universidades deben repensar el papel que están obligadas a desempeñar, reformular los pensum académicos y ofertar la cibercomunicación y el ciberperiodismo para estar al día de las grandes transformaciones.

  19. A THIRD ERA OF MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Liviu NEAMŢU

    2009-12-01

    Full Text Available Management like any social activity through specific stages of development trends from general society. Following these historical trends, this study summarizes the evolution of management at four stages of a full cycle of development, from a informal management to one perfect formalized. These stages of development are found differential represented at the various economic development regions in the world. Evolution increasingly grouped patterns of management and generalization for schools of thought management determines the current global development of worldwide management. For the current stage of evolution may be called as "the third era of management" or "imperial period” in which management pressures on individuals, employers or subordinate, are enormous. Evolution of companies, of markets and national economies also the global economy is driven by the current trend in management, leading to very strong mutations in the relationship of forces. The world economy is in what is called "war of resources" and the alternative that we believe is necessary in this "human management" although speculative trends of concentration of capital are binding on any plans or state regulators global ethical management.

  20. DianaHealth.com, an On-Line Database Containing Appraisals of the Clinical Value and Appropriateness of Healthcare Interventions: Database Development and Retrospective Analysis.

    Science.gov (United States)

    Bonfill, Xavier; Osorio, Dimelza; Solà, Ivan; Pijoan, Jose Ignacio; Balasso, Valentina; Quintana, Maria Jesús; Puig, Teresa; Bolibar, Ignasi; Urrútia, Gerard; Zamora, Javier; Emparanza, José Ignacio; Gómez de la Cámara, Agustín; Ferreira-González, Ignacio

    2016-01-01

    To describe the development of a novel on-line database aimed to serve as a source of information concerning healthcare interventions appraised for their clinical value and appropriateness by several initiatives worldwide, and to present a retrospective analysis of the appraisals already included in the database. Database development and a retrospective analysis. The database DianaHealth.com is already on-line and it is regularly updated, independent, open access and available in English and Spanish. Initiatives are identified in medical news, in article references, and by contacting experts in the field. We include appraisals in the form of clinical recommendations, expert analyses, conclusions from systematic reviews, and original research that label any health care intervention as low-value or inappropriate. We obtain the information necessary to classify the appraisals according to type of intervention, specialties involved, publication year, authoring initiative, and key words. The database is accessible through a search engine which retrieves a list of appraisals and a link to the website where they were published. DianaHealth.com also provides a brief description of the initiatives and a section where users can report new appraisals or suggest new initiatives. From January 2014 to July 2015, the on-line database included 2940 appraisals from 22 initiatives: eleven campaigns gathering clinical recommendations from scientific societies, five sets of conclusions from literature review, three sets of recommendations from guidelines, two collections of articles on low clinical value in medical journals, and an initiative of our own. We have developed an open access on-line database of appraisals about healthcare interventions considered of low clinical value or inappropriate. DianaHealth.com could help physicians and other stakeholders make better decisions concerning patient care and healthcare systems sustainability. Future efforts should be focused on

  1. DianaHealth.com, an On-Line Database Containing Appraisals of the Clinical Value and Appropriateness of Healthcare Interventions: Database Development and Retrospective Analysis.

    Directory of Open Access Journals (Sweden)

    Xavier Bonfill

    Full Text Available To describe the development of a novel on-line database aimed to serve as a source of information concerning healthcare interventions appraised for their clinical value and appropriateness by several initiatives worldwide, and to present a retrospective analysis of the appraisals already included in the database.Database development and a retrospective analysis. The database DianaHealth.com is already on-line and it is regularly updated, independent, open access and available in English and Spanish. Initiatives are identified in medical news, in article references, and by contacting experts in the field. We include appraisals in the form of clinical recommendations, expert analyses, conclusions from systematic reviews, and original research that label any health care intervention as low-value or inappropriate. We obtain the information necessary to classify the appraisals according to type of intervention, specialties involved, publication year, authoring initiative, and key words. The database is accessible through a search engine which retrieves a list of appraisals and a link to the website where they were published. DianaHealth.com also provides a brief description of the initiatives and a section where users can report new appraisals or suggest new initiatives. From January 2014 to July 2015, the on-line database included 2940 appraisals from 22 initiatives: eleven campaigns gathering clinical recommendations from scientific societies, five sets of conclusions from literature review, three sets of recommendations from guidelines, two collections of articles on low clinical value in medical journals, and an initiative of our own.We have developed an open access on-line database of appraisals about healthcare interventions considered of low clinical value or inappropriate. DianaHealth.com could help physicians and other stakeholders make better decisions concerning patient care and healthcare systems sustainability. Future efforts should be

  2. Gemcitabine/cisplatin versus 5-fluorouracil/mitomycin C chemoradiotherapy in locally advanced pancreatic cancer: a retrospective analysis of 93 patients

    Directory of Open Access Journals (Sweden)

    Sauer Rolf

    2011-07-01

    Full Text Available Abstract Background Despite of a growing number of gemcitabine based chemoradiotherapy studies in locally advanced pancreatic cancer (LAPC, 5-fluorouracil based regimens are still regarded to be standard and the debate of superiority between the two drugs is going on. The aim of this retrospective analysis was to evaluate the effect of two concurrent chemoradiotherapy regimens using 5-fluorouracil or gemcitabine to compare their effect and tolerance. Methods We have performed a single centre retrospective analysis of 93 patients treated with conventionally fractionated radiotherapy of 55.8 Gray using either concurrent 5-fluorouracil, 1 g/m² on days 1-5 and 29-33 of radiotherapy and 10 mg/m² of mitomycin C on day 1, 29 of radiotherapy (FM group, 35 patients versus gemcitabine (300 mg/m² and cisplatin, (30 mg/m² on days 1, 8, 22, and 29 (GC group, 58 patients. Primary endpoint was the median overall survival (OS rate. Results The median OS rate was 12.7 months in the GC group and 9.7 months in the FM group. The 1-year OS rate was 53% versus 40%, respectively (p = 0.009. GC led to more grade 3 leukocytopenia and thrombocytopenia than FM, but not to more grade 4 myelosuppression. Thrombocytopenia was the most frequently observed grade 4 toxicity in both groups (11% after FM versus 12% after GC. No grade 3/4 febrile neutropenia was observed. Grade 3 nausea was more common in the FM group (20% versus 9% and grade 4 nausea was observed in one patient per group only. Conclusions GC was superior to FM for overall survival and both regimens were similar in terms of tolerance. We conclude that GC leads to encouraging results and that the use of FM for chemoradiotherapy in LAPC cannot be recommended without concerns.

  3. Demystifying traditional herbal medicine with modern approach.

    Science.gov (United States)

    Li, Fu-Shuang; Weng, Jing-Ke

    2017-07-31

    Plants have long been recognized for their therapeutic properties. For centuries, indigenous cultures around the world have used traditional herbal medicine to treat a myriad of maladies. By contrast, the rise of the modern pharmaceutical industry in the past century has been based on exploiting individual active compounds with precise modes of action. This surge has yielded highly effective drugs that are widely used in the clinic, including many plant natural products and analogues derived from these products, but has fallen short of delivering effective cures for complex human diseases with complicated causes, such as cancer, diabetes, autoimmune disorders and degenerative diseases. While the plant kingdom continues to serve as an important source for chemical entities supporting drug discovery, the rich traditions of herbal medicine developed by trial and error on human subjects over thousands of years contain invaluable biomedical information just waiting to be uncovered using modern scientific approaches. Here we provide an evolutionary and historical perspective on why plants are of particular significance as medicines for humans. We highlight several plant natural products that are either in the clinic or currently under active research and clinical development, with particular emphasis on their mechanisms of action. Recent efforts in developing modern multi-herb prescriptions through rigorous molecular-level investigations and standardized clinical trials are also discussed. Emerging technologies, such as genomics and synthetic biology, are enabling new ways for discovering and utilizing the medicinal properties of plants. We are entering an exciting era where the ancient wisdom distilled into the world's traditional herbal medicines can be reinterpreted and exploited through the lens of modern science.

  4. Modernity in Two Great American Writers' Vision: Ernest Miller Hemingway and Scott Fitzgerald

    Science.gov (United States)

    Keshmiri, Fahimeh; Darzikola, Shahla Sorkhabi

    2016-01-01

    Scott Fitzgerald and Ernest Hemingway, American memorable novelists have had philosophic ideas about modernity. In fact their idea about existential interests of American, and the effects of American system on society, is mirrored in their creative works. All through his early works, Fitzgerald echoes the existential center of his era. Obviously,…

  5. What on Earth is the Modern World-System? Foodgetting and Territory in the Modern Era and Beyond

    Directory of Open Access Journals (Sweden)

    Harriet Friedman

    2015-08-01

    Full Text Available The promise, and dangers of genetic technologies have refocused the attention of city dwellers on an enduring reality of the human species: We are eating animals. We are breathing animals, too, forced (as we render them extinct to notice that we exchange gases with plants. We are drinking animals, forced (as we render it toxic to notice that the same water we drink and urinate in circulates through rivers, seas and clouds, and through the cells of all species. Until we pushed back the wild places of earth—that is, until very recently—humans were able to take oxygen, water, and the in?nitude of wild beings for granted. Not so with food. Only since our fascination with industry developed has human attention drifted away from the source and meaning of food.

  6. The Performing Arts in a New Era

    National Research Council Canada - National Science Library

    McCarthy, Kevin

    2001-01-01

    The Pew Charitable Trust commissioned The Performing Arts in a New Era from RAND in 1999 as part of a broad initiative aimed at increasing policy and financial support for nonprofit culture in the United States...

  7. MEMAKNAI SUMPAH PEMUDA DI ERA REFORMASI

    Directory of Open Access Journals (Sweden)

    Sutejo K. Widodo

    2013-03-01

    Full Text Available The moment of Sumpah Pemuda (Young Man Oath took place 84 years ago, reflecting the spirit of nationalism that is still very important in this Reformation era. This paper endeavors to dig deeper meaning of Sumpah Pemuda in its pre-independence era and applying it to our contemporary situation. The method used here is historical research using literature resources, such as articles, books, and other readings in internet. It is then concluded that the spirit of Sumpah Pemuda should be our contemplative materials and valuable Iesson so that Reformation era may succeed in achieving national goals stated in the Constitution, a society that is fair, prosperous, and democratic. Keywords: Sumpah Pemuda, Reformation era, nationalism.

  8. Technology: A New Era in Education

    Science.gov (United States)

    Cunningham, William G.

    1977-01-01

    Teachers and technologists have lived apart, with much doubt on both sides. The author suggests that collaboration, mutual trust, and respect, will usher in a new era for effective education. (Editor)

  9. Requirements of modernization strategies

    International Nuclear Information System (INIS)

    Heinbuch, R.

    1997-01-01

    Instrumentation and control contributed a major share to the current level of safety, economic efficiency, and availability of the German nuclear power plants. German NPPs occupy a top position in this respect at international level, but novel instrumentation and digital control technology alone will not guarantee further enhancements. Therefore, the owner/operators established carefully devised maintenance and modernization strategies in order to safeguard their NPPs top position in the long run. The German NPPs are the most thoroughly automated plants of the world. In addition to the sweeping modernization strategies recommended by the plant manufacturers, based on computer-supported control, alternative modernization strategies have been considered in the evaluation process. This approach provides for room for maneuvre, for manufacturers as well as managers responsible for risk and cost optimization, which is a major task in view of the changing regulatory framework in the electricity market. (orig./CB) [de

  10. CAPITALISM EMERGING ERA TAX SYSTEMS OF THE EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Виктория Александровна Цокова

    2013-05-01

    Full Text Available Three phases should be distinguished in the development of tax systems:I. The Ancient World and Middle Ages (from the IV - III centuries. BC. till. XVII - XVIII centuries AD.II. The new time (from the XVII - XVIII centuries till the end of XIX century. - the era of the emerging capitalism.III. Modern History (from the XX century and up to the present time. The capitalism emerging era scientific ideas and tax systems research relevance (importance is caused by the emergence of the main distinct characteristics of any state, that is by the permanently increasing demand of that institution for money. This fact, in its turn, contributes to the formation of the state tax system, and, of course, the evolution of scientific views on taxation.Nowadays, some theoretical ideas in the field of taxation, clarifying the nature and the role of taxes in the European countries budget formation begin to appear in Europe, especially in theUK. The development of tax systems in England, France and Germany have  been analyzed;  and , basing on the  dialectical, historical and logical approaches, and the method of scientific abstraction, the authors identify the following common features of the  capitalism emerging era tax systems in the European countries: the taxation on a regular (permanent basis, the expansion of the tax-payers  range – all citizens of the state are becoming tax payers, the introduction of the income tax and the abolishment  of the revenue leasing – creation of government agencies system responsible for the administration of taxes, to establishing and collecting taxes only with the Parliament approval and permission.Classical theoretical and practical approaches to creation of tax systems of the states have been formulated in Europe in the era of nascent capitalism and they haven’t lost the relevance yet.DOI: http://dx.doi.org/10.12731/2218-7405-2013-4-55

  11. Liminality and the Modern

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    of the liquid structures of modern society. Shedding new light on a concept central to social thought, as well as its capacity for pushing social and political theory in new directions, this book will be of interest to scholars across the social sciences and philosophy working in fields such as social......-for-granted order of the world ceases to exist and novel forms emerge, often in unpredictable ways. Liminality and the Modern offers a comprehensive introduction to this concept, discussing its development and laying out a conceptual and experiential framework for thinking about change in terms of liminality...

  12. Introduction to modern physics

    International Nuclear Information System (INIS)

    Pfeffer, J.; Nir, S.

    1993-01-01

    The modern physics and its uses changed our world of concepts and ways of life. This book explains the basics of modern physics in a simple and extensive form. The main subjects included in the book are: The relativistic theory, quantum theory, the structure of the atom, the interaction of radiation with matter and nuclear physics. The book elaborates on some advanced subjects: The laser, Moessbauer effect, Nuclear magnetic Resonance and solids electric conductivity. The book is for natural sciences students, whose main subject is not physics. The book can be used also in high schools. (authors)

  13. Modern electronic maintenance principles

    CERN Document Server

    Garland, DJ

    2013-01-01

    Modern Electronic Maintenance Principles reviews the principles of maintaining modern, complex electronic equipment, with emphasis on preventive and corrective maintenance. Unfamiliar subjects such as the half-split method of fault location, functional diagrams, and fault finding guides are explained. This book consists of 12 chapters and begins by stressing the need for maintenance principles and discussing the problem of complexity as well as the requirements for a maintenance technician. The next chapter deals with the connection between reliability and maintenance and defines the terms fai

  14. Det sentimentalt moderne

    DEFF Research Database (Denmark)

    Thule Kristensen, Peter

    2005-01-01

    Romantikken er blevet afskrevet som en mørk epoke, hvor en hang til mystik og tvetydighed ikke passer til det moderne oplysningsprojekts mål om klarhed og orden. Afhendlingen viser imidlertid, hvordan dele af arkitekturen i det 20. århundrede er fyldt med romantisk tankegods, og hvordan romantisk...... nøglemotiver som f.eks. fragment, arabesk, krystal, symbol eller poesi kan bruges i en analyse - også af moderne arkitektur. det ses i bogens nyfortolkninger af værker og teorier hos arkitekterne Erik Gunnar Asplund, Josef Frank, Rudolf Schwarz, Aldo Rossi og Daniel Libeskind...

  15. Modern recording techniques

    CERN Document Server

    Huber, David Miles

    2013-01-01

    As the most popular and authoritative guide to recording Modern Recording Techniques provides everything you need to master the tools and day to day practice of music recording and production. From room acoustics and running a session to mic placement and designing a studio Modern Recording Techniques will give you a really good grounding in the theory and industry practice. Expanded to include the latest digital audio technology the 7th edition now includes sections on podcasting, new surround sound formats and HD and audio.If you are just starting out or looking for a step up

  16. BARCELONA: URBANSCAPES OF MODERNITY

    Directory of Open Access Journals (Sweden)

    Antoni Remesar

    2015-04-01

    The Do.Co.Mo.Mo’s. database, referring to Barcelona, lists 34 buildings that could be classified as rationalists and / or modern. According to other sources, we could reach fifty constructed buildings between the late 1920s and the end of the war in Spain. The article presents the results of a field work that, using different sources, has tried to to order and record the architectural production that can be considered modern / rationalist in Barcelona in the 1920s and 1930s

  17. Modern physics for engineers

    CERN Document Server

    Singh, Jasprit

    1999-01-01

    Linking physics fundamentals to modern technology-a highly applied primer for students and engineersReminding us that modern inventions-new materials, information technologies, medical technological breakthroughs-are based on well-established fundamental principles of physics, Jasprit Singh integrates important topics from quantum mechanics, statistical thermodynamics, and materials science, as well as the special theory of relativity. He then goes a step farther and applies these fundamentals to the workings of electronic devices-an essential leap for anyone interested in developing n

  18. Modern social life and never-married women's health problems

    Directory of Open Access Journals (Sweden)

    Patrapan Tamdee

    2016-01-01

    Full Text Available This study explored the health problems of never-married women as they relate to modern social life. In-depth interviews were conducted with a purposive sample of 45 never-married women aged 30–50 working or living in Bangkok and having health problems. It was found that never-married women in this modern era have experienced a variety of illnesses, such as “office syndrome” symptoms, chronic illnesses, and psychological and psychosomatic symptoms. Their social life resulted from the response to the context of modernity and was made through careful thought and deliberation. Whichever choice of social life they make, the consequences may lead them to a state of illness, distress, anxiety, and paranoia. These choices involve work, living conditions/environments, and intimacy aspects of their modern social life. This is the result of procuring by “husky modernity” which seems to be merely a “husk” or superficial modernization and changes so rapidly, but there is no core and it is full of double standards of traditional and new norms that have mixed together and fight against each other. Supporting health-related knowledge and information exchange within the network coupled with experience sharing essential for living in the modern society will enable them to sensibly decide on a path to good health.

  19. A new era of competitiveness.

    Science.gov (United States)

    Theadore, Jason C

    2011-01-01

    Many of my family, friends, and colleagues would describe me as competitive and that at times I overuse this skill with a win-at-all-costs attitude. I would tend to agree. I love to win. Yet for me winning is not about me, it is as our coaches suggest, about others. I was recently asked by a new clinical leader if I missed taking care of patients. Without thinking, my response was that I take part in the care (add value) of every patient as a leader. Every decision we make as leaders (coaches) impacts many others regardless of the magnitude of our decision and, at times, our direct involvement. Operational excellence, in any field, is about winning. We all have different definitions of winning, defined by the strategic vision for our organizations. An organization's managers, supervisors, and employees all play an important role in the team to achieve the vision of the organization. As some elite coaches have suggested, winning starts with each of us being our best. Today's environment requires consistent change. Yet many in the radiology field change the wrong things for the wrong reasons. Many organizations and individuals look for instant gratification, specifically in this new era of competitiveness. Many evaluate what their competitors are doing in the market, what cars their neighbors are buying, or become jealous over a friend's success. Focusing on others and not improving yourself takes your focus away from what is important-you and the team you lead. Keeping your focus on your operations and what you can control may very well help you coach a winning team.

  20. Modern Fortran in practice

    NARCIS (Netherlands)

    Markus, A.

    2012-01-01

    From its earliest days, the Fortran programming language has been designed with computing efficiency in mind. The latest standard, Fortran 2008, incorporates a host of modern features, including object-orientation, array operations, user-defined types, and provisions for parallel computing. This

  1. Modern Versus Traditional Mathematics

    Science.gov (United States)

    Roberts, A. M.

    1974-01-01

    The effect of different secondary school mathematics syllabi on first-year performance in college-level mathematics was studied in an attempt to evaluate the syllabus change. Students with a modern mathematics background performed sigficantly better on most first-year units. A topic-by-topic analysis of results is included. (DT)

  2. Late-modern hipsters

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2014-01-01

    The article deals with the cultural significance of a new figure in late-modern Western culture: the hipster. The current hipster culture, so I argue, can be used as a magnifying glass that makes impending changes to our conception of culture and of cultural development visible. It ushers...

  3. Dimensions of Modern Federalism.

    Science.gov (United States)

    Williams, Robert F.; And Others

    1995-01-01

    Encapsulates a series of brief essays exploring different aspects of modern federalism. Issues include further protection of individual rights extended through state constitutions and federalism and the world economy. Authors include Robert F. Williams, Earl H. Fry, and Daniel J. Elazar. (MJP)

  4. Landau and modern physics

    International Nuclear Information System (INIS)

    Pokrovsky, Valery L

    2009-01-01

    This article describes the history of the creation and further development of Landau's famous works on phase transitions, diamagnetism of electron gas (Landau levels), and quantum transitions at a level crossing (the Landau-Zener phenomenon), and its role in modern physics. (methodological notes)

  5. Meta Modernism: An Introduction

    Science.gov (United States)

    Snell, Joel

    2016-01-01

    The author introduces Hegel. From the triad (Hegelian Dialect), he briefly gives an overview of the history of philosophy. In true Hegelian form, it is now time to reform "Postmodernism" and replace it with "Meta modernism." Postmodern had a short life from 1950 to now and has left few adherents. It is confusing and…

  6. Modern vs. Traditional.

    Science.gov (United States)

    Zhenhui, Rao

    1999-01-01

    This article discusses traditional methods, such as the grammar-translation, and modern methods, the communicative approach, for teaching English-as-a-foreign-language in China. The relationship between linguistic accuracy and communicative competence, student-centered orientation, and the role of the teacher are highlighted. (Author/VWL)

  7. Den moderne bevidstheds katedral

    DEFF Research Database (Denmark)

    Ostenfeld Pedersen, Simon

    2002-01-01

    Interview med idéhistorikeren Dorthe Jørgensen der under overskriften ”Den moderne bevidstheds katedral” blotlægger hendes mangeårige arbejde med Hegel, og hvor hun giver en række relevante bud på en aktualiserende Hegel-læsning centreret omkring felter som metafysik, historiefilosofi og æstetik....

  8. Euripides in Modern Europe

    NARCIS (Netherlands)

    den Boer, P.

    2010-01-01

    Euripides is considered the most human, modern and existentialist of the famous Greek tragedians. Extremely popular after his death, he continued to be staged, read and much recited in Hellenistic and Roman times. As the Greek-speaking elite of the Roman Empire disappeared, the popularity of the

  9. A Modern Periodic Table.

    Science.gov (United States)

    Herrenden-Harker, B. D.

    1997-01-01

    Presents a modern Periodic Table based on the electron distribution in the outermost shell and the order of filling of the sublevels within the shells. Enables a student to read off directly the electronic configuration of the element and the order in which filling occurs. (JRH)

  10. Modern Reduction Methods

    CERN Document Server

    Andersson, Pher G

    2008-01-01

    With its comprehensive overview of modern reduction methods, this book features high quality contributions allowing readers to find reliable solutions quickly and easily. The monograph treats the reduction of carbonyles, alkenes, imines and alkynes, as well as reductive aminations and cross and heck couplings, before finishing off with sections on kinetic resolutions and hydrogenolysis. An indispensable lab companion for every chemist.

  11. Modern programming language

    Science.gov (United States)

    Feldman, G. H.; Johnson, J. A.

    1980-01-01

    Structural-programming language is especially-tailored for producing assembly language programs for MODCOMP II and IV mini-computes. Modern programming language consists of set of simple and powerful control structures that include sequencing alternative selection, looping, sub-module linking, comment insertion, statement continuation, and compilation termination capabilities.

  12. The Ideological Foundations of Taiwanese Modernity: Mou Zongsan’s New Moral Philosophy

    Directory of Open Access Journals (Sweden)

    Jana Rošker

    2011-12-01

    Full Text Available In order to understand the social, political and intellectual process of Chinese modernization, it is necessary to evaluate their ideological foundations and to thus become able to place it in the suitable political context. Chinese philosophy of the first half of the 20th century was still determined by the conditions of the decline of the pre-modern era. The present article aims to explore and to introduce the rise and growth of Modern Confucianism, as well as some crucial philosophical elaborations in the field of the new moral philosophy, developed by the most well-known exponent of its so-called 2nd generation, Mou Zongsan.

  13. Era Transmídia

    Directory of Open Access Journals (Sweden)

    Rodrigo Dias Arnaut

    2011-12-01

    Full Text Available A abordagem transmídia se mostra cada vez mais atual e interessante por integrar todos os conceitos de produção de conteúdos em uma única metodologia e processo de criação e distribuição. Atualmente, e cada vez mais, as pessoas, o público em geral é um potencial produtor de conteúdo nas novas mídias, seja através de uma simples câmera fotográfica, um telefone celular, um PC ou mesmo do mais sofisticado tablet. Nesta nova dinâmica, o mercado (conjunto de: audiência, mídia, concorrência e demais agentes apresenta novas plataformas de comuni-cação que, devido a sua abertura e amplo acesso, trazem consigo uma grande perda de controle do que é publi-cado e do próprio contexto originalmente planejado, pois a mídia espontânea e a interpretação do público criam novos caminhos para a história principal do projeto.A necessidade do mercado em estreitar relacionamento com seus clientes ou públicos (cada segmento de mercado é considerado um público diferente passa por uma grande transformação, que se implementada de forma impul-siva e despreparada, no que diz respeito à análise do público-alvo, aos formatos de distribuição e à mensagem enviada, pode acarretar na perda de oportunidades e propostas de comunicação. O foco dos projetos transmídia é utilizar  metodologias e  processos mais completos e abrangentes, do ponto de vista das áreas de criação de con-teúdo, tecnologia, marketing e outras, utilizando as melhores plataformas de mídia para o sucesso do projeto. De forma resumida o grupo de estudos em transmídia, #EraTransmídia, irá apresentar seus conceitos com o objetivo de proporcionar o engajamento social multiplataforma para resultados positivos.

  14. RADIKALISME SEBAGAI BLOCKING FACTOR BAGI PERKEMBANGAN PERADABAN ISLAM MODERN

    Directory of Open Access Journals (Sweden)

    Hammis Syafaq

    2015-09-01

    Full Text Available This article highlights the evolution of Islamic civilization starting from its glory during the classical period until its collapse in modern times. This article also discusses radicalism as a part of inhibiting factors of the development of Islamic civilization in the modern era. Radicalism is a model of understanding which tends to be destructive. This model of understanding has been a fertile ground of the emergence of rigid and normative theological understanding. Hostile attitude of the followers of radicalism often trap them into combat actions of others, even to the extent of murder, especially to the Western people. Such radical attitude has been also manifested in the form of destruction of public facilities. This destructive action has led to the devastation of civilization, which has been built by a nation. The conditions of a number of Arab-Muslim countries, which have not been free from prolonged internal warfare, prove that radicalism is an obvious blocking factor in the development of Islamic civilization in the modern era.Keywords: radicalism, blocking factor, Islamic civilization.

  15. Molecular Adsorbent Recirculating System Can Reduce Short-Term Mortality Among Patients With Acute-on-Chronic Liver Failure-A Retrospective Analysis.

    Science.gov (United States)

    Gerth, Hans U; Pohlen, Michele; Thölking, Gerold; Pavenstädt, Hermann; Brand, Marcus; Hüsing-Kabar, Anna; Wilms, Christian; Maschmeier, Miriam; Kabar, Iyad; Torner, Josep; Pavesi, Marco; Arroyo, Vicente; Banares, Rafael; Schmidt, Hartmut H J

    2017-10-01

    Acute-on-chronic liver failure is associated with numerous consecutive organ failures and a high short-term mortality rate. Molecular adsorbent recirculating system therapy has demonstrated beneficial effects on the distinct symptoms, but the associated mortality data remain controversial. Retrospective analysis of acute-on-chronic liver failure patients receiving either standard medical treatment or standard medical treatment and molecular adsorbent recirculating system. Secondary analysis of data from the prospective randomized Recompensation of Exacerbated Liver Insufficiency with Hyperbilirubinemia and/or Encephalopathy and/or Renal Failure trial by applying the recently introduced Chronic Liver Failure-criteria. Medical Departments of University Hospital Muenster (Germany). This analysis was conducted in two parts. First, 101 patients with acute-on-chronic liver failure grades 1-3 and Chronic Liver Failure-C-Organ Failure liver subscore equals to 3 but stable pulmonary function were identified and received either standard medical treatment (standard medical treatment, n = 54) or standard medical treatment and molecular adsorbent recirculating system (n = 47) at the University Hospital Muenster. Second, the results of this retrospective analysis were tested against the Recompensation of Exacerbated Liver Insufficiency with Hyperbilirubinemia and/or Encephalopathy and/or Renal Failure trial. Standard medical treatment and molecular adsorbent recirculating system. Additionally to improved laboratory variables (bilirubin and creatinine), the short-term mortality (up to day 14) of the molecular adsorbent recirculating system group was significantly reduced compared with standard medical treatment. A reduced 14-day mortality rate was observed in the molecular adsorbent recirculating system group (9.5% vs 50.0% with standard medical treatment; p = 0.004), especially in patients with multiple organ failure (acute-on-chronic liver failure grade 2-3). Concerning the

  16. THE DEMAND FOR A NEW CONCEPT OF ANTHROPOLOGY IN THE EARLY MODERN AGE: THE DOCTRINE OF HUME

    Directory of Open Access Journals (Sweden)

    A. M. Malivskyi

    2016-12-01

    Full Text Available Purpose. The purpose of the investigation is to outline the main points of Hume’s interpretation of the basic anthropological project of the era based on radical cultural transformations of the early modern age; to represent a modern vision of Hume's anthropology as a response to the demand of the era and necessity to complete its basic project. Methodology. The research was based on phenomenological and hermeneutic approaches. Originality. Contemporary understanding of the position of anthropological project in Hume's philosophy is regarded as unsatisfactory by the author. Development of the basic project as anthropological is rooted in scientific revolution and needs to be continued and completed. Contemporary prevalence of deanthropogical versions of Hume's philosophy is the result of underestimated significance of the concept of nature in the broad sense. According to the philosopher's texts, heuristic potential of Hume's position is emphasized by the author. The modern version of the basic project in the early modern age is criticized and demands significant changes to become anthropological. Findings. Modern perception of Hume’s philosophy as an anthropological project is unsatisfactory in terms of historical and philosophical science and needs detailed analysis. In order to understand the conditions of anthropological project significance, it is advisable to focus on: a scientific revolution and the necessity to complete it; b determine the role of the concept of nature in its broad sense. Nowadays the way of Hume's rethinking of the basic project of modern philosophy as insufficiently anthropological is quite heuristic. Empiricism, dogmatism, superstition and skepticism are the manifestations of the latter. For Hume, the era was as an incomplete anthropological project and its legacy as the most complete form of explication. Today the interest in the phenomenon of a human provides a reasonable basis to define that modern period is

  17. Phase transitions modern applications

    CERN Document Server

    Gitterman, Moshe

    2014-01-01

    This book provides a comprehensive review of the theory of phase transitions and its modern applications, based on the five pillars of the modern theory of phase transitions i.e. the Ising model, mean field, scaling, renormalization group and universality. This expanded second edition includes, along with a description of vortices and high temperature superconductivity, a discussion of phase transitions in chemical reaction and moving systems. The book covers a close connection between phase transitions and small world phenomena as well as scale-free systems such as the stock market and the Internet. Readership: Scientists working in different fields of physics, chemistry, biology and economics as well as teaching material for undergraduate and graduate courses.

  18. Methods in Modern Biophysics

    CERN Document Server

    Nölting, Bengt

    2006-01-01

    Incorporating recent dramatic advances, this textbook presents a fresh and timely introduction to modern biophysical methods. An array of new, faster and higher-power biophysical methods now enables scientists to examine the mysteries of life at a molecular level. This innovative text surveys and explains the ten key biophysical methods, including those related to biophysical nanotechnology, scanning probe microscopy, X-ray crystallography, ion mobility spectrometry, mass spectrometry, proteomics, and protein folding and structure. Incorporating much information previously unavailable in tutorial form, Nölting employs worked examples and 267 illustrations to fully detail the techniques and their underlying mechanisms. Methods in Modern Biophysics is written for advanced undergraduate and graduate students, postdocs, researchers, lecturers and professors in biophysics, biochemistry and related fields. Special features in the 2nd edition: • Illustrates the high-resolution methods for ultrashort-living protei...

  19. Methods in Modern Biophysics

    CERN Document Server

    Nölting, Bengt

    2010-01-01

    Incorporating recent dramatic advances, this textbook presents a fresh and timely introduction to modern biophysical methods. An array of new, faster and higher-power biophysical methods now enables scientists to examine the mysteries of life at a molecular level. This innovative text surveys and explains the ten key biophysical methods, including those related to biophysical nanotechnology, scanning probe microscopy, X-ray crystallography, ion mobility spectrometry, mass spectrometry, proteomics, and protein folding and structure. Incorporating much information previously unavailable in tutorial form, Nölting employs worked examples and about 270 illustrations to fully detail the techniques and their underlying mechanisms. Methods in Modern Biophysics is written for advanced undergraduate and graduate students, postdocs, researchers, lecturers, and professors in biophysics, biochemistry and related fields. Special features in the 3rd edition: Introduces rapid partial protein ladder sequencing - an important...

  20. Modernization mixed with nationalism

    Directory of Open Access Journals (Sweden)

    Nikiforov Konstantin V.

    2014-01-01

    Full Text Available This essay reflects on a particular manner in which modernisation have taken place in the Balkans in modern history, from the 1878 Berlin Congress onwards. The Balkan countries faced twofold difficulties in their development: they had to overcome their backwardness stemming from the centuries of the Ottoman yoke and catch up with modern Western Europe, and resolve their numerous mutual territorial and political disputes. The latter task was especially difficult due to the constant interference in Balkan affairs on the part of Great Powers. This interference further aggravated nationalistic tensions between the Balkan states. The peculiar mixture of modernisation efforts and nationalism remains to this day when the entire region strives to join the European Union.

  1. Modern real analysis

    CERN Document Server

    Ziemer, William P

    2017-01-01

    This first year graduate text is a comprehensive resource in real analysis based on a modern treatment of measure and integration. Presented in a definitive and self-contained manner, it features a natural progression of concepts from simple to difficult. Several innovative topics are featured, including differentiation of measures, elements of Functional Analysis, the Riesz Representation Theorem, Schwartz distributions, the area formula, Sobolev functions and applications to harmonic functions. Together, the selection of topics forms a sound foundation in real analysis that is particularly suited to students going on to further study in partial differential equations. This second edition of Modern Real Analysis contains many substantial improvements, including the addition of problems for practicing techniques, and an entirely new section devoted to the relationship between Lebesgue and improper integrals. Aimed at graduate students with an understanding of advanced calculus, the text will also appeal to mo...

  2. Relativity in modern physics

    CERN Document Server

    Deruelle, Nathalie

    2018-01-01

    This comprehensive textbook on relativity integrates Newtonian physics, special relativity and general relativity into a single book that emphasizes the deep underlying principles common to them all, yet explains how they are applied in different ways in these three contexts. Newton's ideas about how to represent space and time, his laws of dynamics, and his theory of gravitation established the conceptual foundation from which modern physics developed. Book I in this volume offers undergraduates a modern view of Newtonian theory, emphasizing those aspects needed for understanding quantum and relativistic contemporary physics. In 1905, Albert Einstein proposed a novel representation of space and time, special relativity. Book II presents relativistic dynamics in inertial and accelerated frames, as well as a detailed overview of Maxwell's theory of electromagnetism. This provides undergraduate and graduate students with the background necessary for studying particle and accelerator physics, astrophysics and ...

  3. Modern particle physics

    CERN Document Server

    AUTHOR|(CDS)2079874

    2013-01-01

    Unique in its coverage of all aspects of modern particle physics, this textbook provides a clear connection between the theory and recent experimental results, including the discovery of the Higgs boson at CERN. It provides a comprehensive and self-contained description of the Standard Model of particle physics suitable for upper-level undergraduate students and graduate students studying experimental particle physics. Physical theory is introduced in a straightforward manner with full mathematical derivations throughout. Fully-worked examples enable students to link the mathematical theory to results from modern particle physics experiments. End-of-chapter exercises, graded by difficulty, provide students with a deeper understanding of the subject. Online resources available at www.cambridge.org/MPP feature password-protected fully-worked solutions to problems for instructors, numerical solutions and hints to the problems for students and PowerPoint slides and JPEGs of figures from the book

  4. Modern operating systems

    CERN Document Server

    Tanenbaum, Andrew S

    2015-01-01

    Modern Operating Systems, Fourth Edition, is intended for introductory courses in Operating Systems in Computer Science, Computer Engineering, and Electrical Engineering programs. It also serves as a useful reference for OS professionals ' The widely anticipated revision of this worldwide best-seller incorporates the latest developments in operating systems (OS) technologies. The Fourth Edition includes up-to-date materials on relevant'OS. Tanenbaum also provides information on current research based on his experience as an operating systems researcher. ' Modern Operating Systems, Third Editionwas the recipient of the 2010 McGuffey Longevity Award. The McGuffey Longevity Award recognizes textbooks whose excellence has been demonstrated over time.'http://taaonline.net/index.html " Teaching and Learning Experience This program will provide a better teaching and learning experience-for you and your students. It will help: ' *Provide Practical Detail on the Big Picture Concepts: A clear and entertaining writing s...

  5. Modern water resources engineering

    CERN Document Server

    Yang, Chih

    2014-01-01

    The Handbook of Environmental Engineering series is an incredible collection of methodologies that study the effects of pollution and waste in their three basic forms: gas, solid, and liquid. This exciting new addition to the series, Volume 15: Modern Water Resources Engineering , has been designed to serve as a water resources engineering reference book as well as a supplemental textbook. We hope and expect it will prove of equal high value to advanced undergraduate and graduate students, to designers of water resources systems, and to scientists and researchers. A critical volume in the Handbook of Environmental Engineering series, chapters employ methods of practical design and calculation illustrated by numerical examples, include pertinent cost data whenever possible, and explore in great detail the fundamental principles of the field. Volume 15: Modern Water Resources Engineering, provides information on some of the most innovative and ground-breaking advances in the field today from a panel of esteemed...

  6. Cobol software modernization

    CERN Document Server

    Barbier, Franck

    2015-01-01

    Nowadays, billions of lines of code are in the COBOL programming language. This book is an analysis, a diagnosis, a strategy, a MDD method and a tool to transform legacy COBOL into modernized applications that comply with Internet computing, Service-Oriented Architecture (SOA) and the Cloud.  It serves as a blueprint for those in charge of finding solutions to this considerable challenge.

  7. Modern optical science

    International Nuclear Information System (INIS)

    2001-05-01

    This book deals with modern optical science, which gives description of properties of light and transmission, ray tracing like Gaussian image, ray tracing and optical system, properties about light wave, a vector properties of light, interference and an interferometer, transform and application of interferometer, diffraction, application on diffraction, solid optical science, measurement of light and laser such as basic principle of laser, kinds of laser, pulse laser, resonator and single mode and multimode.

  8. Designing Modern Equity Portfolios

    OpenAIRE

    Ronald Jean Degen

    2011-01-01

    This aim of this paper is to describe possible ways of investing in equity; choosing the right stocks(among small-cap, large-cap, value, growth, and foreign) using fundamental analysis, defining their appropriate mix in the portfolios according to the desired return-risk profiles based on Markowitz?s modern portfolio theory, and using technical analysis to buy and sell them.

  9. Modern Human Capital Management

    OpenAIRE

    Feldberger, Madita

    2008-01-01

    Title: Modern Human Capital Management Seminar date: 30th of May 2008 Course: Master thesis in Business Administration, 15 ECTS Authors: Madita Feldberger Supervisor: Lars Svensson Keywords: Human capital, SWOT Analysis, Strategic Map, Balanced Scorecard Research Problem: Despite of the success of Human Capital Management (HCM) in research it did not arrive yet in the HR departments of many companies. Numerous firms even have problems to set their strategic goals with focus on HR. The HR Bala...

  10. 1998 Army Modernization Plan

    Science.gov (United States)

    1998-01-01

    Biological (CB) Protective Duty Uniform (STO) • Biometrics (SRO) • Nanoscience (SRO) • Millimeter Wave Material and Dissemination Technology... Biometrics and Nanoscience SROs will enable the development of advanced NBC detection and characterization systems, including the exploitation of biologically...Requirements Trailers • Procure HEMAT Trailers Figure K-23 K-19 //;<?. U.S. Army 1997Modernization Plan This final fleet assessment, made against the

  11. Modern electronic materials

    CERN Document Server

    Watkins, John B

    2013-01-01

    Modern Electronic Materials focuses on the development of electronic components. The book first discusses the history of electronic components, including early developments up to 1900, developments up to World War II, post-war developments, and a comparison of present microelectric techniques. The text takes a look at resistive materials. Topics include resistor requirements, basic properties, evaporated film resistors, thick film resistors, and special resistors. The text examines dielectric materials. Considerations include basic properties, evaporated dielectric materials, ceramic dielectri

  12. Modern algebra essentials

    CERN Document Server

    Lutfiyya, Lutfi A

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Modern Algebra includes set theory, operations, relations, basic properties of the integers, group theory, and ring theory.

  13. Modern electrochemistry and industry

    International Nuclear Information System (INIS)

    Kim, Sun Yong

    1985-04-01

    This book is divided into fifteen chapters on modern electrochemistry and industry. The contents of this book are electrochemistry and industry, electrochemistry for electrolyte like ionic mobility quantity of activity of electrolyte, potential balance system like cell potential, concentration cell and membrane potential, electrochemical kinetics, electrochemistry for surfactant, electrochemistry for electrolysis test such as polarography, chronopotentiometry and Cyclic voltametry, electrolysis reactor NaOH electrolysis industry, H 2 O electrolysis, molten metal electrolysis, copper electrolysis, battery and electro-organic chemistry.

  14. Modern windships. Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    Knud E. Hansen A/S (KEH) has, partly funded by the Energy Research Programme, (EFP-95) investigated in the possibilities of using windships for transportation of cargo on long routes, i.e. across the Atlantic or Pacific Ocean. The task was to peruse experiences from projects made during the past 30 years and then, based on new materials and design principle to make proposals to modern wind driven ships to transportation of cargo - especially bulk carriers. KEH has thus prepared a suggestion for a 50,000 DWT wind driven bulk carrier on these terms. The bulk carrier in question is a modern rig inspired by the classical lugger and junk sail with a total sail area of abt. 10,000 m{sup 2}. The hull of the ship has been developed in order to limit wave resistance and drifting. Project Windship has, in contrast to earlier tests and projects, designed a bulk carrier based on a complete evaluation of ecology, safety, economy and reasonable transportation speed. The research project shows that international sea transportation, with wind as the primary source of energy, does not seem to run up against any obstacles as regards safety. The economical analyses show that windship transportation, with today`s oil prices, will be about 10% higher compared to the diesel driven transportation. In the light of the positive results of the research project the steering committee recommends that phase II of project `Modern Windships` is carried out. (EG)

  15. Modern windships. Phase 1

    International Nuclear Information System (INIS)

    1996-11-01

    Knud E. Hansen A/S (KEH) has, partly funded by the Energy Research Programme, (EFP-95) investigated in the possibilities of using windships for transportation of cargo on long routes, i.e. across the Atlantic or Pacific Ocean. The task was to peruse experiences from projects made during the past 30 years and then, based on new materials and design principle to make proposals to modern wind driven ships to transportation of cargo - especially bulk carriers. KEH has thus prepared a suggestion for a 50,000 DWT wind driven bulk carrier on these terms. The bulk carrier in question is a modern rig inspired by the classical lugger and junk sail with a total sail area of abt. 10,000 m 2 . The hull of the ship has been developed in order to limit wave resistance and drifting. Project Windship has, in contrast to earlier tests and projects, designed a bulk carrier based on a complete evaluation of ecology, safety, economy and reasonable transportation speed. The research project shows that international sea transportation, with wind as the primary source of energy, does not seem to run up against any obstacles as regards safety. The economical analyses show that windship transportation, with today's oil prices, will be about 10% higher compared to the diesel driven transportation. In the light of the positive results of the research project the steering committee recommends that phase II of project 'Modern Windships' is carried out. (EG)

  16. Code Modernization of VPIC

    Science.gov (United States)

    Bird, Robert; Nystrom, David; Albright, Brian

    2017-10-01

    The ability of scientific simulations to effectively deliver performant computation is increasingly being challenged by successive generations of high-performance computing architectures. Code development to support efficient computation on these modern architectures is both expensive, and highly complex; if it is approached without due care, it may also not be directly transferable between subsequent hardware generations. Previous works have discussed techniques to support the process of adapting a legacy code for modern hardware generations, but despite the breakthroughs in the areas of mini-app development, portable-performance, and cache oblivious algorithms the problem still remains largely unsolved. In this work we demonstrate how a focus on platform agnostic modern code-development can be applied to Particle-in-Cell (PIC) simulations to facilitate effective scientific delivery. This work builds directly on our previous work optimizing VPIC, in which we replaced intrinsic based vectorisation with compile generated auto-vectorization to improve the performance and portability of VPIC. In this work we present the use of a specialized SIMD queue for processing some particle operations, and also preview a GPU capable OpenMP variant of VPIC. Finally we include a lessons learnt. Work performed under the auspices of the U.S. Dept. of Energy by the Los Alamos National Security, LLC Los Alamos National Laboratory under contract DE-AC52-06NA25396 and supported by the LANL LDRD program.

  17. Hand infections: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Tolga Türker

    2014-09-01

    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  18. A Retrospective Analysis of Nostalgia.

    Science.gov (United States)

    Moriarty, Sandra Ernst

    Prompted by an awareness of nostalgic trends during the 1960s and 1970s in movies, television programing, fashion, interior design, and architecture, a study compared such trends in graphic design in both magazine articles and magazine advertisements. Specifically, it noted the frequency of occurrence of nostalgia in the two graphic design areas…

  19. Communicating mathematics in the digital era

    CERN Document Server

    Borwein, Jonathan; Rodrigues, Jose Francisco

    2008-01-01

    The digital era has dramatically changed the ways that researchers search, produce, publish, and disseminate their scientific work. These processes are still rapidly evolving due to improvements in information science, new achievements in computer science technologies, and initiatives such as DML and open access journals, digitization projects, scientific reference catalogs, and digital repositories. These changes have prompted many mathematicians to play an active part in the developments of the digital era, and have led mathematicians to promote and discuss new ideas with colleagues from other fields, such as technology developers and publishers. This book is a collection of contributions by key leaders in the field, offering the paradigms and mechanisms for producing, searching, and exploiting scientific and technical scholarship in mathematics in the digital era.

  20. Trends in prescribing behavior of systemic agents used in the treatment of acne among dermatologists and nondermatologists: A retrospective analysis, 2004-2013.

    Science.gov (United States)

    Barbieri, John S; James, William D; Margolis, David J

    2017-09-01

    Despite recommendations to limit the use of oral antibiotics and increasing support for hormonal agents in the treatment of acne, it is unclear whether there have been any significant changes in practice patterns. To characterize changes in prescribing behavior for systemic agents in the treatment of acne in the United States between 2004 and 2013. We conducted a retrospective analysis using the OptumInsight Clinformatics DataMart (Optum, Eden Prairie, MN). The number of courses of spironolactone prescribed per 100 female patients being managed for acne by dermatologists and nondermatologists increased from 2.08 to 8.13 and from 1.43 to 4.09, respectively. The median duration of therapy with oral antibiotics was 126 and 129 days among patients managed by dermatologists and nondermatologists, respectively, and did not change significantly over the study period. The OptumInsight Clinformatics DataMart lacks information on acne severity and clinical outcomes. Additional work to identify patients who would benefit most from alternative therapies such as spironolactone, oral contraceptives, or isotretinoin represents a potential opportunity to improve the care of patients with acne. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesion

    Directory of Open Access Journals (Sweden)

    Candinas Daniel

    2009-03-01

    Full Text Available Abstract Background This study investigated the role of a negative FAST in the diagnostic and therapeutic algorithm of multiply injured patients with liver or splenic lesions. Methods A retrospective analysis of 226 multiply injured patients with liver or splenic lesions treated at Bern University Hospital, Switzerland. Results FAST failed to detect free fluid or organ lesions in 45 of 226 patients with spleen or liver injuries (sensitivity 80.1%. Overall specificity was 99.5%. The positive and negative predictive values were 99.4% and 83.3%. The overall likelihood ratios for a positive and negative FAST were 160.2 and 0.2. Grade III-V organ lesions were detected more frequently than grade I and II lesions. Without the additional diagnostic accuracy of a CT scan, the mean ISS of the FAST-false-negative patients would be significantly underestimated and 7 previously unsuspected intra-abdominal injuries would have been missed. Conclusion FAST is an expedient tool for the primary assessment of polytraumatized patients to rule out high grade intra-abdominal injuries. However, the low overall diagnostic sensitivity of FAST may lead to underestimated injury patterns and delayed complications may occur. Hence, in hemodynamically stable patients with abdominal trauma, an early CT scan should be considered and one must be aware of the potential shortcomings of a "negative FAST".

  2. A retrospective analysis of in vivo eye irritation, skin irritation and skin sensitisation studies with agrochemical formulations: Setting the scene for development of alternative strategies.

    Science.gov (United States)

    Corvaro, M; Gehen, S; Andrews, K; Chatfield, R; Macleod, F; Mehta, J

    2017-10-01

    Analysis of the prevalence of health effects in large scale databases is key in defining testing strategies within the context of Integrated Approaches on Testing and Assessment (IATA), and is relevant to drive policy changes in existing regulatory toxicology frameworks towards non-animal approaches. A retrospective analysis of existing results from in vivo skin irritation, eye irritation, and skin sensitisation studies on a database of 223 agrochemical formulations is herein published. For skin or eye effects, high prevalence of mild to non-irritant formulations (i.e. per GHS, CLP or EPA classification) would generally suggest a bottom-up approach. Severity of erythema or corneal opacity, for skinor eye effects respectively, were the key drivers for classification, consistent with existing literature. The reciprocal predictivity of skin versus eye irritation and the good negative predictivity of the GHS additivity calculation approach (>85%) provided valuable non-testing evidence for irritation endpoints. For dermal sensitisation, concordance on data from three different methods confirmed the high false negative rate for the Buehler method in this product class. These results have been reviewed together with existing literature on the use of in vitro alternatives for agrochemical formulations, to propose improvements to current regulatory strategies and to identify further research needs. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Diagnostic efficacy of CA 15-3 and CEA in the early detection of metastatic breast cancer-A retrospective analysis of kinetics on 743 breast cancer patients.

    Science.gov (United States)

    Stieber, Petra; Nagel, Dorothea; Blankenburg, Irene; Heinemann, Volker; Untch, Michael; Bauerfeind, Ingo; Di Gioia, Dorit

    2015-08-25

    We investigated the diagnostic capacity of CEA and CA 15-3 kinetics for the early detection of metastatic disease in comparison to fixed cut off values. In a retrospective analysis, a total of 743 patients with early breast cancer and available baseline values of CEA and CA 15-3 were included. A reproducible increase of 100% of single or combined markers was considered as a strong indicator of metastatic disease. 187 patients developed metastatic disease and 556 remained disease-free. On the basis of tumor marker kinetics, we reached a specificity of >98% for both biomarkers and a sensitivity of 40.6% for CEA alone, 55.6% for CA 15-3 alone and 66.3% for the combination of both markers. Using fixed cut-off values (CEA: 4ng/mL, CA 15-3: 30U/mL) we ended up with a specificity of 86.3% and a sensitivity of 70.6% for the combination of CEA and CA 15-3. Using higher cut-off values (CEA: 6ng/mL, CA 15-3: 60U/mL) we reached a specificity of 96.9% and a sensitivity of 49.7% for the combination. We conclude that the interpretation of these markers in follow-up using individual baseline values and kinetics leads to a significant superior profile of specificity and sensitivity. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013.

    Science.gov (United States)

    Shalaka, N S; Garred, N A; Zeglam, H T; Awasi, S A; Abukathir, L A; Altagdi, M E; Rayes, A A

    2015-10-02

    In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/μL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality.

  5. Improvement in Obstructive Sleep Apnea Diagnosis and Management Wait Times: A Retrospective Analysis of a Home Management Pathway for Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Samuel Alan Stewart

    2015-01-01

    Full Text Available Obstructive sleep apnea is a common condition within the Canadian population. The current gold standard for diagnosis and management of patients is in-laboratory (in-lab polysomnography; however, the limited availability of testing options for patients has led to long wait times and increased disease burden within the population. The Sleep Research Laboratory in Saskatoon (Saskatchewan implemented a home management program to run in parallel with the in-lab system several years ago in an effort to increase their capacity and reduce wait times. The present study was a retrospective analysis of all patients referred to the program between 2009 and 2012. The home management system has improved wait times by diagnosing and managing up to one-half of the referred patient population, reducing the wait for in-lab treatment from a median of 152 days in 2009 to 92 days in 2012 (P<0.0001. Moving forward, home management can provide a viable alternative to in-lab testing for patients who meet strict entry criteria, reducing the in-lab workload and, ultimately, reducing wait times.

  6. Retrospective analysis of risk factors and predictors of intraoperative complications in neuraxial blocks at Faculdade de Medicina de Botucatu-UNESP.

    Science.gov (United States)

    Pereira, Ivan Dias Fernandes; Grando, Marcela Miguel; Vianna, Pedro Thadeu Galvão; Braz, José Reinaldo Cerqueira; Castiglia, Yara Marcondes Machado; Vane, Luís Antônio; Módolo, Norma Sueli Pinheiro; do Nascimento, Paulo; Amorim, Rosa Beatriz; Rodrigues, Geraldo Rolim; Braz, Leandro Gobbo; Ganem, Eliana Marisa

    2011-01-01

    Cardiovascular changes associated with neuraxial blocks are a cause of concern due to their frequency and because some of them can be considered physiological effects triggered by the sympathetic nervous system blockade. The objective of this study was to evaluate intraoperative cardiovascular complications and predictive factors associated with neuraxial blocks in patients ≥ 18 years of age undergoing non-obstetric procedures over an 18-year period in a tertiary university hospital--HCFMB-UNESP. A retrospective analysis of the following complications was undertaken: hypertension, hypotension, sinus bradycardia, and sinus tachycardia. These complications were correlated with anesthetic technique, physical status (ASA), age, gender, and preoperative co-morbidities. The Tukey test for comparisons among proportions and logistic regression was used for statistical analysis. 32,554 patients underwent neuraxial blocks. Intraoperative complications mentioned included hypotension (n=4,109), sinus bradycardia (n=1,107), sinus tachycardia (n=601), and hypertension (n=466). Hypotension was seen more often in patients undergoing continuous subarachnoid anesthesia (29.4%, OR=2.39), ≥ 61 years of age, and female (OR=1.27). Intraoperative hypotension and bradycardia were the complications observed more often. Hypotension was related to anesthetic technique (CSA), increased age, and female. Tachycardia and hypertension may not have been directly related to neuraxial blocks. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  7. Probabilistic approach to decision making under uncertainty during volcanic crises. Retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands

    Science.gov (United States)

    Sobradelo, Rosa; Martí, Joan; Kilburn, Christopher; López, Carmen

    2014-05-01

    Understanding the potential evolution of a volcanic crisis is crucial to improving the design of effective mitigation strategies. This is especially the case for volcanoes close to densely-populated regions, where inappropriate decisions may trigger widespread loss of life, economic disruption and public distress. An outstanding goal for improving the management of volcanic crises, therefore, is to develop objective, real-time methodologies for evaluating how an emergency will develop and how scientists communicate with decision makers. Here we present a new model BADEMO (Bayesian Decision Model) that applies a general and flexible, probabilistic approach to managing volcanic crises. The model combines the hazard and risk factors that decision makers need for a holistic analysis of a volcanic crisis. These factors include eruption scenarios and their probabilities of occurrence, the vulnerability of populations and their activities, and the costs of false alarms and failed forecasts. The model can be implemented before an emergency, to identify actions for reducing the vulnerability of a district; during an emergency, to identify the optimum mitigating actions and how these may change as new information is obtained; and after an emergency, to assess the effectiveness of a mitigating response and, from the results, to improve strategies before another crisis occurs. As illustrated by a retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands, BADEMO provides the basis for quantifying the uncertainty associated with each recommended action as an emergency evolves, and serves as a mechanism for improving communications between scientists and decision makers.

  8. Comparison of intracytoplasmic sperm injection with testicular spermatozoa success in infertile men with obstructive and non-obstructive azoospermia; a retrospective analysis.

    Science.gov (United States)

    Yalcin, Ibrahim; Berker, Bulent; Sukur, Yavuz Emre; Kahraman, Korhan; Ates, Can

    2017-09-01

    The aim of this study was to compare the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer between couples with infertility due to male non-obstructive azoospermia (NOA) and obstructive azoospermia (OA). A retrospective analysis of 234 couples with azoospermia who were treated by ICSI and embryo transfer between January 2007 and October 2010 was performed. There were 61 couples in NOA group and 173 couples in OA group. Fertilization rates, pregnancy and clinical pregnancy rates were the main outcome measures. The number of retrieved mature oocytes, injected oocytes, metaphase II (MII) oocytes, two distinct pronuclei oocytes, cleavage embryos and embryos transferred was not significantly different between the groups. The fertilization rate was significantly lower in NOA group when compared to OA group (56.2 vs. 66.7%, respectively; p = 0.013) and the pregnancy rate was significantly lower in NOA group than OA group (36.1 vs. 50.9%, respectively; p = 0.046). The clinical pregnancy rates were not statistically different between the patients with NOA and OA azoospermia groups (24.6 vs. 36.4%, respectively; p = 0.09). This study suggests that ICSI and embryo transfer together with testicular sperm extraction results in statistically significant lower fertilization and pregnancy rates in men with NOA when compared to men with OA.

  9. Efficacy of Scutellaria baicalensis for the Treatment of Hand, Foot, and Mouth Disease Associated with Encephalitis in Patients Infected with EV71: A Multicenter, Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Hailong Lin

    2016-01-01

    Full Text Available This study aimed to evaluate the clinical efficacy and safety of using the traditional Chinese herbal medicine Scutellaria baicalensis for the treatment of severe HFMD in 725 patients aged >1 year in a multicenter, retrospective analysis. The patients were divided into the S. baicalensis and ribavirin groups, and the temperatures, presence or absence of skin rashes and oral lesions, nervous system (NS involvement, and viral loads of the patients, as well as the safety of the treatments, were evaluated. The median duration of fever, median time to NS involvement, and the number of patients with oral ulcers and/or vesicles, as well as skin rashes, were decreased in the S. baicalensis group compared with the ribavirin group. In addition, the EV71 viral loads were decreased in the S. baicalensis group, suggesting that S. baicalensis exerted more potent antiviral effects compared with ribavirin. The present study demonstrated that S. baicalensis was suitable for the treatment of severe HFMD in patients aged >1 year, since it was shown to rapidly relieve fever, attenuate oral lesions and rashes, and improve NS involvement. Furthermore, it was demonstrated to be relatively safe for topical application.

  10. Clinical, general, hemocoagulation and pathologicanatomical features of patients with moderate and severe community acquired pneumonia by the data of retrospective analysis

    Directory of Open Access Journals (Sweden)

    Pertseva T.A.

    2017-10-01

    Full Text Available According to literature data, patients with community acquired pneumonia (CAP fall into several groups of unfavorable prognostic factors. Development of thrombotic complications is one of causes of mortality of hospitalized patients. In this case systemic inflammation, which is always present in moderate and severe CAP, is the starting mechanism of formation of disorders in the hemostasis system. The aim of our work was to determine anamnestic, clinical, laboratory and pathologic anatomical features in patients with CAP, taking into account markers of systemic inflammation and coagulogram indices, as well as predicting the occurrence of complications. In the course of the work, a retrospective analysis of 151 medical histories of hospitalized patients with CAP was made. We analyzed anthropometric indicators, complaints at the time of hospitalization, results of physical examination, results of the chest X-ray, clinical and laboratory indicators, microbiological sputum analysis and to assess the possibility of thrombotic complications a RAM scale was used. It was found that late asking for medical help, the presence of mixed infection, underestimation of the severity of condition and severe systemic inflammation increase the risk of lethal outcome in patients with CAP. Considering a high risk of thrombosis in patients with CAP, it is necessary to assess the risk of thrombotic complications with the help of special scales, as well as timely detection and correction of disorders from the hemostasis system.

  11. Therapy with low-dose azacitidine for MDS in children and young adults: a retrospective analysis of the EWOG-MDS study group.

    Science.gov (United States)

    Cseh, Annamaria M; Niemeyer, Charlotte M; Yoshimi, Ayami; Catala, Albert; Frühwald, Michael C; Hasle, Henrik; van den Heuvel-Eibrink, Mary M; Lauten, Melchior; De Moerloose, Barbara; Smith, Owen P; Bernig, Toralf; Gruhn, Bernd; Kulozik, Andreas E; Metzler, Markus; Olcay, Lale; Suttorp, Meinolf; Furlan, Ingrid; Strahm, Brigitte; Flotho, Christian

    2016-03-01

    Low-dose azacitidine is efficient and safe in the therapy of malignant myeloid disorders in adults but data in children are lacking. We present a retrospective analysis of 24 children and young adults with myelodysplastic syndrome (MDS) who received azacitidine at the time of first diagnosis or relapse after allotransplant (2 children were treated with azacitidine both initially and for relapse). Diagnoses were refractory cytopenia of childhood (N = 4), advanced primary MDS (N = 9) and secondary MDS (N = 11). The median duration of treatment was four cycles. Azacitidine was well tolerated, but cytopenias led to dose reduction in five cases. Treatment was discontinued in one child because of impaired renal function. Sixteen MDS patients were treated with azacitidine at first diagnosis. One complete clinical remission was observed and one child showed complete marrow remission; six children experienced stable disease with haematological improvement. Ten children received azacitidine for relapsed MDS after transplant: of these, seven experienced stable disease for 2-30 cycles (median 3), including one patient with haematological improvement for seven cycles. In summary, azacitidine is effective in some children with MDS and appears to be a non-toxic option in palliative situations to prolong survival. © 2016 John Wiley & Sons Ltd.

  12. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Justin Shmalberg

    2015-01-01

    Full Text Available Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions. The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.. Older neutered or spayed dogs (mean age = 9.0 years and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients. Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P<0.05. The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented.

  13. Chinese librarianship in the digital era

    CERN Document Server

    Fang, Conghui

    2013-01-01

    The library in China has been transformed by rapid socioeconomic development, and the proliferation of the Internet. The issues faced by Chinese libraries andlibrarians are those faced by library practitioners more globally, however, China also has its own unique set of issues in the digital era, including developmental imbalance between East and West, urban and rural areas, and availability of skilled practitioners. Chinese Librarianship in the Digital Era is the first book on Chinese libraries responding to these issues, and more.The first part of the book places discussion in historical con

  14. RPO networking in the digital era: prospects and challenges in the year 2000 and beyond

    International Nuclear Information System (INIS)

    Baharuddin Aziz

    2000-01-01

    Crucial activities pertaining to the harnessing of nuclear science and technology and their attendant initiatives, inevitably, are expected to increase as the nation embarks on a development plan to achieve a modern industrial nation status. As such activities/initiatives increase in scope and applications, they also dictate the need to continually assess and upgrade radiation protection and expand the functions of RPOs. This article briefly surveys recent developments in information and communication technologies and attempts to relate the digital era to various aspects of radiation protection. It briefly discusses the implications of the digital era to RPO initiatives and offers suggestions to intensify Radiation Safety networking, management, documentation and the sharing of information. (author)

  15. Modernization of African Armed Forces

    DEFF Research Database (Denmark)

    Mandrup, Thomas

    2015-01-01

    Concept paper framing the debate at the Dakar Forum Workshop on Modernization of Armed forces in Africa.......Concept paper framing the debate at the Dakar Forum Workshop on Modernization of Armed forces in Africa....

  16. PUBLIC ADMINISTRATION: MODERNIZING THE CURRENT MODEL OF STATE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Evgenii V. Ohotskii

    2014-01-01

    Full Text Available Applying the method of retrospective analysis the article deals with the process of forming the scientific fundamentals and the search by the international community of effective and adequate to the current stage of social development public administration system. The author attempts to analyze, in a number of cases in terms of models, features of public administration systems at different stages of historical development, drawing attention to reasons why the Soviet model of public administration did not manage to meet competition, did not provide the required social effect and as a natural result suffered a defeat in the global confrontation between the two social systems. Current models and theoretical concepts of public administration, especially the "new public administration", which became scientific basis for administrative reforms implemented in many countries, are the particular subject of scientific analysis. The author draws attention to major comprehensive characteristics of modern state public administration: making it impossible to absolutize principles of traditional hierarchy system of forced administration; globalization - gradual destruction of boundaries between national and international levels of administration, the growing role of supranational subjects of administration relations; informatization - increasing importance of information and communication technologies and of political networks: development of civil society, especially political parties and non-governmental organizations, growing public involvement in discussion and adoption of the most important administrative decisions; making the state policy more pluralistic and which will result in the formation of nonlinear - humanistic social consciousness as the intellectual basis of modern social governance. The author's position is that Russia is yet to solve the issue of choosing a public administration model that would be effective for further administrative

  17. Changing Face of Wood Science in Modern Era: Contribution of Nanotechnology.

    Science.gov (United States)

    Mishra, Pawan Kumar; Giagli, Kyriaki; Tsalagkas, Dimitrios; Mishra, Harshita; Talegaonkar, Sushma; Gryc, Vladimír; Wimmer, Rupert

    2018-02-14

    Wood science and nanomaterials science interact together in two different aspects; a) fabrication of lignocellulosic nanomaterials derived from wood and plant-based sources and b) surface or bulk wood modification by nanoparticles. In this review, we attempt to visualize the impact of nanoparticles on the wood coating and preservation treatments based on a thorough registration of the patent databases. The study was carried out as an overview of the scientifically most followed trends on nanoparticles utilization in wood science and wood protection depicted by recent universal filed patents. This review is exclusively targeted on the solid (timber) wood as a subject material. Utilization of mainly metal nanoparticles as photoprotection, antibacterial, antifungal, antiabrasive and functional component on wood modification treatments was found to be widely patented. Additionally, an apparent minimization in the emission of volatile organic compounds (VOCs) has been succeeded. Bulk wood preservation and more importantly, wood coating, splay the range of strengthening wood dimensional stability and biological degradation, against moisture absorption and fungi respectively. Nanoparticle materials have addressed various issues of wood science in a more efficient and environmental way than the traditional methods. Nevertheless, abundant tests and regulations are still needed before industrializing or recycling these products. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  18. Sounding off on social media: the ethics of patient storytelling in the modern era.

    Science.gov (United States)

    Wells, Deva M; Lehavot, Keren; Isaac, Margaret L

    2015-08-01

    Use of social networking programs like Facebook and Twitter, which enable the public sharing of diverse content over the Internet, has risen dramatically in recent years. Although health professionals have faced consequences for clearly unethical online behavior, a relatively unexamined practice among medical students is the disclosure of patient care stories on social media in a manner that is technically compliant with the Health Insurance Portability and Accountability Act, yet is ethically questionable. In this Perspective, the authors review three such cases in which students do not specifically reveal a patient's identity but share details of a personal nature, motivated by a variety of intentions (e.g., a desire to reflect on a meaningful experience, reaching out for social support in the event of a patient's death). Using ethical principles and professional policy recommendations, they discuss aspects of these postings that are potentially problematic. Consequences include the possibility of undermining public trust in the profession, inadvertently identifying patients, and violating expectations of privacy. The authors recommend that medical schools explicitly address these issues across the preclinical and clinical curricula and emphasize that patient-related postings on social media may carry inherent risks both to patients and to the profession.

  19. Klein and Lacan meet 21st century schizoid man: fairy stories for the modern era.

    Science.gov (United States)

    Charles, Marilyn

    2014-09-01

    Melanie Klein invited us into the phenomenology of the schizoid dilemma through her depictions of the paranoid-schizoid position. By inserting his recursive arrows, Bion extended this conceptualization, showing us the folly of believing that we can ever entirely move beyond the frightening fantasies and realities of social exclusion and isolation. The 21st century has brought, along with the explosion of technology, an expulsion from the social order of many children who have found refuge from isolation and humiliation in the more accessible and less terrifying world of media and technological invention. What may look like narcissism can mask a terrible underlying schizoid failure to enter into the human race. This is the realm of fantasy run amok, where desire becomes alien and alienated such that one is haunted and hunted down by its very possibility. In this universe, conceptualizations from Klein, Bion, and Lacan help us to locate the individual who has become caught in a massive psychic retreat such that there is no subject because there are no objects. To illustrate, I describe my work with a young man who is living in a terrible "zombie zone" where people are not real and therefore are incomprehensible and terribly dangerous. The poignancy of his dilemma is heartbreaking. Perhaps that is one lesson we can still take from our old fairy tales: when one's heart can be broken by another's plight, then comes the possibility of a healing, an entry through that piercing of what had been impenetrable.

  20. Theology: Still a queen of science in the post-modern era

    Directory of Open Access Journals (Sweden)

    Erna Oliver

    2016-08-01

    Full Text Available Theology is just as relevant today as it was in the time of Aquinas who called theology ‘the queen of science’ although the knowledge-driven network society does not seem to be in agreement. By using the tools provided by the fourth revolution in the development of society, theology can, as part of the academic world of higher education that is supposed to lead society, strengthen ties with the past, seek explanations and solutions to current problems and produce guidelines for future investigation through multi- and interdisciplinary discourse. Theology can and should influence people to become positive change agents, re-shape the way in which the message of salvation is brought to the world in order to stay relevant in changing circumstances and be on the forefront of progressive transformation in society. This should be achieved through constant dialogue with other academic disciplines, the Church as institution and with society in general.

  1. Role of radiotherapy in extracranial metastatic malignant melanoma in the modern era

    Directory of Open Access Journals (Sweden)

    Ryan S. Youland

    2017-10-01

    Conclusions: SBRT for extracranial MM exhibited improved MF compared with CHRT, consistent with intracranial radiosurgery data. Though these data are retrospective and subject to selection bias, our findings support the prudent use of SBRT in a select group of favorable, oligometastatic MM patients, and should be discussed as an alternative to surgery and ablation.

  2. Impact of diet and exercise on lipid management in the modern era.

    Science.gov (United States)

    Franklin, Barry A; Durstine, J Larry; Roberts, Christian K; Barnard, R James

    2014-06-01

    Unfortunately, many patients as well as the medical community, continue to rely on coronary revascularization procedures and cardioprotective medications as a first-line strategy to stabilize or favorably modify established risk factors and the course of coronary artery disease. However, these therapies do not address the root of the problem, that is, the most proximal risk factors for heart disease, including unhealthy dietary practices, physical inactivity, and cigarette smoking. We argue that more emphasis must be placed on novel approaches to embrace current primary and secondary prevention guidelines, which requires attacking conventional risk factors and their underlying environmental causes. The impact of lifestyle on the risk of cardiovascular disease has been well established in clinical trials, but these results are often overlooked and underemphasized. Considerable data also strongly support the role of lifestyle intervention to improve glucose and insulin homeostasis, as well as physical inactivity and/or low aerobic fitness. Accordingly, intensive diet and exercise interventions can be highly effective in facilitating coronary risk reduction, complementing and enhancing medications, and in some instances, even outperforming drug therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Computer vision syndrome-A common cause of unexplained visual symptoms in the modern era.

    Science.gov (United States)

    Munshi, Sunil; Varghese, Ashley; Dhar-Munshi, Sushma

    2017-07-01

    The aim of this study was to assess the evidence and available literature on the clinical, pathogenetic, prognostic and therapeutic aspects of Computer vision syndrome. Information was collected from Medline, Embase & National Library of Medicine over the last 30 years up to March 2016. The bibliographies of relevant articles were searched for additional references. Patients with Computer vision syndrome present to a variety of different specialists, including General Practitioners, Neurologists, Stroke physicians and Ophthalmologists. While the condition is common, there is a poor awareness in the public and among health professionals. Recognising this condition in the clinic or in emergency situations like the TIA clinic is crucial. The implications are potentially huge in view of the extensive and widespread use of computers and visual display units. Greater public awareness of Computer vision syndrome and education of health professionals is vital. Preventive strategies should form part of work place ergonomics routinely. Prompt and correct recognition is important to allow management and avoid unnecessary treatments. © 2017 John Wiley & Sons Ltd.

  4. Hungry women: sin and rebellion through food and music in the early modern era

    Directory of Open Access Journals (Sweden)

    Gioia Filocamo

    2015-01-01

    Full Text Available Longing for food has always had different implications for men and women: associated with power and strength for men, it tends to have a worrying proximity to sexual pleasure for women. Showing an interesting parallelism throughout the Cinquecento, Italian humanists and teachers insisted on forbidding women music and gluttony. Food and music were both considered dangerous stimulants for the female senses, and every woman was encouraged to consider herself as a kind of food to be offered to the only human beings authorized to feel and satisfy desires: men and babies. Women could properly express themselves only inside monastic circles: the most prolific female composer of the seventeenth century was a nun, as was the first woman who wrote down recipes. Elaborate music and food became the means to maintain a lively relationship with the external world. Moreover, nuns also escaped male control by using the opposite system of affirming themselves through fasting and mortifying the flesh.

  5. Becoming Ottomans: Sephardi Jews and Imperial Citizenship in the Modern Era

    Czech Academy of Sciences Publication Activity Database

    Taglia, Stefano

    2015-01-01

    Roč. 130, č. 547 (2015), s. 1579-1580 ISSN 0013-8266 Institutional support: RVO:68378009 OBOR OECD: History (history of science and technology to be 6.3, history of specific sciences to be under the respective headings)

  6. Overview of gynecomastia in the modern era and the Leeds Gynaecomastia Investigation algorithm.

    Science.gov (United States)

    Rahmani, Samir; Turton, Philip; Shaaban, Abeer; Dall, Barbara

    2011-01-01

    Gynecomastia is a benign enlargement of male breast glandular tissue. At least a third of males are affected at some time during their lifetime. Idiopathic causes exceed other etiologies and relate to an imbalance in the ratio of estrogen to androgen tissue levels or end-organ responsiveness to these hormones. Assessment must include a thorough history and clinical examination, specific blood investigations and usually tissue sampling and/or breast imaging. Management consists of a combination of measures that may include simple reassurance, pharmacological manipulation, medical treatment or surgery. Hormone therapy may help to abort the acute proliferative phase of gynecomastia with a 30% response rate but should not be considered in chronic established cases. Surgical treatment may comprise simple liposuction for a predominant fatty component or direct excision when glandular tissue is predominant. The main aim is to control the patient's symptoms and to exclude other etiological factors. © 2011 Wiley Periodicals, Inc.

  7. A Balance of Power-Army Transformation and Modernization in an Era of Persistent Conflict

    National Research Council Canada - National Science Library

    Kinkead, Matthew S

    2008-01-01

    The enduring mission of the U.S. Army is to provide ready forces and land force capabilities to the Combatant Commanders in support of the National Security Strategy, the National Defense Strategy and the National Military Strategy...

  8. [CHALLENGES IN THE DIAGNOSIS OF CUSHING'S SYNDROME IN THE MODERN ERA].

    Science.gov (United States)

    Saiegh, Leonard; Sheikh-Ahmad, Mohammad; Reut, Maria; Jubran, Yousef; Shechner, Carmela

    2015-12-01

    Cushing's syndrome results from prolonged and excessive exposure to medically prescribed corticosteroids, or from excess endogenous cortisol secretion. When endogenous cortisol secretion is suspected, several screening tests are conducted in order to confirm or to rule out the diagnosis. In recent years, as the cut-off point of cortisol concentration on the 1 mg overnight dexamethasone suppression test was lowered, the prevalence of Cushing's syndrome has increased, and more cases of mild syndromes, with negative results on one or more screening tests, have increasingly been reported. In this paper, we will describe the various screening tests used for Cushing's syndrome, and will discuss their degree of sensitivity in the diagnosis of mild cases. We conclude that, in cases of mild syndromes, the sensitivity of some tests appears to be notably lower than has been reported. Until recently, the major challenge has been to distinguish between pseudo-Cushing's states and Cushing's syndrome. Today, however, the challenge has become to avoid misdiagnosis of mild cases, presenting with normal results on some screening tests. The sensitivity of urinary free cortisol seems to be lower than previously reported. Therefore, we recommend not to rely solely on this test in ruling out Cushing's syndrome.

  9. Celiac Node Failure Patterns After Definitive Chemoradiation for Esophageal Cancer in the Modern Era

    International Nuclear Information System (INIS)

    Amini, Arya; Xiao Lianchun; Allen, Pamela K.; Suzuki, Akihiro; Hayashi, Yuki; Liao, Zhongxing; Hofstetter, Wayne; Crane, Christopher; Komaki, Ritsuko; Bhutani, Manoop S.; Lee, Jeffrey H.; Ajani, Jaffer A.; Welsh, James

    2012-01-01

    Purpose: The celiac lymph node axis acts as a gateway for metastatic systemic spread. The need for prophylactic celiac nodal coverage in chemoradiation therapy for esophageal cancer is controversial. Given the improved ability to evaluate lymph node status before treatment via positron emission tomography (PET) and endoscopic ultrasound, we hypothesized that prophylactic celiac node irradiation may not be needed for patients with localized esophageal carcinoma. Methods and Materials: We reviewed the radiation treatment volumes for 131 patients who underwent definitive chemoradiation for esophageal cancer. Patients with celiac lymph node involvement at baseline were excluded. Median radiation dose was 50.4 Gy. The location of all celiac node failures was compared with the radiation treatment plan to determine whether the failures occurred within or outside the radiation treatment field. Results: At a median follow-up time of 52.6 months (95% CI 46.1–56.7 months), 6 of 60 patients (10%) without celiac node coverage had celiac nodal failure; in 5 of these patients, the failures represented the first site of recurrence. Of the 71 patients who had celiac coverage, only 5 patients (7%) had celiac region relapse. In multivariate analyses, having a pretreatment-to-post-treatment change in standardized uptake value on PET >52% (odds ratio [OR] 0.198, p = 0.0327) and having failure in the clinical target volume (OR 10.72, p = 0.001) were associated with risk of celiac region relapse. Of those without celiac coverage, the 6 patients that later developed celiac failure had a worse median overall survival time compared with the other 54 patients who did not fail (median overall survival time: 16.5 months vs. 31.5 months, p = 0.041). Acute and late toxicities were similar in both groups. Conclusions: Although celiac lymph node failures occur in approximately 1 of 10 patients, the lack of effective salvage treatments and subsequent low morbidity may justify prophylactic treatment in distal esophageal cancer patients.

  10. Celiac Node Failure Patterns After Definitive Chemoradiation for Esophageal Cancer in the Modern Era

    Energy Technology Data Exchange (ETDEWEB)

    Amini, Arya [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); UC Irvine School of Medicine, Irvine, California (United States); Xiao Lianchun [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Suzuki, Akihiro; Hayashi, Yuki [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hofstetter, Wayne [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Crane, Christopher; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Bhutani, Manoop S.; Lee, Jeffrey H.; Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-06-01

    Purpose: The celiac lymph node axis acts as a gateway for metastatic systemic spread. The need for prophylactic celiac nodal coverage in chemoradiation therapy for esophageal cancer is controversial. Given the improved ability to evaluate lymph node status before treatment via positron emission tomography (PET) and endoscopic ultrasound, we hypothesized that prophylactic celiac node irradiation may not be needed for patients with localized esophageal carcinoma. Methods and Materials: We reviewed the radiation treatment volumes for 131 patients who underwent definitive chemoradiation for esophageal cancer. Patients with celiac lymph node involvement at baseline were excluded. Median radiation dose was 50.4 Gy. The location of all celiac node failures was compared with the radiation treatment plan to determine whether the failures occurred within or outside the radiation treatment field. Results: At a median follow-up time of 52.6 months (95% CI 46.1-56.7 months), 6 of 60 patients (10%) without celiac node coverage had celiac nodal failure; in 5 of these patients, the failures represented the first site of recurrence. Of the 71 patients who had celiac coverage, only 5 patients (7%) had celiac region relapse. In multivariate analyses, having a pretreatment-to-post-treatment change in standardized uptake value on PET >52% (odds ratio [OR] 0.198, p = 0.0327) and having failure in the clinical target volume (OR 10.72, p = 0.001) were associated with risk of celiac region relapse. Of those without celiac coverage, the 6 patients that later developed celiac failure had a worse median overall survival time compared with the other 54 patients who did not fail (median overall survival time: 16.5 months vs. 31.5 months, p = 0.041). Acute and late toxicities were similar in both groups. Conclusions: Although celiac lymph node failures occur in approximately 1 of 10 patients, the lack of effective salvage treatments and subsequent low morbidity may justify prophylactic treatment in distal esophageal cancer patients.

  11. Modern basal insulins: an ongoing story or the start of a new era?

    Directory of Open Access Journals (Sweden)

    Ivan Ivanovich Dedov

    2015-11-01

    Full Text Available Basal insulin represents an essential tool in the treatment of both type 1 and type 2 diabetes mellitus. The development of insulin analogues has improved the possibilities of diabetes treatment. Despite significant progress in understanding the physiology, chemistry, kinetics and action of insulin, currently available basal insulin products do not optimally mimic the endogenous profile of insulin. Although basal insulin analogues have some advantages over neutral protamine Hagedorn insulin in diabetes treatment, hypoglycaemia remains the main problem in the achievement of optimal glycaemic control in most patients with diabetes. These unmet clinical needs have stimulated the development of new basal insulin analogues with improved pharmacological profiles. This article reviews the specific characteristics of new long-acting insulin analogues to try and understand their benefits and limitations in the improvement of diabetes management and their possibilities in physiologic and safe insulin replacement.

  12. The East India Company: Agent of Empire in the Early Modern Capitalist Era

    Science.gov (United States)

    Brunton, Bruce

    2013-01-01

    The world economy and political map changed dramatically between the seventeenth and nineteenth centuries. Unprecedented trade linked the continents together and set off a European scramble to discover new resources and markets. European ships and merchants reached across the world, and their governments followed after them, inaugurating the…

  13. The Golem in the era of technical reproducibility: filmic apparatus, modern man and representation

    Directory of Open Access Journals (Sweden)

    Isabella Cristina Stangherlin Santucci

    2012-05-01

    Full Text Available Approaching Walter Benjamin to the expressionist movement in its cinematic form and its subversive attitude, this article proposes to consider the automaton's image as an allegory in the Age of Mechanical Reproduction. Thus, starting from the ideal expressionist as cinematographic technique and plot, and going through the Benjamin's Theses "On the Concept of History", as well as going through the various ideas contained in the work of the German philosopher concerning the work of art in the twentieth century, we will see the Golem, mystical character of the Jewish tradition represented by the figure of a giant, made from inanimate matter, coming to life in this text-screen. Life that has come to interrupt the course of a History which presents herself as a continuous line reporting only the history of the winners, ie, of the holders of political and / or social power, and ignoring the history of the subdued men, that is, of the until now obedient men. And such irruption should not only be the work of a mythical being, but also work of the man, as a proletarian in the capitalistic system, and of the cinematography as apparatus and representation.

  14. Laparoscopic surgery for renal stones: is it indicated in the modern endourology era?

    Directory of Open Access Journals (Sweden)

    Andrei Nadu

    2009-02-01

    Full Text Available Purpose: To report the outcomes of laparoscopic surgery combined with endourological assistance for the treatment of renal stones in patients with associated anomalies of the urinary tract. To discuss the role of laparoscopy in kidney stone disease. Materials and Methods: Thirteen patients with renal stones and concomitant urinary anomalies underwent laparoscopic stone surgery combined with ancillary endourological assistance as needed. Their data were analyzed retrospectively including stone burden, associated malformations, perioperative complications and outcomes. Results: Encountered anomalies included ureteropelvic junction obstruction, horseshoe kidney, ectopic pelvic kidney, fussed-crossed ectopic kidney, and double collecting system. Treatment included laparoscopic pyeloplasty, pyelolithotomy, and nephrolithotomy combined with flexible nephroscopy and stone retrieval. Intraoperative complications were lost stones in the abdomen diagnosed in two patients during follow up. Mean number of stones removed was 12 (range 3 to 214. Stone free status was 77% (10/13 and 100% after one ancillary treatment in the remaining patients. One patient had a postoperative urinary leak managed conservatively. Laparoscopic pyeloplasty was successful in all patients according to clinical and dynamic renal scan parameters. Conclusions: In carefully selected patients, laparoscopic and endourological techniques can be successfully combined in a one procedure solution that deals with complex stone disease and repairs underlying urinary anomalies.

  15. Long-term Outcomes for Living Pancreas Donors in the Modern Era.

    Science.gov (United States)

    Kirchner, Varvara A; Finger, Erik B; Bellin, Melena D; Dunn, Ty B; Gruessner, Rainer W G; Hering, Bernhard J; Humar, Abhinav; Kukla, Aleksandra K; Matas, Arthur J; Pruett, Timothy L; Sutherland, David E R; Kandaswamy, Raja

    2016-06-01

    Living donor segmental pancreas transplants (LDSPTx) have been performed selectively to offer a preemptive transplant option for simultaneous pancreas-kidney recipients and to perform a single operation decreasing the cost of pancreas after kidney transplant. For solitary pancreas transplants, this option historically provided a better immunologic match. Although short-term donor outcomes have been documented, there are no long-term studies. We studied postdonation outcomes in 46 segmental pancreas living donors. Surgical complications, risk factors (RF) for development of diabetes mellitus (DM) and quality of life were studied. A risk stratification model (RSM) for DM was created using predonation and postdonation RFs. Recipient outcomes were analyzed. Between January 1, 1994 and May 1, 2013, 46 LDSPTx were performed. Intraoperatively, 5 (11%) donors received transfusion. Overall, 9 (20%) donors underwent splenectomy. Postoperative complications included: 6 (13%) peripancreatic fluid collections and 2 (4%) pancreatitis episodes. Postdonation, DM requiring oral hypoglycemics was diagnosed in 7 (15%) donors and insulin-dependent DM in 5 (11%) donors. RSM with three predonation RFs (oral glucose tolerance test, basal insulin, fasting plasma glucose) and 1 postdonation RF, greater than 15% increase in body mass index from preoperative (Δ body mass index >15), predicted 12 (100%) donors that developed postdonation DM. Quality of life was not significantly affected by donation. Mean graft survival was 9.5 (±4.4) years from donors without and 9.6 (±5.4) years from donors with postdonation DM. LDSPTx can be performed with good recipient outcomes. The donation is associated with donor morbidity including impaired glucose control. Donor morbidity can be minimized by using RSM and predonation counseling on life style modifications postdonation.

  16. Visualization in modern cartography

    CERN Document Server

    MacEachren, AM

    1994-01-01

    Visualization in Modern Cartography explores links between the centuries-old discipline of cartography and today's revolutionary developments in scientific visualization. The book has three main goals: (1) to pass on design and symbolization expertise to the scientific visualization community - information that comes from centuries of pre-computer visualization by cartographers, and their more recent experiences with computerizing the discipline; (2) to help cartographers cope with the dramatic shift from print cartography to a dynamic virtual cartography for which their role is changing from

  17. Modern gear production

    CERN Document Server

    Watson, H J

    1970-01-01

    Modern Gear Production focuses on the processes and methods in gear making. The book first gives information on the history of gear making and types of gears. Topics such as the classification of gears based on the disposition of their shafts; shafts lying in the same plane with axes intersecting; and shafts lying in parallel planes but with axes inclined to one another are then discussed. The text describes gear groups, tooth forms, and gear materials. Heat treatment of steels, casehardening, nitriding, induction hardening, sulfinuzing, and flame hardening are explained. The book takes a look

  18. Modern Physics Simulations

    Science.gov (United States)

    Brandt, Douglas; Hiller, John R.; Moloney, Michael J.

    1995-10-01

    The Consortium for Upper Level Physics Software (CUPS) has developed a comprehensive series of Nine Book/Software packages that Wiley will publish in FY `95 and `96. CUPS is an international group of 27 physicists, all with extensive backgrounds in the research, teaching, and development of instructional software. The project is being supported by the National Science Foundation (PHY-9014548), and it has received other support from the IBM Corp., Apple Computer Corp., and George Mason University. The Simulations being developed are: Astrophysics, Classical Mechanics, Electricity & Magnetism, Modern Physics, Nuclear and Particle Physics, Quantum Mechanics, Solid State, Thermal and Statistical, and Wave and Optics.

  19. Modern TTL circuits manual

    CERN Document Server

    Marston, R M

    2013-01-01

    Modern TTL Circuits Manual provides an introduction to the basic principles of Transistor-Transistor Logic (TTL). This book outlines the major features of the 74 series of integrated circuits (ICs) and introduces the various sub-groups of the TTL family.Organized into seven chapters, this book begins with an overview of the basics of digital ICs. This text then examines the symbology and mathematics of digital logic. Other chapters consider a variety of topics, including waveform generator circuitry, clocked flip-flop and counter circuits, special counter/dividers, registers, data latches, com

  20. Dialogues on modern physics

    CERN Document Server

    Sachs, Mendel

    1998-01-01

    In this book, important conceptual developments of the two major revolutions of modern physics - the quantum and relativity theories - are presented in a nonmathematical, dialectical form of dialogue. The implications of conflicting philosophical attitudes of these revolutions in physics and applications to topics such as cosmology/astrophysics and high energy physics are emphasized. It is argued that for any substantial progress in our understanding of 21st century physics, it will be necessary to resolve these 20th century conflicts. These richly rewarding dialogues provide a starting point

  1. Introduction to modern cryptography

    CERN Document Server

    Katz, Jonathan

    2014-01-01

    Praise for the First Edition:""This book is a comprehensive, rigorous introduction to what the authors name 'modern' cryptography. … a novel approach to how cryptography is taught, replacing the older, construction-based approach. … The concepts are clearly stated, both in an intuitive fashion and formally. … I would heartily recommend this book to anyone who is interested in cryptography. … The exercises are challenging and interesting, and can benefit readers of all academic levels.""-IACR Book Reviews, January 2010""Over the past 30 years, cryptography has been transformed from a mysterious

  2. Liminality and the Modern

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    This book provides the history and genealogy of an increasingly important subject: liminality. Coming to the fore in recent years in social and political theory and extending beyond is original use as developed within anthropology, liminality has come to denote spaces and moments in which the taken...... of the liquid structures of modern society. Shedding new light on a concept central to social thought, as well as its capacity for pushing social and political theory in new directions, this book will be of interest to scholars across the social sciences and philosophy working in fields such as social...

  3. Modern fluid dynamics

    CERN Document Server

    Kleinstreuer, Clement

    2018-01-01

    Modern Fluid Dynamics, Second Edition provides up-to-date coverage of intermediate and advanced fluids topics. The text emphasizes fundamentals and applications, supported by worked examples and case studies. Scale analysis, non-Newtonian fluid flow, surface coating, convection heat transfer, lubrication, fluid-particle dynamics, microfluidics, entropy generation, and fluid-structure interactions are among the topics covered. Part A presents fluids principles, and prepares readers for the applications of fluid dynamics covered in Part B, which includes computer simulations and project writing. A review of the engineering math needed for fluid dynamics is included in an appendix.

  4. Modern vacuum physics

    CERN Document Server

    Chambers, Austin

    2005-01-01

    Modern Vacuum Physics presents the principles and practices of vacuum science and technology along with a number of applications in research and industrial production. The first half of the book builds a foundation in gases and vapors under rarefied conditions, The second half presents examples of the analysis of representative systems and describes some of the exciting developments in which vacuum plays an important role. The final chapter addresses practical matters, such as materials, components, and leak detection. Throughout the book, the author''s explanations are presented in terms of first principles and basic physics, augmented by illustrative worked examples and numerous figures.

  5. Modern wiring practice

    CERN Document Server

    Steward, W E

    2012-01-01

    Continuously in print since 1952, Modern Wiring Practice has now been fully revised to provide an up-to-date source of reference to building services design and installation in the 21st century. This compact and practical guide addresses wiring systems design and electrical installation together in one volume, creating a comprehensive overview of the whole process for contractors and architects, as well as electricians and other installation engineers. Best practice is incorporated throughout, combining theory and practice with clear and accessible explanation, all

  6. Late Modern Play Culture

    DEFF Research Database (Denmark)

    Karoff, Helle Skovbjerg

    2008-01-01

    and the Danish University of Education (among others) have been working with different kind of products, all referred to as PlAYWARE. Playware combines modern technology and knowledge about play culture in order to produce playful experiences for its players. This paper will exemplify how the concept of play can...... from one generation to the next. Because older children are no longer present as younger children grow up, the traditional "cultural leaders" are gone. They have taken with them much of the inspiration for play as well as important knowledge about how to organise a game. In that sense we can say...

  7. Early modern mathematical instruments.

    Science.gov (United States)

    Bennett, Jim

    2011-12-01

    In considering the appropriate use of the terms "science" and "scientific instrument," tracing the history of "mathematical instruments" in the early modern period is offered as an illuminating alternative to the historian's natural instinct to follow the guiding lights of originality and innovation, even if the trail transgresses contemporary boundaries. The mathematical instrument was a well-defined category, shared across the academic, artisanal, and commercial aspects of instrumentation, and its narrative from the sixteenth to the eighteenth century was largely independent from other classes of device, in a period when a "scientific" instrument was unheard of.

  8. Modern dictionary of electronics

    CERN Document Server

    Graf, Rudolf F

    1999-01-01

    Included in this fully revised classic are well over 28,000 terms, phrases, acronyms, and abbreviations from the ever-expanding worlds of consumer electronics, optics, microelectronics, computers, communications, and medical electronics. From the basic elements of theory to the most cutting-edge circuit technology, this book explains it all in both words and pictures.For easy reference, the author has provided definitions for standard abbreviations and equations as well as tables of SI (International System of Units) units, measurements, and schematic symbolsModern Dictionary of Electronics is

  9. History as Modernity. Introduction

    Directory of Open Access Journals (Sweden)

    Pierangelo Schiera

    2016-12-01

    Full Text Available The introduction starts from the exhaustion of modernity, drawing the fundamental lines of its development inside Western historical experience. The end of the political nexus between theology and politics, the evanescence of nation-state sovereignty, the check of great historical interpretations reveal the necessity of new categories and new organizational models, able to make us answer to the violence that the ongoing processes are liberating. Schiera underlines in particular the relevance of the administrative apparatus because of its capacity to link the global government with global organization, human rights and the commons.

  10. Handbook of Optimization From Classical to Modern Approach

    CERN Document Server

    Snášel, Václav; Abraham, Ajith

    2013-01-01

    Optimization problems were and still are the focus of mathematics from antiquity to the present. Since the beginning of our civilization, the human race has had to confront numerous technological challenges, such as finding the optimal solution of various problems including control technologies, power sources construction, applications in economy, mechanical engineering and energy distribution amongst others. These examples encompass both ancient as well as modern technologies like the first electrical energy distribution network in USA etc. Some of the key principles formulated in the middle ages were done by Johannes Kepler (Problem of the wine barrels), Johan Bernoulli (brachystochrone problem), Leonhard Euler (Calculus of Variations), Lagrange (Principle multipliers), that were formulated primarily in the ancient world and are of a geometric nature. In the beginning of the modern era, works of L.V. Kantorovich and G.B. Dantzig (so-called linear programming) can be considered amongst others. This book disc...

  11. Critics to Metaphysics by Modern Philosophers: A Discourse on Human Beings in Reality

    Directory of Open Access Journals (Sweden)

    Frederikus Fios

    2016-01-01

    Full Text Available We have entered the 21st century that is popularly known as the era of the development of modern science and technology. Philosophy provides naming for contemporary era as postmodern era. But do we suddenly come to this day and age? No! Because humans are homo viator, persona that does pilgrimage in history, space and time. Philosophy has expanded periodically in the long course of history. Since the days of classical antiquity, philosophy comes with a patterned metaphysical paradigm. This paradigm survives very long in the stage history of philosophy as maintained by many philosophers who hold fast to the philosophical-epistemic claim that philosophy should be (das sollen metaphysical. Classical Greek philosopher, Aristotle was a philosopher who claims metaphysics as the initial philosophy. Then, Immanuel Kant, Hegel, Heidegger, Marx even Habermas offer appropriate shades of metaphysical philosophy versus spirit of the age. Modern philosophers offer a new paradigm in the way of doing philosophy. The new spirit of modern philosophers declared as if giving criticism on traditional western metaphysics (since Aristotle that are considered irrelevant. This paper intends to show the argument between traditional metaphysical and modern philosophers who criticize metaphysics. The author will make a philosophical synthesis to obtain enlightenment to the position of human beings in the space of time. Using the method of Hegelian dialectic (thesis-antiteses-synthesis, this topic will be developed and assessed in accordance with the interests of this paper. 

  12. Patient Privacy in the Era of Big Data.

    Science.gov (United States)

    Kayaalp, Mehmet

    2018-01-20

    Privacy was defined as a fundamental human right in the Universal Declaration of Human Rights at the 1948 United Nations General Assembly. However, there is still no consensus on what constitutes privacy. In this review, we look at the evolution of privacy as a concept from the era of Hippocrates to the era of social media and big data. To appreciate the modern measures of patient privacy protection and correctly interpret the current regulatory framework in the United States, we need to analyze and understand the concepts of individually identifiable information, individually identifiable health information, protected health information, and de-identification. The Privacy Rule of the Health Insurance Portability and Accountability Act defines the regulatory framework and casts a balance between protective measures and access to health information for secondary (scientific) use. The rule defines the conditions when health information is protected by law and how protected health information can be de-identified for secondary use. With the advents of artificial intelligence and computational linguistics, computational text de-identification algorithms produce de-identified results nearly as well as those produced by human experts, but much faster, more consistently and basically for free. Modern clinical text de-identification systems now pave the road to big data and enable scientists to access de-identified clinical information while firmly protecting patient privacy. However, clinical text de-identification is not a perfect process. In order to maximize the protection of patient privacy and to free clinical and scientific information from the confines of electronic healthcare systems, all stakeholders, including patients, health institutions and institutional review boards, scientists and the scientific communities, as well as regulatory and law enforcement agencies must collaborate closely. On the one hand, public health laws and privacy regulations define rules

  13. Family Health in an Era of Stress.

    Science.gov (United States)

    USA Today, 1979

    1979-01-01

    Summarizes major findings of a national survey, "The General Mills American Family Report 1978/79: Family Health in an Era of Stress," conducted by Yankelovich, Skelly and White. Topics covered include attitudes toward medical costs, mental illness, and good health practices, as well as expressed interest in health information. (SJL)

  14. Biotechnology: An Era of Hopes and Fears

    Science.gov (United States)

    2016-01-01

    Strategic Studies Quarterly ♦ Fall 2016 23 Biotechnology An Era of Hopes and Fears LTC Douglas R. Lewis, PhD, US Army Abstract Biotechnology ......ignored. The idea of advances in biotechnology increasing the biological weapons threat is not new. In 2003 an analysis of gene sequencing and

  15. Time Management in the Digital Era

    Science.gov (United States)

    Wodarz, Nan

    2013-01-01

    School business officials can strike a balance between setting a long-term strategy and responding to short-term situations by implementing time management strategies. This article presents tips for time management that could help boost productivity and save time in this digital era. Tips include decreasing meeting times via Skype or…

  16. Aplikasi Citizen Journalism di Era Konvergensi Media

    Directory of Open Access Journals (Sweden)

    Rahmat Edi Irawan

    2014-10-01

    Full Text Available Citizen journalism has now become one of the most developed television program concepts. If the concept was initially more widely used in radio and online media, this time with easier and cheaper technology coverage and delivery of images, it is a concept that provides a place for people to become amateur journalist that can also be easily applied in the medium of television. Research raised the issue on how the concept and implementation of citizen journalism on television in the era of media convergence. The purpose of this study is to explain concepts and demonstrate the implementation of citizen journalism on television in the era of media convergence. Research used qualitative method in which data were obtained using literature study. Results of the study showed that the implementation of citizen journalism on television is also increasingly facilitated by the entry of the television in the era of media convergence, or different media mingle, such as television with printed, radio, and Internet media. The era of media convergence makes the concept of citizen journalism can be more developed, because the platform or media distribution is also increasingly varied for amateur journalist. However, the system equipment that must be provided, human resources that must be owned, as well as huge capital to be owned make a few television stations open a lot of platforms to provide space for amateur journalist in citizen journalism. 

  17. Rethinking Education in an Era of Globalisation

    Science.gov (United States)

    Wrigley, Terry

    2007-01-01

    This article reflects on the historic tensions of education under capitalism, arguing that they have been exacerbated in our era of neo-liberal globalisation. Government drives for greater "accountability" and "effectiveness" are a blinkered response to the threefold global crisis we face: poverty and debt; a collapse of the…

  18. Global Learning in a New Era

    Science.gov (United States)

    Ramaley, Judith

    2016-01-01

    Our nation's colleges and universities frequently adapt their approach to education in response to the reality of social, economic and environmental challenges. Today the reality is that we are increasingly interconnected on a global scale. This new era of globalization impacts every facet of society, and it offers both an exciting blend of…

  19. Scandinavian neuroscience during the Nazi era

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Hansen, Klaus; Zeidman, Lawrence A

    2013-01-01

    Although Scandinavian neuroscience has a proud history, its status during the Nazi era has been overlooked. In fact, prominent neuroscientists in German-occupied Denmark and Norway, as well as in neutral Sweden, were directly affected. Mogens Fog, Poul Thygesen (Denmark) and Haakon Sæthre (Norway...

  20. Family Therapy in the Postmodern Era.

    Science.gov (United States)

    Mills, Steven D.; Sprenkle, Douglas H.

    1995-01-01

    Discusses theoretical and clinical developments that have accompanied family therapy's entry into the postmodern era. Clinical trends, including use of reflecting teams, self-of-the-therapist issues, increased therapist self-disclosure, and postmodern supervision are examined. Feminist critiques, health-care reform, and increasing collaboration…

  1. Faculty Recruitment in an Era of Change

    Science.gov (United States)

    Levine, Marilyn; Schimpf, Martin

    2010-01-01

    Faculty recruitment is a challenge for administration and departments, especially in an era of change in the academy. This article builds on information from an interactive conference panel session that focused on faculty recruitment best practices. The article addresses faculty recruitment strategies that focus on the optimization of search…

  2. Multiscale computing in the exascale era

    NARCIS (Netherlands)

    Alowayyed, S.; Groen, D.; Coveney, P.V.; Hoekstra, A.G.

    We expect that multiscale simulations will be one of the main high performance computing workloads in the exascale era. We propose multiscale computing patterns as a generic vehicle to realise load balanced, fault tolerant and energy aware high performance multiscale computing. Multiscale computing

  3. Plant Modernization Programs

    International Nuclear Information System (INIS)

    O'Hara, John

    2004-01-01

    Most nuclear plants were designed and built from the 1960's through the 1990's. These plants employ predominantly analog instrumentation and control (I and C) technology, and their control rooms are made up of primarily hardwired controls (e.g., switches, knobs and handles) and displays (e.g., gauges, linear scales and indicator lights). Over the past several years, these plants have been modernized with digital I and C and computer-based human-system interfaces (HSIs) such as software-based process controls, touch-screen interfaces and large-screen, overview displays. As these computer based HIS technologies are integrated into control rooms based on conventional technology, hybrid control rooms are created. The paper summarizes lessons learned from the study of plant modernization programs over the past ten years so that they can be used to help improve the modification process. While the research focused on the impact of technology change on human performance, a number of organizational and programmatic issues were observed as well. Eleven lessons learned are presented

  4. Modern introductory physics

    CERN Document Server

    Holbrow, Charles H; Amato, Joseph C; Galvez, Enrique; Parks, M. Elizabeth

    2010-01-01

    Modern Introductory Physics, 2nd Edition, by Charles H. Holbrow, James N. Lloyd, Joseph C. Amato, Enrique Galvez, and Beth Parks, is a successful innovative text for teaching introductory college and university physics. It is thematically organized to emphasize the physics that answers the fundamental question: Why do we believe in atoms and their properties?  The book provides a sound introduction to basic physical concepts with particular attention to the nineteenth- and twentieth-century physics underlying our modern ideas of atoms and their structure.  After a review of basic Newtonian mechanics, the book discusses early physical evidence that matter is made of atoms.  With a simple model of the atom Newtonian mechanics can explain the ideal gas laws, temperature, and viscosity.  Basic concepts of electricity and magnetism are introduced along with a more complicated model of the atom to account for the observed electrical properties of atoms. The physics of waves---particularly light and x-rays---an...

  5. The Multiple Modernities of Europe

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    What Europe? Eric Voegelin on the Mediterranean and the Atlantic modernities. The concept ‘multiple modernities’ has during the last decade established itself in social and political theory, not least due to contributions made by Shmul Eisenstadt. The debate on multiple moderntities has served...... to question certain eurocentric assumptions about modernity and has also reignited the question of European particularity in a world historical perspective. This paper will discuss how ‘Europe’ itself can be considered a result of (at least) two different modernities, as proposed by the political theorist......, Eric Voegelin. Eric Voegelin talked of two spatio-temporal specific modernities, the Mediterranean and the Atlantic modernities. In short, for Voegelin the Atlantic modernity with its breakthroughs in the 17th and 18th centuries was a specific figuration that should not be mistaken for ‘modernity...

  6. The Imaginary Significations of Modernity

    DEFF Research Database (Denmark)

    Carleheden, Mikael

    2010-01-01

    This article deals with the concept of modernity upon which one of the most interesting contemporary theories about modern social change is based - Peter Wagner's theory of successive modernities. Wagner understands modernity as a double imaginary signification which entails a basic tension between...... liberty and discipline. This conception is almost directly taken from Cornelius Castoriadis. I argue that this tension exists in two versions in Castoriadis' philosophy and that the two versions are incompatible. It is further claimed that the two versions reappear in Wagner's theory, which makes his...... theory of successive modernities partly inconsistent. A stance is taken for one of these versions and it is argued that the theory of successive modernities should appropriate that version as its point of departure in order to grasp the history of modernity in a consistent way. Keywords: Cornelius...

  7. Clinical course and outcome of patients with high-level microsatellite instability cancers in a real-life setting: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Halpern N

    2017-03-01

    Full Text Available Naama Halpern,1 Yael Goldberg,2 Luna Kadouri,2 Morasha Duvdevani,2 Tamar Hamburger,2 Tamar Peretz,2 Ayala Hubert2 1Institute of Oncology, The Chaim Sheba Medical Center, Tel Hashomer, Israel; 2Sharett Institute of Oncology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel Background: The prognostic and predictive significance of the high-level microsatellite instability (MSI-H phenotype in various malignancies is unclear. We describe the characteristics, clinical course, and outcomes of patients with MSI-H malignancies treated in a real-life hospital setting.Patients and methods: A retrospective analysis of MSI-H cancer patient files was conducted. We analyzed the genetic data, clinical characteristics, and oncological treatments, including chemotherapy and surgical interventions.Results: Clinical data of 73 MSI-H cancer patients were available. Mean age at diagnosis of first malignancy was 52.3 years. Eight patients (11% had more than four malignancies each. Most patients (76% had colorectal cancer (CRC. Seventeen patients (23% had only extracolonic malignancies. Eighteen women (36% had gynecological malignancy. Nine women (18% had breast cancer. Mean follow-up was 8.5 years. Five-year overall survival and disease-free survival of all MSI-H cancer patients from first malignancy were 86% and 74.6%, respectively. Five-year overall survival rates of stage 2, 3, and 4 MSI-H CRC patients were 89.5%, 58.4%, and 22.9%, respectively.Conclusion: Although the overall prognosis of MSI-H cancer patients is favorable, this advantage may not be maintained in advanced MSI-H CRC patients. Keywords: microsatellite instability, malignancy, treatment, outcome

  8. Retrospective analysis of multiplex polymerase chain reaction-based molecular diagnostics (SES in 70 patients with suspected central nervous system infections: A single-center study

    Directory of Open Access Journals (Sweden)

    Rama Krishnan Tiruppur Chinnappan Ramalingam

    2016-01-01

    Full Text Available Background: Central nervous system (CNS infections present a grave health care challenge due to high morbidity and mortality. Clinical findings and conventional laboratory assessments are not sufficiently distinct for specific etiologic diagnosis. Identification of pathogens is a key to appropriate therapy. Aim: In this retrospective observational study, we evaluated the efficacy and clinical utility of syndrome evaluation system (SES for diagnosing clinically suspected CNS infections. Materials and Methods: This retrospective analysis included inpatients in our tertiary level neurointensive care unit (NICU and ward from February 2010 to December 2013. Cerebrospinal fluid (CSF samples of 70 patients, clinically suspected of having CNS infections, were subjected to routine laboratory tests, culture, imaging, and SES. We analyzed the efficacy of SES in the diagnosis of CNS infections and its utility in therapeutic decision-making. Results: SES had a clinical sensitivity of 57.4% and clinical specificity of 95.6%. Streptococcus pneumoniae and Pseudomonas aeruginosa were the top two bacterial pathogens, whereas Herpes simplex virus (HSV was the most common viral pathogen. Polymicrobial infections were detected in 32.14% of SES-positive cases. SES elicited a change in the management in 30% of the patients from initial empiric therapy. At discharge, 51 patients recovered fully while 11 patients had partial recovery. Three-month follow-up showed only six patients to have neurological deficits. Conclusion: In a tertiary care center, etiological microbial diagnosis is central to appropriate therapy and outcomes. Sensitive and accurate multiplex molecular diagnostics play a critical role in not only identifying the causative pathogen but also in helping clinicians to institute appropriate therapy, reduce overuse of antimicrobials, and ensure superior clinical outcomes.

  9. Functional status, physical activity level, and exercise regularity in patients with fibromyalgia after Multidisciplinary treatment: retrospective analysis of a randomized controlled trial.

    Science.gov (United States)

    Salvat, I; Zaldivar, P; Monterde, S; Montull, S; Miralles, I; Castel, A

    2017-03-01

    Multidisciplinary treatments have shown to be effective for fibromyalgia. We report detailed functional outcomes of patients with fibromyalgia who attended a 3-month Multidisciplinary treatment program. The hypothesis was that patients would have increased functional status, physical activity level, and exercise regularity after attending this program. We performed a retrospective analysis of a randomized, simple blinded clinical trial. The inclusion criteria consisted of female sex, a diagnosis of fibromyalgia, age 18-60  and 3-8 years of schooling. Measures from the Fibromyalgia Impact Questionnaire (FIQ) and the COOP/WONCA Functional Health Assessment Charts (WONCA) were obtained before and at the end of the treatment and at 3-, 6-, and 12-month follow-ups. Patients recorded their number of steps per day with pedometers. They performed the six-minute walk test (6 MW) before and after treatment. In total, 155 women participated in the study. Their median (interquartile interval) FIQ score was 68.0 (53.0-77.0) at the beginning of the treatment, and the difference between the Multidisciplinary and Control groups was statistically and clinically significant in all of the measures (except the 6-month follow-up). The WONCA charts showed significant clinical improvements in the Multidisciplinary group, with physical fitness in the normal range across almost all values. In that group, steps/day showed more regularity, and the 6 MW results showed improvement of -33.00 (-59.8 to -8.25) m, and the differences from the Control group were statistically significant. The patients who underwent the Multidisciplinary treatment had improved functional status, physical activity level, and exercise regularity. The functional improvements were maintained 1 year after treatment completion.

  10. Enzalutamide in Patients With Castration-Resistant Prostate Cancer Progressing After Docetaxel: Retrospective Analysis of the Swiss Enzalutamide Named Patient Program.

    Science.gov (United States)

    Papazoglou, Dimitrios; Wannesson, Luciano; Berthold, Dominik; Cathomas, Richard; Gillessen, Silke; Rothermundt, Christian; Hasler, Loretta; Winterhalder, Ralph; Barth, Andreas; Mingrone, Walter; Nussbaum, Catrina Uhlmann; von Rohr, Lukas; von Burg, Philippe; Schmid, Mathias; Richner, Jürg; Baumann, Sylvia; Kühne, Reto; Stenner, Frank; Rothschild, Sacha I

    2017-06-01

    Enzalutamide is a second-generation androgen receptor (AR) inhibitor that binds to and blocks the AR with higher affinity than previously available AR inhibitors. High activity has been proven in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel and in chemotherapy-naive patients with mCRPC. However, its activity in patients previously treated with other novel agents (for example, abiraterone and/or cabazitaxel), remains controversial. The aim of this retrospective analysis of the Swiss Enzalutamide Named Patient Program was to evaluate clinical efficacy and safety of enzalutamide treatment in patients with mCRPC progressing after docetaxel and other lines of therapy considering different treatment sequences. We report on 44 patients treated with enzalutamide. The median survival time from diagnosis of CPRC was 41.1 months (95% confidence interval [CI], 32.3-49.8 months). Enzalutamide was used as a second, third, fourth, fifth, sixth, or seventh-line therapy in 13%, 20%, 31%, 20%, 11%, and 2% of patients. The median duration of enzalutamide treatment was 3.0 months (range, 1-21 months). Median progression-free survival was 3.0 months (95% CI, 2.4-3.7 months). The estimated median overall survival was 6.3 months (95% CI, 4.6-8.1 months). Sixteen patients (36.4%) had a prostate-specific antigen decrease of ≥ 30%, and 11 patients (25.0%) of ≥ 50%, respectively. In multivariate analysis, the absence of previous therapy with abiraterone and a prostate-specific antigen response of ≥ 50% on enzalutamide therapy were significantly associated with overall survival on enzalutamide treatment. Our results show that enzalutamide has modest activity in extensively pretreated patients. However, there is a subgroup of patients achieving benefit from enzalutamide therapy even after pretreatment with abiraterone. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Improved insulin sensitivity and secretion in prediabetic patients with adrenal insufficiency on dual-release hydrocortisone treatment: a 36-month retrospective analysis.

    Science.gov (United States)

    Guarnotta, Valentina; Ciresi, Alessandro; Pillitteri, Giuseppe; Giordano, Carla

    2018-05-01

    Dual-release hydrocortisone (DR-HC) provides physiological cortisol exposure, leading to an improvement of anthropometric and metabolic parameters. The aim of the study was to evaluate the effects of DR-HC on insulin secretion and sensitivity and cardiometabolic risk, indirectly expressed by the visceral adiposity index (VAI). Retrospective analysis of 49 patients, 13 with primary and 36 with secondary adrenal insufficiency (AI), respectively, on conventional glucocorticoid treatment at baseline and switched to DR-HC for 36 months. Overall, 24 patients had AI-pre-diabetes (impaired fasting glucose, impaired glucose tolerance and the combination), and 25 had AI-normal glucose tolerance (NGT). Clinical and metabolic parameters, including VAI, insulin secretion and sensitivity indexes (fasting insulinaemia, AUC 2 h insulinaemia , oral disposition index [Dio] and ISI-Matsuda), were evaluated. In patients with AI-NGT and AI-prediabetes, a significant decrease in BMI (P = .017 and P 36 and P = .043) was, respectively, observed. In addition, in prediabetic patients, only we found a significant decrease in insulinaemia (P = .014), AUC 2 h insulinaemia (P = .038) and VAI (P = .001), in concomitance with a significant increase in DIo (P = .041) and ISI-Matsuda (P = .038). Long-term DR-HC therapy is associated with an improvement in insulin secretion and sensitivity in patients with prediabetes. However, all patients appear to benefit from the treatment in terms of improvement of metabolic and anthropometric parameters. Larger studies are required to confirm our preliminary data. © 2018 John Wiley & Sons Ltd.

  12. Clinical and Socio-Demographic Predictors of Home Hospice Patients Dying at Home: A Retrospective Analysis of Hospice Care Association's Database in Singapore.

    Science.gov (United States)

    Lee, Yee Song; Akhileswaran, Ramaswamy; Ong, Eng Hock Marcus; Wah, Win; Hui, David; Ng, Sheryl Hui-Xian; Koh, Gerald

    2017-06-01

    Hospice care can be delivered in different settings, but many patients choose to receive it at home because of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home. To examine the independent factors associated with home hospice patient dying at home. Retrospective analysis of Hospice Care Association's database. Hospice Care Association is the largest home hospice provider in Singapore. The study included all patients who were admitted into home hospice service from January 1, 2004 to December 31, 2013. Cox proportional hazards modeling with time as constant was used to study the relationship between independent variables and home death. A total of 19,721 patients were included in the study. Females (adjusted risk ratio [ARR] 1.09, 95% CI 1.04-1.15), older patients (ARR 1.01, 95% CI 1.00-1.01), shorter duration of home hospice stay (ARR 0.88, 95% CI 0.82-0.94), fewer episodes of hospitalization (ARR 0.81, 95% CI 0.75-0.86), living with caregivers (ARR 1.54, 95% CI 1.05-2.26), doctor (ARR 1.05, 95% CI 1.01-1.08) and nurse (ARR 1.06, 95% CI 1.04-1.08) visits were positive predictors of dying-at-home. Diagnosis of cancer (ARR 0.93, 95% CI 0.86-1.00) was a negative predictor of dying-at-home. Female, older age, living with a caregiver, non-cancer diagnosis, more doctor and nurse visits, shorter duration of home hospice stays, and fewer episodes of acute hospitalizations are predictive of dying-at-home for home hospice patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. Relationship between serum uric acid and mortality among hemodialysis patients: Retrospective analysis of Korean end-stage renal disease registry data

    Science.gov (United States)

    Kim, Chang Seong; Jin, Dong-Chan; Yun, Young Cheol; Bae, Eun Hui; Ma, Seong Kwon; Kim, Soo Wan

    2017-01-01

    Background It is thought that hyperuricemia might lower the risk of mortality among hemodialysis patients, unlike in the general population, but the evidence is controversial. The aim of the current study was to evaluate the impact of serum uric acid level on the long-term clinical outcomes of hemodialysis patients in Korea. Methods Retrospective analysis was performed on data from the End-Stage Renal Disease Registry of the Korean Society of Nephrology. This included data for 7,333 patients (mean age, 61 ± 14 years; 61% male) who received hemodialysis from January 2001 through April 2015. Initial laboratory data were used in the analysis. Results The mean serum uric acid level in this study was 7.1 ± 1.7 mg/dL. Body mass index, normalized protein catabolic rate, albumin, and cholesterol were positively correlated with serum uric acid level after controlling for age and sex. After controlling for demographic data, comorbidities, and residual renal function, a higher uric acid level was independently associated with a significantly lower all-cause mortality (hazard ratio [HR], 0.90 per 1 mg/dL increase in uric acid level; 95% confidence interval [CI], 0.83–0.97; P = 0.008), but not cardiovascular mortality (HR, 0.90; 95% CI, 0.80–1.01; P = 0.078). Comparing uric acid levels in the highest and lowest quintiles, the HR for all-cause mortality was 0.65 (95% CI, 0.42–0.99; P = 0.046). Conclusion Hyperuricemia was strongly associated with a lower risk of all-cause mortality, but there seems to be no significant association between serum uric acid level and cardiovascular mortality among Korean hemodialysis patients with end-stage renal disease. PMID:29285429

  14. Retrospective analysis of multiplex polymerase chain reaction-based molecular diagnostics (SES) in 70 patients with suspected central nervous system infections: A single-center study.

    Science.gov (United States)

    Ramalingam, Rama Krishnan Tiruppur Chinnappan; Chakraborty, Dipanjan

    2016-01-01

    Central nervous system (CNS) infections present a grave health care challenge due to high morbidity and mortality. Clinical findings and conventional laboratory assessments are not sufficiently distinct for specific etiologic diagnosis. Identification of pathogens is a key to appropriate therapy. In this retrospective observational study, we evaluated the efficacy and clinical utility of syndrome evaluation system (SES) for diagnosing clinically suspected CNS infections. This retrospective analysis included inpatients in our tertiary level neurointensive care unit (NICU) and ward from February 2010 to December 2013. Cerebrospinal fluid (CSF) samples of 70 patients, clinically suspected of having CNS infections, were subjected to routine laboratory tests, culture, imaging, and SES. We analyzed the efficacy of SES in the diagnosis of CNS infections and its utility in therapeutic decision-making. SES had a clinical sensitivity of 57.4% and clinical specificity of 95.6%. Streptococcus pneumoniae and Pseudomonas aeruginosa were the top two bacterial pathogens, whereas Herpes simplex virus (HSV) was the most common viral pathogen. Polymicrobial infections were detected in 32.14% of SES-positive cases. SES elicited a change in the management in 30% of the patients from initial empiric therapy. At discharge, 51 patients recovered fully while 11 patients had partial recovery. Three-month follow-up showed only six patients to have neurological deficits. In a tertiary care center, etiological microbial diagnosis is central to appropriate therapy and outcomes. Sensitive and accurate multiplex molecular diagnostics play a critical role in not only identifying the causative pathogen but also in helping clinicians to institute appropriate therapy, reduce overuse of antimicrobials, and ensure superior clinical outcomes.

  15. Retrospective analysis of self-reporting pain scores and pain management during head and neck IMRT radiotherapy: A single institution experience

    International Nuclear Information System (INIS)

    O'Connor, P.; Bisson, J.; Asplin, P.; Gahir, D.

    2017-01-01

    Aims: Head and neck carcinomas are relatively rare in the United Kingdom with an estimated 9000 cases diagnosed annually. However, pain associated with disease and treatment side effects such as oral mucositis present a major issue for therapy radiographers in providing effective care and maintaining radiotherapy treatment compliance, all factors that can compromise patient outcome if not managed appropriately. Method: This retrospective analysis of self-reporting pain scores collected during a course of radiotherapy aims to assess the perceived pain intensity scores in 30 patients. Data was collected during radiographer review sessions held weekly to determine if any variables to perceived pain scores occurred during a course of radiotherapy. Results: As treatment progressed, the self-reporting pain scores within the cohort increased, in week one the total cohort pain score was 35, this increased to 114 in week 3 and in the final week had totalled 151. An escalation in pain was observed in week 3 of treatment possibly as a result of radiation induced inflammation alongside cytotoxic chemotherapy. Conclusions: The findings of this study provide further evidence to an individualised approach to patient pain relief and providing regular on treatment reviews, thus maintaining patient comfort and ensuring continued treatment compliance. - Highlights: • Pain is an important but too infrequently analysed symptom in head and neck cancer. • As treatment progressed, the self-reporting pain scores within the cohort increased. • These findings provide the rationale for an individualised approach to pain relief. • Ensuring adequate pain control can positively influence continued treatment compliance.

  16. Retrospective Analysis of Emerging Drugs Use in a Quebec Women's and Children's University Hospital and Perspectives for Safe and Optimal Drug Use.

    Science.gov (United States)

    Corny, Jennifer; Pelletier, Elaine; Lebel, Denis; Bussières, Jean-François

    2017-03-10

    Only few medicines are licensed for children. The use of emerging drugs (unmarketed drug, off-label drug with poorly documented use, and/or costly drugs) might represent an essential alternative for pediatric patients. The objective of the study was to assess emerging drug uses rate and profile in our women's and children's centre to support the implementation of an appropriate policy. We identified retrospectively emerging drugs used between 2013-01-01 and 2014-02-28, using computerized pharmacist software extraction of drugs used. Conventional oncologic drugs were excluded. Retrospective analysis of medical charts for patients who received an emerging drug and literature review for each drug were performed to determine efficacy and safety endpoints. Median delays between first intention and final decision to use the drug and between final decision and first administration were calculated. Proportion of patients who experienced a positive evolution under treatment or a side effect possibly related to the drug was calculated. A total of 26 emerging drugs were identified (89 patients, 99 uses). Median treatment duration was 66 days [1-1435]. Median delay between first evocation and final decision to use the drug was 2 days [0-333] and 0 day [0-404] between final decision and first administration. 52/99 (53%) of patients experienced a positive evolution under treatment and 26/99 (26%) experienced a side effect possibly related to emerging drug use. This study allowed us to describe emerging drug uses in a women and children tertiary hospital. It led to the implementation of a local emerging drug use policy ensuring optimal and safe use of these drugs. There is a significant number of emerging drugs used in pediatric which shows positive improvement in 56% of patients. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  17. Co-existence of chronic non-communicable diseases and common neoplasms among 2,462 endocrine adult inpatients – a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Paweł Szychta

    2015-12-01

    Full Text Available [b]Objective[/b]. To analyze the coexistence of chronic non-communicable diseases (NCDs and common neoplasms among endocrine adult inpatients. [b]Materials and method. [/b]The retrospective analysis was performed using clinical data of 2,462 adult patients (2,003 women and 459 men, hospitalized in the reference endocrine department. Diagnoses of 18 types of benign tumours and 16 types of malignant tumours, together with the most common 25 NCDs and demographic parameters, were all collected from the medical records. The most frequently found 6 types of benign tumours (of thyroid, pituitary, uterus, breast, adrenal and prostate and 4 types of malignant tumours (of thyroid, breast, prostate and uterus were taken for further statistical analyses. [b]Results[/b]. Age predicted the existence of accumulated as well as individual types of benign and malignant tumours, whereas BMI predicted the occurrence of accumulated and some individual types of benign tumours. Accumulated as well as individual types of benign and malignant tumours coexisted more frequently with several NCDs, such as diabetes, hypertension, metabolic syndrome, osteoporosis, Graves’ disease, coronary artery disease, state after cholecystectomy, thus being disorders usually resulting from excessive exposure to harmful environmental factors. The most distinct coexistence was found between breast cancer and metabolic syndrome, between breast cancer and Graves’ disease, between cancer of the uterus and type 2 diabetes, between cancer of the uterus and metabolic syndrome, and between cancer of the uterus and dyslipidemia. [b]Conclusion.[/b] The results obtained indicate a significant relationship between the most common NCDs and several cancers in endocrine adult patients, which suggests that the prevention of the former may reduce the frequency of the latter.

  18. Efficacy and short-term outcomes of preoperative chemoradiotherapy with intermittent oral tegafur-uracil plus leucovorin in Japanese rectal cancer patients: a single center experience retrospective analysis.

    Science.gov (United States)

    Nakagawa, Ryosuke; Inoue, Yuji; Ohki, Takeshi; Kaneko, Yuka; Maeda, Fumi; Yamamoto, Masakazu

    2017-05-31

    Various types of preoperative chemoradiotherapy (CRT) have been established for rectal cancer; thus, Physicians will need to refine the selection of appropriate preoperative CRT for different patients since there are various treatment regimens. Oral tegafur-uracil (UFT) plus leucovorin (LV) is commonly used to treat rectal cancer in Japan. Oral chemotherapy offers patients many potential advantages. Since 2008, we have been performing preoperative CRT with intermittent oral UFT plus LV in locally advanced rectal cancer patients to prevent postoperative local recurrence. Here, in a retrospective analysis, we evaluated the efficacy and short-term outcomes of preoperative CRT with intermittent oral UFT plus LV. We analyzed data from 62 patients with locally advanced rectal cancer, including 31 patients who underwent preoperative CRT between 2009 and 2013 (the CRT group) and 31 patients who were treated with surgery alone between 2001 and 2008 (the non-CRT group). Clinicopathologically, both groups included patients with rectal cancer at clinical tumor stages III-IV or clinical node stages 0-III. In the CRT group, curative operations were performed ≥8 weeks after CRT. Patients were concomitantly treated with 2 cycles of oral UFT (300 mg/m 2 /day, days 1-14 and 29-42) plus LV (75 mg/day, days 1-14 and 29-42) and 45 Gy of radiotherapy. Chemotherapy was repeated every 28 days, followed by a 2-week break. The completion rate of CRT was high at 94% (n = 29/31). The downstaging rate of CRT was 61% (n = 19/31). The pathological complete response rate was 6.5% (n = 2/31). Significant differences were observed in the 3-year local recurrence rate between the two groups (P rectal cancer. A further investigation of a diversification of preoperative CRT for Japanese rectal cancer patients is required.

  19. Surgical treatment of choanal atresia with transnasal endoscopic approach with stentless single side-hinged flap technique: 5 year retrospective analysis

    Directory of Open Access Journals (Sweden)

    Carmelo Saraniti

    Full Text Available Abstract Introduction: Choanal atresia is a rare congenital malformation of the nasal cavity characterized by the complete obliteration of the posterior choanae. In 67% of cases choanal atresia is unilateral, affecting mainly (71% the right nasal cavity. In contrast to the unilateral form, bilateral choanal atresia is a life-threatening condition often associated with respiratory distress with feeding and intermittent cyanosis exacerbated by crying. Surgical treatment remains the only therapeutic option. Objective: To report our experience in the use of a transnasal endoscopic approach with stentless single side-hinged flap technique for the surgical management of choanal atresia. Methods: A 5 year retrospective analysis of surgical outcomes of 18 patients treated for choanal atresia with a transnasal technique employing a single side-hinged flap without stent placement. All subjects were assessed preoperatively with a nasal endoscopy and a Maxillofacial computed tomography scan. Results: Ten males and eight females with a mean age at the time of surgery of 20.05 ± 11.32 years, underwent surgery for choanal atresia. Fifteen subjects (83.33% had a bony while 3 (26.77% a mixed bony-membranous atretic plate. Two and sixteen cases suffered from bilateral and unilateral choanal atresia respectively. No intra- and/or early postoperative complications were observed. Between 2 and 3 months after surgery two cases (11.11% of partial restenosis were found. Only one of these presented a relapse of the nasal obstruction and was subsequently successfully repaired with a second endoscopic procedure. Conclusion: The surgical technique described follows the basic requirements of corrective surgery and allows good visualization, evaluation and treatment of the atretic plate and the posterior third of the septum, in order to create the new choanal opening. We believe that the use of a stent is not necessary, as recommended in case of other surgical techniques

  20. Carcinosarcoma of the uterus-a single institution retrospective analysis of the management and outcome and a brief review of literature.

    Science.gov (United States)

    Anupama, Rajanbabu; Kuriakose, Santhosh; Vijaykumar, D K; Pavithran, K; Jojo, Annie; Indu, R Nair; Sheejamol, V S

    2013-09-01

    Uterine carcinosarcomas are highly aggressive tumors of the uterus associated with a poor prognosis. Though initially classified as sarcomas, now these tumors are classified as carcinomas. The management approach of carcinosarcomas has also changed from those used for high grade sarcomas to that used for managing high grade endometrial carcinomas. The purpose of our study was to analyze the management and outcome of patients with uterine carcinosarcomas treated at our institution and also to attempt a brief review regarding the management of uterine carcinosarcomas. We did a retrospective analysis of all patients with a diagnosis of carcinosarcoma of the uterus treated at our Institution from January 2005 till December 2010. All Patients with a pathological diagnosis of carcinosacrcoma or malignant mixed mullerian tumours of the uterus were included. Data was obtained from the hospital electronic medical records and the hospital cancer registry. Data was analyzed using SPSS v.17. During this 6 year period we had 20 patients with carcinosarcoma of the uterus. 75 % of the patients belonged to Stage I and II. 95 % of the patients underwent Hysterectomy with Bilateral salpingo oophorectomy and 60 % had lymphadenectomy also along with hysterectomy.8 patients had disease recurrence . In patients who had gross extrauterine disease at the time of surgery , the survival was only 9 months whereas in patients who had complete staging with disease confined to the uterus , the survival was 36 months. Carcinosarcomas, accounts for more than 15 % of the uterine cancer associated deaths. Surgery remains the cornerstone of management for these tumors and surgery with pelvic and para aortic lymphadenectomy and peritoneal and omental biopsies is required for the correct staging of the disease and may also provide a survival advantage. Radiation therapy has been shown to provide only better local control without any survival advantage. Further studies are needed to assess