Predicting introductory programming performance: A multi-institutional multivariate study

Science.gov (United States)

Bergin, Susan; Reilly, Ronan

2006-12-01

A model for predicting student performance on introductory programming modules is presented. The model uses attributes identified in a study carried out at four third-level institutions in the Republic of Ireland. Four instruments were used to collect the data and over 25 attributes were examined. A data reduction technique was applied and a logistic regression model using 10-fold stratified cross validation was developed. The model used three attributes: Leaving Certificate Mathematics result (final mathematics examination at second level), number of hours playing computer games while taking the module and programming self-esteem. Prediction success was significant with 80% of students correctly classified. The model also works well on a per-institution level. A discussion on the implications of the model is provided and future work is outlined.

Multi-Institutional Sharing of Electronic Health Record Data to Assess Childhood Obesity.

Directory of Open Access Journals (Sweden)

L Charles Bailey

Full Text Available To evaluate the validity of multi-institutional electronic health record (EHR data sharing for surveillance and study of childhood obesity.We conducted a non-concurrent cohort study of 528,340 children with outpatient visits to six pediatric academic medical centers during 2007-08, with sufficient data in the EHR for body mass index (BMI assessment. EHR data were compared with data from the 2007-08 National Health and Nutrition Examination Survey (NHANES.Among children 2-17 years, BMI was evaluable for 1,398,655 visits (56%. The EHR dataset contained over 6,000 BMI measurements per month of age up to 16 years, yielding precise estimates of BMI. In the EHR dataset, 18% of children were obese versus 18% in NHANES, while 35% were obese or overweight versus 34% in NHANES. BMI for an individual was highly reliable over time (intraclass correlation coefficient 0.90 for obese children and 0.97 for all children. Only 14% of visits with measured obesity (BMI ≥95% had a diagnosis of obesity recorded, and only 20% of children with measured obesity had the diagnosis documented during the study period. Obese children had higher primary care (4.8 versus 4.0 visits, p<0.001 and specialty care (3.7 versus 2.7 visits, p<0.001 utilization than non-obese counterparts, and higher prevalence of diverse co-morbidities. The cohort size in the EHR dataset permitted detection of associations with rare diagnoses. Data sharing did not require investment of extensive institutional resources, yet yielded high data quality.Multi-institutional EHR data sharing is a promising, feasible, and valid approach for population health surveillance. It provides a valuable complement to more resource-intensive national surveys, particularly for iterative surveillance and quality improvement. Low rates of obesity diagnosis present a significant obstacle to surveillance and quality improvement for care of children with obesity.

What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

OpenAIRE

Zhang, Yan; Tang, Wenxi; Zhang, Liang

2017-01-01

Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

SU-E-T-48: A Multi-Institutional Study of Independent Dose Verification for Conventional, SRS and SBRT

International Nuclear Information System (INIS)

Takahashi, R; Kamima, T; Tachibana, H; Baba, H; Itano, M; Yamazaki, T; Ishibashi, S; Higuchi, Y; Shimizu, H; Yamamoto, T; Yamashita, M; Sugawara, Y; Sato, A; Nishiyama, S; Kawai, D; Miyaoka, S

2015-01-01

Purpose: To show the results of a multi-institutional study of the independent dose verification for conventional, Stereotactic radiosurgery and body radiotherapy (SRS and SBRT) plans based on the action level of AAPM TG-114. Methods: This study was performed at 12 institutions in Japan. To eliminate the bias of independent dose verification program (Indp), all of the institutions used the same CT-based independent dose verification software (Simple MU Analysis, Triangle Products, JP) with the Clarkson-based algorithm. Eclipse (AAA, PBC), Pinnacle 3 (Adaptive Convolve) and Xio (Superposition) were used as treatment planning system (TPS). The confidence limits (CL, Mean±2SD) for 18 sites (head, breast, lung, pelvis, etc.) were evaluated in comparison in dose between the TPS and the Indp. Results: A retrospective analysis of 6352 treatment fields was conducted. The CLs for conventional, SRS and SBRT were 1.0±3.7 %, 2.0±2.5 % and 6.2±4.4 %, respectively. In conventional plans, most of the sites showed within 5 % of TG-114 action level. However, there were the systematic difference (4.0±4.0 % and 2.5±5.8 % for breast and lung, respectively). In SRS plans, our results showed good agreement compared to the action level. In SBRT plans, the discrepancy between the Indp was variable depending on dose calculation algorithms of TPS. Conclusion: The impact of dose calculation algorithms for the TPS and the Indp affects the action level. It is effective to set the site-specific tolerances, especially for the site where inhomogeneous correction can affect dose distribution strongly

SU-E-T-48: A Multi-Institutional Study of Independent Dose Verification for Conventional, SRS and SBRT

Energy Technology Data Exchange (ETDEWEB)

Takahashi, R; Kamima, T [The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo (Japan); Tachibana, H; Baba, H [National Cancer Center Hospital East, Kashiwa, Chiba (Japan); Itano, M; Yamazaki, T [Inagi Municipal Hospital, Inagi, Tokyo (Japan); Ishibashi, S; Higuchi, Y [Sasebo City General Hospital, Sasebo, Nagasaki (Japan); Shimizu, H [Kitasato University Medical Center, Kitamoto, Saitama (Japan); Yamamoto, T [Otemae Hospital, Chuou-ku, Osaka-city (Japan); Yamashita, M [Kobe City Medical Center General Hospital, Kobe, Hyogo (Japan); Sugawara, Y [The National Center for Global Health and Medicine, Shinjuku-ku, Tokyo (Japan); Sato, A [Itabashi Central General Hospital, Itabashi-ku, Tokyo (Japan); Nishiyama, S [Kuki General Hospital, Kuki, Saitama (Japan); Kawai, D [Kanagawa Cancer Center, Yokohama, Kanagawa-prefecture (Japan); Miyaoka, S [Kamitsuga General Hospital, Kanuma, Tochigi (Japan)

2015-06-15

Purpose: To show the results of a multi-institutional study of the independent dose verification for conventional, Stereotactic radiosurgery and body radiotherapy (SRS and SBRT) plans based on the action level of AAPM TG-114. Methods: This study was performed at 12 institutions in Japan. To eliminate the bias of independent dose verification program (Indp), all of the institutions used the same CT-based independent dose verification software (Simple MU Analysis, Triangle Products, JP) with the Clarkson-based algorithm. Eclipse (AAA, PBC), Pinnacle{sup 3} (Adaptive Convolve) and Xio (Superposition) were used as treatment planning system (TPS). The confidence limits (CL, Mean±2SD) for 18 sites (head, breast, lung, pelvis, etc.) were evaluated in comparison in dose between the TPS and the Indp. Results: A retrospective analysis of 6352 treatment fields was conducted. The CLs for conventional, SRS and SBRT were 1.0±3.7 %, 2.0±2.5 % and 6.2±4.4 %, respectively. In conventional plans, most of the sites showed within 5 % of TG-114 action level. However, there were the systematic difference (4.0±4.0 % and 2.5±5.8 % for breast and lung, respectively). In SRS plans, our results showed good agreement compared to the action level. In SBRT plans, the discrepancy between the Indp was variable depending on dose calculation algorithms of TPS. Conclusion: The impact of dose calculation algorithms for the TPS and the Indp affects the action level. It is effective to set the site-specific tolerances, especially for the site where inhomogeneous correction can affect dose distribution strongly.

Tamsulosin and spontaneous passage of ureteral stones in children: a multi-institutional cohort study.

Science.gov (United States)

Tasian, Gregory E; Cost, Nicholas G; Granberg, Candace F; Pulido, Jose E; Rivera, Marcelino; Schwen, Zeyad; Schulte, Marion; Fox, Janelle A

2014-08-01

Tamsulosin is associated with increased passage of ureteral stones in adults but its effectiveness in children is uncertain. We determined the association between tamsulosin and the spontaneous passage of ureteral stones in children. We performed a multi-institutional retrospective cohort study of patients 18 years or younger who presented between 2007 and 2012 with ureteral stones up to 10 mm and who were treated with tamsulosin or oral analgesics alone. The outcome was spontaneous stone passage, defined as radiographic clearance and/or patient report of passage. Subjects prescribed tamsulosin were matched with subjects prescribed analgesics alone, using nearest neighbor propensity score matching to adjust for treatment selection. Conditional logistic regression models were used to estimate the association between tamsulosin and spontaneous passage of ureteral stones, adjusting for stone size and location. Of 449 children with ureteral stones 334 were eligible for inclusion, and complete data were available for 274 patients from 4 institutions (99 receiving tamsulosin, 175 receiving analgesics alone). Following case matching, there were no differences in age, gender, weight, height, stone size or stone location between the 99 subjects prescribed tamsulosin and the 99 propensity score matched subjects prescribed analgesics alone. In the tamsulosin cohort 55% of ureteral stones passed, compared to 44% in the analgesics alone cohort (p=0.03). In multivariate analysis adjusting for stone size and location tamsulosin was associated with spontaneous passage of ureteral stones (OR 3.31, 95% CI 1.49-7.34). The odds of spontaneous passage of ureteral stones were greater in children prescribed tamsulosin vs analgesics alone. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Multi institutional quantitative phantom study of yttrium-90 PET in PET/MRI: the MR-QUEST study.

Science.gov (United States)

Maughan, Nichole M; Eldib, Mootaz; Faul, David; Conti, Maurizio; Elschot, Mattijs; Knešaurek, Karin; Leek, Francesca; Townsend, David; DiFilippo, Frank P; Jackson, Kimberly; Nekolla, Stephan G; Lukas, Mathias; Tapner, Michael; Parikh, Parag J; Laforest, Richard

2018-04-04

Yttrium-90 ( 90 Y) radioembolization involves the intra-arterial delivery of radioactive microspheres to treat hepatic malignancies. Though this therapy involves careful pre-treatment planning and imaging, little is known about the precise location of the microspheres once they are administered. Recently, there has been growing interest post-radioembolization imaging using positron-emission tomography (PET) for quantitative dosimetry and identifying lesions that may benefit from additional salvage therapy. In this study, we aim to measure the inter-center variability of 90 Y PET measurements as measured on PET/MRI in preparation for a multi-institutional prospective phase I/II clinical trial. Eight institutions participated in this study and followed a standardized phantom filling and imaging protocol. The NEMA NU2-2012 body phantom was filled with 3 GBq of 90 Y chloride solution. The phantom was imaged for 30 min in listmode on a Siemens Biograph mMR non-TOF PET/MRI scanner at five time points across 10 days (0.3-3.0 GBq). Raw PET data were sent to a central site for image reconstruction and data analysis. Images were reconstructed with optimal parameters determined from a previous study. Volumes of interest (VOIs) matching the known sphere diameters were drawn on the vendor-provided attenuation map and propagated to the PET images. Recovery coefficients (RCs) and coefficient of variation of the RCs (COV) were calculated from these VOIs for each sphere size and activity level. Mean RCs ranged from 14.5 to 75.4%, with the lowest mean RC coming from the smallest sphere (10 mm) on the last day of imaging (0.16 MBq/ml) and the highest mean RC coming from the largest sphere (37 mm) on the first day of imaging (2.16 MBq/ml). The smaller spheres tended to exhibit higher COVs. In contrast, the larger spheres tended to exhibit lower COVs. COVs from the 37 mm sphere were  25%. Post-radioembolization dosimetry of lesions or other VOIs ≥ 22 mm in diameter can

Gamma knife radiosurgery for trigeminal neuralgia. Analysis of a multi institutional study

International Nuclear Information System (INIS)

Takanashi, Masami; Ozaki, Yoshimaru; Satou, Kenichi; Oikawa, Mitsuteru; Nakamura, Hirohiko; Fukuoka, Seiji

2013-01-01

A multi-institutional study was conducted to evaluate the results of gamma knife radiosurgery (GKRS) for the treatment of trigeminal neuralgia. Eleven hundred and thirty-five patients at 39 centers were analyzed. Three hundred and sixty-nine patients had undergone percutaneous nerve block and 173 patients had undergone microvascular decompression (MVD) prior to GKRS. GKRS was performed for 69.4% of patients targeted at the nerve root entry zone (REZ) and for 20.4% of patients targeted at the retrogasserian region (RGR). The target dose of the GKRS used in the current study varied from 70 to 90 Gy (mean: 77.8 Gy). The median follow-up period after GKRS was 21.1 months (range 1 to 125 months). Six hundred and eighty-nine patients (66%) responded with excellent or good control (pain free), 157 (15%) obtained fair control (more than 50% relief), and 192 (19%) experienced treatment failure. After 3 years, 64% of cases were pain free and 80% had more than 50% pain relief. After 4 years, 37 patients underwent additional GKRS, 36 MVD and 36 percutaneous nerve block. Tolerable hypoesthesia or paresthesia occurred in 129 patients (11%), whereas bothersome symptoms developed in 8 patients (1%). But no patient developed deafferentation pain. Nine patients (1%) complained of dry eye, but no other abnormalities of the cornea and conjunctiva were found on ophthalmological examination. Higher maximum radiosurgical dose was associated with a significantly greater factor of complete pain relief (p=0.0101). GKRS is a safe and effective alternative treatment for trigeminal neuralgia, and is a minimally invasive treatment. In addition it provided benefit to a patient population unwilling or unable to undergo more invasive surgical approaches. (author)

A Japanese prospective multi-institutional feasibility study on accelerated partial breast irradiation using interstitial brachytherapy: treatment planning and quality assurance

International Nuclear Information System (INIS)

Otani, Yuki; Nose, Takayuki; Dokiya, Takushi; Saeki, Toshiaki; Kumazaki, Yu

2015-01-01

In Japan, breast-conserving surgery with closed cavity has generally been performed for breast cancer patients, and accelerated partial breast irradiation (APBI) is considered difficult because Asian females generally have smaller breast sizes than Western females. Therefore, common identification of target and treatment plan method in APBI is required. A prospective multicenter study was conducted in Japan to determine institutional compliance with APBI using high-dose-rate interstitial brachytherapy (ISBT) designed for Japanese female patients. For this study, 46 patients were recruited at eight institutions from January 2009 to December 2011. The reproducibility of the ISBT–APBI plan was evaluated using three criteria: (1) minimum clinical target volume dose with a clip dose ≥ 6 Gy/fraction, (2) irradiated volume constraint of 40-150 cm 3 , and (3) uniformity of dose distribution, expressed as the dose non-uniformity ratio (DNR, V150/V100) < 0.35. The ISBT–APBI plan for each patient was considered reproducible when all three criteria were met. When the number of non-reproducible patients was ≤ 4 at study completion, APBI at this institution was considered statistically reproducible. Half of the patients (52 %) had a small bra size (A/B cup). The mean values of the dose-constrained parameters were as follows: Vref, 117 cm 3 (range, 40-282), DNR, 0.30 (range, 0.22-0.51), and clip dose, 784 cGy (range, 469-3146). A total of 43/46 treatment plans were judged to be compliant and ISBT–APBI was concluded to be reproducible. This study showed that multi-institutional ISBT–APBI treatment plan was reproducible for small breast patient with closed cavity

Tamsulosin and the spontaneous passage of ureteral stones in children: A multi-institutional cohort study

Science.gov (United States)

Tasian, Gregory E.; Cost, Nicholas G.; Granberg, Candace F.; Pulido, Jose E.; Rivera, Marcelino; Schwen, Zeyad; Schulte, Marion; Fox, Janelle A.

2014-01-01

Purpose Tamsulosin is associated with increased passage of ureteral stones in adults, but its effectiveness in children is uncertain. We determined the association between tamsulosin and the spontaneous passage of ureteral stones in children. Methods We performed a multi-institutional retrospective cohort study of children ≤ 18 years who presented between 2007 and 2012 with a ureteral stone ≤ 10 mm and were managed with tamsulosin or oral analgesics alone. The outcome was spontaneous stone passage defined as radiographic clearance and/or patient report of passage. Subjects prescribed tamsulosin were matched with subjects prescribed analgesics alone using nearest neighbor propensity score matching to adjust for treatment selection. Conditional logistic regression models were used to estimate the association between tamsulosin and spontaneous passage of ureteral stones, adjusting for stone size and location. Results Of 449 children with ureteral stones, 334 were eligible for inclusion, and complete data were available for 274 children from 4 institutions (99 tamsulosin; 175 analgesics alone). Following case matching, there were no differences in patient age, gender, weight, height, stone size, or stone location between the 99 subjects prescribed tamsulosin and the 99 propensity-score matched subjects prescribed analgesics alone. In the tamsulosin cohort, 55% of ureteral stones passed versus 44% in the analgesics alone cohort (p = 0.03). In multivariate analysis adjusting for stone size and location, tamsulosin was associated with spontaneous passage of ureteral stones (OR 3.31; 95% CI 1.49–7.34). Conclusions The odds of spontaneous passage of ureteral stones were higher in children prescribed tamsulosin versus analgesics alone. PMID:24518765

SU-E-T-50: A Multi-Institutional Study of Independent Dose Verification Software Program for Lung SBRT

International Nuclear Information System (INIS)

Kawai, D; Takahashi, R; Kamima, T; Baba, H; Yamamoto, T; Kubo, Y; Ishibashi, S; Higuchi, Y; Takahashi, H; Tachibana, H

2015-01-01

Purpose: The accuracy of dose distribution depends on treatment planning system especially in heterogeneity-region. The tolerance level (TL) of the secondary check using the independent dose verification may be variable in lung SBRT plans. We conducted a multi-institutional study to evaluate the tolerance level of lung SBRT plans shown in the AAPM TG114. Methods: Five institutes in Japan participated in this study. All of the institutes used a same independent dose verification software program (Simple MU Analysis: SMU, Triangle Product, Ishikawa, JP), which is Clarkson-based and CT images were used to compute radiological path length. Analytical Anisotropic Algorithm (AAA), Pencil Beam Convolution with modified Batho-method (PBC-B) and Adaptive Convolve (AC) were used for lung SBRT planning. A measurement using an ion-chamber was performed in a heterogeneous phantom to compare doses from the three different algorithms and the SMU to the measured dose. In addition to it, a retrospective analysis using clinical lung SBRT plans (547 beams from 77 patients) was conducted to evaluate the confidence limit (CL, Average±2SD) in dose between the three algorithms and the SMU. Results: Compared to the measurement, the AAA showed the larger systematic dose error of 2.9±3.2% than PBC-B and AC. The Clarkson-based SMU showed larger error of 5.8±3.8%. The CLs for clinical plans were 7.7±6.0 % (AAA), 5.3±3.3 % (AC), 5.7±3.4 % (PBC -B), respectively. Conclusion: The TLs from the CLs were evaluated. A Clarkson-based system shows a large systematic variation because of inhomogeneous correction. The AAA showed a significant variation. Thus, we must consider the difference of inhomogeneous correction as well as the dependence of dose calculation engine

SU-E-T-50: A Multi-Institutional Study of Independent Dose Verification Software Program for Lung SBRT

Energy Technology Data Exchange (ETDEWEB)

Kawai, D [Kanagawa Cancer Center, Yokohama, Kanagawa-prefecture (Japan); Takahashi, R; Kamima, T [The Cancer Institute Hospital of JFCR, Koutou-ku, Tokyo (Japan); Baba, H [The National Cancer Center Hospital East, Kashiwa-city, Chiba prefecture (Japan); Yamamoto, T; Kubo, Y [Otemae Hospital, Chuou-ku, Osaka-city (Japan); Ishibashi, S; Higuchi, Y [Sasebo City General Hospital, Sasebo, Nagasaki (Japan); Takahashi, H [St Lukes International Hospital, Chuou-ku, Tokyo (Japan); Tachibana, H [National Cancer Center Hospital East, Kashiwa, Chiba (Japan)

2015-06-15

Purpose: The accuracy of dose distribution depends on treatment planning system especially in heterogeneity-region. The tolerance level (TL) of the secondary check using the independent dose verification may be variable in lung SBRT plans. We conducted a multi-institutional study to evaluate the tolerance level of lung SBRT plans shown in the AAPM TG114. Methods: Five institutes in Japan participated in this study. All of the institutes used a same independent dose verification software program (Simple MU Analysis: SMU, Triangle Product, Ishikawa, JP), which is Clarkson-based and CT images were used to compute radiological path length. Analytical Anisotropic Algorithm (AAA), Pencil Beam Convolution with modified Batho-method (PBC-B) and Adaptive Convolve (AC) were used for lung SBRT planning. A measurement using an ion-chamber was performed in a heterogeneous phantom to compare doses from the three different algorithms and the SMU to the measured dose. In addition to it, a retrospective analysis using clinical lung SBRT plans (547 beams from 77 patients) was conducted to evaluate the confidence limit (CL, Average±2SD) in dose between the three algorithms and the SMU. Results: Compared to the measurement, the AAA showed the larger systematic dose error of 2.9±3.2% than PBC-B and AC. The Clarkson-based SMU showed larger error of 5.8±3.8%. The CLs for clinical plans were 7.7±6.0 % (AAA), 5.3±3.3 % (AC), 5.7±3.4 % (PBC -B), respectively. Conclusion: The TLs from the CLs were evaluated. A Clarkson-based system shows a large systematic variation because of inhomogeneous correction. The AAA showed a significant variation. Thus, we must consider the difference of inhomogeneous correction as well as the dependence of dose calculation engine.

Revealing dynamics and consequences of fit and misfit between formal and informal networks in multi-institutional product development collaborations

NARCIS (Netherlands)

Kratzer, J.; Gemuenden, Hans G.; Lettl, Christopher

The study presents a longitudinal examination about dynamics and consequences of fit and misfit between formally ascribed design interfaces and informal communication networks in two large multi-institutional product development collaborations in space industry. Findings: (1) formally ascribed

Robot-assisted laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction: a multi-institutional experience.

Science.gov (United States)

Sivaraman, Ananthakrishnan; Leveillee, Raymond J; Patel, Manoj B; Chauhan, Sanket; Bracho, Jorge E; Moore, Charles R; Coelho, Rafael F; Palmer, Kenneth J; Schatloff, Oscar; Bird, Vincent G; Munver, Ravi; Patel, Vipul R

2012-02-01

To report a 6-year multi-institutional experience and outcomes with robot-assisted laparoscopic pyeloplasty (RLP) for the repair of ureteropelvic junction obstruction (UPJO). Between June 2002 and October 2008, 168 adult patients from 3 institutions underwent RLP for UPJO. A retrospective analysis of prospectively collected data were performed after institutional review board approval. Diagnosis was by intravenous urogram or computed tomography scan and diuretic renogram. All patients underwent RLP through a 4-port laparoscopic technique. Demographic, preoperative, operative, and postoperative endpoints for primary and secondary repair of UPJO were measured. Success was defined as a T½ of <20 minutes on diuretic renogram and symptom resolution. Pain resolution was assessed by subjective patient reports. Of 168 patients, 147 (87.5%) had primary repairs and 21 (12.5%) had secondary repairs. Of the secondary repairs, 57% had a crossing vessel etiology. Mean operative time was 134.9 minutes, estimated blood loss was 49 mL, and length of stay was 1.5 days. Mean follow-up was 39 months. Overall, 97.6% of patients had a successful outcome, with a 6.6% overall complication rate. To our knowledge, this review represents the largest multi-institutional experience of RLP with intermediate-term follow-up. RLP is a safe, efficacious, and viable option for either primary or secondary repair of UPJO with reproducible outcomes, a high success rate, and a low incidence of complications. Copyright © 2012 Elsevier Inc. All rights reserved.

CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.

Science.gov (United States)

Hazlehurst, Brian L; Kurtz, Stephen E; Masica, Andrew; Stevens, Victor J; McBurnie, Mary Ann; Puro, Jon E; Vijayadeva, Vinutha; Au, David H; Brannon, Elissa D; Sittig, Dean F

2015-10-01

Comparative effectiveness research (CER) requires the capture and analysis of data from disparate sources, often from a variety of institutions with diverse electronic health record (EHR) implementations. In this paper we describe the CER Hub, a web-based informatics platform for developing and conducting research studies that combine comprehensive electronic clinical data from multiple health care organizations. The CER Hub platform implements a data processing pipeline that employs informatics standards for data representation and web-based tools for developing study-specific data processing applications, providing standardized access to the patient-centric electronic health record (EHR) across organizations. The CER Hub is being used to conduct two CER studies utilizing data from six geographically distributed and demographically diverse health systems. These foundational studies address the effectiveness of medications for controlling asthma and the effectiveness of smoking cessation services delivered in primary care. The CER Hub includes four key capabilities: the ability to process and analyze both free-text and coded clinical data in the EHR; a data processing environment supported by distributed data and study governance processes; a clinical data-interchange format for facilitating standardized extraction of clinical data from EHRs; and a library of shareable clinical data processing applications. CER requires coordinated and scalable methods for extracting, aggregating, and analyzing complex, multi-institutional clinical data. By offering a range of informatics tools integrated into a framework for conducting studies using EHR data, the CER Hub provides a solution to the challenges of multi-institutional research using electronic medical record data. Copyright © 2015. Published by Elsevier Ireland Ltd.

The Hazard of Graduation: Analysis of Three Multivariate Statistics Used to Study Multi-Institutional Attendance

Science.gov (United States)

Muehlberg, Jessica Marie

2013-01-01

Adelman (2006) observed that a large quantity of research on retention is "institution-specific or use institutional characteristics as independent variables" (p. 81). However, he observed that over 60% of the students he studied attended multiple institutions making the calculation of institutional effects highly problematic. He argued…

Development of efficiency indicators of operating room management for multi-institutional comparisons.

Science.gov (United States)

Tanaka, Masayuki; Lee, Jason; Ikai, Hiroshi; Imanaka, Yuichi

2013-04-01

The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-institutional comparisons. The aim of this study was to develop indicators of OR management efficiency that would take into account differences in hospital size and manpower, which may then be applied to multi-institutional comparisons. Using administrative data from 224 hospitals in Japan from 2008 to 2010, we performed four multiple linear regression analyses at the hospital level, in which the dependent variables were the number of operations per OR per month, procedural fees per OR per month, total utilization times per OR per month and total fees per OR per month for each of the models. The expected values of these four indicators were produced using multiple regression analysis results, adjusting for differences in hospital size and manpower, which are beyond the control of process owners' management. However, more than half of the variations in three of these four indicators were shown to be explained by differences in hospital size and manpower. Using the ratio of observed to expected values (OE ratio), as well as the difference between the two values (OE difference) allows hospitals to identify weaknesses in efficiency with more validity when compared to unadjusted indicators. The new indicators may support the improvement and sustainment of a high-quality health care system. © 2012 Blackwell Publishing Ltd.

Overcoming Barriers to Public Engagement through a Multi-Institution Consortium

Science.gov (United States)

Lambert, K. F.; Weiss, M.; Garlick, S.

2016-12-01

A growing body of evidence suggests that public engagement with science (PES) can enhance the relevance and impact of science on society. At the same time, advances in our understanding of public engagement suggest that greater skills, resources, and time horizons are often required to create effective programs. Consequently, despite a proliferation of training programs, many scientists still face the challenge of balancing the demands of public engagement with the requirements of their disciplinary research. Novel institutions are emerging that bring together interdisciplinary networks of principle investigators with PES practitioners to overcome barriers to effective and sustained public engagement in the environmental sciences. We will use the Science Policy Exchange (SPE), a consortium housed at the Harvard Forest, Harvard University, to illustrate how PIs and PES practitioners can collaborate to design public engagement processes, conduct policy-relevant scientific syntheses, and implement science communication strategies. Results from two SPE case studies demonstrate how multi-institutional consortia can help scientists overcome barriers such as lack of knowledge of evidence-based PES approaches, limits on time and funding to implement PES projects, and the need to integrate PES activities with research. The case studies also show how SPE strives to achieve credibility, saliency, and legitimacy in different public policy contexts: (1) engagement between scientists and local stakeholders to develop scenarios of landscape change; and (2) engagement between scientists and policy makers to understand the relationship between power plant emission standards, and air quality, human health and ecosystem function. The presentation will conclude with examples of how SPE programs have led to institutional change (staffing and budget), cultural change (attitudes and expectations of senior leaders), and research change (development of research questions, funding proposals

Multi-institutional study of self-reported attitudes and behaviors of general surgery residents about ethical academic practices in test taking.

Science.gov (United States)

Grignol, Valerie P; Grannan, Kevin; Sabra, John; Cromer, Robert M; Jarman, Benjamin; Dent, Daniel; Sticca, Robert P; Nelson, Timothy M; Kukora, John S; Daley, Brian J; Treat, Robert W; Termuhlen, Paula M

2013-01-01

Correlation exists between people who engage in academic dishonesty as students and unethical behavior once in practice. Previously, we assessed the attitudes of general surgery residents and ethical practices in test taking at a single institution. Most residents had not participated in activities they felt were unethical, yet what constituted unethical behavior was unclear. We sought to verify these results in a multi-institutional study. A scenario-based survey describing potentially unethical activities related to the American Board of Surgery In-training Examination (ABSITE) was administered. Participants were asked about their knowledge of or participation in the activities and whether the activity was unethical. Program directors were surveyed about the use of ABSITE results for resident evaluation and promotion. Ten programs participated in the study. The resident response rate was 67% (186/277). Of the respondents, 43% felt that memorizing questions to study for future examinations was unethical and 50% felt that using questions another resident memorized was unethical. Most felt that buying (86%) or selling (79%) questions was unethical. Significantly more senior than junior residents have memorized (30% vs 16%; p = 0.04) or used questions others memorized (33% vs 12%; p = 0.002) to study for future ABSITE examinations and know of other residents who have done so (42% vs 20%; p = 0.004). Most programs used results of the ABSITE in promotion (80%) and set minimum score expectations and consequences (70%). Similar to our single-institution study, residents had not participated in activities they felt to be unethical; however the definition of what constitutes cheating remains unclear. Differences were identified between senior and junior residents with regard to memorizing questions for study. Cheating and unethical behavior is not always clear to the learner and represents an area for further education. © 2013 Association of Program Directors in Surgery

COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY.

Science.gov (United States)

Carmalt, James L; Kneissl, Sibylle; Rawlinson, Jennifer E; Zwick, Timo; Zekas, Lisa; Ohlerth, Stefanie; Bienert-Zeit, Astrid

2016-05-01

Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology. © 2016 American College of Veterinary Radiology.

Migrating a professional field of study in a multi-institutional partnership: facilitators’ experience in the competence-based curriculum development process

Directory of Open Access Journals (Sweden)

Proscovia Namubiru Ssentamu

2014-07-01

Full Text Available With the urge to Africanise the curriculum following colonisation, many African countries are still wary of the educational initiatives from the developed countries. However, with the clear curriculum design and development guidelines provided by various national Quality Assurance bodies, African countries need not fear migrating curricula from developed countries. Drawing from the workshop experiences, authors of this paper illustrate the steps involved in migrating, contextualising and adapting a professional field of study in a multi-institutional partnership, with particular focus on the competence-based curriculum design and development process. The process of migrating higher education (HE Administration, Leadership and Management curriculum taught at the University of Tampere (Finland to a Postgraduate Diploma in Higher Education Leadership and Management (PGDHELM curriculum at Uganda Management Institute (UMI in partnership with the Makerere University and the University of Helsinki involved undertaking a needs assessment, training of trainers and adapting the programme to the UMI context. The training of trainers provided opportunity for the trainees to reflect and generate information on the status of HE leadership and management in Uganda. The curriculum was institutionalised by aligning it to the vision, mission and profile of UMI in the context of the existing internal and external Quality Assurance frameworks. This paper underscores the importance of involving stakeholders, taking into account national and institutional requirements in all the steps when migrating an academic curriculum.

A multi-national report on methods for institutional credentialing for spine radiosurgery

International Nuclear Information System (INIS)

Gerszten, Peter C; Shin, John H; Winey, Brian; Oh, Kevin; Sweeney, Reinhart A; Guckenberger, Matthias; Sahgal, Arjun; Sheehan, Jason P; Kersh, Ronald; Chen, Stephanie; Flickinger, John C; Quader, Mubina; Fahim, Daniel; Grills, Inga

2013-01-01

than one specialist trained to perform spine radiosurgery. All centers believed that credentialing should also be device specific, and all believed that professional societies should formulate guidelines for institutions on the requirements for spine radiosurgery credentialing. Finally, in 4 institutions radiation therapists were required to attend corporate-sponsored device specific training for credentialing, and in only 1 institution were radiation therapists required to also attend academic society training for credentialing. This study represents the first multi-national report of the current practice of institutional credentialing for spine radiosurgery. Key methodologies for safe implementation and credentialing of spine radiosurgery have been identified. There is strong agreement among experienced centers that credentialing is an important component of the safe and effective implementation of a spine radiosurgery program

Radiotherapy for Adrenal Metastasis from Hepatocellular Carcinoma: A Multi-Institutional Retrospective Study (KROG 13-05.

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Jinhong Jung

Full Text Available Although the adrenal glands are not common sites of metastasis from hepatocellular carcinoma (HCC, this metastasis can be met in patients with advanced HCC in some clinical settings. However, the effectiveness of radiotherapy against such metastases is unclear. Therefore, we performed the present multi-institutional study to investigate tumor response, overall survival (OS, treatment-related toxicity, and prognostic factors after radiotherapy. We retrospectively reviewed 134 patients who completed a planned radiotherapy for their adrenal metastases. Complete response was noted in 6 (4.3%, partial response in 48 (34.0%, and stable disease in 78 patients (55.3%. The median OS was 12.8 months, and the 1-, 2-, and 5-year OS rates were 53.1%, 23.9%, and 9.3%, respectively. Grade 3 anorexia occurred in 2 patients, grade 3 diarrhea in 1, and grade 3 fatigue in 1. Multivariate analyses revealed that the following factors had significant effects on OS: controlled intrahepatic tumor; controlled extrahepatic metastasis; and Child-Pugh class A. Although patients with adrenal metastasis from HCC had poor OS, radiotherapy provided an objective response rate of 38.3% and disease stability of 93.6%, with minimal adverse events. Therefore, radiotherapy for these patients could represent a good treatment modality, especially for patients with controlled intrahepatic tumors, controlled extrahepatic metastasis, and good hepatic function.

Connecting the Dots: A Comparative Global Multi-Institutional Study of Prohibitive Factors Affecting Cancer Pain Management.

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Amoatey Odonkor, Charles; Addison, William; Smith, Sean; Osei-Bonsu, Ernest; Tang, Teresa; Erdek, Michael

2017-02-01

The goal of this study was to elucidate the attitudes, beliefs, and barriers interfering with cancer pain management, the degree of barrier interference with trainees’ care of patients, and the relationships among prohibitive factors to pain management for physicians in a low–middle-income countries (LMICs) vs high-income countries (HICs). A multi-institutional cross-sectional survey of physicians in specialties with a focus in pain management training was performed. All surveys were completed anonymously from July 1, 2015, to November 30, 2015. One hundred and twenty physicians participated in the survey. Surveys were based on prior questionnaires published in the literature. Descriptive statistics were calculated, and chi-square (ℵ2) analysis, Fisher’s exact test, and Spearman rank correlation analyses were performed. Compared with their peers in HICs, physicians in LMICs reported less experience with cancer pain management despite seeing more cancer patients with advanced disease (41% vs 15.2%, p pain (84% vs 76%) and lack of training and expertise (87% vs 78%) were significantly more prohibitive for physicians in LMICs than those in HICs; p pain management among trainee physicians in low- vs high-resource environments. Understanding these differences may spur further collaboration in the design of contextually relevant solutions, which could potentially help improve the adequacy of cancer pain management

Comparing predictive models of glioblastoma multiforme built using multi-institutional and local data sources.

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Singleton, Kyle W; Hsu, William; Bui, Alex A T

2012-01-01

The growing amount of electronic data collected from patient care and clinical trials is motivating the creation of national repositories where multiple institutions share data about their patient cohorts. Such efforts aim to provide sufficient sample sizes for data mining and predictive modeling, ultimately improving treatment recommendations and patient outcome prediction. While these repositories offer the potential to improve our understanding of a disease, potential issues need to be addressed to ensure that multi-site data and resultant predictive models are useful to non-contributing institutions. In this paper we examine the challenges of utilizing National Cancer Institute datasets for modeling glioblastoma multiforme. We created several types of prognostic models and compared their results against models generated using data solely from our institution. While overall model performance between the data sources was similar, different variables were selected during model generation, suggesting that mapping data resources between models is not a straightforward issue.

How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives.

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Bogetz, Alyssa L; Orlov, Nicola; Blankenburg, Rebecca; Bhavaraju, Vasudha; McQueen, Alisa; Rassbach, Caroline

2018-04-01

Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified. We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback. In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory. Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions. Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.

Using institutional theory in enterprise systems research

DEFF Research Database (Denmark)

Svejvig, Per

2013-01-01

This paper sets out to examine the use of institutional theory as a conceptually rich lens to study social issues of enterprise systems (ES) research. More precisely, the purpose is to categorize current ES research using institutional theory to develop a conceptual model that advances ES research...... model that advocates multi-level and multi-theory approaches and applies newer institutional aspects such as institutional logics. The findings show that institutional theory in ES research is in its infancy and adopts mainly traditional institutional aspects like isomorphism, with the organization....... Key institutional features are presented such as isomorphism, rationalized myths, and bridging macro and micro structures, and institutional logics and their implications for ES research are discussed. Through a literature review of 181 articles, of which 18 papers are selected, we build a conceptual...

Medical School Applicant Characteristics Associated With Performance in Multiple Mini-Interviews Versus Traditional Interviews: A Multi-Institutional Study.

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Henderson, Mark C; Kelly, Carolyn J; Griffin, Erin; Hall, Theodore R; Jerant, Anthony; Peterson, Ellena M; Rainwater, Julie A; Sousa, Francis J; Wofsy, David; Franks, Peter

2017-10-31

To examine applicant characteristics associated with multi mini-interview (MMI) or traditional interview (TI) performance at five California public medical schools. Of the five California Longitudinal Evaluation of Admissions Practices (CA-LEAP) consortium schools, three used TIs and two used MMIs. Schools provided the following retrospective data on all 2011-2013 admissions cycle interviewees: age, gender, race/ethnicity (under-represented in medicine [UIM] or not), self-identified disadvantaged (DA) status, undergraduate GPA, Medical College Admission Test (MCAT) score, and interview score (standardized as z-score, mean = 0, SD = 1). Adjusted linear regression analyses, stratified by interview type, examined associations with interview performance. The 4,993 applicants who completed 7,516 interviews included 931 (18.6%) UIM and 962 (19.3%) DA individuals; 3,226 (64.6%) had one interview. Mean age was 24.4 (SD = 2.7); mean GPA and MCAT score were 3.72 (SD = 0.22) and 33.6 (SD = 3.7), respectively. Older age, female gender, and number of prior interviews were associated with better performance on both MMIs and TIs. Higher GPA was associated with lower MMI scores (z-score, per unit GPA = -0.26, 95% CI [-0.45, -0.06]), but unrelated to TI scores. DA applicants had higher TI scores (z-score = 0.17, 95% CI [0.07, 0.28]), but lower MMI scores (z-score = -0.18, 95% CI [-0.28, -.08]) than non-DA applicants. Neither UIM status nor MCAT score were associated with interview performance. These findings have potentially important workforce implications, particularly regarding DA applicants, and illustrate the need for other multi-institutional studies of medical school admissions processes.

SU-F-P-13: NRG Oncology Medical Physics Manpower Survey Quantifying Support Demands for Multi Institutional Clinical Trials

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Monroe, J [St. Anthony’s Cancer Center, St. Louis, MO (United States); Case Western Reserve University (United States); Boparai, K [ACR, Reston, VA (United States); Xiao, Y [University of Pennsylvania, Philadelphia, PA (United States); Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States); Galvin, J [Thomas Jefferson University Hospital, Newtown, PA (United States); Sohn, J [Case Western University, Cleveland, OH (United States)

2016-06-15

Purpose: A survey was taken by NRG Oncology to assess Full Time Equivalent (FTE) contributions to multi institutional clinical trials by medical physicists.No current quantification of physicists’ efforts in FTE units associated with clinical trials is available. The complexity of multi-institutional trials increases with new technologies and techniques. Proper staffing may directly impact the quality of trial data and outcomes. The demands on physics time supporting clinical trials needs to be assessed. Methods: The NRG Oncology Medical Physicist Subcommittee created a sixteen question survey to obtain this FTE data. IROC Houston distributed the survey to their list of 1802 contact physicists. Results: After three weeks, 363 responded (20.1% response). 187 (51.5%) institutions reporting external beam participation were processed. There was a wide range in number of protocols active and supported at each institution. Of the 187 clinics, 134 (71.7%) participate in 0 to 10 trials, 28 (15%) in 11 to 20 trials, 10 (5.3%) in 21 to 30 trials, 9 (4.8%) had 40 to 75 trials. On average, physicist spent 2.7 hours (SD: 6.0) per week supervising or interacting with clinical trial staff. 1.25 hours (SD: 3.37), 1.83 hours (SD: 4.13), and 0.64 hours(SD: 1.13) per week were spent on patient simulation, reviewing treatment plans, and maintaining a DICOM server, respectively. For all protocol credentialing activities, physicist spent an average of 37.05 hours (SD: 96.94) yearly. To support dosimetrists, clinicians, and therapists, physicist spend on average 2.07 hours (SD: 3.52) per week just reading protocols. Physicist attended clinical trial meetings for on average 1.13 hours (SD: 1.85) per month. Conclusion: Responding physicists spend a nontrivial amount of time: 8.8 hours per week (0.22 FTE) supporting, on average, 9 active multi-institutional clinical trials.

Colon injury after blunt abdominal trauma: results of the EAST Multi-Institutional Hollow Viscus Injury Study.

Science.gov (United States)

Williams, Michael D; Watts, Dorraine; Fakhry, Samir

2003-11-01

Blunt injury to the colon is rare. Few studies of adequate size and design exist to allow clinically useful conclusions. The Eastern Association for the Surgery of Trauma Multi-institutional Hollow Viscus Injury (HVI) Study presents a unique opportunity to definitively study these injuries. Patients with blunt HVI were identified from the registries of 95 trauma centers over 2 years (1998-1999). Patients with colon injuries (cases) were compared with blunt trauma patient undergoing a negative laparotomy (controls). Data were abstracted by chart review. Of the 227,972 patients represented, 2,632 (1.0%) had an HVI and 798 had a colonic/rectal injury (0.3%). Of patients diagnosed with HVI, 30.2% had a colon injury. No physical findings or imaging modalities were able to discriminate colonic injury. Logistic regression modeling yielded no clinically useful combination of findings that would reliably predict colonic injury. In patients undergoing laparotomy, presence of colon injury was associated with a higher risk of some complications but not mortality. Colon injury was associated with increased hospital (17.4 vs. 13.1, p colon patients (92.0%) underwent laparotomy within 24 hours of injury. Colonic injury after blunt trauma is rare and difficult to diagnose. No diagnostic test or combination of findings reliably excluded blunt colonic injury. Despite the inadequacy of current diagnostic tests, almost all patients with colonic injury were taken to the operating room within 24 hours. Even with relatively prompt surgery, patients with colon injury were at significantly higher risk for serious complications and increased length of stay. In contrast to small bowel perforation, delay in operative intervention appears to be less common but is still associated with serious morbidity.

Standardizing display conditions of diffusion-weighted images using concurrent b0 images. A multi-vendor multi-institutional study

International Nuclear Information System (INIS)

Sasaki, Makoto; Ida, Masahiro; Yamada, Kei; Watanabe, Yoshiyuki; Matsui, Mieko

2007-01-01

The purpose of this study was to establish a practical method that uses concurrent b0 images to standardize the display conditions for diffusion-weighted images (DWI) that vary among institutions and interpreters. Using identical parameters, we obtained DWI for 12 healthy volunteers at 4 institutions using 4 MRI scanners from 3 vendors. Three operators manually set the window width for the images equal to the signal intensity of the normal-appearing thalamus on b0 images and set the window level at half and then exported the images to 8-bit gray-scale images. We calculated the mean pixel values of the brain objects in the images and examined the variation among scanners, operators, and subjects. Following our method, the DWI of the 12 subjects obtained using the 4 different scanners had nearly identical contrast and brightness. The mean pixel values of the brain on the exported images among the operators and subjects were not significantly different, but we found a slight, significant difference among the scanners. Determining DWI display conditions by using b0 images is a simple and practical method to standardize window width and level for evaluating diffusion abnormalities and decreasing variation among institutions and operators. (author)

RMS: a platform for managing cross-disciplinary and multi-institutional research project collaboration.

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Luo, Jake; Apperson-Hansen, Carolyn; Pelfrey, Clara M; Zhang, Guo-Qiang

2014-11-30

Cross-institutional cross-disciplinary collaboration has become a trend as researchers move toward building more productive and innovative teams for scientific research. Research collaboration is significantly changing the organizational structure and strategies used in the clinical and translational science domain. However, due to the obstacles of diverse administrative structures, differences in area of expertise, and communication barriers, establishing and managing a cross-institutional research project is still a challenging task. We address these challenges by creating an integrated informatics platform to reduce the barriers to biomedical research collaboration. The Request Management System (RMS) is an informatics infrastructure designed to transform a patchwork of expertise and resources into an integrated support network. The RMS facilitates investigators' initiation of new collaborative projects and supports the management of the collaboration process. In RMS, experts and their knowledge areas are categorized and managed structurally to provide consistent service. A role-based collaborative workflow is tightly integrated with domain experts and services to streamline and monitor the life-cycle of a research project. The RMS has so far tracked over 1,500 investigators with over 4,800 tasks. The research network based on the data collected in RMS illustrated that the investigators' collaborative projects increased close to 3 times from 2009 to 2012. Our experience with RMS indicates that the platform reduces barriers for cross-institutional collaboration of biomedical research projects. Building a new generation of infrastructure to enhance cross-disciplinary and multi-institutional collaboration has become an important yet challenging task. In this paper, we share the experience of developing and utilizing a collaborative project management system. The results of this study demonstrate that a web-based integrated informatics platform can facilitate and

Multi-Institutional Validation of an OSATS for the Assessment of Cystoscopic and Ureteroscopic Skills.

Science.gov (United States)

Argun, Omer Burak; Chrouser, Kristin; Chauhan, Sanket; Monga, Manoj; Knudsen, Bodo; Box, Geoffrey N; Lee, David I; Gettman, Matthew T; Poniatowski, Lauren H; Wang, Qi; Reihsen, Troy E; Sweet, Robert M

2015-10-01

We evaluated the internal and construct validity of an assessment tool for cystoscopic and ureteroscopic cognitive and psychomotor skills at a multi-institutional level. Subjects included a total of 30 urology residents at Ohio State University, Columbus, Ohio; Penn Presbyterian Medical Center, Philadelphia, Pennsylvania; and Mayo Clinic, Rochester, Minnesota. A single external blinded reviewer evaluated cognitive and psychomotor skills associated with cystoscopic and ureteroscopic surgery using high fidelity bench models. Exercises included navigation, basketing and relocation; holmium laser lithotripsy; and cystoscope assembly. Each resident received a total cognitive score, checklist score and global psychomotor skills score. Construct validity was assessed by calculating correlations between training year and performance scores (both cognitive and psychomotor). Internal validity was confirmed by calculating correlations between test components. The median total cognitive score was 91 (IQR 86.25, 97). For psychomotor performance residents had a median total checklist score of 7 (IQR 5, 8) and a median global psychomotor skills score of 21 (IQR 18, 24.5). Construct validity was supported by the positive and statistically significant correlations between training year and total cognitive score (r = 0.66, 95% CI 0.39-0.82, p = 0.01), checklist scores (r = 0.66, 95% CI 0.35-0.84, p = 0.32) and global psychomotor skills score (r = 0.76, 95% CI 0.55-0.88, p = 0.002). The internal validity of OSATS was supported since total cognitive and checklist scores correlated with the global psychomotor skills score. In this multi-institutional study we successfully demonstrated the construct and internal validity of an objective assessment of cystoscopic and ureteroscopic cognitive and technical skills, including laser lithotripsy. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A multi-institutional study to assess adherence to lung stereotactic body radiotherapy planning goals

International Nuclear Information System (INIS)

Woerner, Andrew; Roeske, John C.; Harkenrider, Matthew M.; Campana, Maria; Surucu, Murat; Fan, John; Aydogan, Bulent; Koshy, Matthew; Laureckas, Robert; Vali, Faisal

2015-01-01

Purpose: A multi-institutional planning study was performed to evaluate the frequency that current guidelines established by Radiation Therapy Oncology Group (RTOG) protocols and other literature for lung stereotactic body radiotherapy (SBRT) treatments are followed. Methods: A total of 300 patients receiving lung SBRT treatments in four different institutions were retrospectively reviewed. The treatments were delivered using Linac based SBRT (160 patients) or image guided robotic radiosurgery (140). Most tumors were located peripherally (250/300). Median fractional doses and ranges were 18 Gy (8–20 Gy), 12 Gy (6–15 Gy), and 10 Gy (5–12 Gy) for three, four, and five fraction treatments, respectively. The following planning criteria derived from RTOG trials and the literature were used to evaluate the treatment plans: planning target volumes, PTV_V _1_0_0 ≥ 95% and PTV_V _9_5 ≥ 99%; conformality indices, CI_1_0_0_% < 1.2 and CI_5_0_% range of 2.9–5.9 dependent on PTV; total lung-ITV: V_2_0_G_y < 10%, V_1_2_._5_G_y < 15%, and V_5_G_y < 37%; contralateral lung V_5_G_y < 26%; and maximum doses for spinal cord, esophagus, trachea/bronchus, and heart and great vessels. Populations were grouped by number of fractions, and dosimetric criteria satisfaction rates (CSRs) were reported. Results: Five fraction regimens were the most common lung SBRT fractionation (46%). The median PTV was 27.2 cm"3 (range: 3.8–419.5 cm"3). For all plans: mean PTV_V _1_0_0 was 94.5% (±5.6%, planning CSR: 69.8%), mean PTV_V _9_5 was 98.1% (±4.1%, CSR: 69.5%), mean CI_1_0_0_% was 1.14 (±0.21, CSR: 79.1%, and 16.5% within minor deviation), and mean CI_5_0_% was 5.63 (±2.8, CSR: 33.0%, and 28.0% within minor deviation). When comparing plans based on location, peripherally located tumors displayed higher PTV_V _1_0_0 and PTV_V _9_5 CSR (71.5% and 71.9%, respectively) than centrally located tumors (61.2% and 57.1%, respectively). Overall, the planning criteria were met for all the

A multi-institutional study to assess adherence to lung stereotactic body radiotherapy planning goals

Energy Technology Data Exchange (ETDEWEB)

Woerner, Andrew; Roeske, John C.; Harkenrider, Matthew M.; Campana, Maria; Surucu, Murat, E-mail: msurucu@lumc.edu [Loyola University Medical Center, Maywood, Illinois 60153 (United States); Fan, John [Edward Cancer Center, Naperville, Illinois 60540 (United States); Aydogan, Bulent; Koshy, Matthew [Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois 60612 (United States); Laureckas, Robert; Vali, Faisal [Advocate Christ Medical Center, Oak Lawn, Illinois 60453 (United States)

2015-08-15

Purpose: A multi-institutional planning study was performed to evaluate the frequency that current guidelines established by Radiation Therapy Oncology Group (RTOG) protocols and other literature for lung stereotactic body radiotherapy (SBRT) treatments are followed. Methods: A total of 300 patients receiving lung SBRT treatments in four different institutions were retrospectively reviewed. The treatments were delivered using Linac based SBRT (160 patients) or image guided robotic radiosurgery (140). Most tumors were located peripherally (250/300). Median fractional doses and ranges were 18 Gy (8–20 Gy), 12 Gy (6–15 Gy), and 10 Gy (5–12 Gy) for three, four, and five fraction treatments, respectively. The following planning criteria derived from RTOG trials and the literature were used to evaluate the treatment plans: planning target volumes, PTV{sub V} {sub 100} ≥ 95% and PTV{sub V} {sub 95} ≥ 99%; conformality indices, CI{sub 100%} < 1.2 and CI{sub 50%} range of 2.9–5.9 dependent on PTV; total lung-ITV: V{sub 20Gy} < 10%, V{sub 12.5Gy} < 15%, and V{sub 5Gy} < 37%; contralateral lung V{sub 5Gy} < 26%; and maximum doses for spinal cord, esophagus, trachea/bronchus, and heart and great vessels. Populations were grouped by number of fractions, and dosimetric criteria satisfaction rates (CSRs) were reported. Results: Five fraction regimens were the most common lung SBRT fractionation (46%). The median PTV was 27.2 cm{sup 3} (range: 3.8–419.5 cm{sup 3}). For all plans: mean PTV{sub V} {sub 100} was 94.5% (±5.6%, planning CSR: 69.8%), mean PTV{sub V} {sub 95} was 98.1% (±4.1%, CSR: 69.5%), mean CI{sub 100%} was 1.14 (±0.21, CSR: 79.1%, and 16.5% within minor deviation), and mean CI{sub 50%} was 5.63 (±2.8, CSR: 33.0%, and 28.0% within minor deviation). When comparing plans based on location, peripherally located tumors displayed higher PTV{sub V} {sub 100} and PTV{sub V} {sub 95} CSR (71.5% and 71.9%, respectively) than centrally located tumors (61

Development of radiation oncology learning system combined with multi-institutional radiotherapy database (ROGAD)

International Nuclear Information System (INIS)

Takemura, Akihiro; Iinuma, Masahiro; Kou, Hiroko; Harauchi, Hajime; Inamura, Kiyonari

1999-01-01

We have constructed and are operating a multi-institutional radiotherapy database ROGAD (Radiation Oncology Greater Area Database) since 1992. One of it's purpose is 'to optimize individual radiotherapy plans'. We developed Radiation oncology learning system combined with ROGAD' which conforms to that purpose. Several medical doctors evaluated our system. According to those evaluations, we are now confident that our system is able to contribute to improvement of radiotherapy results. Our final target is to generate a good cyclic relationship among three components: radiotherapy results according to ''Radiation oncology learning system combined with ROGAD.'; The growth of ROGAD; and radiation oncology learning system. (author)

Risk of complications and urinary incontinence following cytoreductive prostatectomy: a multi-institutional study

Directory of Open Access Journals (Sweden)

Dae Keun Kim

2018-01-01

Full Text Available Emerging evidence has suggested that cytoreductive prostatectomy (CRP allows superior oncologic control when compared to current standard of care androgen deprivation therapy alone. However, the safety and benefit of cytoreduction in metastatic prostate cancer (mPCa has not been proven. Therefore, we evaluated the incidence of complications following CRP in men newly diagnosed with mPCa. A total of 68 patients who underwent CRP from 2006 to 2014 at four tertiary surgical centers were compared to 598 men who underwent radical prostatectomy for clinically localized prostate cancer (PCa. Urinary incontinence was defined as the use of any pad. CRP had longer operative times (200 min vs 140 min, P < 0.0001 and higher estimated blood loss (250 ml vs 125 ml, P < 0.0001 compared to the control group. However, both overall (8.82% vs 5.85% and major complication rates (4.41% vs 2.17% were comparable between the two groups. Importantly, urinary incontinence rate at 1-year after surgery was significantly higher in the CRP group (57.4% vs 90.8%, P < 0.0001. Univariate logistic analysis showed that the estimated blood loss was the only independent predictor of perioperative complications both in the unadjusted model (OR: 1.18; 95% CI: 1.02-1.37; P = 0.025 and surgery type-adjusted model (OR: 1.17; 95% CI: 1.01-1.36; P = 0.034. In conclusion, CRP is more challenging than radical prostatectomy and associated with a notably higher incidence of urinary incontinence. Nevertheless, CRP is a technically feasible and safe surgery for selecting PCa patients who present with node-positive or bony metastasis when performed by experienced surgeons. A prospective, multi-institutional clinical trial is currently underway to verify this concept.

Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education.

Science.gov (United States)

Thayer, Erin K; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A

2016-01-01

Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data.

Studying institutional work in organizations

DEFF Research Database (Denmark)

Bjerregaard, Toke

2011-01-01

Purpose – In order to provide new and other directions to institutional studies in organization theory, Lawrence and Suddaby forward the notion of institutional work of actors aimed at maintaining, changing and disrupting institutions. The purpose of this paper is to further theory and method...... in studying the institutional work of people in organizations. Design/methodology/approach – Methodological insights from the ways in which theories of human agency in institutional contexts have co-evolved with field study methodologies are analyzed in related fields of research, particularly in sociology...... and anthropology. Findings – The ways have been analyzed in which social theories of human agency in institutional contexts and field methodology have co-evolved in an inter-disciplinary perspective. The analysis shows how field methodologies may provide inspirations to theory and method in studying institutional...

Regional climate response collaboratives: Multi-institutional support for climate resilience

Science.gov (United States)

Averyt, Kristen; Derner, Justin D.; Dilling, Lisa; Guerrero, Rafael; Joyce, Linda A.; McNeeley, Shannon; McNie, Elizabeth; Morisette, Jeffrey T.; Ojima, Dennis; O'Malley, Robin; Peck, Dannele; Ray, Andrea J.; Reeves, Matt; Travis, William

2018-01-01

Federal investments by U.S. agencies to enhance climate resilience at regional scales grew over the past decade (2010s). To maximize efficiency and effectiveness in serving multiple sectors and scales, it has become critical to leverage existing agency-specific research, infrastructure, and capacity while avoiding redundancy. We discuss lessons learned from a multi-institutional “regional climate response collaborative” that comprises three different federally-supported climate service entities in the Rocky Mountain west and northern plains region. These lessons include leveraging different strengths of each partner, creating deliberate mechanisms to increase cross-entity communication and joint ownership of projects, and placing a common priority on stakeholder-relevant research and outcomes. We share the conditions that fostered successful collaboration, which can be transferred elsewhere, and suggest mechanisms for overcoming potential barriers. Synergies are essential for producing actionable research that informs climate-related decisions for stakeholders and ultimately enhances climate resilience at regional scales.

Estrogen receptor and progesterone receptor status of breast cancer patients of eastern India: A multi-institutional study.

Science.gov (United States)

Chatterjee, Koushik; Bhaumik, Gautam; Chattopadhyay, Bhargab

2018-01-01

There is a paucity of any significant data on the estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer patients from the eastern part of India. This study aims to document the ER and PR status of breast cancer patients in the eastern Indian population, as catered by two premier tertiary care hospitals in Kolkata. All breast cancer patients registered between January 1, 2013 and December 31, 2015, in the Departments of Oncology, of IPGMER and SSKM Hospitals and R. G. Kar Medical College and Hospital, Kolkata, who had at least undergone a core biopsy or surgery, were analyzed retrospectively for documentation of their ER and PR status, using the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines. Over a period of 3 years, a total of 927 patients were included for the study. A total of 825 (89%) patients had their ER and PR data available for evaluation. ER and PR positive was seen in 312 (37.82%) patients, ER and PR negative in 399 (48.36%) patients, ER positive and PR negative in 71 (8.6%) patients, and ER negative and PR positive results was found in 43 (5.21%) patients. This is the first multi-institutional documentation of ER and PR status from eastern India, having a modest number of patients and one of the earliest documentations using the latest ASCO/CAP interpretation guidelines. These findings resemble the data from the south and also reiterate the fact that majority of the Indian breast cancer patients are still ER and PR negative in spite of the changes in the interpretation guidelines.

Qualitative Insights from a Canadian Multi-Institutional Research Study: In Search of Meaningful E-Learning

Science.gov (United States)

Carter, Lorraine M.; Salyers, Vince; Myers, Sue; Hipfner, Carol; Hoffart, Caroline; MacLean, Christa; White, Kathy; Matus, Theresa; Forssman, Vivian; Barrett, Penelope

2014-01-01

This paper reports the qualitative findings of a mixed methods research study conducted at three Canadian post-secondary institutions. Called the Meaningful E-learning or MEL project, the study was an exploration of the teaching and learning experiences of faculty and students as well as their perceptions of the benefits and challenges of…

Standard of Care Versus Metastases-directed Therapy for PET-detected Nodal Oligorecurrent Prostate Cancer Following Multimodality Treatment: A Multi-institutional Case-control Study.

Science.gov (United States)

Steuber, T; Jilg, C; Tennstedt, P; De Bruycker, A; Tilki, D; Decaestecker, K; Zilli, T; Jereczek-Fossa, B A; Wetterauer, U; Grosu, A L; Schultze-Seemann, W; Heinzer, H; Graefen, M; Morlacco, A; Karnes, R J; Ost, P

2018-03-10

Most prostate cancer (PCa) patients with a biochemical failure following primary multimodality treatment (surgery and postoperative radiotherapy) relapse in the nodes. To perform a matched-case analysis in men with lymph node recurrent PCa comparing standard of care (SOC) with metastasis-directed therapy (MDT). PCa patients with a prostate-specific antigen (PSA) progression following multimodality treatment were included in this retrospective multi-institutional analysis. The SOC cohort (n=1816) received immediate or delayed androgen deprivation therapy administered at PSA progression. The MDT cohort (n=263) received either salvage lymph node dissection (n=166) or stereotactic body radiotherapy (n=97) at PSA progression to a positron emission tomography-detected nodal recurrence. The primary endpoint, cancer-specific survival (CSS), was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. At a median follow-up of 70 (interquartile range: 48-98) mo, MDT was associated with an improved CSS on univariate (p=0.029) and multivariate analysis (hazard ratio: 0.33, 95% confidence interval [CI]: 0.17-0.64) adjusted for the year of radical prostatectomy (RP), age at RP, PSA at RP, time from RP to PSA progression, Gleason score, surgical margin status, pT- and pN-stage. In total, 659 men were matched (3:1 ratio). The 5-yr CSS was 98.6% (95% CI: 94.3-99.6) and 95.7% (95% CI: 93.2-97.3) for MDT and SOC, respectively (p=0.005, log-rank). The main limitations of our study are its retrospective design and lack of standardization of systemic treatment in the SOC cohort. MDT for nodal oligorecurrent PCa improves CSS as compared with SOC. These retrospective data from a multi-institutional pooled analysis should be considered as hypothesis-generating and inform future randomized trials in this setting. Prostate cancer patients experiencing a lymph node recurrence might benefit from local treatments directed at

Development of radiation oncology learning system combined with multi-institutional radiotherapy database (ROGAD)

Energy Technology Data Exchange (ETDEWEB)

Takemura, Akihiro; Iinuma, Masahiro; Kou, Hiroko [Kanazawa Univ. (Japan). School of Medicine; Harauchi, Hajime; Inamura, Kiyonari

1999-09-01

We have constructed and are operating a multi-institutional radiotherapy database ROGAD (Radiation Oncology Greater Area Database) since 1992. One of it's purpose is 'to optimize individual radiotherapy plans'. We developed Radiation oncology learning system combined with ROGAD' which conforms to that purpose. Several medical doctors evaluated our system. According to those evaluations, we are now confident that our system is able to contribute to improvement of radiotherapy results. Our final target is to generate a good cyclic relationship among three components: radiotherapy results according to ''Radiation oncology learning system combined with ROGAD.'; The growth of ROGAD; and radiation oncology learning system. (author)

Nuclear structure studies at Saha Institute of Nuclear Physics using ...

Indian Academy of Sciences (India)

In-beam gamma-ray spectroscopy, carried out at the Saha Institute of Nuclear Physics in the recent past, using heavy-ion projectiles from the pelletron accelerator centres in the country and multi-detector arrays have yielded significant data on the structure of a large number of nuclei spanning different mass regions.

Institutional Aspects of Multi-Agency Transit Operations

OpenAIRE

Miller, Mark A.; Lam, Amy

2003-01-01

In this project we have investigated the institutional changes that have been undertaken recently by transit properties to work more closely - in partnership and coordination rather than in competition - with other regional public agencies (especially including other transit properties) to help address mutual transportation problems from a regional and less parochial perspective. Our investigation includes case studies both within and outside of California. From the case studies, both formal ...

Institutional Repositories in Indian Universities and Research Institutes: A Study

Science.gov (United States)

Krishnamurthy, M.; Kemparaju, T. D.

2011-01-01

Purpose: The purpose of this paper is to report on a study of the institutional repositories (IRs) in use in Indian universities and research institutes. Design/methodology/approach: Repositories in various institutions in India were accessed and described in a standardised way. Findings: The 20 repositories studied covered collections of diverse…

TTI Phase 2 Institutional Support: Indian Institute of Dalit Studies ...

International Development Research Centre (IDRC) Digital Library (Canada)

This funding will enhance the Indian Institute of Dalit Studies' (IIDS) role as a credible public policy institution in India by strengthening its ability to provide high-quality, influential, and policy-relevant research. About the Indian Institute of Dalit Studies IIDS is a social sciences research centre with a focus on development ...

Multi-Institutional, Multidisciplinary Study of the Impact of Course-Based Research Experiences†

Science.gov (United States)

Mader, Catherine M.; Beck, Christopher W.; Grillo, Wendy H.; Hollowell, Gail P.; Hennington, Bettye S.; Staub, Nancy L.; Delesalle, Veronique A.; Lello, Denise; Merritt, Robert B.; Griffin, Gerald D.; Bradford, Chastity; Mao, Jinghe; Blumer, Lawrence S.; White, Sandra L.

2017-01-01

Numerous national reports have called for reforming laboratory courses so that all students experience the research process. In response, many course-based research experiences (CREs) have been developed and implemented. Research on the impact of these CREs suggests that student benefits can be similar to those of traditional apprentice-model research experiences. However, most assessments of CREs have been in individual courses at individual institutions or across institutions using the same CRE model. Furthermore, which structures and components of CREs result in the greatest student gains is unknown. We explored the impact of different CRE models in different contexts on student self-reported gains in understanding, skills, and professional development using the Classroom Undergraduate Research Experience (CURE) survey. Our analysis included 49 courses developed and taught at seven diverse institutions. Overall, students reported greater gains for all benefits when compared with the reported national means for the Survey of Undergraduate Research Experiences (SURE). Two aspects of these CREs were associated with greater student gains: 1) CREs that were the focus of the entire course or that more fully integrated modules within a traditional laboratory and 2) CREs that had a higher degree of student input and results that were unknown to both students and faculty. PMID:28861141

Contestation in multi-level party systems with institutional constraints: A look at ethnically divided countries in Central and Eastern Europe

DEFF Research Database (Denmark)

Bochsler, Daniel

2011-01-01

Contestation is one of the main dimensions of democratic representation. Mainly, research has focused on contestation at the national level, however the concept equally applies for regional and for local politics. This paper discusses the effect of restrictive national-level institutions...... on political plurality in elections at the subnational level. Its argument is two-fold; firstly, the effect of restrictive political institutions spans over different levels of elections, and therefore restrictive national institutions also restrict political competition in subnational elections. This effect...... might hamper political contestation at the local and regional level if restrictive national institutions meet territorially structured political conflicts. Secondly, where free and politically relevant elections are fought, there is a genuine need for political contestation. Where the multi-level logic...

Long-term Follow-up Results of a Multi-institutional Phase 2 Study of Concurrent Chemoradiation Therapy for Locally Advanced Cervical Cancer in East and Southeast Asia

Energy Technology Data Exchange (ETDEWEB)

Kato, Shingo, E-mail: s_kato@saitama-med.ac.jp [Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama (Japan); National Institute of Radiological Sciences of Japan, Chiba (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Gunma University, Gunma (Japan); Thephamongkhol, Kullathorn; Chansilpa, Yaowalak [Division of Radiation Oncology, Department of Radiology, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok (Thailand); Cao, Jianping [School of Radiation Medicine and Public Health, Soochow University, Soochow (China); Xu, Xiaoting [Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow (China); Devi, C. R. Beena; Swee, Tang Tieng [Department of Radiotherapy and Oncology, Hospital Umum Sarawak, Kuching (Malaysia); Calaguas, Miriam J.C. [Department of Radiation Oncology, St. Luke' s Medical Center, Quezon City, the Philippines (Philippines); Reyes, Rey H. de los [Department of Obstetrics and Gynecology, Dr Jose R. Reyes Memorial Medical Center, Manila, the Philippines (Philippines); Cho, Chul-Koo [Department of Radiation Oncology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Dung, To Anh [Department of Breast and Gynecology Radiotherapy, National Cancer Institute, Hanoi (Viet Nam); Supriana, Nana [Department of Radiation Therapy, Faculty of Medicine, University of Indonesia, Dr Cipto Mangunkusumo General Hospital, Jakarta (Indonesia); Erawati, Dyah [Division of Radiotherapy, Dr Soetomo General Hospital, Surabaya (Indonesia); Mizuno, Hideyuki [National Institute of Radiological Sciences of Japan, Chiba (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan); Tsujii, Hirohiko [National Institute of Radiological Sciences of Japan, Chiba (Japan)

2013-09-01

Purpose: To report the long-term survival and toxicity of a multi-institutional phase 2 study of concurrent chemoradiation therapy (CCRT) for locally advanced cervical cancer in east and southeast Asia. Methods and Materials: Ten institutions from 8 Asian countries participated in the study. Between April 2003 and March 2006, 120 patients (60 with bulky stage IIB and 60 with stage IIIB) were treated with CCRT. Radiation therapy consisted of pelvic external beam radiation therapy and either high-dose-rate or low-dose-rate intracavitary brachytherapy. Five cycles of weekly cisplatin (40 mg/m{sup 2}) were administered during the course of radiation therapy. Treatment results were evaluated by the rates of local control, overall survival, and late toxicities. Results: Median follow-up was 63.7 months, and the follow-up rate at 5 years was 98%. The 5-year local control and overall survival rates for all patients were 76.8% and 55.1%, respectively. The 5-year rates of major late toxicities of the rectum and bladder were 7.9% and 0%, respectively. Conclusions: The long-term results have suggested that CCRT is safe and effective for patients with locally advanced cervical cancer in east and southeast Asia. However, further efforts are needed to improve overall survival.

Integrative invasion science: model systems, multi-site studies, focused meta-analysis, and invasion syndromes

Czech Academy of Sciences Publication Activity Database

Kueffer, C.; Pyšek, Petr; Richardson, D. M.

2013-01-01

Roč. 200, č. 3 (2013), s. 615-633 ISSN 1469-8137 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GA206/09/0563 Institutional support: RVO:67985939 Keywords : model systems * invasion syndromes * multi-site studies Subject RIV: EF - Botanics Impact factor: 6.545, year: 2013

Ventilator-associated pneumonia rates at major trauma centers compared with a national benchmark: a multi-institutional study of the AAST.

Science.gov (United States)

Michetti, Christopher P; Fakhry, Samir M; Ferguson, Pamela L; Cook, Alan; Moore, Forrest O; Gross, Ronald

2012-05-01

Ventilator-associated pneumonia (VAP) rates reported by the National Healthcare Safety Network (NHSN) are used as a benchmark and quality measure, yet different rates are reported from many trauma centers. This multi-institutional study was undertaken to elucidate VAP rates at major trauma centers. VAP rate/1,000 ventilator days, diagnostic methods, institutional, and aggregate patient data were collected retrospectively from a convenience sample of trauma centers for 2008 and 2009 and analyzed with descriptive statistics. At 47 participating Level I and II centers, the pooled mean VAP rate was 17.2 versus 8.1 for NHSN (2006-2008). Hospitals' rates were highly variable (range, 1.8-57.6), with 72.3% being above NHSN's mean. Rates differed based on who determined the rate (trauma service, 27.5; infection control or quality or epidemiology, 11.9; or collaborative effort, 19.9) and the frequency with which VAP was excluded based on aspiration or diagnosis before hospital day 5. In 2008 and 2009, blunt trauma patients had higher VAP rates (17.3 and 17.6, respectively) than penetrating patients (11.0 and 10.9, respectively). More centers used a clinical diagnostic strategy (57%) than a bacteriologic strategy (43%). Patients with VAP had a mean Injury Severity Score of 28.7, mean Intensive Care Unit length of stay of 20.8 days, and a 12.2% mortality rate. 50.5% of VAP patients had a traumatic brain injury. VAP rates at major trauma centers are markedly higher than those reported by NHSN and vary significantly among centers. Available data are insufficient to set benchmarks, because it is questionable whether any one data set is truly representative of most trauma centers. Application of a single benchmark to all centers may be inappropriate, and reliable diagnostic and reporting standards are needed. Prospective analysis of a larger data set is warranted, with attention to injury severity, risk factors specific to trauma patients, diagnostic method used, VAP definitions

Surmounting the unique challenges in health disparities education: a multi-institution qualitative study.

Science.gov (United States)

Carter-Pokras, Olivia; Bereknyei, Sylvia; Lie, Desiree; Braddock, Clarence H

2010-05-01

The National Consortium for Multicultural Education for Health Professionals (Consortium) comprises educators representing 18 US medical schools, funded by the National Institutes of Health. Collective lessons learned from curriculum implementation by principal investigators (PIs) have the potential to guide similar educational endeavors. Describe Consortium PI's self-reported challenges with curricular development, solutions and their new curricular products. Information was collected from PIs over 2 months using a 53-question structured three-part questionnaire. The questionnaire addressed PI demographics, curriculum implementation challenges and solutions, and newly created curricular products. Study participants were 18 Consortium PIs. Descriptive analysis was used for quantitative data. Narrative responses were analyzed and interpreted using qualitative thematic coding. Response rate was 100%. Common barriers and challenges identified by PIs were: finding administrative and leadership support, sustaining the momentum, continued funding, finding curricular space, accessing and engaging communities, and lack of education research methodology skills. Solutions identified included engaging stakeholders, project-sharing across schools, advocacy and active participation in committees and community, and seeking sustainable funding. All Consortium PIs reported new curricular products and extensive dissemination efforts outside their own institutions. The Consortium model has added benefits for curricular innovation and dissemination for cultural competence education to address health disparities. Lessons learned may be applicable to other educational innovation efforts.

Multi-institutional Validation Study of Commercially Available Deformable Image Registration Software for Thoracic Images

International Nuclear Information System (INIS)

Kadoya, Noriyuki; Nakajima, Yujiro; Saito, Masahide; Miyabe, Yuki; Kurooka, Masahiko; Kito, Satoshi; Fujita, Yukio; Sasaki, Motoharu; Arai, Kazuhiro; Tani, Kensuke; Yagi, Masashi; Wakita, Akihisa; Tohyama, Naoki; Jingu, Keiichi

2016-01-01

Purpose: To assess the accuracy of the commercially available deformable image registration (DIR) software for thoracic images at multiple institutions. Methods and Materials: Thoracic 4-dimensional (4D) CT images of 10 patients with esophageal or lung cancer were used. Datasets for these patients were provided by DIR-lab ( (dir-lab.com)) and included a coordinate list of anatomic landmarks (300 bronchial bifurcations) that had been manually identified. Deformable image registration was performed between the peak-inhale and -exhale images. Deformable image registration error was determined by calculating the difference at each landmark point between the displacement calculated by DIR software and that calculated by the landmark. Results: Eleven institutions participated in this study: 4 used RayStation (RaySearch Laboratories, Stockholm, Sweden), 5 used MIM Software (Cleveland, OH), and 3 used Velocity (Varian Medical Systems, Palo Alto, CA). The ranges of the average absolute registration errors over all cases were as follows: 0.48 to 1.51 mm (right-left), 0.53 to 2.86 mm (anterior-posterior), 0.85 to 4.46 mm (superior-inferior), and 1.26 to 6.20 mm (3-dimensional). For each DIR software package, the average 3-dimensional registration error (range) was as follows: RayStation, 3.28 mm (1.26-3.91 mm); MIM Software, 3.29 mm (2.17-3.61 mm); and Velocity, 5.01 mm (4.02-6.20 mm). These results demonstrate that there was moderate variation among institutions, although the DIR software was the same. Conclusions: We evaluated the commercially available DIR software using thoracic 4D-CT images from multiple centers. Our results demonstrated that DIR accuracy differed among institutions because it was dependent on both the DIR software and procedure. Our results could be helpful for establishing prospective clinical trials and for the widespread use of DIR software. In addition, for clinical care, we should try to find the optimal DIR procedure using thoracic 4D

Multi-institutional MicroCT image comparison of image-guided small animal irradiators

Science.gov (United States)

Johnstone, Chris D.; Lindsay, Patricia; E Graves, Edward; Wong, Eugene; Perez, Jessica R.; Poirier, Yannick; Ben-Bouchta, Youssef; Kanesalingam, Thilakshan; Chen, Haijian; E Rubinstein, Ashley; Sheng, Ke; Bazalova-Carter, Magdalena

2017-07-01

To recommend imaging protocols and establish tolerance levels for microCT image quality assurance (QA) performed on conformal image-guided small animal irradiators. A fully automated QA software SAPA (small animal phantom analyzer) for image analysis of the commercial Shelley micro-CT MCTP 610 phantom was developed, in which quantitative analyses of CT number linearity, signal-to-noise ratio (SNR), uniformity and noise, geometric accuracy, spatial resolution by means of modulation transfer function (MTF), and CT contrast were performed. Phantom microCT scans from eleven institutions acquired with four image-guided small animal irradiator units (including the commercial PXi X-RAD SmART and Xstrahl SARRP systems) with varying parameters used for routine small animal imaging were analyzed. Multi-institutional data sets were compared using SAPA, based on which tolerance levels for each QA test were established and imaging protocols for QA were recommended. By analyzing microCT data from 11 institutions, we established image QA tolerance levels for all image quality tests. CT number linearity set to R 2  >  0.990 was acceptable in microCT data acquired at all but three institutions. Acceptable SNR  >  36 and noise levels  1.5 lp mm-1 for MTF  =  0.2) was obtained at all but four institutions due to their large image voxel size used (>0.275 mm). Ten of the eleven institutions passed the set QA tolerance for geometric accuracy (2000 HU for 30 mgI ml-1). We recommend performing imaging QA with 70 kVp, 1.5 mA, 120 s imaging time, 0.20 mm voxel size, and a frame rate of 5 fps for the PXi X-RAD SmART. For the Xstrahl SARRP, we recommend using 60 kVp, 1.0 mA, 240 s imaging time, 0.20 mm voxel size, and 6 fps. These imaging protocols should result in high quality images that pass the set tolerance levels on all systems. Average SAPA computation time for complete QA analysis for a 0.20 mm voxel, 400 slice Shelley phantom microCT data set

Benefits of mock oral examinations in a multi-institutional consortium for board certification in general surgery training.

Science.gov (United States)

Subhas, Gokulakkrishna; Yoo, Stephen; Chang, Yeon-Jeen; Peiper, David; Frikker, Mark J; Bouwman, David L; Silbergleit, Allen; Lloyd, Larry R; Mittal, Vijay K

2009-09-01

The Southeast Michigan Center for Medical Education (SEMCME) is a consortium of teaching hospitals in the Greater Detroit metropolitan area. SEMCME pools its resources for several educational means, including mock oral board examinations. The educational and cost benefits to mock oral examinations on a multi-institutional basis in preparation for the American Board of Surgery (ABS) certifying examination were analyzed. Ten-year multi-institution data from the mock oral examinations were correlated with ABS certifying examination pass rates. Mock oral examination scores were available for 107 of 147 graduates, which included 12 candidates who failed their certifying examination on the first attempt (pass rate = 89%). Four of 31 examinees who had a low score (4.9 or less) in their mock oral exams failed their certifying examination in their first attempt. The cost of running the mock examination was low (approximately $35/resident for 50 residents). When graduates from the last 10 years were surveyed, the majority of respondents believed that the mock oral examination helped in their success and with their preparation for the certifying examination. Thus, the many benefits of administering the examination with the resources of a consortium of hospitals result in the accurate reproduction of real-life testing conditions with reasonable overall costs per resident.

Completion of Chinese overseas acquisitions : Institutional perspectives and evidence

NARCIS (Netherlands)

Zhang, J.; Zhou, C.; Ebbers, H.A.

2011-01-01

This study investigates how institutional factors influence the likelihood that Chinese overseas acquisition deals are completed. We argue that a Chinese firm to succeed in a cross-border acquisition is an outcome of the multi-level institutional contingencies. Using a data set containing 1324

Literature Review of Enterprise Systems Research Using Institutional Theory: Towards a Conceptual Model

DEFF Research Database (Denmark)

Svejvig, Per

This paper sets out to examine the use of institutional theory as a conceptually rich lens to study social issues of enterprise systems (ES) research. More precisely, the purpose is to categorize current ES research using institutional theory to develop a conceptual model that advances ES research...... model which advocates for multi-level and multi-theory approaches, and applies newer institutional aspects such as institutional logics. The findings show that institutional theory in ES research is in its infancy and adopts mainly traditional institutional aspects like isomorphism....... Key institutional features are presented such as isomorphism, rationalized myths, bridging macro and micro structures, and institutional logics and their implications for ES research are discussed. Through a literature review of 180 articles, of which 18 papers are selected, we build a conceptual...

Matched-pair analysis of a multi-institutional cohort reveals that epidermal growth factor receptor mutation is not a risk factor for postoperative recurrence of lung adenocarcinoma.

Science.gov (United States)

Matsumura, Yuki; Suzuki, Hiroyuki; Ohira, Tetsuya; Shiono, Satoshi; Abe, Jiro; Sagawa, Motoyasu; Sakurada, Akira; Katahira, Masato; Machida, Yuichiro; Takahashi, Satomi; Okada, Yoshinori

2017-12-01

It is unclear whether epidermal growth factor receptor (EGFR) mutation status is a risk factor for postoperative recurrence of surgically resected lung adenocarcinoma (ADC). Therefore, we conducted a multi-institutional study employing matched-pair analysis to compare recurrence-free survival (RFS) and overall survival (OS) of patients with lung ADC according to EGFR mutation status. We collected the records of 909 patients who underwent surgical resection for lung ADC between 2005 and 2012 at five participating institutions and were also examined their EGFR mutation status. For each patient with an EGFR mutation, we selected one with the wild-type EGFR sequence and matched them according to institution, age, gender, smoking history, pathological stage (pStage), and adjuvant treatment. We compared RFS and OS of the matched cohort. The patients were allocated into groups (n=181 each) with mutated or wild-type EGFR sequences. Both cohorts had identical characteristics as follows: institution, median age (68 years), men (85, 47%), ever smokers (77, 43%), and pStage (IA, 108, 60%; IB, 48, 27%; II, 14, 8%; III, 11, 6%). The 3- and 5-year RFS rates of patients with mutated or wild-type EGFR sequence were 79%, 68% and 77%, 68%, respectively (p=0.557). The respective OS rates were 92%, 81%, and 89%, 79% (p=0.574). Matched-pair and multi-institutional analysis reveals that an EGFR mutation was not a significant risk factor for recurrence of patients with surgically resected lung adenocarcinoma. Copyright © 2017 Elsevier B.V. All rights reserved.

Performance Assessment Institute-NV

Energy Technology Data Exchange (ETDEWEB)

Lombardo, Joesph [Univ. of Nevada, Las Vegas, NV (United States)

2012-12-31

The National Supercomputing Center for Energy and the Environment’s intention is to purchase a multi-purpose computer cluster in support of the Performance Assessment Institute (PA Institute). The PA Institute will serve as a research consortium located in Las Vegas Nevada with membership that includes: national laboratories, universities, industry partners, and domestic and international governments. This center will provide a one-of-a-kind centralized facility for the accumulation of information for use by Institutions of Higher Learning, the U.S. Government, and Regulatory Agencies and approved users. This initiative will enhance and extend High Performance Computing (HPC) resources in Nevada to support critical national and international needs in "scientific confirmation". The PA Institute will be promoted as the leading Modeling, Learning and Research Center worldwide. The program proposes to utilize the existing supercomputing capabilities and alliances of the University of Nevada Las Vegas as a base, and to extend these resource and capabilities through a collaborative relationship with its membership. The PA Institute will provide an academic setting for interactive sharing, learning, mentoring and monitoring of multi-disciplinary performance assessment and performance confirmation information. The role of the PA Institute is to facilitate research, knowledge-increase, and knowledge-sharing among users.

Multi-institutional Feasibility Study of a Fast Patient Localization Method in Total Marrow Irradiation With Helical Tomotherapy: A Global Health Initiative by the International Consortium of Total Marrow Irradiation

International Nuclear Information System (INIS)

Takahashi, Yutaka; Vagge, Stefano; Agostinelli, Stefano; Han, Eunyoung; Matulewicz, Lukasz; Schubert, Kai; Chityala, Ravishankar; Ratanatharathorn, Vaneerat; Tournel, Koen; Penagaricano, Jose A.; Florian, Sterzing; Mahe, Marc-Andre; Verneris, Michael R.; Weisdorf, Daniel J.

2015-01-01

Purpose: To develop, characterize, and implement a fast patient localization method for total marrow irradiation. Methods and Materials: Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo). We also generated kilovoltage topograms (kVtopo) from the projection data of 3-dimensional CT images to reproduce the same geometry as helical tomotherapy. The MVtopo imaging dose and the optimal image acquisition parameters were investigated. A multi-institutional phantom study was performed to verify the image registration uncertainty. Forty-five MVtopo images were acquired and analyzed with in-house image registration software. Results: The smallest jaw size (front and backup jaws of 0) provided the best image contrast and longitudinal resolution. Couch velocity did not affect the image quality or geometric accuracy. The MVtopo dose was less than the MVCT dose. The image registration uncertainty from the multi-institutional study was within 2.8 mm. In patient localization, the differences in calculated couch shift between the registration with MVtopo-kVtopo and MVCT-kVCT images in lateral, cranial–caudal, and vertical directions were 2.2 ± 1.7 mm, 2.6 ± 1.4 mm, and 2.7 ± 1.1 mm, respectively. The imaging time in MVtopo acquisition at the couch speed of 3 cm/s was <1 minute, compared with ≥15 minutes in MVCT for all patients. Conclusion: Whole-body MVtopo imaging could be an effective alternative to time-consuming MVCT for total marrow irradiation patient localization

SU-E-T-49: A Multi-Institutional Study of Independent Dose Verification for IMRT

International Nuclear Information System (INIS)

Baba, H; Tachibana, H; Kamima, T; Takahashi, R; Kawai, D; Sugawara, Y; Yamamoto, T; Sato, A; Yamashita, M

2015-01-01

Purpose: AAPM TG114 does not cover the independent verification for IMRT. We conducted a study of independent dose verification for IMRT in seven institutes to show the feasibility. Methods: 384 IMRT plans in the sites of prostate and head and neck (HN) were collected from the institutes, where the planning was performed using Eclipse and Pinnacle3 with the two techniques of step and shoot (S&S) and sliding window (SW). All of the institutes used a same independent dose verification software program (Simple MU Analysis: SMU, Triangle Product, Ishikawa, JP), which is Clarkson-based and CT images were used to compute radiological path length. An ion-chamber measurement in a water-equivalent slab phantom was performed to compare the doses computed using the TPS and an independent dose verification program. Additionally, the agreement in dose computed in patient CT images between using the TPS and using the SMU was assessed. The dose of the composite beams in the plan was evaluated. Results: The agreement between the measurement and the SMU were −2.3±1.9 % and −5.6±3.6 % for prostate and HN sites, respectively. The agreement between the TPSs and the SMU were −2.1±1.9 % and −3.0±3.7 for prostate and HN sites, respectively. There was a negative systematic difference with similar standard deviation and the difference was larger in the HN site. The S&S technique showed a statistically significant difference between the SW. Because the Clarkson-based method in the independent program underestimated (cannot consider) the dose under the MLC. Conclusion: The accuracy would be improved when the Clarkson-based algorithm should be modified for IMRT and the tolerance level would be within 5%

"Less Clicking, More Watching": Results from the User-Centered Design of a Multi-Institutional Web Site for Art and Culture.

Science.gov (United States)

Vergo, John; Karat, Clare-Marie; Karat, John; Pinhanez, Claudio; Arora, Renee; Cofino, Thomas; Riecken, Doug; Podlaseck, Mark

This paper summarizes a 10-month long research project conducted at the IBM T.J. Watson Research Center aimed at developing the design concept of a multi-institutional art and culture web site. The work followed a user-centered design (UCD) approach, where interaction with prototypes and feedback from potential users of the web site were sought…

Diffusion trajectory of self-propagating innovations interacting with institutions-incorporation of multi-factors learning function to model PV diffusion in Japan

International Nuclear Information System (INIS)

Nagamatsu, Akira; Watanabe, Chihiro; Shum, Kwok L.

2006-01-01

This paper first proposes a modeling framework to study diffusion of innovations which exhibit strong interaction with the institution systems across which they diffuse. A unique character of such generic innovation is that specific applications are continually developed during its diffusion. This self-propagation in continual applications generation, which is dependent upon the cumulative installed base of the technological innovation, can be modeled to lead to a dynamic changing carrying capacity in an otherwise simple logistic diffusion curve. The cumulative installed base is dependent upon the price of technology and the cost learning dynamics. This paper utilizes a multi-factors learning function to represent such learning dynamics. Empirical estimates from our model are compared with those from other logistics curve formulations and are shown to better fit the annual PV production data during the past quarter century in the case of Japan. The very fact that the potential of this class of innovation can be leveraged only if it interacts closely with the institution highlights the importance of institutional determinants of adoption and diffusion of such innovations like PV. We therefore attempt to put forward an institutional framework, based on viewing PV as a technology platform, to consider PV diffusion beyond mathematical and empirical modeling. Some future research directions are also proposed. (author)

TTI Phase 2 Institutional Support: Institute for Policy Analysis and ...

International Development Research Centre (IDRC) Digital Library (Canada)

... and Research's (IPAR-Rwanda) role as a credible public policy institution in ... TTI is a multi-funder program dedicated to strengthening independent policy ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

Multi-institutional validation of a novel textural analysis tool for preoperative stratification of suspected thyroid tumors on diffusion-weighted MRI.

Science.gov (United States)

Brown, Anna M; Nagala, Sidhartha; McLean, Mary A; Lu, Yonggang; Scoffings, Daniel; Apte, Aditya; Gonen, Mithat; Stambuk, Hilda E; Shaha, Ashok R; Tuttle, R Michael; Deasy, Joseph O; Priest, Andrew N; Jani, Piyush; Shukla-Dave, Amita; Griffiths, John

2016-04-01

Ultrasound-guided fine needle aspirate cytology fails to diagnose many malignant thyroid nodules; consequently, patients may undergo diagnostic lobectomy. This study assessed whether textural analysis (TA) could noninvasively stratify thyroid nodules accurately using diffusion-weighted MRI (DW-MRI). This multi-institutional study examined 3T DW-MRI images obtained with spin echo echo planar imaging sequences. The training data set included 26 patients from Cambridge, United Kingdom, and the test data set included 18 thyroid cancer patients from Memorial Sloan Kettering Cancer Center (New York, New York, USA). Apparent diffusion coefficients (ADCs) were compared over regions of interest (ROIs) defined on thyroid nodules. TA, linear discriminant analysis (LDA), and feature reduction were performed using the 21 MaZda-generated texture parameters that best distinguished benign and malignant ROIs. Training data set mean ADC values were significantly different for benign and malignant nodules (P = 0.02) with a sensitivity and specificity of 70% and 63%, respectively, and a receiver operator characteristic (ROC) area under the curve (AUC) of 0.73. The LDA model of the top 21 textural features correctly classified 89/94 DW-MRI ROIs with 92% sensitivity, 96% specificity, and an AUC of 0.97. This algorithm correctly classified 16/18 (89%) patients in the independently obtained test set of thyroid DW-MRI scans. TA classifies thyroid nodules with high sensitivity and specificity on multi-institutional DW-MRI data sets. This method requires further validation in a larger prospective study. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

Mainstreaming Multi-Risk Approaches into Policy

Directory of Open Access Journals (Sweden)

Anna Scolobig

2017-12-01

Full Text Available Multi-risk environments are characterized by domino effects that often amplify the overall risk. Those include chains of hazardous events and increasing vulnerability, among other types of correlations within the risk process. The recently developed methods for multi-hazard and risk assessment integrate interactions between different risks by using harmonized procedures based on common metrics. While the products of these assessments, such as multi-hazard and -risk indexes, maps, cascade scenarios, or warning systems provide innovative and effective information, they also pose specific challenges to policy makers and practitioners due to their novel cross-disciplinary aspects. In this paper we discuss the institutional barriers to the adoption of multi-risk approaches, summarizing the results of the fieldwork conducted in Italy and Guadeloupe and of workshops with disaster risk reduction practitioners from eleven European countries. Results show the need for a clear identification of responsibilities for the implementation of multi-risk approaches, as institutional frameworks for risk reduction remain to this day primarily single-risk centered. Authorities are rarely officially responsible for the management of domino effects between e.g., tsunamis and industrial accidents, earthquake and landslides, floods and electricity network failures. Other barriers for the implementation of multi-risk approaches include the limited measures to reduce exposure at the household level, inadequate financial capacities at the local level and limited public-private partnerships, especially in case of interactions between natural and industrial risks. Adapting the scale of institutions to that of multi-risk environments remains a major challenge to better mainstream multi-risk approaches into policy. To address it, we propose a multi-risk governance framework, which includes the phases of observation, social and institutional context analysis, generation of

A Study on Predictor Variables of Organizational Climate in Educational Institutes

Directory of Open Access Journals (Sweden)

Gudivada Venkat Rao

2014-12-01

Full Text Available The Organization Climate is a fancied term which is relevant at any point of time and is transient. The contextual reference of Organizational Climate is made for its ability to attract, retain and nurture talent. But, even though higher education in India is important; it failed to attract the best talent. The Organizational Climate and its contents were subjected to further scrutiny in this paper in Institutes of Higher Education in Visakhapatnam. The study examines the profile factors and their influence on the components of Organizational Climate. Further, the intra and inter relationships were also tested. The results show direction to the practioners for improving the significant influencing factors. The sample of 150 faculty members was drawn from five Institutes of Higher Education in Visakhapatnam. The human resources practices relating to Working Conditions, Job Design, Performance Management, Compensation, Relations, Communications, Training and Development, Objectivity and Rationality, Grievance Handling and Welfare were considered for estimating the organizational climate. The multi-regression and mean analysis find organizational climate as moderate. The gender diversity and female influence were there in the Educational Institutes. However, Compensation has a very low mean. The Performance Management, Objectivity & Rationality and Relations were found to be the major influencers.

Multi-Province Listeriosis Outbreak Linked to Contaminated Deli Meat Consumed Primarily in Institutional Settings, Canada, 2008.

Science.gov (United States)

Currie, Andrea; Farber, Jeffrey M; Nadon, Céline; Sharma, Davendra; Whitfield, Yvonne; Gaulin, Colette; Galanis, Eleni; Bekal, Sadjia; Flint, James; Tschetter, Lorelee; Pagotto, Franco; Lee, Brenda; Jamieson, Fred; Badiani, Tina; MacDonald, Diane; Ellis, Andrea; May-Hadford, Jennifer; McCormick, Rachel; Savelli, Carmen; Middleton, Dean; Allen, Vanessa; Tremblay, Francois-William; MacDougall, Laura; Hoang, Linda; Shyng, Sion; Everett, Doug; Chui, Linda; Louie, Marie; Bangura, Helen; Levett, Paul N; Wilkinson, Krista; Wylie, John; Reid, Janet; Major, Brian; Engel, Dave; Douey, Donna; Huszczynski, George; Di Lecci, Joe; Strazds, Judy; Rousseau, Josée; Ma, Kenneth; Isaac, Leah; Sierpinska, Urszula

2015-08-01

A multi-province outbreak of listeriosis occurred in Canada from June to November 2008. Fifty-seven persons were infected with 1 of 3 similar outbreak strains defined by pulsed-field gel electrophoresis, and 24 (42%) individuals died. Forty-one (72%) of 57 individuals were residents of long-term care facilities or hospital inpatients during their exposure period. Descriptive epidemiology, product traceback, and detection of the outbreak strains of Listeria monocytogenes in food samples and the plant environment confirmed delicatessen meat manufactured by one establishment and purchased primarily by institutions was the source of the outbreak. The food safety investigation identified a plant environment conducive to the introduction and proliferation of L. monocytogenes and persistently contaminated with Listeria spp. This outbreak demonstrated the need for improved listeriosis surveillance, strict control of L. monocytogenes in establishments producing ready-to-eat foods, and advice to vulnerable populations and institutions serving these populations regarding which high-risk foods to avoid.

Audiovisual biofeedback breathing guidance for lung cancer patients receiving radiotherapy: a multi-institutional phase II randomised clinical trial.

Science.gov (United States)

Pollock, Sean; O'Brien, Ricky; Makhija, Kuldeep; Hegi-Johnson, Fiona; Ludbrook, Jane; Rezo, Angela; Tse, Regina; Eade, Thomas; Yeghiaian-Alvandi, Roland; Gebski, Val; Keall, Paul J

2015-07-18

There is a clear link between irregular breathing and errors in medical imaging and radiation treatment. The audiovisual biofeedback system is an advanced form of respiratory guidance that has previously demonstrated to facilitate regular patient breathing. The clinical benefits of audiovisual biofeedback will be investigated in an upcoming multi-institutional, randomised, and stratified clinical trial recruiting a total of 75 lung cancer patients undergoing radiation therapy. To comprehensively perform a clinical evaluation of the audiovisual biofeedback system, a multi-institutional study will be performed. Our methodological framework will be based on the widely used Technology Acceptance Model, which gives qualitative scales for two specific variables, perceived usefulness and perceived ease of use, which are fundamental determinants for user acceptance. A total of 75 lung cancer patients will be recruited across seven radiation oncology departments across Australia. Patients will be randomised in a 2:1 ratio, with 2/3 of the patients being recruited into the intervention arm and 1/3 in the control arm. 2:1 randomisation is appropriate as within the interventional arm there is a screening procedure where only patients whose breathing is more regular with audiovisual biofeedback will continue to use this system for their imaging and treatment procedures. Patients within the intervention arm whose free breathing is more regular than audiovisual biofeedback in the screen procedure will remain in the intervention arm of the study but their imaging and treatment procedures will be performed without audiovisual biofeedback. Patients will also be stratified by treating institution and for treatment intent (palliative vs. radical) to ensure similar balance in the arms across the sites. Patients and hospital staff operating the audiovisual biofeedback system will complete questionnaires to assess their experience with audiovisual biofeedback. The objectives of this

Audiovisual biofeedback breathing guidance for lung cancer patients receiving radiotherapy: a multi-institutional phase II randomised clinical trial

International Nuclear Information System (INIS)

Pollock, Sean; O’Brien, Ricky; Makhija, Kuldeep; Hegi-Johnson, Fiona; Ludbrook, Jane; Rezo, Angela; Tse, Regina; Eade, Thomas; Yeghiaian-Alvandi, Roland; Gebski, Val; Keall, Paul J

2015-01-01

There is a clear link between irregular breathing and errors in medical imaging and radiation treatment. The audiovisual biofeedback system is an advanced form of respiratory guidance that has previously demonstrated to facilitate regular patient breathing. The clinical benefits of audiovisual biofeedback will be investigated in an upcoming multi-institutional, randomised, and stratified clinical trial recruiting a total of 75 lung cancer patients undergoing radiation therapy. To comprehensively perform a clinical evaluation of the audiovisual biofeedback system, a multi-institutional study will be performed. Our methodological framework will be based on the widely used Technology Acceptance Model, which gives qualitative scales for two specific variables, perceived usefulness and perceived ease of use, which are fundamental determinants for user acceptance. A total of 75 lung cancer patients will be recruited across seven radiation oncology departments across Australia. Patients will be randomised in a 2:1 ratio, with 2/3 of the patients being recruited into the intervention arm and 1/3 in the control arm. 2:1 randomisation is appropriate as within the interventional arm there is a screening procedure where only patients whose breathing is more regular with audiovisual biofeedback will continue to use this system for their imaging and treatment procedures. Patients within the intervention arm whose free breathing is more regular than audiovisual biofeedback in the screen procedure will remain in the intervention arm of the study but their imaging and treatment procedures will be performed without audiovisual biofeedback. Patients will also be stratified by treating institution and for treatment intent (palliative vs. radical) to ensure similar balance in the arms across the sites. Patients and hospital staff operating the audiovisual biofeedback system will complete questionnaires to assess their experience with audiovisual biofeedback. The objectives of this

The nitrogen footprint tool network: a multi-institution program ...

Science.gov (United States)

Anthropogenic sources of reactive nitrogen have local and global impacts on air and water quality and detrimental effects on human and ecosystem health. This paper uses the nitrogen footprint tool (NFT) to determine the amount of nitrogen (N) released as a result of institutional consumption. The sectors accounted for include food (consumption and the upstream production), energy, transportation, fertilizer, research animals, and agricultural research. The NFT is then used for scenario analysis to manage and track reductions to institution N footprints, which are driven by the consumption behaviors of both the institution itself and its constituent individuals. In this paper, the first seven institution N footprint results are presented. The institution NFT network aims to develop footprints for many institutions to encourage widespread upper-level management strategies that will create significant reductions in reactive N released to the environment. Energy use and food purchases are the two largest contributors to institution N footprints. Ongoing efforts by institutions to reduce greenhouse gas emissions also help to reduce the N footprint, but the impact of food production on N pollution has not been directly addressed by the higher-ed sustainability community. The NFT Network found that institutions could reduce their N footprints by optimizing food purchasing to reduce consumption of animal products and minimize food waste, as well as reducing dependence o

A Multi-institutional Comparison of Adrenal Venous Sampling in Patients with Primary Aldosteronism: Caution Advised if Successful Bilateral Adrenal Vein Sampling is Not Achieved.

Science.gov (United States)

Wang, Tracy S; Kline, Greg; Yen, Tina W; Yin, Ziyan; Liu, Ying; Rilling, William; So, Benny; Findling, James W; Evans, Douglas B; Pasieka, Janice L

2018-02-01

In patients with primary aldosteronism (PA), adrenal venous sampling (AVS) is recommended to differentiate between unilateral (UNI) or bilateral (BIL) adrenal disease. A recent study suggested that lateralization could be predicted, based on the ratio of aldosterone/cortisol levels (A/C) between the left adrenal vein (LAV) and inferior vena cava (IVC), with a 100% positive predictive value (PPV). This study aimed to validate those findings utilizing a larger, multi-institutional cohort. A retrospective review was performed of patients with PA who underwent AVS from 2 tertiary-care institutions. Laterality was predicted by an A/C ratio of >3:1 between the dominant and non-dominant adrenal. AVS results were compared to LAV/IVC ratios utilizing the published criteria (Lt ≥ 5.5; Rt ≤ 0.5). Of 222 patients, 124 (57%) had UNI and 98 (43%) had BIL disease based on AVS. AVS and LAV/IVC findings were concordant for laterality in 141 (64%) patients (69 UNI, 72 BIL). Using only the LAV/IVC ratio, 54 (24%) patients with UNI disease on AVS who underwent successful surgery would have been assumed to have BAH unless AVS was repeated, and 24 (11%) patients with BIL disease on AVS may have been incorrectly offered surgery (PPV 70%). Based on median LAV/IVC ratios (left 5.26; right 0.31; BIL 2.84), no LAV/IVC ratio accurately predicted laterality. This multi-institutional study of patients with both UNI and BIL PA failed to validate the previously reported PPV of LAV/IVC ratio for lateralization. Caution should be used in interpreting incomplete AVS data to differentiate between UNI versus BIL disease and strong consideration given to repeat AVS prior to adrenalectomy.

Information extraction from multi-institutional radiology reports.

Science.gov (United States)

Hassanpour, Saeed; Langlotz, Curtis P

2016-01-01

The radiology report is the most important source of clinical imaging information. It documents critical information about the patient's health and the radiologist's interpretation of medical findings. It also communicates information to the referring physicians and records that information for future clinical and research use. Although efforts to structure some radiology report information through predefined templates are beginning to bear fruit, a large portion of radiology report information is entered in free text. The free text format is a major obstacle for rapid extraction and subsequent use of information by clinicians, researchers, and healthcare information systems. This difficulty is due to the ambiguity and subtlety of natural language, complexity of described images, and variations among different radiologists and healthcare organizations. As a result, radiology reports are used only once by the clinician who ordered the study and rarely are used again for research and data mining. In this work, machine learning techniques and a large multi-institutional radiology report repository are used to extract the semantics of the radiology report and overcome the barriers to the re-use of radiology report information in clinical research and other healthcare applications. We describe a machine learning system to annotate radiology reports and extract report contents according to an information model. This information model covers the majority of clinically significant contents in radiology reports and is applicable to a wide variety of radiology study types. Our automated approach uses discriminative sequence classifiers for named-entity recognition to extract and organize clinically significant terms and phrases consistent with the information model. We evaluated our information extraction system on 150 radiology reports from three major healthcare organizations and compared its results to a commonly used non-machine learning information extraction method. We

Nuclear grade and necrosis predict prognosis in malignant epithelioid pleural mesothelioma: a multi-institutional study.

Science.gov (United States)

Rosen, Lauren E; Karrison, Theodore; Ananthanarayanan, Vijayalakshmi; Gallan, Alexander J; Adusumilli, Prasad S; Alchami, Fouad S; Attanoos, Richard; Brcic, Luka; Butnor, Kelly J; Galateau-Sallé, Françoise; Hiroshima, Kenzo; Kadota, Kyuichi; Klampatsa, Astero; Stang, Nolween Le; Lindenmann, Joerg; Litzky, Leslie A; Marchevsky, Alberto; Medeiros, Filomena; Montero, M Angeles; Moore, David A; Nabeshima, Kazuki; Pavlisko, Elizabeth N; Roggli, Victor L; Sauter, Jennifer L; Sharma, Anupama; Sheaff, Michael; Travis, William D; Vigneswaran, Wickii T; Vrugt, Bart; Walts, Ann E; Tjota, Melissa Y; Krausz, Thomas; Husain, Aliya N

2018-04-01

A recently described nuclear grading system predicted survival in patients with epithelioid malignant pleural mesothelioma. The current study was undertaken to validate the grading system and to identify additional prognostic factors. We analyzed cases of epithelioid malignant pleural mesothelioma from 17 institutions across the globe from 1998 to 2014. Nuclear grade was computed combining nuclear atypia and mitotic count into a grade of I-III using the published system. Nuclear grade was assessed by one pathologist for three institutions, the remaining were scored independently. The presence or absence of necrosis and predominant growth pattern were also evaluated. Two additional scoring systems were evaluated, one combining nuclear grade and necrosis and the other mitotic count and necrosis. Median overall survival was the primary endpoint. A total of 776 cases were identified including 301 (39%) nuclear grade I tumors, 354 (45%) grade II tumors and 121 (16%) grade III tumors. The overall survival was 16 months, and correlated independently with age (P=0.006), sex (0.015), necrosis (0.030), mitotic count (0.001), nuclear atypia (0.009), nuclear grade (<0.0001), and mitosis and necrosis score (<0.0001). The addition of necrosis to nuclear grade further stratified overall survival, allowing classification of epithelioid malignant pleural mesothelioma into four distinct prognostic groups: nuclear grade I tumors without necrosis (29 months), nuclear grade I tumors with necrosis and grade II tumors without necrosis (16 months), nuclear grade II tumors with necrosis (10 months) and nuclear grade III tumors (8 months). The mitosis-necrosis score stratified patients by survival, but not as well as the combination of necrosis and nuclear grade. This study confirms that nuclear grade predicts survival in epithelioid malignant pleural mesothelioma, identifies necrosis as factor that further stratifies overall survival, and validates the grading system across multiple

MO-G-201-01: A Multi-Institutional Study Investigating the Performance of a Knowledge-Based Planning System Against Pinnacle Auto-Planning Engine in SIB-IMRT for the Head-And-Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Wu, B; Pang, D [Georgetown University Hospital, Washington, DC (United States); Kusters, M; Kunze-busch, M; Dijkema, T [Radboud University Medical Center, Nijmegen (Netherlands); McNutt, T [Johns Hopkins University, Baltimore, MD (United States); Sanguineti, G [Istituto Nazionale Tumori Regina Elena, Roma (Italy)

2016-06-15

Purpose: Knowledge-based Planning (KBP) founded on prior planning experience and Auto-Planning Engine (APE; commercialized in Pinnacle v9.10 TPS) based on progressive optimization algorithm both aim to eliminate the trial-and-error process in radiotherapy inverse planning. This study investigates the performance of the approaches in a multi-institutional setting to evaluate their functionalities in oropharyngeal cancer and offers suggestions how they can be implemented in the clinic. Methods: Radboud University Medical Center (RUMC) provided 35 oropharyngeal cancer patients (SIB-IMRT with two-dose-level prescription: 68 Gy to PTV68 and 50.3 Gy to PTV50.3) with corresponding comparative APE plans. Johns Hopkins University (JHU) contributed to a three-dose-level (70 Gy 63 Gy and 58.1 Gy) plan library for RUMC’s patient KBP generation. MedStar Georgetown University Hospital (MGUH) contributed to a KBP approach employing overlap-volume histogram (OVH-KBP) for generating RUMC’s patient KBP plans using JHU’s plan library. Since both approaches need their own user-defined parameters as initial inputs the first 10 patients were set aside as training set to finalize them. Meanwhile cross-institutional comparisons and adjustments were implemented for investigating institutions’ protocol discrepancies and the approaches’ user-defined parameters were updated accordingly. The finalized parameters were then applied to the remaining 25 patients for OVH-KBP and APE generation. A Wilcoxon rank-sum test was used for statistical comparison with significance level of p<0.05. Results: On average PTV68’s V95 was 96.5% in APE plans vs. 97% in OVH-KBP plans (p=0.36); PTV50.3’s V95 in APE plans was 97.8% vs.97.6% in OVH-KBP plans (p=0.6); cord’s D0.1 cc was 38.6 Gy in OVH-KBP plans vs. 43.7 Gy in APE plans (p=0.0001); mean doses to larynxes oral cavities parotids and submandibular glands were similar with p>0.2. Conclusions: The study demonstrates that KBP and APE can

A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogeneous clinical data

Science.gov (United States)

Sittig, Dean F.; Hazlehurst, Brian L.; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B.

2012-01-01

Comparative Effectiveness Research (CER) has the potential to transform the current healthcare delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for inter-institutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast six, large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, socio-technical model of health information technology use to help guide our work. We identified six generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions. PMID:22692259

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

International Nuclear Information System (INIS)

Yamazaki, Hideya; Ogita, Mikio; Kodani, Naohiro; Nakamura, Satoakai; Inoue, Hiroshi; Himei, Kengo; Kotsuma, Tadayuki; Yoshida, Ken; Yoshioka, Yasuo; Yamashita, Koichi; Udono, Hiroki

2013-01-01

Purpose: Re-irradiation has attracted attention as a potential therapy for recurrent head and neck tumors. However, carotid blowout syndrome (CBS) has become a serious complication of re-irradiation because of the associated life-threatening toxicity. Determining of the characteristics of CBS is important. We conducted a multi-institutional study. Methods and patients: Head and neck carcinoma patients (n = 381) were treated with 484 re-irradiation sessions at 7 Japanese CyberKnife institutions between 2000 and 2010. Results: Of these, 32 (8.4%) developed CBS, which proved fatal that median survival time after CBS onset was 0.1 month, and the 1-year survival rate was 37.5%. The median duration between re-irradiation and CBS onset was 5 months (range, 0–69 months). Elder age, skin invasion, and necrosis/infection were identified as statistically significant risk factors after CBS by univariate analysis. The presence of skin invasion at the time of treatment found only in postoperative case, is identified as only statistically significant prognostic factor after CBS in multivariate analysis. The 1-year survival rate for the group without skin invasion was 42%, whereas no patient with skin invasion survived more than 4 months (0% at 1 year, p = 0.0049). Conclusions: Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion at CBS onset is ominous sign of lethal consequences

Salvage radical prostatectomy for radiation-recurrent prostate cancer: a multi-institutional collaboration.

Science.gov (United States)

Chade, Daher C; Shariat, Shahrokh F; Cronin, Angel M; Savage, Caroline J; Karnes, R Jeffrey; Blute, Michael L; Briganti, Alberto; Montorsi, Francesco; van der Poel, Henk G; Van Poppel, Hendrik; Joniau, Steven; Godoy, Guilherme; Hurtado-Coll, Antonio; Gleave, Martin E; Dall'Oglio, Marcos; Srougi, Miguel; Scardino, Peter T; Eastham, James A

2011-08-01

Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Open SRP. BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥ 0.1 or ≥ 0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31-43), 77% (95% CI, 71-82), and 83% (95% CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p 75% of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Radiogenomics of High-Grade Serous Ovarian Cancer: Multireader Multi-Institutional Study from the Cancer Genome Atlas Ovarian Cancer Imaging Research Group.

Science.gov (United States)

Vargas, Hebert Alberto; Huang, Erich P; Lakhman, Yulia; Ippolito, Joseph E; Bhosale, Priya; Mellnick, Vincent; Shinagare, Atul B; Anello, Maria; Kirby, Justin; Fevrier-Sullivan, Brenda; Freymann, John; Jaffe, C Carl; Sala, Evis

2017-11-01

Purpose To evaluate interradiologist agreement on assessments of computed tomography (CT) imaging features of high-grade serous ovarian cancer (HGSOC), to assess their associations with time-to-disease progression (TTP) and HGSOC transcriptomic profiles (Classification of Ovarian Cancer [CLOVAR]), and to develop an imaging-based risk score system to predict TTP and CLOVAR profiles. Materials and Methods This study was a multireader, multi-institutional, institutional review board-approved, HIPAA-compliant retrospective analysis of 92 patients with HGSOC (median age, 61 years) with abdominopelvic CT before primary cytoreductive surgery available through the Cancer Imaging Archive. Eight radiologists from the Cancer Genome Atlas Ovarian Cancer Imaging Research Group developed and independently recorded the following CT features: characteristics of primary ovarian mass(es), presence of definable mesenteric implants and infiltration, presence of other implants, presence and distribution of peritoneal spread, presence and size of pleural effusions and ascites, lymphadenopathy, and distant metastases. Interobserver agreement for CT features was assessed, as were univariate and multivariate associations with TTP and CLOVAR mesenchymal profile (worst prognosis). Results Interobserver agreement for some features was strong (eg, α = .78 for pleural effusion and ascites) but was lower for others (eg, α = .08 for intraparenchymal splenic metastases). Presence of peritoneal disease in the right upper quadrant (P = .0003), supradiaphragmatic lymphadenopathy (P = .0004), more peritoneal disease sites (P = .0006), and nonvisualization of a discrete ovarian mass (P = .0037) were associated with shorter TTP. More peritoneal disease sites (P = .0025) and presence of pouch of Douglas implants (P = .0045) were associated with CLOVAR mesenchymal profile. Combinations of imaging features contained predictive signal for TTP (concordance index = 0.658; P = .0006) and CLOVAR profile (mean

Multi-proxy studies in palaeolimnology

OpenAIRE

Birks, Hilary H.; Birks, Harry John Betteley

2006-01-01

Multi-proxy studies are becoming increasingly common in palaeolimnology. Eight basic requirements and challenges for a multi-proxy study are outlined in this essay – definition of research questions, leadership, site selection and coring, data storage, chronology, presentation of results, numerical tools, and data interpretation. The nature of proxy data is discussed in terms of physical proxies and biotic proxies. Loss-on-ignition changes and the use of transfer functions are reviewed as exa...

Progression-free Survival Following Stereotactic Body Radiotherapy for Oligometastatic Prostate Cancer Treatment-naive Recurrence: A Multi-institutional Analysis.

Science.gov (United States)

Ost, Piet; Jereczek-Fossa, Barbara Alicja; As, Nicholas Van; Zilli, Thomas; Muacevic, Alexander; Olivier, Kenneth; Henderson, Daniel; Casamassima, Franco; Orecchia, Roberto; Surgo, Alessia; Brown, Lindsay; Tree, Alison; Miralbell, Raymond; De Meerleer, Gert

2016-01-01

The literature on metastasis-directed therapy for oligometastatic prostate cancer (PCa) recurrence consists of small heterogeneous studies. This study aimed to reduce the heterogeneity by pooling individual patient data from different institutions treating oligometastatic PCa recurrence with stereotactic body radiotherapy (SBRT). We focussed on patients who were treatment naive, with the aim of determining if SBRT could delay disease progression. We included patients with three or fewer metastases. The Kaplan-Meier method was used to estimate distant progression-free survival (DPFS) and local progression-free survival (LPFS). Toxicity was scored using the Common Terminology Criteria for Adverse Events. In total, 163 metastases were treated in 119 patients. The median DPFS was 21 mo (95% confidence interval, 15-26 mo). A lower radiotherapy dose predicted a higher local recurrence rate with a 3-yr LPFS of 79% for patients treated with a biologically effective dose ≤100Gy versus 99% for patients treated with >100Gy (p=0.01). Seventeen patients (14%) developed toxicity classified as grade 1, and three patients (3%) developed grade 2 toxicity. No grade ≥3 toxicity occurred. These results should serve as a benchmark for future prospective trials. This multi-institutional study pools all of the available data on the use of stereotactic body radiotherapy for limited prostate cancer metastases. We concluded that this approach is safe and associated with a prolonged treatment progression-free survival. Copyright © 2015. Published by Elsevier B.V.

Institutional Profiles: Some Strategic Tools

Directory of Open Access Journals (Sweden)

Frans van Vught

2014-04-01

Full Text Available In this paper we argue that both internal and external pressures and conditions urge contemporary higher education institutions to carefully think through their institutional profiles positions in domestic and global higher education contexts. We subsequently analyse strategic positioning from the strategic management literature and offer four tools — mapping, multi-dimensional ranking, benchmarking and degree profiling — to assist higher education institutions in their profiling and positioning strategies.

Enhancing Comparative Effectiveness Research With Automated Pediatric Pneumonia Detection in a Multi-Institutional Clinical Repository: A PHIS+ Pilot Study.

Science.gov (United States)

Meystre, Stephane; Gouripeddi, Ramkiran; Tieder, Joel; Simmons, Jeffrey; Srivastava, Rajendu; Shah, Samir

2017-05-15

Community-acquired pneumonia is a leading cause of pediatric morbidity. Administrative data are often used to conduct comparative effectiveness research (CER) with sufficient sample sizes to enhance detection of important outcomes. However, such studies are prone to misclassification errors because of the variable accuracy of discharge diagnosis codes. The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. The multi-institutional PHIS+ clinical repository was developed to support pediatric CER by expanding an administrative database of children's hospitals with detailed clinical data. To develop a scalable approach to find patients with bacterial pneumonia more accurately, we developed a Natural Language Processing (NLP) application to extract relevant information from chest diagnostic imaging reports. Domain experts established a reference standard by manually annotating 282 reports to train and then test the NLP application. Findings of pleural effusion, pulmonary infiltrate, and pneumonia were automatically extracted from the reports and then used to automatically classify whether a report was consistent with bacterial pneumonia. Compared with the annotated diagnostic imaging reports reference standard, the most accurate implementation of machine learning algorithms in our NLP application allowed extracting relevant findings with a sensitivity of .939 and a positive predictive value of .925. It allowed classifying reports with a sensitivity of .71, a positive predictive value of .86, and a specificity of .962. When compared with each of the domain experts manually annotating these reports, the NLP application allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity . NLP-based pneumonia information extraction of pediatric diagnostic imaging reports performed better than domain experts in this

Safety of open ventral hernia repair in high-risk patients with metabolic syndrome: a multi-institutional analysis of 39,118 cases.

Science.gov (United States)

Zavlin, Dmitry; Jubbal, Kevin T; Van Eps, Jeffrey L; Bass, Barbara L; Ellsworth, Warren A; Echo, Anthony; Friedman, Jeffrey D; Dunkin, Brian J

2018-02-01

Metabolic syndrome (MetS) entails the simultaneous presence of a constellation of dangerous risk factors including obesity, diabetes, hypertension, and dyslipidemia. The prevalence of MetS in Western society continues to rise and implies an elevated risk for surgical complications and/or poor surgical outcomes within the affected population. To assess the risks and outcomes of multi-morbid patients with MetS undergoing open ventral hernia repair. Multi-institutional case-control study in the United States. The American College of Surgeons National Surgical Quality Improvement Program database was sampled for patients undergoing initial open ventral hernia repair from 2012 through 2014 and then stratified into 2 cohorts based on the presence or absence of MetS. Statistical analyses were performed to evaluate preoperative co-morbidities, intraoperative details, and postoperative morbidity and mortality to identify risk factors for adverse outcomes. Mean age (61.0 versus 56.0 yr, Phigh operative risk in a population that is generally prone to obesity and its associated diseases. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Urinary and Rectal Toxicity Profiles After Permanent Iodine-125 Implant Brachytherapy in Japanese Men: Nationwide J-POPS Multi-institutional Prospective Cohort Study

Energy Technology Data Exchange (ETDEWEB)

Ohashi, Toshio, E-mail: ohashi@rad.med.keio.ac.jp [Keio University School of Medicine, Tokyo (Japan); Yorozu, Atsunori; Saito, Shiro [National Hospital Organization Tokyo Medical Center, Tokyo (Japan); Tanaka, Nobumichi [Nara Medical University School of Medicine, Nara (Japan); Katayama, Norihisa [Okayama University School of Medicine, Okayama (Japan); Kojima, Shinsuke; Maruo, Shinichiro; Kikuchi, Takashi [Translational Research Informatics Center, Hyogo (Japan); Dokiya, Takushi [Kyoundo Hospital, Tokyo (Japan); Fukushima, Masanori [Translational Research Informatics Center, Hyogo (Japan); Yamanaka, Hidetoshi [Institutes of Preventive Medicine, Kurosawa Hospital, Gunma (Japan)

2015-09-01

Purpose: To assess, in a nationwide multi-institutional cohort study begun in 2005 and in which 6927 subjects were enrolled by 2010, the urinary and rectal toxicity profiles of subjects who enrolled during the first 2 years, and evaluate the toxicity profiles for permanent seed implantation (PI) and a combination therapy with PI and external beam radiation therapy (EBRT). Methods and Materials: Baseline data for 2339 subjects out of 2354 patients were available for the analyses. Toxicities were evaluated using the National Cancer Institute's Common Terminology Criteria for Adverse Events, and the International Prostate Symptom Scores were recorded prospectively until 36 months after radiation therapy. Results: Grade 2+ acute urinary toxicities developed in 7.36% (172 of 2337) and grade 2+ acute rectal toxicities developed in 1.03% (24 of 2336) of the patients. Grade 2+ late urinary and rectal toxicities developed in 5.75% (133 of 2312) and 1.86% (43 of 2312) of the patients, respectively. A higher incidence of grade 2+ acute urinary toxicity occurred in the PI group than in the EBRT group (8.49% vs 3.66%; P<.01). Acute rectal toxicity outcomes were similar between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late urinary toxicities were 6.04% versus 4.82% for the PI and the EBRT groups, respectively, with no significant differences between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late rectal toxicities were 0.90% versus 5.01% (P<.01) for the PI and the EBRT groups, respectively. The mean of the postimplant International Prostate Symptom Score peaked at 3 months, but it decreased to a range that was within 2 points of the baseline score, which was observed in 1625 subjects (69.47%) at the 1-year follow-up assessment. Conclusions: The acute urinary toxicities observed were acceptable given the frequency and retention, and the late rectal toxicities were more favorable than those of other

A Comparison of Secondary Polycythemia in Hypogonadal Men Treated with Clomiphene Citrate versus Testosterone Replacement: A Multi-Institutional Study.

Science.gov (United States)

Wheeler, Karen M; Smith, Ryan P; Kumar, Raj A; Setia, Shaan; Costabile, Raymond A; Kavoussi, Parviz K

2017-04-01

We evaluated the relative prevalence of secondary polycythemia in hypogonadal men treated with clomiphene citrate or testosterone replacement therapy. In this retrospective, multi-institutional study, we included 188 men who received clomiphene citrate and 175 who received testosterone replacement therapy with symptomatic hypogonadism. The overall prevalence and ORs of secondary polycythemia for clomiphene citrate treatment vs testosterone replacement were primarily measured, as were baseline characteristics. Subset analysis included polycythemia rates for different types of testosterone replacement therapy. Overall, men on testosterone replacement therapy were older than clomiphene citrate treated men (age 51.5 vs 38 years). Men on testosterone replacement had longer treatment duration than clomiphene citrate treated men (19.6 vs 9.2 months). For testosterone replacement therapy and clomiphene citrate the mean change in hematocrit was 3.0% and 0.6%, and the mean change in serum testosterone was 333.1 and 367.6 ng/dl, respectively. The prevalence of polycythemia in men on testosterone replacement was 11.2% vs 1.7% in men on clomiphene citrate (p = 0.0003). This significance remained on logistic regression after correcting for age, site, smoking history and pretreatment hematocrit. The prevalence of polycythemia in men treated with clomiphene citrate was markedly lower than that in men on testosterone replacement therapy. The improvement in absolute serum testosterone levels was similar to that in men on testosterone replacement. There is no significant risk of polycythemia in men treated with clomiphene citrate for hypogonadism. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Variability in Women Faculty’s Preferences Regarding Mentor Similarity: A Multi-Institution Study in Academic Medicine

Science.gov (United States)

Carapinha, René; Ortiz-Walters, Rowena; McCracken, Caitlin M.; Hill, Emorcia V.; Reede, Joan Y.

2016-01-01

Purpose To investigate which mentor similarity characteristics women faculty in academic medicine rate most important and to determine whether the importance of similarity differs among women faculty based on current and prior mentoring, demographic and personal factors, and career factors. Method Cross-sectional survey data from 3,100 women faculty at 13 purposively sampled U.S. medical schools were collected in 2012. The preferences of participants regarding the importance of mentor similarity in terms of race/ethnicity, gender, personal and career interests, and department and institution were studied. Analysis entailed chi square tests and multivariable ordered logistic models. Results Overall, respondents ranked having a mentor in the same department and institution as most important. Same department and institution were less important for those without a current mentor and for senior faculty, and were more important for Asian faculty. Same career and personal interests were less important for older faculty and more important for those with a doctorate only. Same gender was more important for Black faculty, faculty at the rank of instructor, and those without current mentoring. Overall, same race/ethnicity was rated least important; however, it was more important for racial/ethnic minorities, foreign-born faculty, and those who had never had a mentor. Conclusions Mentor preferences, as indicated by level of importance assigned to types of mentor similarity, varied among women faculty. To advance effective mentoring, characterized by high degree of mentor-mentee fit, the authors provide recommendations on matching strategies to be used in academic medicine when considering the diverse mentor preferences of women faculty. PMID:27332871

Value added or misattributed? A multi-institution study on the educational benefit of labs for reinforcing physics content

Science.gov (United States)

Holmes, N. G.; Olsen, Jack; Thomas, James L.; Wieman, Carl E.

2017-06-01

Instructional labs are widely seen as a unique, albeit expensive, way to teach scientific content. We measured the effectiveness of introductory lab courses at achieving this educational goal across nine different lab courses at three very different institutions. These institutions and courses encompassed a broad range of student populations and instructional styles. The nine courses studied had two key things in common: the labs aimed to reinforce the content presented in lectures, and the labs were optional. By comparing the performance of students who did and did not take the labs (with careful normalization for selection effects), we found universally and precisely no added value to learning course content from taking the labs as measured by course exam performance. This work should motivate institutions and departments to reexamine the goals and conduct of their lab courses, given their resource-intensive nature. We show why these results make sense when looking at the comparative mental processes of students involved in research and instructional labs, and offer alternative goals and instructional approaches that would make lab courses more educationally valuable.

Inverse correlation between coffee consumption and prevalence of metabolic syndrome: baseline survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study in Tokushima, Japan.

Science.gov (United States)

Takami, Hidenobu; Nakamoto, Mariko; Uemura, Hirokazu; Katsuura, Sakurako; Yamaguchi, Miwa; Hiyoshi, Mineyoshi; Sawachika, Fusakazu; Juta, Tomoya; Arisawa, Kokichi

2013-01-01

It is unclear whether consumption of coffee and green tea is associated with metabolic syndrome. This cross-sectional study enrolled 554 adults who had participated in the baseline survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study in Tokushima Prefecture, Japan. Consumption of coffee and green tea was assessed using a questionnaire. Metabolic syndrome was diagnosed using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the Japan Society for the Study of Obesity (JASSO). Logistic regression analysis was used to examine the association between consumption of coffee and green tea and prevalence of metabolic syndrome and its components. After adjustment for sex, age, and other potential confounders, greater coffee consumption was associated with a significantly lower prevalence of metabolic syndrome, as defined by NCEP ATP III criteria (P for trend = 0.03). Participants who drank more coffee had a lower odds ratio (OR) for high serum triglycerides (P for trend = 0.02), but not for increased waist circumference or high blood pressure. Using JASSO criteria, moderate coffee consumption (1.5 to inversely correlated with metabolic syndrome diagnosed using NCEP ATP III criteria, mainly because it was associated with lower serum triglyceride levels. This association highlights the need for further prospective studies of the causality of these relationships.

Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis.

Science.gov (United States)

Verma, Vivek; Shostrom, Valerie K; Zhen, Weining; Zhang, Mutian; Braunstein, Steve E; Holland, John; Hallemeier, Christopher L; Harkenrider, Matthew M; Iskhanian, Adrian; Jabbour, Salma K; Attia, Albert; Lee, Percy; Wang, Kyle; Decker, Roy H; McGarry, Ronald C; Simone, Charles B

2017-03-15

To describe the impact of fractionation scheme and tumor location on toxicities in stereotactic body radiation therapy (SBRT) for ≥5-cm non-small cell lung cancer (NSCLC), as part of a multi-institutional analysis. Patients with primary ≥5-cm N0 M0 NSCLC who underwent ≤5-fraction SBRT were examined across multiple high-volume SBRT centers. Collected data included clinical/treatment parameters; toxicities were prospectively assessed at each institution according to the Common Terminology Criteria for Adverse Events. Patients treated daily were compared with those treated every other day (QOD)/other nondaily regimens. Stratification between central and peripheral tumors was also performed. Ninety-two patients from 12 institutions were evaluated (2004-2016), with median follow-up of 12 months. In total there were 23 (25%) and 6 (7%) grade ≥2 and grade ≥3 toxicities, respectively. Grades 2 and 3 pulmonary toxicities occurred in 9% and 4%, respectively; 1 patient treated daily experienced grade 5 radiation pneumonitis. Of the entire cohort, 46 patients underwent daily SBRT, and 46 received QOD (n=40)/other nondaily (n=6) regimens. Clinical/treatment parameters were similar between groups; the QOD/other group was more likely to receive 3-/4-fraction schemas. Patients treated QOD/other experienced significantly fewer grade ≥2 toxicities as compared with daily treatment (7% vs 43%, Plocation (P>.05). From this multi-institutional study, toxicity of SBRT for ≥5-cm lesions is acceptable, and daily treatment was associated with a higher rate of toxicities. Copyright © 2016 Elsevier Inc. All rights reserved.

SU-F-T-494: A Multi-Institutional Study of Independent Dose Verification Using Golden Beam Data

Energy Technology Data Exchange (ETDEWEB)

Itano, M; Yamazaki, T [Inagi Municipal Hospital, Inagi, Tokyo (Japan); Tachibana, R; Uchida, Y [National Cancer Center Hospital East, Kashiwa, Chiba (Japan); Yamashita, M [Kobe City Medical Center General Hospital, Kobe, Hyogo (Japan); Shimizu, H [Kitasato University Medical Center, Kitamoto, Saitama (Japan); Sugawara, Y; Kotabe, K [National Center for Global Health and Medicine, Shinjuku, Tokyo (Japan); Kamima, T [Cancer Institute Hospital Japanese Foundation for Cancer Research, Koto, Tokyo (Japan); Takahashi, R [Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo (Japan); Ishibashi, S [Sasebo City General Hospital, Sasebo, Nagasaki (Japan); Tachibana, H [National Cancer Center, Kashiwa, Chiba (Japan)

2016-06-15

Purpose: In general, beam data of individual linac is measured for independent dose verification software program and the verification is performed as a secondary check. In this study, independent dose verification using golden beam data was compared to that using individual linac’s beam data. Methods: Six institutions were participated and three different beam data were prepared. The one was individual measured data (Original Beam Data, OBD) .The others were generated by all measurements from same linac model (Model-GBD) and all linac models (All-GBD). The three different beam data were registered to the independent verification software program for each institute. Subsequently, patient’s plans in eight sites (brain, head and neck, lung, esophagus, breast, abdomen, pelvis and bone) were analyzed using the verification program to compare doses calculated using the three different beam data. Results: 1116 plans were collected from six institutes. Compared to using the OBD, the results shows the variation using the Model-GBD based calculation and the All-GBD was 0.0 ± 0.3% and 0.0 ± 0.6%, respectively. The maximum variations were 1.2% and 2.3%, respectively. The plans with the variation over 1% shows the reference points were located away from the central axis with/without physical wedge. Conclusion: The confidence limit (2SD) using the Model-GBD and the All-GBD was within 0.6% and 1.2%, respectively. Thus, the use of golden beam data may be feasible for independent verification. In addition to it, the verification using golden beam data provide quality assurance of planning from the view of audit. This research is partially supported by Japan Agency for Medical Research and Development(AMED)

SU-F-T-494: A Multi-Institutional Study of Independent Dose Verification Using Golden Beam Data

International Nuclear Information System (INIS)

Itano, M; Yamazaki, T; Tachibana, R; Uchida, Y; Yamashita, M; Shimizu, H; Sugawara, Y; Kotabe, K; Kamima, T; Takahashi, R; Ishibashi, S; Tachibana, H

2016-01-01

Purpose: In general, beam data of individual linac is measured for independent dose verification software program and the verification is performed as a secondary check. In this study, independent dose verification using golden beam data was compared to that using individual linac’s beam data. Methods: Six institutions were participated and three different beam data were prepared. The one was individual measured data (Original Beam Data, OBD) .The others were generated by all measurements from same linac model (Model-GBD) and all linac models (All-GBD). The three different beam data were registered to the independent verification software program for each institute. Subsequently, patient’s plans in eight sites (brain, head and neck, lung, esophagus, breast, abdomen, pelvis and bone) were analyzed using the verification program to compare doses calculated using the three different beam data. Results: 1116 plans were collected from six institutes. Compared to using the OBD, the results shows the variation using the Model-GBD based calculation and the All-GBD was 0.0 ± 0.3% and 0.0 ± 0.6%, respectively. The maximum variations were 1.2% and 2.3%, respectively. The plans with the variation over 1% shows the reference points were located away from the central axis with/without physical wedge. Conclusion: The confidence limit (2SD) using the Model-GBD and the All-GBD was within 0.6% and 1.2%, respectively. Thus, the use of golden beam data may be feasible for independent verification. In addition to it, the verification using golden beam data provide quality assurance of planning from the view of audit. This research is partially supported by Japan Agency for Medical Research and Development(AMED)

Complications and Short-Term Explantation Rate Following Artificial Urinary Sphincter Implantation: Results from a Large Middle European Multi-Institutional Case Series.

Science.gov (United States)

Kretschmer, Alexander; Hüsch, Tanja; Thomsen, Frauke; Kronlachner, Dominik; Obaje, Alice; Anding, Ralf; Pottek, Tobias; Rose, Achim; Olianas, Roberto; Friedl, Alexander; Hübner, Wilhelm; Homberg, Roland; Pfitzenmaier, Jesco; Grein, Ulrich; Queissert, Fabian; Naumann, Carsten Maik; Schweiger, Josef; Wotzka, Carola; Nyarangi-Dix, Joanne N; Hofmann, Torben; Seiler, Roland; Haferkamp, Axel; Bauer, Ricarda M

2016-01-01

Background/Aims/Objectives: To analyze perioperative complication and short-term explantation rates after perineal or penoscrotal single-cuff and double-cuff artificial urinary sphincter (AUS) implantation in a large middle European multi-institutional patient cohort. 467 male patients with stress urinary incontinence underwent implantation of a perineal single-cuff (n = 152), penoscrotal single-cuff (n = 99), or perineal double-cuff (n = 216) AUS between 2010 and 2012. Postoperative complications and 6-month explantation rates were assessed. For statistical analysis, Fisher's exact test and Kruskal-Wallis rank sum test, and a multiple logistic regression model were used (p AUS, penoscrotal single-cuff implantation led to significantly increased short-term explantation rates (8.6% (perineal) vs. 19.2% (penoscrotal), p = 0.019). The postoperative infection rate was significantly higher after double-cuff compared to single-cuff implantation (6.0% (single-cuff) vs. 13.9% (double-cuff), p = 0.019). The short-term explantation rate after primary double-cuff placement was 6.5% (p = 0.543 vs. perineal single-cuff). In multivariate analysis, the penoscrotal approach (p = 0.004), intraoperative complications (p = 0.005), postoperative bleeding (p = 0.011), and perioperative infection (p < 0.001) were independent risk factors for short-term explantation. Providing data from a large contemporary multi-institutional patient cohort from high-volume and low-volume institutions, our results reflect the current standard of care in middle Europe. We indicate that the penoscrotal approach is an independent risk factor for increased short-term explantation rates. © 2016 S. Karger AG, Basel.

Case Study of Multi-Unit Risk: Multi-Unit Station Black-Out

Energy Technology Data Exchange (ETDEWEB)

Oh, Kyemin; Jang, Seung-cheol [KAERI, Daejeon (Korea, Republic of); Heo, Gyunyoung [Kyung Hee University, Yongin (Korea, Republic of)

2015-05-15

After Fukushima Daiichi Accident, importance and public concern for Multi-Unit Risk (MUR) or Probabilistic Safety Assessment (PSA) have been increased. Most of nuclear power plant sites in the world have more than two units. These sites have been facing the problems of MUR or accident such as Fukushima. In case of South Korea, there are generally more than four units on the same site and even more than ten units are also expected. In other words, sites in South Korea also have been facing same problems. Considering number of units on the same site, potential of these problems may be larger than other countries. The purpose of this paper is to perform case study based on another paper submitted in the conference. MUR is depended on various site features such as design, shared systems/structures, layout, environmental condition, and so on. Considering various dependencies, we assessed Multi-Unit Station Black-out (MSBO) accident based on Hanul Unit 3 and 4 model. In this paper, case study for multi-unit risk or PSA had been performed. Our result was incomplete to assess total multi-unit risk because of two challenging issues. First, economic impact had not been evaluated to estimate multi-unit risk. Second, large uncertainties were included in our result because of various assumptions. These issues must be resolved in the future.

Case Study of Multi-Unit Risk: Multi-Unit Station Black-Out

International Nuclear Information System (INIS)

Oh, Kyemin; Jang, Seung-cheol; Heo, Gyunyoung

2015-01-01

After Fukushima Daiichi Accident, importance and public concern for Multi-Unit Risk (MUR) or Probabilistic Safety Assessment (PSA) have been increased. Most of nuclear power plant sites in the world have more than two units. These sites have been facing the problems of MUR or accident such as Fukushima. In case of South Korea, there are generally more than four units on the same site and even more than ten units are also expected. In other words, sites in South Korea also have been facing same problems. Considering number of units on the same site, potential of these problems may be larger than other countries. The purpose of this paper is to perform case study based on another paper submitted in the conference. MUR is depended on various site features such as design, shared systems/structures, layout, environmental condition, and so on. Considering various dependencies, we assessed Multi-Unit Station Black-out (MSBO) accident based on Hanul Unit 3 and 4 model. In this paper, case study for multi-unit risk or PSA had been performed. Our result was incomplete to assess total multi-unit risk because of two challenging issues. First, economic impact had not been evaluated to estimate multi-unit risk. Second, large uncertainties were included in our result because of various assumptions. These issues must be resolved in the future

Crisis checklists for in-hospital emergencies: expert consensus, simulation testing and recommendations for a template determined by a multi-institutional and multi-disciplinary learning collaborative.

Science.gov (United States)

Subbe, Christian P; Kellett, John; Barach, Paul; Chaloner, Catriona; Cleaver, Hayley; Cooksley, Tim; Korsten, Erik; Croke, Eilish; Davis, Elinor; De Bie, Ashley Jr; Durham, Lesley; Hancock, Chris; Hartin, Jilian; Savijn, Tracy; Welch, John

2017-05-08

'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology. A scoping study of the literature was followed by a multi-institutional and multi-disciplinary international learning collaborative. We sought to achieve a consensus on procedures and clinical simulation technology to determine the requirements, develop and test a safe using a checklist template that is rapidly accessible to assist in emergency management of common events for general ward use. Safety considerations about deteriorating patients were agreed upon and summarized. A consensus was achieved among an international group of experts on currently available checklist formats performing poorly in simulation testing as first responders in general ward clinical crises. The Crisis Checklist Collaborative ratified a consensus template for a general ward checklist that provides a list of issues for first responders to address (i.e. 'Check In'), a list of prompts regarding common omissions (i.e. 'Stop & Think'), and, a list of items required for the safe "handover" of patients that remain on the general ward (i.e. 'Check Out'). Simulation usability assessment of the template demonstrated feasibility for clinical management of deteriorating patients. Emergency checklists custom-designed for general ward patients have the potential to guide the treatment speed and reliability of responses for emergency management of patients with abnormal physiology while minimizing the risk of adverse events. Interventional trials are

Institutional solid waste management practices in developing countries. A case study of three academic institutions in Tanzania

Energy Technology Data Exchange (ETDEWEB)

Mbuligwe, Stephen E. [Faculty of Lands and Environmental Engineering, Department of Environmental Engineering, University College of Lands and Architectural Studies UCLAS, PO Box 35176, Dar es Salaam (Tanzania, United Republic of)

2002-05-01

This paper reports on institutional solid waste management in three Tanzanian institutions. It is noted that there are indeed advantages in managing solid waste at institutional level because of the institutions' unique characteristics that also influence their waste management needs. The paper outlines findings from a yearlong study on institutional solid waste management at three institutions: University of Dar es Salaam (UDSM), University College of Lands and Architectural Studies (UCLAS) and Water Resources Institute (WRI). Surveys and field investigations, including on-site waste measurements and questionnaire surveys were done at UDSM, UCLAS and WRI. The study has revealed, among other things, that per capita waste generation rates, W{sub G} vary between staff and students within each institution as well as among the three institutions. The composition of the waste was found to be predominantly organic in nature, suggesting a strong resource recovery potential in terms of animal feed or production of biogas through anaerobic digestion. Additionally, the W{sub G} was found to vary in line with changes in institutional activities like normal studies, examinations and holidays. The study has shown that resource recovery could greatly enhance solid waste management at the case study institutions.

Building a Science Software Institute: Synthesizing the Lessons Learned from the ISEES and WSSI Software Institute Conceptualization Efforts

Science.gov (United States)

Idaszak, R.; Lenhardt, W. C.; Jones, M. B.; Ahalt, S.; Schildhauer, M.; Hampton, S. E.

2014-12-01

The NSF, in an effort to support the creation of sustainable science software, funded 16 science software institute conceptualization efforts. The goal of these conceptualization efforts is to explore approaches to creating the institutional, sociological, and physical infrastructures to support sustainable science software. This paper will present the lessons learned from two of these conceptualization efforts, the Institute for Sustainable Earth and Environmental Software (ISEES - http://isees.nceas.ucsb.edu) and the Water Science Software Institute (WSSI - http://waters2i2.org). ISEES is a multi-partner effort led by National Center for Ecological Analysis and Synthesis (NCEAS). WSSI, also a multi-partner effort, is led by the Renaissance Computing Institute (RENCI). The two conceptualization efforts have been collaborating due to the complementarity of their approaches and given the potential synergies of their science focus. ISEES and WSSI have engaged in a number of activities to address the challenges of science software such as workshops, hackathons, and coding efforts. More recently, the two institutes have also collaborated on joint activities including training, proposals, and papers. In addition to presenting lessons learned, this paper will synthesize across the two efforts to project a unified vision for a science software institute.

Latina Social Studies Teachers Negotiating Public Institutions

Science.gov (United States)

Rivas, Elizabeth D.

2017-01-01

This mixed methods study explores the institutionalized master narrative of public institutions and how the mandated policies enacted by public institutions impact Latina social studies teachers when delivering instruction to their students. A socio-transformative constructivist framework guides this study to affirm that knowledge is socially…

Prospective, multi-institutional pain assessment of 150 women undergoing diagnostic cystoscopy.

Science.gov (United States)

Seklehner, Stephan; Saratlija-Novakovic, Zana; Skopek, Matthias; Fajkovic, Harun; Remzi, Mesut; Duvnjak, Mario; Resch, Irene; Hruby, Stephan; lmHÜBNER, Wilhelm; Librenjak, Davor; Breinl, Eckart; Riedl, Claus; Engelhardt, Paul F

2016-10-01

The aim of this study was to prospectively assess women's pain during rigid and flexible diagnostic cystoscopy and afterwards during a one-week follow-up. Prospective, multi-institutional trial analyzing numeric rating scales (NRS) of women undergoing diagnostic cystoscopy. Pain categories: no (0 points), mild (1-3), moderate (4-6) and severe pain (7-10). Assessing of pain before, during cystoscopy, and at day 1, 4 and 7 of follow-up. A total of 150 women undergoing rigid (N.=85) or flexible (N.=65) diagnostic cystoscopy were analyzed. Women undergoing flexible cystoscopy were more frequently pain-free (64.6% vs. 40%, P=0.003) and experienced mild pain less frequently (27.7% vs. 52.9% vs. P=0.002). No significant differences were noted among moderate (6.2% vs. 5.9%, P=0.95) and severe pain (1.5% vs. 1.2%, P=0.85). Patients undergoing their first (P=0.14) and repeat cystoscopy (P=0.08) had similar pain perception. In multivariate logistic regression analyses, women undergoing flexible cystoscopy had a 2.6 increased chance of being pain-free (OR=2.6, CI: 1.28-5.11, P=0.08) and their odds of experiencing mild pain were significantly lower (OR=0.34, CI: 0.17-0.71, P=0.004). The likelihood of experiencing moderate (OR=1.1, CI: 0.28- 4.4, P=0.83) or severe pain (OR=2.42, CI: 0.11-51.79, P=0.57) differed insignificantly. Rigid and flexible cystoscopies were well-tolerated by most women. However, flexible cystoscopy was associated with a higher likelihood of being pain-free and lower chances of experiencing mild pain. Patients' previous experience with cystoscopy did not influence pain perception.

Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

Science.gov (United States)

Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

2018-03-10

The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

Brand Coherence at a Major Multi-Campus Public Research University: An Exploratory Case Study

Science.gov (United States)

Zinkan, Rob

2016-01-01

With increased competition and other market forces affecting higher education, branding has emerged as a strategic imperative for colleges and universities. Branding in academia faces many inherent challenges, including institutions' multi-pronged missions and decentralized organizational structures. In some cases, branding is not widely…

Breaking ground in cross-cultural research on the fear of being laughted at (gelotophobia): A multi-national study involving 73 countries

Czech Academy of Sciences Publication Activity Database

Proyer, R.T.; Ruch, W.; Ali, N.S.; Al-Olimat, H. S.; Amemiya, T.; Adal, T.A.; Ansari, S. A.; Arhar, Š.; Asem, G.; Baudin, N.; Bawab, S.; Bergen, D.; Brdar, I.; Brites, R.; Brunner-Sciarra, M.; Carrell, A.; Dios, H.C.; Celik, M.; Ceschi, G.; Chang, K.; Cheryomukhin, A.; Chik, M.P.Y.; Chlopicki, W.; Cranney, J.; Dahourou, D.; Doosje, S.; Dore, M.; El-Arousy, N.; Ficková, E.; Führ, M.; Gallivan, J.; Geling, H.; Germikova, L.; Goh, A.; Gonzáles, R.D.; Ho, S.K.; Hřebíčková, Martina; Jaime, B.; Hertzberg Kaare, B.; Kamble, S.; Kazarian, S.; Kerkkänen, P.; Klementová, M.; Kobozeva, I.M.; Kovjanic, S.; Kumaraswamy, N.; Lampert, M.; Liao, Ch.; Levesque, M.; Loizou, L.; Loving, R.D.; Lyttle, J.; Machline, V.C.; McGoldrick, S.; McRorie, M.; Min, L.; Mottus, R.; Munyae, M.; Navia, C.E.; Nkhalamba, M.; Pedrini, P.P.; Petkova, M.; Platt, T.; Popa, D-E.; Radomska, A.; Rashid, T.; Rawlings, D.; Rubio, V.J.; Samson, A.C.; Sarid, O.; Shams, S.; Sisokohm, S.; Smári, J.; Sneddon, I.; Snikhovska, I.; Stephanenko, E.A.; Stokenberga, L.; Stuer, B.; Tanoto, Y.S.R.; Tapia, L.; Taylor, J.; Thibault, P.; Thompson, A.; Thőrn, H.; Toyota, H.; Ujlaky, J.; Vanno, V.; van der Westhuizen, B.; Wijayathilake, D.; Wong, P.S.O.; Wycoff, E.B.; Yeun, E.J.

2009-01-01

Roč. 22, 1/2 (2009), s. 253-279 ISSN 0933-1719 R&D Projects: GA ČR GA406/07/1561 Institutional research plan: CEZ:AV0Z70250504 Keywords : cross -cultural comparisons * gelotophobia * humor * multi-national study Subject RIV: AN - Psychology Impact factor: 0.771, year: 2009

An institution for object-z with inheritance and polymorphism

DEFF Research Database (Denmark)

Baumeister, Hubert; Bettaz, Mohamed; Maouche, Mourad

2015-01-01

logical systems and their connections. This is the foundation of multi-modelling languages allowing one to deal with heterogeneous specifications in a consistent way. To make Object-Z accessible as part of such a multi-modelling language, we define the institution OZS for Object-Z. We have chosen Object......-Z in part because it is a prominent software modelling language and in part because it allows us to study the formalisation of object-oriented concepts, like object identity, object state, dynamic behaviour, polymorphic sorts and inheritance....

Interobserver variability of clinical target volume delineation in supra-diaphragmatic Hodgkin's disease. A multi-institutional experience

International Nuclear Information System (INIS)

Genovesi, Domenico; Cefaro, Giampiero Ausili; Vinciguerra, Annamaria

2011-01-01

To determine interobserver variability in clinical target volume (CTV) of supra-diaphragmatic Hodgkin's lymphoma. At the 2008 AIRO (Italian Society of Radiation Oncology) Meeting, the Radiation Oncology Department of Chieti proposed a multi-institutional contouring dummy-run of two cases of early stage supra-diaphragmatic Hodgkin's lymphoma after chemotherapy. Clinical history, diagnostics, and planning CT imaging were available on Chieti's radiotherapy website (www.radioterapia.unich.it). Participating centers were requested to delineate the CTV and submit it to the coordinating center. To quantify interobserver variability of CTV delineations, the total volume, craniocaudal, laterolateral, and anteroposterior diameters were calculated. A total of 18 institutions for case A and 15 institutions for case B submitted the targets. Case A presented significant variability in total volume (range: 74.1-1,157.1 cc), craniocaudal (range: 6.5-22.5 cm; median: 16.25 cm), anteroposterior (range: 5.04-14.82 cm; median: 10.28 cm), and laterolateral diameters (range: 8.23-22.88 cm; median: 15.5 cm). Mean CTV was 464.8 cc (standard deviation: 280.5 cc). Case B presented significant variability in total volume (range: 341.8-1,662 cc), cranio-caudal (range: 8.0-28.5 cm; median: 23 cm), anteroposterior (range: 7.9-1.8 cm; median: 11.1 cm), and laterolateral diameters (range: 12.9-24.0 cm; median: 18.8 cm). Mean CTV was 926.0 cc (standard deviation: 445.7 cc). This significant variability confirms the need to apply specific guidelines to improve contouring uniformity in Hodgkin's lymphoma. (orig.)

IMRT QA using machine learning: A multi-institutional validation.

Science.gov (United States)

Valdes, Gilmer; Chan, Maria F; Lim, Seng Boh; Scheuermann, Ryan; Deasy, Joseph O; Solberg, Timothy D

2017-09-01

To validate a machine learning approach to Virtual intensity-modulated radiation therapy (IMRT) quality assurance (QA) for accurately predicting gamma passing rates using different measurement approaches at different institutions. A Virtual IMRT QA framework was previously developed using a machine learning algorithm based on 498 IMRT plans, in which QA measurements were performed using diode-array detectors and a 3%local/3 mm with 10% threshold at Institution 1. An independent set of 139 IMRT measurements from a different institution, Institution 2, with QA data based on portal dosimetry using the same gamma index, was used to test the mathematical framework. Only pixels with ≥10% of the maximum calibrated units (CU) or dose were included in the comparison. Plans were characterized by 90 different complexity metrics. A weighted poison regression with Lasso regularization was trained to predict passing rates using the complexity metrics as input. The methodology predicted passing rates within 3% accuracy for all composite plans measured using diode-array detectors at Institution 1, and within 3.5% for 120 of 139 plans using portal dosimetry measurements performed on a per-beam basis at Institution 2. The remaining measurements (19) had large areas of low CU, where portal dosimetry has a larger disagreement with the calculated dose and as such, the failure was expected. These beams need further modeling in the treatment planning system to correct the under-response in low-dose regions. Important features selected by Lasso to predict gamma passing rates were as follows: complete irradiated area outline (CIAO), jaw position, fraction of MLC leafs with gaps smaller than 20 or 5 mm, fraction of area receiving less than 50% of the total CU, fraction of the area receiving dose from penumbra, weighted average irregularity factor, and duty cycle. We have demonstrated that Virtual IMRT QA can predict passing rates using different measurement techniques and across multiple

CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A multi-institutional review

Energy Technology Data Exchange (ETDEWEB)

Cornelis, F.; Grenier, N. [Pellegrin Hospital, Department of Radiology, Bordeaux (France); Ambrosetti, D. [Pasteur Hospital, Department of Pathology, Nice (France); Rocher, L. [Kremlin-Bicetre Hospital, Department of Radiology, Paris (France); Derchi, L.E. [University of Genoa, IRCCS AOU Ospedale, San Martino IST, Department of Health Sciences (DISSAL), Genoa (Italy); Renard, B.; Puech, P. [Claude Huriez Hospital, Department of Radiology, Lille (France); Claudon, M. [Brabois Hospital, Department of Radiology, Vandoeuvre-les-Nancy (France); Rouviere, O. [E. Herriot Hospital, Department of Radiology, Lyon (France); Ferlicot, S. [Kremlin-Bicetre Hospital, Department of Pathology, Paris (France); Roy, C. [Civil Hospital, Department of Radiology, Strasbourg (France); Yacoub, M. [Pellegrin Hospital, Department of Pathology, Bordeaux (France); Bernhard, J.C. [Pellegrin Hospital, Department of Urologic Surgery, Bordeaux (France)

2017-03-15

Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a recently identified renal malignancy. Diagnosis of this rare subtype of renal tumour can be challenging for pathologists, and as such, any additional data would be helpful to improve diagnostic reliability. As imaging features of this new and rare sub-type have not yet been clearly described, the purpose of this study was to describe the main radiologic features on computed tomography (CT) and magnetic resonance imaging (MRI), based jointly on the literature and findings from a multi-institutional retrospective review of pathology and imaging databases. Using a combination of CT/MRI features, diagnosis of MTSCC could be suggested in many cases. A combination of slow enhancement with plateau on dynamic contrast-enhanced CT/MRI, intermediate to high T2 signal intensity contrasting with low apparent diffusion coefficient values on MRI appeared evocative of this diagnosis. (orig.)

Urology Residents' Experience and Attitude Toward Surgical Simulation: Presenting our 4-Year Experience With a Multi-institutional, Multi-modality Simulation Model.

Science.gov (United States)

Chow, Alexander K; Sherer, Benjamin A; Yura, Emily; Kielb, Stephanie; Kocjancic, Ervin; Eggener, Scott; Turk, Thomas; Park, Sangtae; Psutka, Sarah; Abern, Michael; Latchamsetty, Kalyan C; Coogan, Christopher L

2017-11-01

To evaluate the Urological resident's attitude and experience with surgical simulation in residency education using a multi-institutional, multi-modality model. Residents from 6 area urology training programs rotated through simulation stations in 4 consecutive sessions from 2014 to 2017. Workshops included GreenLight photovaporization of the prostate, ureteroscopic stone extraction, laparoscopic peg transfer, 3-dimensional laparoscopy rope pass, transobturator sling placement, intravesical injection, high definition video system trainer, vasectomy, and Urolift. Faculty members provided teaching assistance, objective scoring, and verbal feedback. Participants completed a nonvalidated questionnaire evaluating utility of the workshop and soliciting suggestions for improvement. Sixty-three of 75 participants (84%) (postgraduate years 1-6) completed the exit questionnaire. Median rating of exercise usefulness on a scale of 1-10 ranged from 7.5 to 9. On a scale of 0-10, cumulative median scores of the course remained high over 4 years: time limit per station (9; interquartile range [IQR] 2), faculty instruction (9, IQR 2), ease of use (9, IQR 2), face validity (8, IQR 3), and overall course (9, IQR 2). On multivariate analysis, there was no difference in rating of domains between postgraduate years. Sixty-seven percent (42/63) believe that simulation training should be a requirement of Urology residency. Ninety-seven percent (63/65) viewed the laboratory as beneficial to their education. This workshop model is a valuable training experience for residents. Most participants believe that surgical simulation is beneficial and should be a requirement for Urology residency. High ratings of usefulness for each exercise demonstrated excellent face validity provided by the course. Copyright © 2017 Elsevier Inc. All rights reserved.

A case study of a Cuban government institution

International Nuclear Information System (INIS)

Nunez, A.L.; Vazquez, A.; Cruz Cabrera, L.

2004-01-01

The aim of this contribution is to present a case study on the partial implementation of a knowledge management system in an institution. In this case the knowledge management has been directed toward the best performance of the organization. The tool used in case study can be implemented at any institution, including institutions of nuclear or radiological profiles. (author)

A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogenous clinical data.

Science.gov (United States)

Sittig, Dean F; Hazlehurst, Brian L; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B

2012-07-01

Comparative effectiveness research (CER) has the potential to transform the current health care delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods, and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for interinstitutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast 6 large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, sociotechnical model of health information technology to help guide our work. We identified 6 generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions.

Arguments for the Study of Institutionalism and Institutional Reform in Romania

Directory of Open Access Journals (Sweden)

Ion Pohoata

2006-07-01

Full Text Available The study and comprehension of institutions – viewed as written and unwritten constraints (rules initiated by people to create and improve human interaction – represents the key to understand the success (and failure of contemporary economies and societies. The framework inspired by institutions to which people dedicated maximum energy and talent also explains the different levels of efficiency in modern times. The founders of institutionalism – in its old and new versions – explain, for example, that human endeavour for social improvement led to the appearance of Law, private ownership, contract and market. For Romania, such explanations are inspirational and of utmost necessity in presenting the real context and in finding the necessary measures and directions towards desired progress.

Arguments for the Study of Institutionalism and Institutional Reform in Romania

Directory of Open Access Journals (Sweden)

Ion Pohoata

2006-09-01

Full Text Available The study and comprehension of institutions – viewed as written and unwritten constraints (rules initiated by people to create and improve human interaction – represents the key to understand the success (and failure of contemporary economies and societies. The framework inspired by institutions to which people dedicated maximum energy and talent also explains the different levels of efficiency in modern times. The founders of institutionalism – in its old and new versions – explain, for example, that human endeavour for social improvement led to the appearance of Law, private ownership, contract and market. For Romania, such explanations are inspirational and of utmost necessity in presenting the real context and in finding the necessary measures and directions towards desired progress.

Laparoscopy for bowel obstruction--a contradiction? Results of a multi-institutional survey in Germany.

Science.gov (United States)

Zimmermann, M; Hoffmann, M; Laubert, T; Bruch, H P; Keck, T; Benecke, C; Schlöricke, E

2016-05-01

The purpose of the present study was to investigate on the acceptance and frequency of laparoscopic surgery for the management of acute and chronic bowel obstruction in a general patient population in German hospitals. To receive an authoritative opinion on laparoscopic treatment of bowel obstruction in Germany, a cross-sectional online study was conducted. We designed an online-based survey, supported by the German College of Surgeons (Berufsverband der Deutschen Chirurgen, BDC) to get multi-institutional-based data from various level providers of patient care. Between January and February 2014, we received completed questionnaires from 235 individuals (16.7 %). The participating surgeons were a representative sample of German hospitals with regard to hospital size, level of center size, and localization. A total of 74.9 % (n = 176) of all responders stated to use laparoscopy as the initial step of exploration in expected bowel obstruction. This procedure was highly statistically associated with the frequency of overall laparoscopic interventions and laparoscopic experience. The overall conversion rate was reported to be 29.4 %. This survey, investigating on the use of laparoscopic exploration or interventions in bowel obstruction, was able to show that by now, a majority of the responding surgeons accept laparoscopy as an initial step for exploration of the abdomen in the case of bowel obstruction. Laparoscopy was considered to be at least comparable to open surgery in an emergency setting. Furthermore, data analysis demonstrated generally accepted advantages and disadvantages of the laparoscopic approach. Indications for or against laparoscopy are made after careful consideration in each individual case.

Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions.

Science.gov (United States)

Volmar, Keith E; Idowu, Michael O; Hunt, Jennifer L; Souers, Rhona J; Meier, Frederick A; Nakhleh, Raouf E

2014-05-01

The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. Seventy-three institutions reported 1688 report defects discovered in 360,218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P benchmarking data on report defects and defect fractions using standardized taxonomy.

Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis

Energy Technology Data Exchange (ETDEWEB)

Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Shostrom, Valerie K. [Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska (United States); Zhen, Weining; Zhang, Mutian [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Braunstein, Steve E. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Holland, John [Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Harkenrider, Matthew M. [Department of Radiation Oncology, Loyola University Stritch School of Medicine, Maywood, Illinois (United States); Iskhanian, Adrian [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida (United States); Jabbour, Salma K. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey (United States); Attia, Albert [Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Wang, Kyle [Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina (United States); Decker, Roy H. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); McGarry, Ronald C. [Department of Radiation Oncology, University of Kentucky, Lexington, Kentucky (United States); Simone, Charles B., E-mail: charlessimone@umm.edu [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States)

2017-03-15

Purpose: To describe the impact of fractionation scheme and tumor location on toxicities in stereotactic body radiation therapy (SBRT) for ≥5-cm non-small cell lung cancer (NSCLC), as part of a multi-institutional analysis. Methods: Patients with primary ≥5-cm N0 M0 NSCLC who underwent ≤5-fraction SBRT were examined across multiple high-volume SBRT centers. Collected data included clinical/treatment parameters; toxicities were prospectively assessed at each institution according to the Common Terminology Criteria for Adverse Events. Patients treated daily were compared with those treated every other day (QOD)/other nondaily regimens. Stratification between central and peripheral tumors was also performed. Results: Ninety-two patients from 12 institutions were evaluated (2004-2016), with median follow-up of 12 months. In total there were 23 (25%) and 6 (7%) grade ≥2 and grade ≥3 toxicities, respectively. Grades 2 and 3 pulmonary toxicities occurred in 9% and 4%, respectively; 1 patient treated daily experienced grade 5 radiation pneumonitis. Of the entire cohort, 46 patients underwent daily SBRT, and 46 received QOD (n=40)/other nondaily (n=6) regimens. Clinical/treatment parameters were similar between groups; the QOD/other group was more likely to receive 3-/4-fraction schemas. Patients treated QOD/other experienced significantly fewer grade ≥2 toxicities as compared with daily treatment (7% vs 43%, P<.001). Patients treated daily also had higher rates of grade ≥2 pulmonary toxicities (P=.014). Patients with peripheral tumors (n=66) were more likely to receive 3-/4-fraction regimens than those with central tumors (n=26). No significant differences in grade ≥2 toxicities were identified according to tumor location (P>.05). Conclusions: From this multi-institutional study, toxicity of SBRT for ≥5-cm lesions is acceptable, and daily treatment was associated with a higher rate of toxicities.

Entrepreneurship Education in Delta State Tertiary Institution as a Means of Achieving National Growth and Development

Science.gov (United States)

Osakwe, Regina N.

2015-01-01

This study examined entrepreneurship education in Delta Sate tertiary institutions as a means of national growth and development. Two research questions were asked to guide the study. The population comprised all the 1,898 academic staff in eight tertiary institutions in the state. A sample of 800 lecturers was drawn through the multi stage and…

Student Success in Top 20 Courses of an Online Institution: Demographic Differences in a Multi-Semester Cross-Curricular Study

Science.gov (United States)

Gibson, Angela M.; Kupczynski, Lori; Ice, Phil

2010-01-01

Student success is vitally important. Without academic achievement student self-efficacy is lost, persistence is blocked, and matriculation is unachievable. Exponential growth at online institutions necessitates the inquiry into factors that play a role in student success. In this study, approximately 15,000 cases from the Top 20 enrolled courses…

Multi-institutional evaluation of end-to-end protocol for IMRT/VMAT treatment chains utilizing conventional linacs.

Science.gov (United States)

Loughery, Brian; Knill, Cory; Silverstein, Evan; Zakjevskii, Viatcheslav; Masi, Kathryn; Covington, Elizabeth; Snyder, Karen; Song, Kwang; Snyder, Michael

2018-03-20

We conducted a multi-institutional assessment of a recently developed end-to-end monthly quality assurance (QA) protocol for external beam radiation therapy treatment chains. This protocol validates the entire treatment chain against a baseline to detect the presence of complex errors not easily found in standard component-based QA methods. Participating physicists from 3 institutions ran the end-to-end protocol on treatment chains that include Imaging and Radiation Oncology Core (IROC)-credentialed linacs. Results were analyzed in the form of American Association of Physicists in Medicine (AAPM) Task Group (TG)-119 so that they may be referenced by future test participants. Optically stimulated luminescent dosimeter (OSLD), EBT3 radiochromic film, and A1SL ion chamber readings were accumulated across 10 test runs. Confidence limits were calculated to determine where 95% of measurements should fall. From calculated confidence limits, 95% of measurements should be within 5% error for OSLDs, 4% error for ionization chambers, and 4% error for (96% relative gamma pass rate) radiochromic film at 3% agreement/3 mm distance to agreement. Data were separated by institution, model of linac, and treatment protocol (intensity-modulated radiation therapy [IMRT] vs volumetric modulated arc therapy [VMAT]). A total of 97% of OSLDs, 98% of ion chambers, and 93% of films were within the confidence limits; measurements were found outside these limits by a maximum of 4%, consistent despite institutional differences in OSLD reading equipment and radiochromic film calibration techniques. Results from this test may be used by clinics for data comparison. Areas of improvement were identified in the end-to-end protocol that can be implemented in an updated version. The consistency of our data demonstrates the reproducibility and ease-of-use of such tests and suggests a potential role for their use in broad end-to-end QA initiatives. Copyright © 2018 American Association of Medical

Race/Ethnicity and Success in Academic Medicine: Findings From a Longitudinal Multi-Institutional Study.

Science.gov (United States)

Kaplan, Samantha E; Raj, Anita; Carr, Phyllis L; Terrin, Norma; Breeze, Janis L; Freund, Karen M

2017-10-24

To understand differences in productivity, advancement, retention, satisfaction, and compensation comparing underrepresented medical (URM) faculty with other faculty at multiple institutions. A 17-year follow-up was conducted of the National Faculty Survey, a random sample from 24 U.S. medical schools, oversampled for URM faculty. The authors examined academic productivity, advancement, retention, satisfaction, and compensation, comparing white, URM, and non-URM faculty. Retention, productivity, and advancement data were obtained from public sources for nonrespondents. Covariates included gender, specialty, time distribution, and years in academia. Negative binomial regression was used for count data, logistic regression for binary outcomes, and linear regression for continuous outcomes. In productivity analyses, advancement, and retention, 1,270 participants were included; 604 participants responded to the compensation and satisfaction survey. Response rates were lower for African American (26%) and Hispanic faculty (39%) than white faculty (52%, P career satisfaction, or compensation between URM and white faculty. URM and white faculty had similar career satisfaction, grant support, leadership, and compensation; URM faculty had fewer publications and were less likely to be promoted and retained in academic careers. Successful retention of URM faculty requires comprehensive institutional commitment to changing the academic climate and deliberative programming to support productivity and advancement.

The influence of multi-frontal teaching method on the effectiveness of the teaching process in the applied studies in technical sciences

Directory of Open Access Journals (Sweden)

Novković Dragan

2015-01-01

Full Text Available The orientation towards equity and quality in education clearly imposes the need for individual approach to each student separately. This situation is especially pronounced in the higher education institutions of applied studies in the field of technology, whose primary goal is very often individual training for use of highly specialized software and hardware tools. In such a situation it is necessary to move away from classical ex-cathedra methodology, and to develop student-centred learning environments. The multi-frontal teaching method was until now experimentally analyzed at the level of primary and secondary education in Serbia, where it shows results that suggest additional research is warranted. The research presented in this paper aims to investigate the effectiveness of this method applied in higher education institution of applied studies in the domain of technology. Results of the conducted research indicate that the application of the multi-frontal teaching method shows a positive effect on students' performance, self-efficacy and overall sense of personal gain and satisfaction.

Market development study for active solar thermal systems in the institutional, commercial and industrial sectors : final report

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

Promising market opportunities for the sale of Active Solar Thermal Systems (ASTS) in the institutional, commercial and industrial sectors of the Canadian economy were examined in an effort to identify the main factors for success and the barriers to development of the ASTS market. This report described some of the action plans which could help Natural Resources Canada and the industry to develop these markets. It was noted that a promising ASTS application should have a substantial market. Some of the promising applications for ASTS include air heating applications such as: (1) make-up air to an industrial facility, particularly one that requires a high rate of air flow or air layer destratification, such as in welding operations, paint shops or vehicle maintenance facilities, (2) ventilation to a high-walled commercial or institutional building that requires high air flow such as in schools, recreational facilities, multi-residential or retail buildings, and (3) slow drying applications for crops, lumber or other materials. Promising water heating applications include: (1) high volume low temperature rise applications such as in swimming pools, (2) domestic hot water to high density accommodations such as in hotels, multi-unit dwellings, college residences and military barracks, (3) domestic hot water to an isolated location such as campgrounds or lodges, and (4) process hot water used for water washing in industry, restaurants, farms and car washes. This study concluded that there are many opportunities for sales of ASTS to the institutional, commercial and industrial sectors, but combined efforts are needed by committed members of the community to take advantage of these opportunities. 15 refs., 11 tabs., 2 figs., 4 append.

Clinicopathological features and prognosis of mucin-producing bile duct tumor and mucinous cystic tumor of the liver: a multi-institutional study by the Japan Biliary Association.

Science.gov (United States)

Kubota, Keiichi; Nakanuma, Yasuni; Kondo, Fukuo; Hachiya, Hiroyuki; Miyazaki, Masaru; Nagino, Masato; Yamamoto, Masakazu; Isayama, Hiroyuki; Tabata, Masami; Kinoshita, Hisafumi; Kamisawa, Terumi; Inui, Kazuo

2014-03-01

The aim of this study was to determine the clinicopathological features and surgical outcomes of mucinous cystic neoplasm of the liver (MCN) and mucin-producing intraductal papillary neoplasm of the intrahepatic bile duct (M-IPNB). We performed a multi-institutional, retrospective study of patients with MCN or M-IPNB pathologically defined by the presence or absence of an ovarian-like stroma. The M-IPNB and MCN were diagnosed in 119 and nine patients, respectively. MCN was observed in female patients, while M-IPNB produced symptoms of cholangitis. M-IPNBs were classed as low or intermediate grade in 53 cases, high grade in 23 and invasive carcinoma in 43. Fifty-one of the M-IPNBs were the pancreatobiliary type (PT), 33 were the intestinal type (IT), 23 were the oncocytic type (OT), and 12 were the gastric type (GT). The 1-, 5- and 10-year survival rates for the 105 patients with M-IPNB were 96%, 84% and 81%, respectively, while the 5-year survival rate for patients with MCN was 100%. OT and GT M-IPNB had better 10-year survival rates than PT and IT M-IPNB. Although MCN has different features from M-IPNB, both diseases have a good prognosis after resection. The cellular type of M-IPNB appears to predict outcome. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

SU-F-T-435: Helical Tomotherapy for Craniospinal Irradiation: What We Have Learned from a Multi-Institutional Study

Energy Technology Data Exchange (ETDEWEB)

Du, D; Kaprealian, T; Low, D; Qi, X [University of California Los Angeles, Los Angeles, CA (United States); Han, C [City of Hope National Medical Center, Los Angeles, CA (United States); Chen, J; Perez-Andujar, A [University of California San Francisco, Lafayette, CA (United States); Lee, B [University of California, Los Angeles, Los Angeles, CA (United States)

2016-06-15

Purpose: To report cranio-spinal irradiation (CSI) planning experience, compare dosimetric quality and delivery efficiency with Tomotherapy from different institutions, and to investigate effect of planning parameters on plan quality and treatment time. Methods: Clinical helical tomotherapy IMRT plans for thirty-nine CSI cases from three academic institutions were retrospectively evaluated. The planning parameters: field width (FW), pitch, modulation factor (MF), and achieved dosimetric endpoints were cross-compared. A fraction-dose-delivery-timing index (FDTI), defined as treatment time per fraction dose per PTV length, was utilized to evaluate plan delivery efficiency. A lower FDTI indicates higher delivery efficiency. We studied the correlation between planning quality, treatment time and planning parameters by grouping the plans under specific planning parameters. Additionally, we created new plans using 5cm jaw for a subset of plans that used 2.5cm jaw to exam if treatment efficiency can be improved without sacrificing plan quality. Results: There were significant dosimetric differences for organ at risks (OARs) among different institutions (A,B,C). Using the lowest average MF (1.9±0.4) and 5cm field width, C had the highest lung, heart, kidney, liver mean doses and maximum doses for lens. Using the same field width of 5cm, but higher MF (2.6±0.6), B had lower doses to the OARs in the thorax and abdomen area. Most of A’s plans were planned with 2.5cm jaw, the plans yielded better PTV coverage, higher OAR doses and slightly shorter FDTI compared to institution B. The replanned 5cm jaw plans achieved comparable PTV coverage and OARs sparing, while saving up to 44.7% treatment time. Conclusion: Plan quality and delivery efficiency could vary significantly in CSI planning on Tomotheapy due to choice of different planning parameters. CSI plans using a 5cm jaw, with proper selection of pitch and MF, can achieve comparable/ better plan quality with shorter

Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.

Directory of Open Access Journals (Sweden)

Calistus Wilunda

Full Text Available South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County.Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis.The barriers to institutional childbirth were categorised under four main themes: 1 Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2 Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3 Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4 Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission.Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested.

Community Forest Management and the Emergence of Multi-Scale Governance Institutions: Lessons for REDD+ Development from Mexico, Brazil and Bolivia

Directory of Open Access Journals (Sweden)

Gabriel Medina

2011-03-01

Full Text Available At their most local, initiatives to reduce emissions from deforestation and degradation (REDD will depend on rural people to manage forest resources. Although the design of frameworks, mechanisms and arrangements, to implement REDD programs have received significant attention, it is not yet clear how REDD+ will function on the ground or how the participation of local populations will be assured. Community forest management (CFM could be an option under REDD+ depending on how it is negotiated, largely because of the expectation that CFM could reduce emissions from deforestation and degradation. Examining institutional factors in the emergence of successful CFM systems and local forest enterprises could provide valuable lessons for REDD planners. We examine cases of CFM development in Mexico, Brazil and Bolivia, to assess the role of multi-scaled governance institutions in their development. Comparing and contrasting advanced CFM systems to regions where it is still emerging, we will show how the establishment of a local organizational base for communal resource management is crucial.

MUC1 Expression by Immunohistochemistry Is Associated with Adverse Pathologic Features in Prostate Cancer: A Multi-Institutional Study.

Directory of Open Access Journals (Sweden)

Okyaz Eminaga

Full Text Available The uncertainties inherent in clinical measures of prostate cancer (CaP aggressiveness endorse the investigation of clinically validated tissue biomarkers. MUC1 expression has been previously reported to independently predict aggressive localized prostate cancer. We used a large cohort to validate whether MUC1 protein levels measured by immunohistochemistry (IHC predict aggressive cancer, recurrence and survival outcomes after radical prostatectomy independent of clinical and pathological parameters.MUC1 IHC was performed on a multi-institutional tissue microarray (TMA resource including 1,326 men with a median follow-up of 5 years. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazard models and the Log-rank test.The presence of MUC1 expression was significantly associated with extracapsular extension and higher Gleason score, but not with seminal vesicle invasion, age, positive surgical margins or pre-operative serum PSA levels. In univariable analyses, positive MUC1 staining was significantly associated with a worse recurrence free survival (RFS (HR: 1.24, CI 1.03-1.49, P = 0.02, although not with disease specific survival (DSS, P>0.5. On multivariable analyses, the presence of positive surgical margins, extracapsular extension, seminal vesicle invasion, as well as higher pre-operative PSA and increasing Gleason score were independently associated with RFS, while MUC1 expression was not. Positive MUC1 expression was not independently associated with disease specific survival (DSS, but was weakly associated with overall survival (OS.In our large, rigorously designed validation cohort, MUC1 protein expression was associated with adverse pathological features, although it was not an independent predictor of outcome after radical prostatectomy.

Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer—IMIGASTRIC

Science.gov (United States)

Desiderio, Jacopo; Jiang, Zhi-Wei; Nguyen, Ninh T; Zhang, Shu; Reim, Daniel; Alimoglu, Orhan; Azagra, Juan-Santiago; Yu, Pei-Wu; Coburn, Natalie G; Qi, Feng; Jackson, Patrick G; Zang, Lu; Brower, Steven T; Kurokawa, Yukinori; Facy, Olivier; Tsujimoto, Hironori; Coratti, Andrea; Annecchiarico, Mario; Bazzocchi, Francesca; Avanzolini, Andrea; Gagniere, Johan; Pezet, Denis; Cianchi, Fabio; Badii, Benedetta; Novotny, Alexander; Eren, Tunc; Leblebici, Metin; Goergen, Martine; Zhang, Ben; Zhao, Yong-Liang; Liu, Tong; Al-Refaie, Waddah; Ma, Junjun; Takiguchi, Shuji; Lequeu, Jean-Baptiste; Trastulli, Stefano; Parisi, Amilcare

2015-01-01

Introduction Gastric cancer represents a great challenge for healthcare providers and requires a multidisciplinary treatment approach in which surgery plays a major role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and recently with the spread of robotic surgery, but a number of issues are currently being debated, including the limitations in performing an effective extended lymph node dissection, the real advantages of robotic systems, the role of laparoscopy for Advanced Gastric Cancer, the reproducibility of a total intracorporeal technique and the oncological results achievable during long-term follow-up. Methods and analysis A multi-institutional international database will be established to evaluate the role of robotic, laparoscopic and open approaches in gastric cancer, comprising of information regarding surgical, clinical and oncological features. A chart review will be conducted to enter data of participants with gastric cancer, previously treated at the participating institutions. The database is the first of its kind, through an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centres. Ethics and dissemination This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. A multicentre study with a large number of patients will permit further investigation of the safety and efficacy as well as the long-term outcomes of robotic, laparoscopic and open approaches for the management of gastric cancer. Trial registration number NCT02325453; Pre-results. PMID:26482769

Issues in assessing multi-institutional performance of BI-RADS-based CAD systems

Science.gov (United States)

Markey, Mia K.; Lo, Joseph Y.

2005-04-01

The purpose of this study was to investigate factors that impact the generalization of breast cancer computer-aided diagnosis (CAD) systems that utilize the Breast Imaging Reporting and Data System (BI-RADS). Data sets from four institutions were analyzed: Duke University Medical Center, University of Pennsylvania Medical Center, Massachusetts General Hospital, and Wake Forest University. The latter two data sets are subsets of the Digital Database for Screening Mammography. Each data set consisted of descriptions of mammographic lesions according to the BI-RADS lexicon, patient age, and pathology status (benign/malignant). Models were developed to predict pathology status from the BI-RADS descriptors and the patient age. Comparisons between the models built on data from the different institutions were made in terms of empirical (non-parametric) receiver operating characteristic (ROC) curves. Results suggest that BI-RADS-based CAD systems focused on specific classes of lesions may be more generally applicable than models that cover several lesion types. However, better generalization was seen in terms of the area under the ROC curve than in the partial area index (>90% sensitivity). Previous studies have illustrated the challenges in translating a BI-RADS-based CAD system from one institution to another. This study provides new insights into possible approaches to improve the generalization of BI-RADS-based CAD systems.

Imitation Modeling and Institutional Studies

Directory of Open Access Journals (Sweden)

Maksim Y. Barbashin

2017-09-01

Full Text Available This article discusses the use of imitation modeling in the conduct of institutional research. The institutional approach is based on the observation of social behavior. To understand a social process means to determine the key rules that individuals use, undertaking social actions associated with this process or phenomenon. This does not mean that institutions determine behavioral reactions, although there are a number of social situations where the majority of individuals follow the dominant rules. If the main laws of development of the institutional patterns are known, one can describe most of the social processes accurately. The author believes that the main difficulty with the analysis of institutional processes is their recursive nature: from the standards of behavior one may find the proposed actions of social agents who follow, obey or violate institutions, but the possibility of reconstructive analysis is not obvious. The author demonstrates how the institutional approach is applied to the analysis of social behavior. The article describes the basic principles and methodology of imitation modeling. Imitation modeling reveals the importance of institutions in structuring social transactions. The article concludes that in the long term institutional processes are not determined by initial conditions.

Deprivation and non-institutional political participation

DEFF Research Database (Denmark)

Ejrnæs, Anders

2017-01-01

This article examines how the relationship between perceived economic deprivation (PED) and non-institutional forms of political activity interacted with institutional trust during the economic crisis in 24 European countries. Using multi-level regression analysis, two broad questions are addressed......: (1) does PED have an impact on the level of non-institutional political participation among European citizens? And (2) does the level of institutional trust within countries have an impact on the relationship between PED and political activity among European citizens? The empirical analyses are based...... the opposite correlation on an individual level within the countries. Second, the analysis provides evidence that the institutional context shapes the connection between PED and political participation on the individual level. In countries with a high level of institutional trust, economically deprived...

The geographic dimensions of institutions

NARCIS (Netherlands)

Bhupatiraju, S.

2014-01-01

In this paper we examine the role of institutions relative to economic performance, absolute geography and financial performance of a country. In order to do this, we use the spatial principal component analysis and a spatial canonical correlation analysis to obtain multi-dimensional measure of

Multi-donor Research Platform on Social Protection, Financial ...

International Development Research Centre (IDRC) Digital Library (Canada)

Multi-donor Research Platform on Social Protection, Financial Inclusion and ... There have been some experiments linking a financial inclusion component to CCT programs, ... Universidad de Chile. Institution Country. Chile. Institution Website.

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules.

Science.gov (United States)

Dobbins, James T; McAdams, H Page; Sabol, John M; Chakraborty, Dev P; Kazerooni, Ella A; Reddy, Gautham P; Vikgren, Jenny; Båth, Magnus

2017-01-01

Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P chest radiography for all nodules (1.49-fold, P chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest

TTI Phase 2 Institutional Support: Instituto de Estudios Peruanos ...

International Development Research Centre (IDRC) Digital Library (Canada)

TTI is a multi-funder program dedicated to strengthening independent policy research institutions ... -achieve a diversified and expanded portfolio of funding partners by ... -establish a culture of continuous reflection, improvement, and learning through ... Health, SDGs, and public policy—the role of policy research institutions.

Multi-donor Research Platform on Social Protection, Financial ...

International Development Research Centre (IDRC) Digital Library (Canada)

Multi-donor Research Platform on Social Protection, Financial Inclusion and ICTs ... been some experiments linking a financial inclusion component to CCT programs, ... Institution. Universidad de Chile. Pays d' institution. Chile. Site internet.

Research Review of the Institute of African Studies

African Journals Online (AJOL)

Please note: As of 2013 the Research Review of the Institute of African Studies is now publishing under the title Contemporary Journal of African Studies. You can view the CJAS pages on AJOL here: http://www.ajol.info/index.php/contjas/index. The Research Review of the Institute of African Studies at the University of ...

Introduction to Special Issue "Gender, Culture and Alcohol Problems: A Multi-national Study

DEFF Research Database (Denmark)

Bloomfield, Kim; Gmel, Gerhard; Wilsnack, Sharon

2006-01-01

and global level. Country surveys were independently conducted and then centralized at one institution for further data standardization and processing. Several results indicated that the greater the societal gender equality in a country, the smaller the gender differences in drinking behavior. In most...... analyses the smallest gender differences in drinking behaviour were found in Nordic countries, followed by western and central European countries, with the largest gender differences in countries with developing economies.......This paper provides an introduction to a series of articles reporting results from the EU concerted action "Gender, Culture and Alcohol Problems: A Multi-national Study" which examined differences in drinking among women and men in 13 European and two non-European countries. The gender gap...

Quality assurance in clinical trials : a multi-disciplinary approach

International Nuclear Information System (INIS)

Cornes, D.

2001-01-01

Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

Study of African Dust with Multi-Wavelength Raman Lidar During "Shadow" Campaign in Senegal

Science.gov (United States)

Veselovskii, Igor; Goloub, Philippe; Podvin, Thierry; Bovchaliuk, Valentyn; Tanre, Didier; Derimian, Yevgeny; Korenskiy, Mikhail; Dubovik, Oleg

2016-06-01

West Africa and the adjacent oceanic regions are very important locations for studying dust properties and their influence on weather and climate. The SHADOW (Study of SaHAran Dust Over West Africa) campaign is performing a multi-scale and multi-laboratory study of aerosol properties and dynamics using a set of in situ and remote sensing instruments at an observation site located at IRD (Institute for Research and Development) Center, Mbour, Senegal (14°N, 17°W). In this paper, we present the results of lidar measurements performed during the first phase of SHADOW which occurred in March-April, 2015. The multiwavelength Mie-Raman lidar acquired 3β+2α+1δ measurements during this period. This set of measurements has permitted particle intensive properties such as extinction and backscattering Ångström exponents (BAE) for 355/532 nm wavelengths corresponding lidar ratios and depolarization ratio at 532 nm to be determined. The backscattering Ångström exponent during the dust episodes decreased to ~-0.7, while the extinction Ångström exponent though being negative, was greater than -0.2. Low values of BAE can likely be explained by an increase in the imaginary part of the dust refractive index at 355 nm compared to 532 nm.

Cyberinfrastructure for Open Science at the Montreal Neurological Institute.

Science.gov (United States)

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C

2016-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing

Non-Linear Multi-Physics Analysis and Multi-Objective Optimization in Electroheating Applications

Czech Academy of Sciences Publication Activity Database

di Barba, P.; Doležel, Ivo; Mognaschi, M. E.; Savini, A.; Karban, P.

2014-01-01

Roč. 50, č. 2 (2014), s. 7016604-7016604 ISSN 0018-9464 Institutional support: RVO:61388998 Keywords : coupled multi-physics problems * finite element method * non-linear equations Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 1.386, year: 2014

Multi-media pollution prevention: A case study of a refinery

International Nuclear Information System (INIS)

Schmitt, R.E.; Podar, M.K.

1994-01-01

In late 1989, Amoco Corporation and the United States Environmental Protection Agency began a voluntary, joint project to study pollution prevention opportunities at an industrial facility. Amoco proposed use of its refinery at Yorktown, Virginia, to conduct a multi-media assessment of releases to the environment, then to develop and evaluate options to reduce these releases. A Workgroup composed of state, federal, and Amoco representatives provided oversight to the Project. Monthly Workgroup meetings provided Project oversight, a forum for presentations on different Project components, and an opportunity for informal discussion of different viewpoints about environmental management. The Workgroup identified four objectives for this study: (1) Inventory refinery releases to the environment to define their chemical type, quantity, source, and medium of release; (2) develop options to reduce selected releases identified, as well as rank and prioritize the options based on a variety of criteria and perspectives; (3) identify and evaluate factors as technical, legislative, regulatory, institutional, permitting, and economic, that impede or encourage pollution prevention; and (4) enhance participates' knowledge of refinery and regulatory systems

Studies on the closed-loop digital control of multi-modular reactors

International Nuclear Information System (INIS)

Bernard, J.A.; Henry, A.F.; Lanning, D.D.; Meyer, J.E.

1992-11-01

This report describes the theoretical development and the evaluation via both experiment and simulation of digital methods for the closed-loop control of power, temperature, and steam generator level in multi-modular reactors. The major conclusion of the research reported here is that the technology is currently available to automate many aspects of the operation of multi-modular plants. This will in turn minimize the number of required personnel and thus contain both operating and personnel costs, allow each module to be operated at a different power level thereby staggering the times at which refuelings would be needed, and maintain the competitiveness of US industry relative to foreign vendors who are developing and applying advanced control concepts. The technology described in this report is appropriate to the proposed multi-modular reactor designs and to present-generation pressurized water reactors. Its extension to boiling water reactors is possible provided that the commitment is made to create a real-time model of a BWR. The work reported here was performed by the Massachusetts Institute of Technology (MIT) under contract to the Oak Ridge National Laboratory (ORNL) and to the United States Department of Energy (Division of Industry and University Programs, Contract No. DE-FG07-90ER12930.)

Annual report of the Institute of Physical and Chemical Research, for fiscal 1999

International Nuclear Information System (INIS)

2000-01-01

The research activities in the Institute of Physical and Chemical Research (RIKEN) for the fiscal year 1999 were briefly described in this report. In addition, the research papers published in the year from the laboratories in RIKEN Wako Main Campus, RIKEN Tsukuba Research Center of Life Science and RIKEN Harima Institute were presented. Moreover, ten special research projects for basic science are now progressing on the following themes: photosynthetic science (artificial photosynthesis and the mechanism of photosynthesis), biodesign research (cellular function system, membranous function system), coherent science research (coherent control for free electron, quantum processing, structural control and coherent molecular interaction), research on multi-bioprobes (development of multi-functional bioactive compounds), research on essential reaction (stereo-control and energy control), atomic-scale sciengineering (phase 2 study), MR science research (phase 2 study), slow quantum beam production of ultra slow highly charged ions and ecomolecular science research (material conversion and biological/chemical conversion for environmental compounds). The research activities of RIKEN Brain Science Institute were also outlined and RIKEN Genomic Sciences Center were also outlined. In the year, RIKEN symposium was held 38 times by various laboratories. Here, the themes of these symposia were listed as well as those of international symposia sponsored by RIKEN Institute. (M.N.)

77 FR 22581 - National Institute on Drug Abuse; Notice of Closed Meeting

Science.gov (United States)

2012-04-16

... personal privacy. Name of Committee: National Institute on Drug Abuse Special Emphasis Panel Multi-site... Branch, Office of Extramural Affairs, National Institute on Drug Abuse, NIH, DHHS, 6001 Executive Blvd... Domestic Assistance Program Nos.: 93.279, Drug Abuse and Addiction Research Programs, National Institutes...

Global Benchmarking of Marketing Doctoral Program Faculty and Institutions by Subarea

Science.gov (United States)

Elbeck, Matt; Vander Schee, Brian A.

2014-01-01

This study benchmarks marketing doctoral programs worldwide in five popular subareas by faculty and institutional scholarly impact. A multi-item approach identifies a collection of top-tier scholarly journals for each subarea, while citation data over the decade 2003 to 2012 identify high scholarly impact marketing faculty by subarea used to…

Ethical dilemmas of a large national multi-centre study in Australia: time for some consistency.

Science.gov (United States)

Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon

2008-08-01

To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits

40 Anniversary of Institute of International Studies: From a Problem Laboratory to The Institute of International Studies

Directory of Open Access Journals (Sweden)

Alexander Leonidovich Chechevishnikov

2016-01-01

Full Text Available Applied foreign policy analysis is the hallmark of MGIMO-University. 2016 marks 40 anniversary of introduction of this element to the identity of our university in a form of Problem Research Laboratory. MGIMO development as a leading think tank took place in cooperation with the Ministry of Foreign Affairs and in close cooperation with other key institutions that shape foreign policy and are responsible for ensuring the national interests of Russia in the world. Today MGIMO's priority is the development of political policy expertise and analytical development-oriented scientific and practical support of the activities of state bodies. Such studies are the main but not the only focus of the Institute of International Studies.

SU-D-201-01: A Multi-Institutional Study Quantifying the Impact of Simulated Linear Accelerator VMAT Errors for Nasopharynx

International Nuclear Information System (INIS)

Pogson, E; Hansen, C; Blake, S; Thwaites, D; Arumugam, S; Juresic, J; Ochoa, C; Yakobi, J; Haman, A; Trtovac, A; Holloway, L

2016-01-01

Purpose: To quantify the impact of differing magnitudes of simulated linear accelerator errors on the dose to the target volume and organs at risk for nasopharynx VMAT. Methods: Ten nasopharynx cancer patients were retrospectively replanned twice with one full arc VMAT by two institutions. Treatment uncertainties (gantry angle and collimator in degrees, MLC field size and MLC shifts in mm) were introduced into these plans at increments of 5,2,1,−1,−2 and −5. This was completed using an in-house Python script within Pinnacle3 and analysed using 3DVH and MatLab. The mean and maximum dose were calculated for the Planning Target Volume (PTV1), parotids, brainstem, and spinal cord and then compared to the original baseline plan. The D1cc was also calculated for the spinal cord and brainstem. Patient average results were compared across institutions. Results: Introduced gantry angle errors had the smallest effect of dose, no tolerances were exceeded for one institution, and the second institutions VMAT plans were only exceeded for gantry angle of ±5° affecting different sided parotids by 14–18%. PTV1, brainstem and spinal cord tolerances were exceeded for collimator angles of ±5 degrees, MLC shifts and MLC field sizes of ±1 and beyond, at the first institution. At the second institution, sensitivity to errors was marginally higher for some errors including the collimator error producing doses exceeding tolerances above ±2 degrees, and marginally lower with tolerances exceeded above MLC shifts of ±2. The largest differences occur with MLC field sizes, with both institutions reporting exceeded tolerances, for all introduced errors (±1 and beyond). Conclusion: The plan robustness for VMAT nasopharynx plans has been demonstrated. Gantry errors have the least impact on patient doses, however MLC field sizes exceed tolerances even with relatively low introduced errors and also produce the largest errors. This was consistent across both departments. The authors

SU-D-201-01: A Multi-Institutional Study Quantifying the Impact of Simulated Linear Accelerator VMAT Errors for Nasopharynx

Energy Technology Data Exchange (ETDEWEB)

Pogson, E [Institute of Medical Physics, The University of Sydney, Sydney, NSW (Australia); Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (Australia); Ingham Institute for Applied Medical Research, Sydney, NSW (Australia); Hansen, C [Laboratory of Radiation Physics, Odense University Hospital, Odense (Denmark); Institute of Clinical Research, University of Southern Denmark, Odense (Denmark); Blake, S; Thwaites, D [Institute of Medical Physics, The University of Sydney, Sydney, NSW (Australia); Arumugam, S; Juresic, J; Ochoa, C; Yakobi, J; Haman, A; Trtovac, A [Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (Australia); Holloway, L [Institute of Medical Physics, The University of Sydney, Sydney, NSW (Australia); Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (Australia); Ingham Institute for Applied Medical Research, Sydney, NSW (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney, NSW (Australia); University of Wollongong, Wollongong, NSW (Australia)

2016-06-15

Purpose: To quantify the impact of differing magnitudes of simulated linear accelerator errors on the dose to the target volume and organs at risk for nasopharynx VMAT. Methods: Ten nasopharynx cancer patients were retrospectively replanned twice with one full arc VMAT by two institutions. Treatment uncertainties (gantry angle and collimator in degrees, MLC field size and MLC shifts in mm) were introduced into these plans at increments of 5,2,1,−1,−2 and −5. This was completed using an in-house Python script within Pinnacle3 and analysed using 3DVH and MatLab. The mean and maximum dose were calculated for the Planning Target Volume (PTV1), parotids, brainstem, and spinal cord and then compared to the original baseline plan. The D1cc was also calculated for the spinal cord and brainstem. Patient average results were compared across institutions. Results: Introduced gantry angle errors had the smallest effect of dose, no tolerances were exceeded for one institution, and the second institutions VMAT plans were only exceeded for gantry angle of ±5° affecting different sided parotids by 14–18%. PTV1, brainstem and spinal cord tolerances were exceeded for collimator angles of ±5 degrees, MLC shifts and MLC field sizes of ±1 and beyond, at the first institution. At the second institution, sensitivity to errors was marginally higher for some errors including the collimator error producing doses exceeding tolerances above ±2 degrees, and marginally lower with tolerances exceeded above MLC shifts of ±2. The largest differences occur with MLC field sizes, with both institutions reporting exceeded tolerances, for all introduced errors (±1 and beyond). Conclusion: The plan robustness for VMAT nasopharynx plans has been demonstrated. Gantry errors have the least impact on patient doses, however MLC field sizes exceed tolerances even with relatively low introduced errors and also produce the largest errors. This was consistent across both departments. The authors

Planning a multi-institutional information for development study centre

CSIR Research Space (South Africa)

Moreno, A

2010-05-01

Full Text Available . The I4D Study Centre tasks are to increase both the research expertise pool available for Meraka and the partner university, and the joint development of study programs with universities that will prepare students for a researcher career with an ICT4D...

Extended multi-configuration quasi-degenerate perturbation theory: the new approach to multi-state multi-reference perturbation theory.

Science.gov (United States)

Granovsky, Alexander A

2011-06-07

The distinctive desirable features, both mathematically and physically meaningful, for all partially contracted multi-state multi-reference perturbation theories (MS-MR-PT) are explicitly formulated. The original approach to MS-MR-PT theory, called extended multi-configuration quasi-degenerate perturbation theory (XMCQDPT), having most, if not all, of the desirable properties is introduced. The new method is applied at the second order of perturbation theory (XMCQDPT2) to the 1(1)A(')-2(1)A(') conical intersection in allene molecule, the avoided crossing in LiF molecule, and the 1(1)A(1) to 2(1)A(1) electronic transition in cis-1,3-butadiene. The new theory has several advantages compared to those of well-established approaches, such as second order multi-configuration quasi-degenerate perturbation theory and multi-state-second order complete active space perturbation theory. The analysis of the prevalent approaches to the MS-MR-PT theory performed within the framework of the XMCQDPT theory unveils the origin of their common inherent problems. We describe the efficient implementation strategy that makes XMCQDPT2 an especially useful general-purpose tool in the high-level modeling of small to large molecular systems. © 2011 American Institute of Physics

Institutional Disparities in the Cost Effectiveness of GCE A-Level Provision: A Multi-Level Approach.

Science.gov (United States)

Fielding, A.

1995-01-01

Reanalyzes H. Thomas's 1980s data, which used teaching group as the unit of analysis and illuminated some institutional disparities in provision of General Certificate of Education (GCE) A-levels. Uses multilevel analysis to focus on individual students in a hierarchical framework. Among the study institutions, school sixth forms appear less…

Peptide receptor radionuclide therapy for neuroendocrine tumors in Germany: first results of a multi-institutional cancer registry.

Science.gov (United States)

Hörsch, Dieter; Ezziddin, Samer; Haug, Alexander; Gratz, Klaus Friedrich; Dunkelmann, Simone; Krause, Bernd Joachim; Schümichen, Carl; Bengel, Frank M; Knapp, Wolfram H; Bartenstein, Peter; Biersack, Hans-Jürgen; Plöckinger, Ursula; Schwartz-Fuchs, Sabine; Baum, R P

2013-01-01

Peptide receptor radionuclide therapy is an effective treatment option for patients with well-differentiated somatostatin receptor-expressing neuroendocrine tumors. However, published data result mainly from retrospective monocentric studies. We initiated a multi-institutional, prospective, board-reviewed registry for patients treated with peptide receptor radionuclide therapy in Germany in 2009. In five centers, 297 patients were registered. Primary tumors were mainly derived from pancreas (117/297) and small intestine (80/297), whereas 56 were of unknown primary. Most tumors were well differentiated with median Ki67 proliferation rate of 5% (range 0.9-70%). Peptide receptor radionuclide therapy was performed using mainly yttrium-90 and/or lutetium-177 as radionuclides in 1-8 cycles. Mean overall survival was estimated at 213 months with follow-up between 1 and 230 months after initial diagnosis, and 87 months with follow-up between 1 and 92 months after start of peptide receptor radionuclide therapy. Median overall survival was not yet reached. Subgroup analysis demonstrated that best results were obtained in neuroendocrine tumors with proliferation rate below 20%. Our results indicate that peptide receptor radionuclide therapy is an effective treatment for well- and moderately differentiated neuroendocrine tumors irrespective of previous therapies and should be regarded as one of the primary treatment options for patients with somatostatin receptor-expressing neuroendocrine tumors.

Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

Directory of Open Access Journals (Sweden)

Salvatore Sansalone

2017-01-01

Full Text Available Penile cancer is an uncommon malignancy. Surgical treatment is inevitably mutilating. Considering the strong impact on patients′ sexual life we want to evaluate sexual function and satisfaction after partial penectomy. The patients in this study (n = 25 represented all those who attended our institutions and were diagnosed and treated for penile cancer from October 2011 to November 2013. All patients underwent partial penectomy and followed-up (mean: 14 months; range: 12-25. Sexual presurgical baseline was estimated using the International Index of Erectile Dysfunction 15 (IIEF-15. Sexual outcomes of each patient were estimated considering four standardized and validated questionnaires. We analyzed the means and ranges of IIEF-15 including erectile function (IIEF-1-5 and -15, orgasmic function (IIEF-9 and -10, sexual desire (IIEF-11 and -12, intercourse satisfaction (IIEF-6-8, and overall satisfaction (IIEF-13 and -14. Then, we also used Quality of Erection Questionnaire (QEQ, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS and Self-Esteem and Relationship (SEAR to evaluate the sexual function and satisfaction of our patients. The final results showed that penile cancer leads to several sexual and psychosexual dysfunctions. Nevertheless, patients who undergo partial penectomy for penile cancer can maintain the sexual outcomes at levels slightly lower to those that existed in the period before surgery.

Neo-Institutional Approach to the Study of Electronic Government

Directory of Open Access Journals (Sweden)

Yan I. Vaslavskiy

2016-01-01

Full Text Available The article is devoted to the neo-institutional approach as a methodological basis in the study of electronic government. In this article substantiates the choice of neo-institutional approach to the study of the processes of implementation of information and communication technologies in the activity of state institutions, analyzes the differences of neoinstitutionalism from traditional institutional approach, considers the features of the different directions of neo-institutionalism, namely sociological, historical and rational choice theory. Attention is paid to the reasons for the renewed interest in political institutions in political science. The article emphasizes the importance of considering the electronic government as an institution, and the conditions for its implementation in the Russian political system as the institutional environment. The authors pay special attention to the variety of sociological neo-institutionalism, used, in addition to political science in sociology of organizations. The article substantiates the value of using sociological institutionalism to explore the electronic government based on a comparative analysis of e-government projects in Russia and abroad and explores its heuristic capabilities. It examines the impact of the system of norms and values of the institutional environment on the processes of formation and development of electronic government in Russia. The research capacity of this theory is due to the fact that it allows us to trace the reasons for copying and replication of inefficient practices and organizational and management schemes, to identify the factors impeding innovation use by the state of electronic interaction technologies. It is emphasized that the use of the theory of institutional isomorphism is useful in the sphere of implementation of electronic technologies, in which a key role play pluralism, horizontal managerial communication, inter-agency coordination.

Institutional Frameworks for Management of Epizoonotic ...

African Journals Online (AJOL)

Introduction: The Eastern Africa region is a hot-spot for epidemics of emerging zoonotic diseases ('epizoonotics'). However, the region's capacity for response to epidemics of zoonotic origin has not been documented. This paper presents a multi-country situational analysis on the institutional frameworks for management of ...

Multi-Institutional Experience of Stereotactic Ablative Radiation Therapy for Stage I Small Cell Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Simone, Charles B. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gajjar, Sameer R. [Baylor College of Medicine, Houston, Texas (United States); Shah, Chirag [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Zhen, Weining [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Harkenrider, Matthew M. [Department of Radiation Oncology, Loyola University Stritch School of Medicine, Maywood, Illinois (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Jabbour, Salma K. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey (United States); Matthiesen, Chance L. [Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, Oklahoma (United States); Braunstein, Steve E. [Department of Radiation Oncology, University of California, San Francisco, School of Medicine, San Francisco, California (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Dilling, Thomas J. [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida (United States); Allen, Bryan G. [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Nichols, Elizabeth M. [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States); and others

2017-02-01

Purpose: For inoperable stage I (T1-T2N0) small cell lung cancer (SCLC), national guidelines recommend chemotherapy with or without conventionally fractionated radiation therapy. The present multi-institutional cohort study investigated the role of stereotactic ablative radiation therapy (SABR) for this population. Methods and Materials: The clinical and treatment characteristics, toxicities, outcomes, and patterns of failure were assessed in patients with histologically confirmed stage T1-T2N0M0 SCLC. Kaplan-Meier analysis was used to evaluate the survival outcomes. Univariate and multivariate analyses identified predictors of outcomes. Results: From 24 institutions, 76 lesions were treated in 74 patients (median follow-up 18 months). The median age and tumor size was 72 years and 2.5 cm, respectively. Chemotherapy and prophylactic cranial irradiation were delivered in 56% and 23% of cases, respectively. The median SABR dose and fractionation was 50 Gy and 5 fractions. The 1- and 3-year local control rate was 97.4% and 96.1%, respectively. The median disease-free survival (DFS) duration was 49.7 months. The DFS rate was 58.3% and 53.2% at 1 and 3 years, respectively. The median, 1-year, and 3-year disease-specific survival was 52.3 months, 84.5%, and 64.4%, respectively. The median, 1-year, and 3-year overall survival (OS) was 17.8 months, 69.9%, and 34.0% respectively. Patients receiving chemotherapy experienced an increased median DFS (61.3 vs 9.0 months; P=.02) and OS (31.4 vs 14.3 months; P=.02). The receipt of chemotherapy independently predicted better outcomes for DFS/OS on multivariate analysis (P=.01). Toxicities were uncommon; 5.2% experienced grade ≥2 pneumonitis. Post-treatment failure was most commonly distant (45.8% of recurrence), followed by nodal (25.0%) and “elsewhere lung” (20.8%). The median time to each was 5 to 7 months. Conclusions: From the findings of the largest report of SABR for stage T1-T2N0 SCLC to date, SABR (≥50�

The Multi-Campus System's Role in Maintaining Institutional Diversity in Texas, Public Universities

Science.gov (United States)

Lewis, Rebecca J.

2012-01-01

Institutional diversity is a long-held value in U.S. higher education with origins dating back 300 years to pre-Revolutionary colonial colleges. Institutional diversity is still valued today, but Institutional theory predicts that institutional organizations, such as universities, will homogenize without intervention to prevent loss of diversity.…

A nationwide multi-institutional retrospective study to identify prognostic factors and develop a graded prognostic assessment system for patients with brain metastases from uterine corpus and cervical cancer.

Science.gov (United States)

Hayashi, Nakamasa; Takahashi, Hideaki; Hasegawa, Yuzo; Higuchi, Fumi; Takahashi, Masamichi; Makino, Keishi; Takagaki, Masatoshi; Akimoto, Jiro; Okuda, Takeshi; Okita, Yoshiko; Mitsuya, Koichi; Hirashima, Yasuyuki; Narita, Yoshitaka; Nakasu, Yoko

2017-06-02

The prevalence of brain metastases (BM) from uterine cancer has recently increased because of the improvement of overall survival (OS) of patients with uterine cancer due to its early detection and improved local control as a result of new effective treatments. However, little information is available regarding their clinical characteristics and prognosis, because oncologists have encountered BM from uterine cancer on rare occasions. Records from 81 patients with uterine BM were collected from 10 institutes in Japan. These were used in a multi-institutional study to identify prognostic factors and develop a graded prognostic assessment (GPA) for patients with BM from uterine cancer. Median OS after the development of BM was 7 months (95% confidence interval, 4 to 10 months). Multivariate analysis revealed that there were survival differences according to the existence of extracranial metastases and number of BM. In the present uterine-GPA, a score of 0 was assigned to those patients with ≥5 BM and extracranial metastasis, a score of 2 was assigned to those patients with one to four BM or without extracranial metastasis, and a score of 4 was assigned to those patients with one to four BM and without extracranial metastasis. The median OS for patients with a uterine-GPA scores of 0, 2, and 4 was 3, 7, and 22 months, respectively. A survival analysis confirmed the presence of statistically significant differences between these groups (p Brain Tumor Registry of Japan. Uterine GPA incorporates two simple clinical parameters of high prognostic significance and can be used to predict the expected survival times in patients with BM from uterine cancer. Its use may help in determining an appropriate treatment for individual patients with BM.

Using multi-state markov models to identify credit card risk

Directory of Open Access Journals (Sweden)

Daniel Evangelista Régis

2016-06-01

Full Text Available Abstract The main interest of this work is to analyze the application of multi-state Markov models to evaluate credit card risk by investigating the characteristics of different state transitions in client-institution relationships over time, thereby generating score models for various purposes. We also used logistic regression models to compare the results with those obtained using multi-state Markov models. The models were applied to an actual database of a Brazilian financial institution. In this application, multi-state Markov models performed better than logistic regression models in predicting default risk, and logistic regression models performed better in predicting cancellation risk.

Multi-Institutional Collaborative Astronomy Education Research

Science.gov (United States)

Slater, T. F.; Slater, S. J.

2011-09-01

ASP, AAS, APS, and AAPT advocate that scientists should be engaged and acknowledged for successfully engaging in astronomy and physics education research and the scholarship of teaching because these efforts serve to improve pedagogical techniques and the evaluation of teaching. However, scientists have had the opportunity to pursue formal training in how to meaningfully engage in astronomy education research as an important scholarly endeavor. This special interest session for college and university physics and astronomy faculty, post-docs, and graduate students provided a forum to discuss the motivations, strategies, methodology, and publication routes for improving astronomy education through conducting rigorous science education research. Topics for discussion targeted the value of various education research questions, strengths and weaknesses of several different research design methodologies, strategies to successfully obtain Institutional Review Board approval to conduct education research on human subjects, and become more aware of how education research articles are created for publication in journals such as the Astronomy Education Review.

Building, breaking, overriding…? Migrants and institutional trust in the Danish welfare state

DEFF Research Database (Denmark)

Fersch, Barbara; Breidahl, Karen Nielsen

2018-01-01

Migrants constitute an interesting case concerning the question of how trust in welfare state institutions can emerge, as one can study their newly built relationships with such institutions in a distinct way. The Danish welfare state can be considered a ‘high trust’ context in terms of social...... and institutional trust. With the help of a multi-dimensional theoretical concept this paper provides an analysis of qualitative interviews with migrants on how institutional trust in the welfare state can emerge. Among other things, it finds that a perceived experience of distributive justice is of crucial...... importance for building trust and that strong trust in the systemic checks and balances of the welfare state can ‘override’ negative experiences at its access points, that is, welfare state professionals....

40th Anniversary of Institute of International Studies: From a Problem Laboratory to The Institute of International Studies

Directory of Open Access Journals (Sweden)

Alexander Leonidovich Chechevishnikov

2016-01-01

Full Text Available Applied foreign policy analysis is the hallmark of MGIMO-University. 2016 marks 40th anniversary of introduction of this element to the identity of our university in a form of Problem Research Laboratory. MGIMO development as a leading think tank took place in cooperation with the Ministry of Foreign Affairs and in close cooperation with other key institutions that shape foreign policy and are responsible for ensuring the national interests of Russia in the world. Today MGIMO's priority is the development of political policy expertise and analytical development-oriented scientific and practical support of the activities of state bodies. Such studies are the main but not the only focus of the Institute of International Studies.

A CASE STUDY OF LUNTIAN MULTI-PURPOSE COOPERATIVE IN BARANGAY LALAIG, TIAONG, QUEZON, PHILIPPINES: A VERTICAL INTEGRATION APPROACH

Directory of Open Access Journals (Sweden)

M.V. Perilla

2014-10-01

Full Text Available The Luntian Multi-Purpose Cooperative located in Tiaong, Quezon, Philippines. The Luntian MultiPurposecooperative focuses more on feed production as well as hog fattening. The LMC applied thevertical integration to develop the cooperative. They have their members as their primary costumers of theirfeeds. The cooperative’s business activity includes also meat shop, granting of production loan, microfinance,mobilization of saving deposits, aside from feed milling and hog fattening. Different agencies, industryorganizations and private institutions provide trainings, seminars, assistance, as well as credit for thecooperative.The aims of the study was to determine the present and discuss a noteworthy business issue (sof Luntian Multipurpose Cooperative, evaluate the business environment prevailing at a particular time ofthis case , assess the cooperative’s performance in terms of the four business functions , define the problemrelevant to the business issue(s being studied. The study used primary and secondary data. Primary datawere gathered through interviews with the key personnel, managers, and other informants of the LuntianMultipurpose Cooperative in order to obtain responses regarding the overall status of the cooperative includingits problem and plans. Secondary data were taken from files and documents, especially the history, backgroundinformation and financial statements. Other data were taken through research materials such as book,unpublished special problems and from some government institutions. The recommendation of this researchshowed that Luntian MPC should engage in establishing a communal farm as to become the primary sourceof hybrid piglets that their members would raised. The alternatives solution was establishing a breeding farmthat would ask for initial investment.

OPREVENT2: Design of a multi-institutional intervention for obesity control and prevention for American Indian adults.

Science.gov (United States)

Gittelsohn, Joel; Jock, Brittany; Redmond, Leslie; Fleischhacker, Sheila; Eckmann, Thomas; Bleich, Sara N; Loh, Hong; Ogburn, Elizabeth; Gadhoke, Preety; Swartz, Jacqueline; Pardilla, Marla; Caballero, Benjamin

2017-01-23

Obesity and other nutrition-related chronic disease rates are high in American Indian (AI) populations, and an urgent need exists to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component (MLMC) interventions are needed, but there are significant knowledge gaps on how to deliver these types of interventions in low-income rural AI communities. OPREVENT2 is a MLMC intervention targeting AI adults living in six rural reservations in New Mexico and Wisconsin. Aiming to prevent and reduce obesity in adults by working at multiple levels of the food and physical activity (PA) environments, OPREVENT2 focuses on evidence-based strategies known to increase access to, demand for, and consumption of healthier foods and beverages, and increase worksite and home-based opportunities for PA. OPREVENT2 works to create systems-level change by partnering with tribal stakeholders, multiple levels of the food and PA environment (food stores, worksites, schools), and the social environment (children as change agents, families, social media). Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures. Novel aspects of OPREVENT2 include: active engagement with stakeholders at many levels (policy, institutional, and at multiple levels of the food and PA system); use of community-based strategies to engage policymakers and other key stakeholders (community workshops, action committees); emphasis on both the built environment (intervening with retail food sources) and the social environment. This paper describes the design of the intervention and the evaluation plan of the OPREVENT2. Clinical Trial Registration: NCT02803853 (June 10, 2016).

Study on high density multi-scale calculation technique

International Nuclear Information System (INIS)

Sekiguchi, S.; Tanaka, Y.; Nakada, H.; Nishikawa, T.; Yamamoto, N.; Yokokawa, M.

2004-01-01

To understand degradation of nuclear materials under irradiation, it is essential to know as much about each phenomenon observed from multi-scale points of view; they are micro-scale in atomic-level, macro-level in structural scale and intermediate level. In this study for application to meso-scale materials (100A ∼ 2μm), computer technology approaching from micro- and macro-scales was developed including modeling and computer application using computational science and technology method. And environmental condition of grid technology for multi-scale calculation was prepared. The software and MD (molecular dynamics) stencil for verifying the multi-scale calculation were improved and their movement was confirmed. (A. Hishinuma)

Multi-Band (K- Q- and E-Band) Multi-Tone Millimeter-Wave Frequency Synthesizer for Radio Wave Propagation Studies

Science.gov (United States)

Simons, Rainee N.; Wintucky, Edwin G.

2014-01-01

This paper presents the design and test results of a multi-band multi-tone millimeter-wave frequency synthesizer, based on a solid-state frequency comb generator. The intended application of the synthesizer is in a space-borne transmitter for radio wave atmospheric studies at K-band (18 to 26.5 GHz), Q-band (37 to 42 GHz), and E-band (71 to 76 GHz). These studies would enable the design of robust multi-Gbps data rate space-to-ground satellite communication links. Lastly, the architecture for a compact multi-tone beacon transmitter, which includes a high frequency synthesizer, a polarizer, and a conical horn antenna, has been investigated for a notional CubeSat based space-to-ground radio wave propagation experiment.

Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

Directory of Open Access Journals (Sweden)

Rudel Ruthann A

2010-07-01

Full Text Available Abstract Background We report on the challenges of obtaining Institutional Review Board (IRB coverage for a community-based participatory research (CBPR environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities.

Studying at the UCL Institute of Archaeology

Directory of Open Access Journals (Sweden)

Bill Sillar

2013-10-01

Full Text Available Ranked 1st in 'The Guardian' (2013 league table for studying archaeology Ranked 2nd in 'The Times' (2013 ‘Good University Guide’ 100% of Institute undergraduate finalists expressed satisfaction with our teaching and support in the UK National Student Surveys 2010 and 2011 Students at the UCL Institute of Archaeology discover the rich diversity of the human past, exploring societies from two million years ago to the present day, and asking questions of relevance to our shared global future. To address these questions students integrate the humanities and the sciences; using a wide range of approaches to collect, evaluate and interpret relevant evidence. At UCL and during survey and excavation projects students make life-long friends while developing teamwork, management and leadership skills. Studying archaeology demands energy and enthusiasm, it challenges expectations while developing the problem-solving and transferable skills which all employers are looking for. Graduates from the Institute go on to make wide-ranging contributions to society, including business, academia and archaeology.

The risk of midgut volvulus in patients with abdominal wall defects: A multi-institutional study.

Science.gov (United States)

Fawley, Jason A; Abdelhafeez, Abdelhafeez H; Schultz, Jessica A; Ertl, Allison; Cassidy, Laura D; Peter, Shawn St; Wagner, Amy J

2017-01-01

The management of malrotation in patients with congenital abdominal wall defects has varied among surgeons. We were interested in investigating the risk of midgut volvulus in patients with gastroschisis and omphalocele to help determine if these patients may benefit from undergoing a Ladd procedure. A retrospective chart review was performed for all patients managed at three institutions born between 1/1/2000 and 12/31/2008 with a diagnosis of gastroschisis or omphalocele. Patient charts were reviewed through 12/31/2012 for occurrence of midgut volvulus or need for second laparotomy. Of the 414 patients identified with abdominal wall defects, 299 patients (72%) had gastroschisis, and 115 patients (28%) had omphalocele. The mean gestational age at birth was 36.1±2.3weeks, and the mean birth weight was 2.57±0.7kg. There were a total of 8 (1.9%) cases of midgut volvulus: 3 (1.0%) patients with gastroschisis compared to 5 patients (4.4%) with omphalocele (p=0.04). Patients with omphalocele have a greater risk of developing midgut volvulus, and a Ladd procedure should be considered during definitive repair to mitigate these risks. III; retrospective comparative study. Copyright © 2017 Elsevier Inc. All rights reserved.

Design and construction of a multi-layer CsI(Tl) telescope for high-energy reaction studies

International Nuclear Information System (INIS)

Yan, D.; Sun, Z.Y.; Yue, K.; Wang, S.T.; Zhang, X.H.; Yu, Y.H.; Chen, J.L.; Tang, S.W.; Fang, F.; Zhou, Y.; Sun, Y.; Wang, Z.M.; Sun, Y.Z.

2017-01-01

A prototype of a new CsI(Tl) telescope, which will be used in the reaction studies of light isotopes with energy of several hundred AMeV, was constructed and tested at the Institute of Modern Physics, Chinese Academy of Sciences. The telescope has a multi-layer structure, and the range information was obtained to improve the particle identification performance. This prototype has seven layers of different thickness. An energy resolution of 5.0% (FWHM) was obtained for one of the layers in a beam test experiment. Positive improvement for the identification of 14 O and 15 O isotopes was achieved using the range information.

Design and construction of a multi-layer CsI(Tl) telescope for high-energy reaction studies

Energy Technology Data Exchange (ETDEWEB)

Yan, D.; Sun, Z.Y. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Yue, K., E-mail: yueke@impcas.ac.cn [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Wang, S.T.; Zhang, X.H.; Yu, Y.H.; Chen, J.L.; Tang, S.W.; Fang, F. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Zhou, Y.; Sun, Y. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); University of Chinese Academy of Sciences, Beijing 100049 (China); Lanzhou University, Lanzhou 730000 (China); Wang, Z.M.; Sun, Y.Z. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); University of Chinese Academy of Sciences, Beijing 100049 (China)

2017-01-21

A prototype of a new CsI(Tl) telescope, which will be used in the reaction studies of light isotopes with energy of several hundred AMeV, was constructed and tested at the Institute of Modern Physics, Chinese Academy of Sciences. The telescope has a multi-layer structure, and the range information was obtained to improve the particle identification performance. This prototype has seven layers of different thickness. An energy resolution of 5.0% (FWHM) was obtained for one of the layers in a beam test experiment. Positive improvement for the identification of {sup 14}O and {sup 15}O isotopes was achieved using the range information.

Preparing culture change agents for academic medicine in a multi-institutional consortium: the C - change learning action network.

Science.gov (United States)

Pololi, Linda H; Krupat, Edward; Schnell, Eugene R; Kern, David E

2013-01-01

Research suggests an ongoing need for change in the culture of academic medicine. This article describes the structure, activities and evaluation of a culture change project: the C - Change Learning Action Network (LAN) and its impact on participants. The LAN was developed to create the experience of a culture that would prepare participants to facilitate a culture in academic medicine that would be more collaborative, inclusive, relational, and that supports the humanity and vitality of faculty. Purposefully diverse faculty, leaders, and deans from 5 US medical schools convened in 2 1/2-day meetings biannually over 4 years. LAN meetings employed experiential, cognitive, and affective learning modes; innovative dialogue strategies; and reflective practice aimed at facilitating deep dialogue, relationship formation, collaboration, authenticity, and transformative learning to help members experience the desired culture. Robust aggregated qualitative and quantitative data collected from the 5 schools were used to inform and stimulate culture-change plans. Quantitative and qualitative evaluation methods were used. Participants indicated that a safe, supportive, inclusive, collaborative culture was established in LAN and highly valued. LAN members reported a deepened understanding of organizational change, new and valued interpersonal connections, increased motivation and resilience, new skills and approaches, increased self-awareness and personal growth, emotional connection to the issues of diversity and inclusion, and application of new learnings in their work. A carefully designed multi-institutional learning community can transform the way participants experience and view institutional culture. It can motivate and prepare them to be change agents in their own institutions. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

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Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

2011-12-01

New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice.

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Duncombe, Daphne C

2018-03-01

To examine perceived barriers and facilitators to implementing evidence-based practice among nurses working in psychiatric, geriatric, hospital and community settings in The Bahamas. It is evident from previous studies that a number of factors exist which either obstruct or promote the utilisation of research evidence in nursing practice. Identifying these factors is vital to the successful uptake of evidence-based practice in nursing. Descriptive, comparative study. Data were collected using self-administered questionnaires. A stratified random sample (n = 100) of registered nurses participated; 5-point Likert-like scales were used to examine nurses' perceptions of barriers and facilitators of evidence-based practice. Descriptive statistics were used to describe demographic characteristics and to compare responses of nurses. Participants were predominantly female (98.4%), in the 25 to implement evidence-based practice previously. The greatest barriers identified were as follows: "Inadequate resources for implementing research findings" (85.2%; n = 52) and "Inadequate training in research methods" (83.6%; n = 51). The top facilitators identified were as follows: "Training in research methods" (88.5%; n = 54) and "Organisational policies and protocols that are evidence-based" (86.9%; n = 53). Nurses generally expressed that they required additional training in research and evidence-based practice concepts. Although some nurses had a desire to implement evidence-based practice to provide quality care and improve patient outcomes, many expressed that they lacked the required resources. The study draws attention to the need for prioritisation of evidence-based practice both at institutional and governmental levels. Successful adoption of evidence-based practice implies combined efforts of nurses, healthcare providers and policymakers. Further research is needed to determine the best method for successfully incorporating evidence-based practice into nursing

Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.

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Miyazaki, Jun; Nishiyama, Hiroyuki; Fujimoto, Hiroyuki; Ohyama, Chikara; Koie, Takuya; Hinotsu, Shiro; Kikuchi, Eiji; Sakura, Mizuaki; Inokuchi, Junichi; Hara, Tomohiko

2015-11-01

To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan. A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed. The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the perspective of both healthcare and medical economies. © 2015 The Japanese Urological Association.

Biofuels are (Not the Future! Legitimation Strategies of Sustainable Ventures in Complex Institutional Environments

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Neil A. Thompson

2018-04-01

Full Text Available Sustainable ventures often lack legitimacy (perceived to be desirable and appropriate because various stakeholder groups use contradictory institutions (rules and norms to make their judgements, which leads to there being fewer resources available and higher failure rates. Using an institutional theory framework and a multi-case research design with 15 biofuel ventures operating in the Netherlands, this study asks how sustainable entrepreneurs attempt to gain legitimacy in these circumstances. Analysis reveals that the entrepreneurs use a combination of rhetorical, reconciliatory and institutional change strategies to obtain legitimacy from different stakeholder groups. These findings further our understanding of sustainable entrepreneurial behavior by revealing how and why different legitimation strategies are used in complex institutional environments.

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

International Nuclear Information System (INIS)

Nakajima, Kenichi; Tamaki, Nagara; Kuwabara, Yoichi; Kawano, Masaya; Matsunari, Ichiro; Taki, Junichi; Nishimura, Shigeyuki; Yamashina, Akira; Ishida, Yoshio; Tomoike, Hitonobu

2008-01-01

Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99m Tc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments. Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p 99m Tc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study. (orig.)

Professional Use of Social Media Among Surgeons: Results of a Multi-Institutional Study.

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Wagner, Justin P; Cochran, Amalia L; Jones, Christian; Gusani, Niraj J; Varghese, Thomas K; Attai, Deanna J

2017-09-27

Among surgeons, professional use of social media (SM) is varied, and attitudes are ambiguous. We sought to characterize surgeons' professional use and perceptions of SM. Surgical faculty and trainees received institutional review board-approved e-mail surveys assessing SM usage and attitudes. Regression analyses identified predictors of SM attitudes and preference for professional contact. Surveys were administered to surgical faculty, fellows, and residents at 4 academic medical centers between January and April 2016. Of 1037 surgeons, clinical fellows, and residents e-mailed, 208 (20%) responded, including 132 faculty and 76 trainees. Among 208 respondents, 46 (22%) indicated they preferred some form of SM as their preferred networking and communication modality. A total of 145 (70%) indicated they believe SM benefits professional development. The position of clinical resident predicted preference to maintain professional contact via SM (p = 0.03). Age professional purposes. Perceived barriers include lack of value, time constraints, and personal and patient privacy concerns. Generational differences in surgeon attitudes suggest usage of SM among surgeons will expand over time. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A multi-institutional phase II study of hyperfractionated accelerated radiation therapy for unresectable non-small cell lung cancer: initial report of ECOG 4593

International Nuclear Information System (INIS)

Tannehill, Scott P.; Froseth, Carrie; Wagner, Henry; Petereit, Dan P.; Mehta, Minesh P.

1996-01-01

Purpose: To assess the feasibility, acute toxicity, response and survival in a trial of hyperfractionated accelerated radiation therapy for unresectable locally advanced non-small cell lung cancer (NSCLC) using a t.i.d. regimen 5 days a week in an 8 hour schedule. Materials and Methods: Thirty patients (pts) from 6 institutions were enrolled in this pilot trial. Pt characteristics: 24 male, 6 female; median age 67 yrs (range 47-84); ECOG PS 0 in 22 pts, 1 in 8 pts; weight loss >5% in 7 pts. Stage was II (inoperable) in 1 pt, IIIA in 12 pts, and IIIB in 17 pts. Radiation therapy (total 57.6 Gy/36 fx) encompassing gross disease and draining lymphatics to 36 Gy (1.5 Gy b.i.d., 8 hours apart) with daily off-cord concomitant boost to 21.6 Gy (1.8 Gy 4 hours after first fraction) was given over 12 treatment days (15 elapsed days). Results: (28(30)) (93%) pts completed radiation therapy on schedule without toxicity-related treatment interruptions. Two pts did not complete radiation therapy; 1 due to in-field progression and 1 due to fatal acute gastric bleed unrelated to therapy. Two additional pts died in the first 6 weeks: 1 due to a presumed acute cardiovascular event and another due to complications of pre-existing cardiovascular disease. The major treatment-related toxicities were esophagitis in 6 pts (18%: 5 Grade 3 and 1 Grade 4) scored using a study specific esophagitis grading tool and 2 grade 3 dermatitis, in a total of 6 pts. Only 1 pt (3%) required hospitalization for IV hydration (Grade 4 esophagitis). Median weight loss at 6 weeks was 3 kg. Response data are pending in 2 pts and unavailable in 2 due to early death. Of the remaining 26 pts, local response analysis showed CR in 4, PR in 14, stable in 7 and progressive disease in 1 for an overall response rate of (18(26)) (69%). With a median potential follow-up of 13 months, the median survival has not yet been reached. The 1-yr actuarial survival is 63%. Exclusion of the 3 pts experiencing early death (in

Achieving and sustaining profound institutional change in healthcare: case study using neo-institutional theory.

Science.gov (United States)

Macfarlane, Fraser; Barton-Sweeney, Cathy; Woodard, Fran; Greenhalgh, Trisha

2013-03-01

Change efforts in healthcare sometimes have an ambitious, whole-system remit and seek to achieve fundamental changes in norms and organisational culture rather than (or as well as) restructuring the service. Long-term evaluation of such initiatives is rarely undertaken. We report a secondary analysis of data from an evaluation of a profound institutional change effort in London, England, using a mixed-method longitudinal case study design. The service had received £15 million modernisation funding in 2004, covering multiple organisations and sectors and overseen by a bespoke management and governance infrastructure that was dismantled in 2008. In 2010-11, we gathered data (activity statistics, documents, interviews, questionnaires, site visits) and compared these with data from 2003 to 2008. Data analysis was informed by neo-institutional theory, which considers organisational change as resulting from the material-resource environment and three 'institutional pillars' (regulative, normative and cultural-cognitive), enacted and reproduced via the identities, values and activities of human actors. Explaining the long-term fortunes of the different components of the original programme and their continuing adaptation to a changing context required attention to all three of Scott's pillars and to the interplay between macro institutional structures and embedded human agency. The paper illustrates how neo-institutional theory (which is typically used by academics to theorise macro-level changes in institutional structures over time) can also be applied at a more meso level to inform an empirical analysis of how healthcare organisations achieve change and what helps or hinders efforts to sustain those changes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Are Public Master's Institutions Cost Efficient? A Stochastic Frontier and Spatial Analysis

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Titus, Marvin A.; Vamosiu, Adriana; McClure, Kevin R.

2017-01-01

The current study examines costs, measured by educational and general (E&G) spending, and cost efficiency at 252 public master's institutions in the United States over a nine-year (2004-2012) period. We use a multi-product quadratic cost function and results from a random-effects model with a first-order autoregressive (AR1) disturbance term…

Multi-Wavelength Photomagnetic Imaging for Oral Cancer

Science.gov (United States)

Marks, Michael

In this study, a multi-wavelength Photomagnetic Imaging (PMI) system is developed and evaluated with experimental studies.. PMI measures temperature increases in samples illuminated by near-infrared light sources using magnetic resonance thermometry. A multiphysics solver combining light and heat transfer models the spatiotemporal distribution of the temperature change. The PMI system develop in this work uses three lasers of varying wavelength (785 nm, 808 nm, 860 nm) to heat the sample. By using multiple wavelengths, we enable the PMI system to quantify the relative concentrations of optical contrast in turbid media and monitor their distribution, at a higher resolution than conventional diffuse optical imaging. The data collected from agarose phantoms with multiple embedded contrast agents designed to simulate the optical properties of oxy- and deoxy-hemoglobin is presented. The reconstructed images demonstrate that multi-wavelength PMI can resolve this complex inclusion structure with high resolution and recover the concentration of each contrast agent with high quantitative accuracy. The modified multi-wavelength PMI system operates under the maximum skin exposure limits defined by the American National Standards Institute, to enable future clinical applications.

Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.

Science.gov (United States)

Hong, Theodore S; Wo, Jennifer Y; Yeap, Beow Y; Ben-Josef, Edgar; McDonnell, Erin I; Blaszkowsky, Lawrence S; Kwak, Eunice L; Allen, Jill N; Clark, Jeffrey W; Goyal, Lipika; Murphy, Janet E; Javle, Milind M; Wolfgang, John A; Drapek, Lorraine C; Arellano, Ronald S; Mamon, Harvey J; Mullen, John T; Yoon, Sam S; Tanabe, Kenneth K; Ferrone, Cristina R; Ryan, David P; DeLaney, Thomas F; Crane, Christopher H; Zhu, Andrew X

2016-02-10

To evaluate the efficacy and safety of high-dose, hypofractionated proton beam therapy for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). In this single-arm, phase II, multi-institutional study, 92 patients with biopsy-confirmed HCC or ICC, determined to be unresectable by multidisciplinary review, with a Child-Turcotte-Pugh score (CTP) of A or B, ECOG performance status of 0 to 2, no extrahepatic disease, and no prior radiation received 15 fractions of proton therapy to a maximum total dose of 67.5 Gy equivalent. Sample size was calculated to demonstrate > 80% local control (LC) defined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.0 criteria at 2 years for HCC patients, with the parallel goal of obtaining acceptable precision for estimating outcomes for ICC. Eighty-three patients were evaluable: 44 with HCC, 37 with ICC, and two with mixed HCC/ICC. The CTP score was A for 79.5% of patients and B for 15.7%; 4.8% of patients had no cirrhosis. Prior treatment had been given to 31.8% of HCC patients and 61.5% of ICC patients. The median maximum dimension was 5.0 cm (range, 1.9 to 12.0 cm) for HCC patients and 6.0 cm (range, 2.2 to 10.9 cm) for ICC patients. Multiple tumors were present in 27.3% of HCC patients and in 12.8% of ICC patients. Tumor vascular thrombosis was present in 29.5% of HCC patients and in 28.2% of ICC patients. The median dose delivered to both HCC and ICC patients was 58.0 Gy. With a median follow-up among survivors of 19.5 months, the LC rate at 2 years was 94.8% for HCC and 94.1% for ICC. The overall survival rate at 2 years was 63.2% for HCC and 46.5% ICC. High-dose hypofractionated proton therapy demonstrated high LC rates for HCC and ICC safely, supporting ongoing phase III trials of radiation in HCC and ICC. © 2015 by American Society of Clinical Oncology.

Editorial : Facilitating multi-stakeholder processes : balancing internal dynamics and institutional politics

NARCIS (Netherlands)

Brouwers, J.H.A.M.; Buchanan, K.S.; Brouwer, J.H.; Klerkx, L.W.A.; Schaap, M.; Borgne, Le E.

2013-01-01

This issue of the Knowledge Management for Development Journal focuses on the connection between the knowledge function in knowledge management for development (KM4D) and the facilitation function within multi stakeholder processes (MSPs). Both functions are key functions in innovation processes.

OPREVENT2: Design of a multi-institutional intervention for obesity control and prevention for American Indian adults

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Joel Gittelsohn

2017-01-01

Full Text Available Abstract Background Obesity and other nutrition-related chronic disease rates are high in American Indian (AI populations, and an urgent need exists to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component (MLMC interventions are needed, but there are significant knowledge gaps on how to deliver these types of interventions in low-income rural AI communities. Methods OPREVENT2 is a MLMC intervention targeting AI adults living in six rural reservations in New Mexico and Wisconsin. Aiming to prevent and reduce obesity in adults by working at multiple levels of the food and physical activity (PA environments, OPREVENT2 focuses on evidence-based strategies known to increase access to, demand for, and consumption of healthier foods and beverages, and increase worksite and home-based opportunities for PA. OPREVENT2 works to create systems-level change by partnering with tribal stakeholders, multiple levels of the food and PA environment (food stores, worksites, schools, and the social environment (children as change agents, families, social media. Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures. Discussion Novel aspects of OPREVENT2 include: active engagement with stakeholders at many levels (policy, institutional, and at multiple levels of the food and PA system; use of community-based strategies to engage policymakers and other key stakeholders (community workshops, action committees; emphasis on both the built environment (intervening with retail food sources and the social environment. This paper describes the design of the intervention and the evaluation plan of the OPREVENT2. Trial registration Clinical Trial Registration: NCT02803853 (June 10, 2016

First observation of multi-pulse X-ray train via multi-collision laser Compton scattering

International Nuclear Information System (INIS)

Kuroda, R.; Toyokawa, H.; Yasumoto, M.; Ikeura-Sekiguchi, H.; Koike, M.; Yamada, K.; Yanagida, T.; Nakajyo, T.; Sakai, F.

2009-01-01

A compact hard X-ray source via laser Compton scattering (LCS) has been developed for biological and medical applications at the National Institute of Advanced Industrial Science and Technology (AIST) in Japan. The multi-collision LCS has been investigated in order to enhance the X-ray yields. The first observation of multi-pulse X-ray train with 6 pulses via the multi-collision LCS has been successfully demonstrated between the multi-bunch electron train with 6 bunches and the multi-pulse Ti:Sa laser train with 6 pulses. The 32 MeV electron train was generated from a Cs 2 Te photocathode rf gun with a multi-pulse UV laser and the S-band linac. The Ti:Sa laser train was obtained with the chirp pulse amplification (CPA) including the modified regenerative amplifier. The X-ray train with 6 pulses with 12.6 ns spacing was observed with the micro-channel plate (MCP). The maximum energy of the X-ray is analytically estimated to be about 24 keV and the total number of generated photons was calculated to be about 1.8x10 6 photons/train.

CONSTRUCTING A MULTI-REGIONAL SOCIAL ACCOUNTING MATRIX FOR TURKEY

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Metin Piskin

2017-12-01

Full Text Available Regional impacts of public policies in Turkey have led to Regional Development Agencies and related institutions having responsibility for setting and achieving sustainability policies at the regional level. As a result, there is a significant interest in developing empirical models that can deal with the macro, micro and regional impacts of economic policies and interregional spillover effects. Spatial or Multi-Regional Computable General Equilibrium models are the most capable models to handle a wide range of policy relevant regional questions and the effects of policies on a comprehensive set of regional and national economic variables. However, an important ingredient in meeting the Multi-Regional CGE analysis is Multi-Regional Social Accounting Matrices. This study is focusing on the building the first Multi-Regional Social Accounting Matrix for Turkey with 11 regions and 8 sectors. We utilize from the most updated available datasets and implement the most conveninent non-survey methods which fit to data availability in Turkey.

NATO Advanced Study Institute on Insurance and Risk Theory

CERN Document Server

Vylder, F; Haezendonck, J

1986-01-01

Canadian financial institutions have been in rapid change in the past five years. In response to these changes, the Department of Finance issued a discussion paper: The Regulation of Canadian Financial Institutions, in April 1985, and the government intends to introduce legislation in the fall. This paper studi.es the combinantion of financial institutions from the viewpoint of ruin probability. In risk theory developed to describe insurance companies [1,2,3,4,5J, the ruin probability of a company with initial reserve (capital) u is 6 1 -:;-7;;f3 u 1jJ(u) = H6 e H6 (1) Here,we assume that claims arrive as a Poisson process, and the claim amount is distributed as exponential distribution with expectation liS. 6 is the loading, i.e., premium charged is (1+6) times expected claims. Financial institutions are treated as "insurance companies": the difference between interest charged and interest paid is regarded as premiums, loan defaults are treated as claims.

Literacy Skills Development for Tertiary Institutions: A Case Study of ...

African Journals Online (AJOL)

Literacy Skills Development for Tertiary Institutions: A Case Study of the University of Calabar. ... These were drawn from five faculties, namely Education, Social Sciences, Law, Arts and Agriculture. The study observed that there is a ... more literacy skills. Key Words: Literacy skills, university, Nigeria, tertiary institution ...

Engagement and learning: an exploratory study of situated practice in multi-disciplinary stroke rehabilitation.

Science.gov (United States)

Horton, Simon; Howell, Alison; Humby, Kate; Ross, Alexandra

2011-01-01

Active participation is considered to be a key factor in stroke rehabilitation. Patient engagement in learning is an important part of this process. This study sets out to explore how active participation and engagement are 'produced' in the course of day-to-day multi-disciplinary stroke rehabilitation. Ethnographic observation, analytic concepts drawn from discourse analysis (DA) and the perspective and methods of conversation analysis (CA) were applied to videotaped data from three sessions of rehabilitation therapy each for two patients with communication impairments (dysarthria, aphasia). Engagement was facilitated (and hindered) through the interactional work of patients and healthcare professionals. An institutional ethos of 'right practice' was evidenced in the working practices of therapists and aligned with or resisted by patients; therapeutic activity type (impairment, activity or functional focus) impacted on the ways in which patient engagement was developed and sustained. This exploration of multi-disciplinary rehabilitation practice adds a new dimension to our understanding of the barriers and facilitators to patient engagement in the learning process and provides scope for further research. Harmonising the rehabilitation process across disciplines through more focused attention to ways in which patient participation is enhanced may help improve the consistency and quality of patient engagement.

Comparative inter-institutional study of stress among dentists.

Science.gov (United States)

Pozos-Radillo, Blanca E; Galván-Ramírez, Ma Luz; Pando, Manuel; Carrión, Ma De los Angeles; González, Guillermo J

2010-01-01

Dentistry is considered to be a stressful profession due to different factors caused by work, representing a threat to dentists'health. The objectives of this work were to identify and compare chronic stress in dentists among the different health institutions and the association of stress with risk factors. The study in question is observational, transversal and comparative; 256 dentists were included, distributed among five public health institutions in the city of Guadalajara, Jalisco, Mexico, namely: the Mexican Institute of Social Security (IMSS), the Ministry of Health (SS), the Integral Development of the Family (DIF), the Social Security Services Institute for the Workers (ISSSTE) and the University of Guadalajara (U. de G) Data were obtained by means of the census technique. Stress was identified using the Stress Symptoms Inventory and the statistical analysis was performed using the Odds Ratio (O.R.) and the chi-square statistic. From the total population studied, 219 subjects presented high levels of chronic stress and 37, low levels. In the results of comparative analysis, significant differences were found between IMSS and U. de G and likewise between IMSS and SS. However, in the analysis of association, only U. de G was found to be associated with the high level of chronic stress.

Contemporary management of rectal injuries at Level I trauma centers: The results of an American Association for the Surgery of Trauma multi-institutional study.

Science.gov (United States)

Brown, Carlos V R; Teixeira, Pedro G; Furay, Elisa; Sharpe, John P; Musonza, Tashinga; Holcomb, John; Bui, Eric; Bruns, Brandon; Hopper, H Andrew; Truitt, Michael S; Burlew, Clay C; Schellenberg, Morgan; Sava, Jack; VanHorn, John; Eastridge, Pa-C Brian; Cross, Alicia M; Vasak, Richard; Vercruysse, Gary; Curtis, Eleanor E; Haan, James; Coimbra, Raul; Bohan, Phillip; Gale, Stephen; Bendix, Peter G

2018-02-01

Rectal injuries have been historically treated with a combination of modalities including direct repair, resection, proximal diversion, presacral drainage, and distal rectal washout. We hypothesized that intraperitoneal rectal injuries may be selectively managed without diversion and the addition of distal rectal washout and presacral drainage in the management of extraperitoneal injuries are not beneficial. This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004 to 2015 of all patients who sustained a traumatic rectal injury and were admitted to one of the 22 participating centers. Demographics, mechanism, location and grade of injury, and management of rectal injury were collected. The primary outcome was abdominal complications (abdominal abscess, pelvic abscess, and fascial dehiscence). After exclusions, there were 785 patients in the cohort. Rectal injuries were intraperitoneal in 32%, extraperitoneal in 58%, both in 9%, and not documented in 1%. Rectal injury severity included the following grades I, 28%; II, 41%; III, 13%; IV, 12%; and V, 5%. Patients with intraperitoneal injury managed with a proximal diversion developed more abdominal complications (22% vs 10%, p = 0.003). Among patients with extraperitoneal injuries, there were more abdominal complications in patients who received proximal diversion (p = 0.0002), presacral drain (p = 0.004), or distal rectal washout (p = 0.002). After multivariate analysis, distal rectal washout [3.4 (1.4-8.5), p = 0.008] and presacral drain [2.6 (1.1-6.1), p = 0.02] were independent risk factors to develop abdominal complications. Most patients with intraperitoneal injuries undergo direct repair or resection as well as diversion, although diversion is not associated with improved outcomes. While 20% of patients with extraperitoneal injuries still receive a presacral drain and/or distal rectal washout, these additional maneuvers are independently associated with a three

Study on the characteristics of multi-infeed HVDC

Science.gov (United States)

Li, Ming; Song, Xinli; Liu, Wenzhuo; Xiang, Yinxing; Zhao, Shutao; Su, Zhida; Meng, Hang

2017-09-01

China has built more than ten HVDC transmission projects in recent years [1]. Now, east China has formed a multi-HVDC feed pattern grid. It is imminent to study the interaction of the multi-HVDC and the characteristics of it. In this paper, an electromechanical-electromagnetic hybrid model is built with electromechanical data of a certain power network. We use electromagnetic models to simulate the HVDC section and electromechanical models simulate the AC power network [2]. In order to study the characteristics of the grid, this paper adds some faults to the line and analysed the fault characteristics. At last give analysis of the fault characteristics.

Study of fast electron generation using multi beam of LFEX-class laser

International Nuclear Information System (INIS)

Hata, M; Nagatomo, H; Sakagami, H; Johzaki, T; Sentoku, Y

2016-01-01

Fast Ignition Realization Experiment project phase-I (FIREX-I) is being performed at Institute of Laser Engineering, Osaka University. In this project, the four-beam bundled high-energy Petawatt laser (LFEX) is being operated. LFEX laser provides great multi-beam irradiation flexibility, with the possibility of arrange the pulses in temporal sequence, spatially separate them in distinct spots of focus them in a single spot. In this paper, we study the two- beam interference effects on high-intensity picosecond laser-plasma interaction (LPI) by twodimensional relativistic Particle-In-Cell simulations. The interference causes surface perturbation, which enhances laser absorption and underdense plasma generation, increasing the accelerated electron number and their slope temperature. The laser-to-electron energy conversion efficiency for two-beam interference case is suitable for Fast Ignition (FI) compared to the single beam case, but the increment of fast electron divergence leads to lower energy coupling. To optimize the target design for FI, these interference effects should be taken into consideration. (paper)

Institutional total energy case studies

Energy Technology Data Exchange (ETDEWEB)

Wulfinghoff, D.

1979-07-01

Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

Annual report of National Institute for Fusion Science. April 2013 - March 2014

International Nuclear Information System (INIS)

2014-01-01

This annual report summarizes achievements from research activities at the National Institute for Fusion Science (NIFS) between April 2013 and March 2014. NIFS is an inter-university research organization and conducts open collaboration research under three frameworks which are the General Collaboration Research, the Large Helical Device Collaboration Research and the Bilateral Collaboration Research. More than 500 collaborating studies were implemented during the covered period. About 2,400 collaborators studies were implemented during the covered period. About 2,400 collaborators participated in joint research from 220 external institutions. Many intensively advanced results in plasma physics, fusion science and related fields have been obtained from these studies. Not only NIFS, but also 6 university centers serve as joint research laboratories/centers under bilateral collaboration research. NIFS also organizes diversified frameworks for international collaboration through 6 bilateral agreements, 3 multi-lateral agreements and academic exchange agreements with 18 institutes abroad for the global development of the function of inter-university research organization. (J.P.N.)

Determining School Administrators’ Perceptions on Institutional Culture: A Qualitative Study

Directory of Open Access Journals (Sweden)

Secil Eda Kartal

2016-03-01

Full Text Available Schools, the where educational activities are carried out, are among the major institutions society considers as important. Schools undertake strategic responsibilities in maintaining cultural values and conveying them to future generations. The primary responsibility in achieving these missions is assigned to the school administrators. The purpose of this study is to determine the perceptions of school administrators on institutional culture. This is a qualitative study conducted on school administrators who were selected based on the volunteering principle. Perceptions of school administrators concerning their institutions’ culture and the differences between their institutional culture and other institution’s cultures were determined and analyzed. Findings of this study suggest that school administrators have both positive and negative opinions regarding their institutional culture and cultural difference. While love-respect, collaboration-solidarity and common history were prominent positive opinions; lack of communication, lack of shared values and low expectation were prominent negative opinions. In addition, participants stated the environment as a crucial factor when defining culture.

Transformational leadership in merging higher education institutions: A case study

Directory of Open Access Journals (Sweden)

Crispen Chipunza

2010-06-01

Research purpose: The objectives of this study were to establish an understanding of ‘transformational leadership’ and to determine the extent to which it was employed by leaders in an institution of higher education which had incorporated another institution. Motivations for the study: The study provides a starting point, not only for the successful implementation of higher education changes in the future but also the building of leadership commitment and alignment to the proposed changes in the sector as well as the development of institutional leadership teams to take responsibility for any other transformation processes. Research design, approach and method: The population of the study consisted of 350 full-time employees of the institution who had experienced the incorporation process. Two samples – one consisting of six executive management leaders and the other consisting of 153 employees – were used. Both qualitative and quantitative research approaches were employed using the case study method. Main findings: Results showed that transformational principles of idealised influence, intellectual stimulation, and inspirational motivation principles were used more than others and that employees were generally not satisfied with how the incorporation process had taken place. Practical/managerial implications: The results of the study affected the attitude and satisfaction of the employees in this study. Contribution/value-add: The study reveals that leaders in the institution played key roles such as shared vision, team work and the creation of an enabling environment. An important point that has emanated from this study is the evidence that during transformation, a lack of strategic direction and empowering of followers and capacitating them leads to dissatisfaction with the whole process, despite the transformation process being declared a success.

An Assessment of Institutional Capacity for Integrated Landscape Management in Eastern Cameroon.

Science.gov (United States)

Brown, H Carolyn Peach

2018-07-01

Landscape approaches have become prominent in efforts to address issues of conservation and development through bringing together different actors and sectors, to reconcile diverse land uses, and promote synergies. Some have suggested that integrated landscape management approaches are consistent with the goals of REDD+ and offer a strategy to address multiple goals of climate change mitigation, biodiversity conservation, maintenance of ecosystem services, and socio-economic development. Institutional or governance arrangements have been shown to be a critical component in influencing outcomes in landscapes. Using diverse methodologies, this study investigated the capacity of institutions to support the planning, implementation, and resource mobilization needed to integrate climate change mitigation, conservation, and livelihood goals in a forest mosaic landscape in East Cameroon. Results showed that diverse institutions are present in the landscape, including institutions of relevant government agencies, local government, local non-government, the private sector, and hybrid institutions of conservation, development and research institutions. However, the overall institutional capacity for integrated landscape planning and management in the study area is limited, although some institutions exhibit increased capacity in some areas over others. Multiple strategies can be employed to build the necessary human, financial, and leadership capacity, and facilitate the institutional planning and coordination that is foundational to multi-stakeholder landscape governance. Given the complexity of integrating climate change mitigation, conservation and livelihood goals in a landscape, building such institutional capacity is a long term endeavour that requires sustained effort and ongoing financial, technical and human resource support.

How different institutional arrangements promote integrated river basin management

DEFF Research Database (Denmark)

Nielsen, Helle Ørsted; Frederiksen, Pia; Saarikoski, Heli

2013-01-01

Management Planning processes in six countries around the Baltic Sea. We use theories on multi-level governance, regime interplay and institutional effectiveness. We find that, in most cases, central governments have played a dominant role in the formulation of river basin management plans, while local......, member states must therefore address both the roles of different institutional actors and the interplay among institutions. In this paper, we will explore strengths and weaknesses of different institutional arrangements for integrated water management through a comparative analysis of River Basin...... influence has been somewhat limited. The tight procedural deadlines of the di-rective appear to have pushed for more centralisation than originally intended by the countries. But the analysis also shows that interplay mechanisms such as norms, ideas and incentives do promote effective institutional...

Regulated open multi-agent systems (ROMAS) a multi-agent approach for designing normative open systems

CERN Document Server

Garcia, Emilia; Botti, Vicente

2015-01-01

Addressing the open problem of engineering normative open systems using the multi-agent paradigm, normative open systems are explained as systems in which heterogeneous and autonomous entities and institutions coexist in a complex social and legal framework that can evolve to address the different and often conflicting objectives of the many stakeholders involved. Presenting  a software engineering approach which covers both the analysis and design of these kinds of systems, and which deals with the open issues in the area, ROMAS (Regulated Open Multi-Agent Systems) defines a specific multi-agent architecture, meta-model, methodology and CASE tool. This CASE tool is based on Model-Driven technology and integrates the graphical design with the formal verification of some properties of these systems by means of model checking techniques. Utilizing tables to enhance reader insights into the most important requirements for designing normative open multi-agent systems, the book also provides a detailed and easy t...

Forschungszentrum Rossendorf. Institute of Safety Research. Report. January 1998 - June 1999

Energy Technology Data Exchange (ETDEWEB)

Weiss, F P; Rindelhardt, U [eds.

1999-09-01

The Institute of Safety Research is one of the five scientific institutes of Forschungszentrum Rossendorf e.V. The Forschungszentrum Rossendorf is a member of the 'Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz' and is funded by the Federal Ministry of Education and Research and by the Saxon Ministry of Science and Arts with 50% each. The research work of the institute aims at the assessment and increase of the safety and environmental sustainability of technical plants. The emphasis is put on the development and validation of mathematical and physical models for process and plant analysis, and of techniques for process and components monitoring. Subject of investigations are equally nuclear plants and installations of process industries. To analyse the thermo-fluiddynamics of normal plant operation and of the behaviour during accidents, physical models and computer codes are developed for multi-phase and multi-component flows, and for the space and time dependent heat release (neutron kinetics, chemical kinetics). (orig.)

Forschungszentrum Rossendorf. Institute of Safety Research. Report. January 1998 - June 1999

Energy Technology Data Exchange (ETDEWEB)

Weiss, F.P.; Rindelhardt, U. [eds.

1999-09-01

The Institute of Safety Research is one of the five scientific institutes of Forschungszentrum Rossendorf e.V. The Forschungszentrum Rossendorf is a member of the 'Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz' and is funded by the Federal Ministry of Education and Research and by the Saxon Ministry of Science and Arts with 50% each. The research work of the institute aims at the assessment and increase of the safety and environmental sustainability of technical plants. The emphasis is put on the development and validation of mathematical and physical models for process and plant analysis, and of techniques for process and components monitoring. Subject of investigations are equally nuclear plants and installations of process industries. To analyse the thermo-fluiddynamics of normal plant operation and of the behaviour during accidents, physical models and computer codes are developed for multi-phase and multi-component flows, and for the space and time dependent heat release (neutron kinetics, chemical kinetics). (orig.)

Prehospital care training in a rapidly developing economy: a multi-institutional study.

Science.gov (United States)

Vyas, Dinesh; Hollis, Michael; Abraham, Rohit; Rustagi, Neeti; Chandra, Siddharth; Malhotra, Ajai; Rajpurohit, Vikas; Purohit, Harshada; Pal, Ranabir

2016-06-01

The trauma pandemic is one of the leading causes of death worldwide but especially in rapidly developing economies. Perhaps, a common cause of trauma-related mortality in these settings comes from the rapid expansion of motor vehicle ownership without the corresponding expansion of national prehospital training in developed countries. The resulting road traffic injuries often never make it to the hospital in time for effective treatment, resulting in preventable disability and death. The current article examines the development of a medical first responder training program that has the potential to reduce this unnecessary morbidity and mortality. An intensive training workshop has been differentiated into two progressive tiers: acute trauma training (ATT) and broad trauma training (BTT) protocols. These four-hour and two-day protocols, respectively, allow for the mass education of laypersons-such as police officials, fire brigade, and taxi and/or ambulance drivers-who are most likely to interact first with prehospital victims. Over 750 ATT participants and 168 BTT participants were trained across three Indian educational institutions at Jodhpur and Jaipur. Trainees were given didactic and hands-on education in a series of critical trauma topics, in addition to pretraining and post-training self-assessments to rate clinical confidence across curricular topics. Two-sample t-test statistical analyses were performed to compare pretraining and post-training confidence levels. Program development resulted in recruitment of a variety of career backgrounds for enrollment in both our ATT and BTT workshops. The workshops were run by local physicians from a wide spectrum of medical specialties and previously ATT-trained police officials. Statistically significant improvements in clinical confidence across all curricular topics for ATT and BTT protocols were identified (P developing settings. Program expansion can offer an exponential growth in the training rate of medical

The Multiplier Effect: The Case for Multi-School, Global Education Programs

Science.gov (United States)

Dugan, Rik; Nink, Matt

2010-01-01

Multi-school and multi-country programs greatly enhance leadership development and global awareness in students and teachers, while creating better problem solvers, stronger relationships, and wider community impact than any single-school program. That's why Global Youth Leadership Institute (GYLI) and National Association of Independent Schools…

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

OpenAIRE

Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

2010-01-01

New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

SATISFACTION LEVEL OF MEDICAL EDUCATORS WORKING IN TEACHING INSTITUTIONS : A QUESTIONNAIRE BASED CROSS-SECTIONAL STUDY

Directory of Open Access Journals (Sweden)

Sudeshna Chatterjee

2016-12-01

Full Text Available In a resource-limited and high-burden disease setting, satisfied health professional is an asset in terms of maximized productivity, efficiency and quality health care. Job Satisfaction Index is a validated measure to identify the components that influence those issues. A multi-faceted structured questionnaire study was conducted upon a cross-section of medical educators (n=160 serving two tertiary care teaching institutions under different management set-up. Multiple demographic features were independent variables whereas three (3 critical areas of satisfaction index (SI were outcome variables. All participants were interviewed using 15 item Likert response-based, modified job satisfaction scale. It was observed that total SI scores among doctors representing the private group remained marginally higher (P<0.05 while compared to the other group. The comparative analysis of SI scores in critical areas like availability of academic supports and job security remained higher among the private doctors than that of the government ones though not significant. However the private doctors remained marginally satisfied in terms of working environment. The study outcome necessitates appropriate intervention measures at the organizational levels.

Symplicity multi-electrode radiofrequency renal denervation system feasibility study.

Science.gov (United States)

Whitbourn, Robert; Harding, Scott A; Walton, Antony

2015-05-01

The aim of this study was to test the safety and performance of the Symplicity™ multi-electrode radio-frequency renal denervation system which was designed to reduce procedure time during renal denervation. The multi-electrode radiofrequency renal denervation system feasibility study is a prospective, non-randomised, open label, feasibility study that enrolled 50 subjects with hypertension. The study utilises a new renal denervation catheter which contains an array of four electrodes mounted in a helical configuration at 90 degrees from each other to deliver radiofrequency energy simultaneously to all four renal artery quadrants for 60 seconds. The protocol specified one renal denervation treatment towards the distal end of each main renal artery with radiofrequency energy delivered for 60 seconds per treatment. Total treatment time for both renal arteries was two minutes. The 12-month change in office systolic blood pressure (SBP) and 24-hour SBP was -19.2±25.2 mmHg, prenal artery stenosis or hypertensive emergencies occurred. The Symplicity multi-electrode radiofrequency renal denervation system was associated with a significant reduction in SBP at 12 months and minimal complications whilst it also reduced procedure time. NCT01699529.

A Multi-Institution Look at College Students Seeking Counseling: Nature and Severity of Concerns

Science.gov (United States)

Krumrei, Elizabeth J.; Newton, Fred B.; Kim, Eunhee

2010-01-01

This study provides information about students seeking counseling (N = 3,844) at 9 institutions of higher education. The K-PIRS, an empirically validated measure, was used to assess 7 problem areas (mood difficulties, learning problems, food concerns, interpersonal conflicts, career uncertainties, self-harm indicators, and addiction issues).…

Academic Venturing in Higher Education: Institutional Effects on Performance of University Technology Transfer. ASHE Annual Meeting Paper.

Science.gov (United States)

Powers, Joshua B.

This study investigated institutional resource factors that may explain differential performance with university technology transfer--the process by which university research is transformed into marketable products. Using multi-source data on 108 research universities, a set of internal resources (financial, physical, human capital, and…

Using a multi-scale approach to identify and quantify oil and gas emissions: a case study for GHG emissions verification

Science.gov (United States)

Sweeney, C.; Kort, E. A.; Rella, C.; Conley, S. A.; Karion, A.; Lauvaux, T.; Frankenberg, C.

2015-12-01

Along with a boom in oil and natural gas production in the US, there has been a substantial effort to understand the true environmental impact of these operations on air and water quality, as well asnet radiation balance. This multi-institution effort funded by both governmental and non-governmental agencies has provided a case study for identification and verification of emissions using a multi-scale, top-down approach. This approach leverages a combination of remote sensing to identify areas that need specific focus and airborne in-situ measurements to quantify both regional and large- to mid-size single-point emitters. Ground-based networks of mobile and stationary measurements provide the bottom tier of measurements from which process-level information can be gathered to better understand the specific sources and temporal distribution of the emitters. The motivation for this type of approach is largely driven by recent work in the Barnett Shale region in Texas as well as the San Juan Basin in New Mexico and Colorado; these studies suggest that relatively few single-point emitters dominate the regional emissions of CH4.

Intensity correction method customized for multi-animal abdominal MR imaging with 3 T clinical scanner and multi-array coil

International Nuclear Information System (INIS)

Mitsuda, Minoru; Yamaguchi, Masayuki; Nakagami, Ryutaro; Furuta, Toshihiro; Fujii, Hirofumi; Sekine, Norio; Niitsu, Mamoru; Moriyama, Noriyuki

2013-01-01

Simultaneous magnetic resonance (MR) imaging of multiple small animals in a single session increases throughput of preclinical imaging experiments. Such imaging using a 3-tesla clinical scanner with multi-array coil requires correction of intensity variation caused by the inhomogeneous sensitivity profile of the coil. We explored a method for correcting intensity that we customized for multi-animal MR imaging, especially abdominal imaging. Our institutional committee for animal experimentation approved the protocol. We acquired high resolution T 1 -, T 2 -, and T 2 * -weighted images and low resolution proton density-weighted images (PDWIs) of 4 rat abdomens simultaneously using a 3T clinical scanner and custom-made multi-array coil. For comparison, we also acquired T 1 -, T 2 -, and T 2 * -weighted volume coil images in the same rats in 4 separate sessions. We used software created in-house to correct intensity variation. We applied thresholding to the PDWIs to produce binary images that displayed only a signal-producing area, calculated multi-array coil sensitivity maps by dividing low-pass filtered PDWIs by low-pass filtered binary images pixel by pixel, and divided uncorrected T 1 -, T 2 -, or T 2 * -weighted images by those maps to obtain intensity-corrected images. We compared tissue contrast among the liver, spinal canal, and muscle between intensity-corrected multi-array coil images and volume coil images. Our intensity correction method performed well for all pulse sequences studied and corrected variation in original multi-array coil images without deteriorating the throughput of animal experiments. Tissue contrasts were comparable between intensity-corrected multi-array coil images and volume coil images. Our intensity correction method customized for multi-animal abdominal MR imaging using a 3T clinical scanner and dedicated multi-array coil could facilitate image interpretation. (author)

Availability and quality of paraffin blocks identified in pathology archives: A multi-institutional study by the Shared Pathology Informatics Network (SPIN)

International Nuclear Information System (INIS)

Patel, Ashokkumar A; Dry, Sarah; Schirripa, Osvaldo; Yu, Hong; Becich, Michael J; Parwani, Anil V; Gupta, Dilipkumar; Seligson, David; Hattab, Eyas M; Balis, Ulysses J; Ulbright, Thomas M; Kohane, Isaac S; Berman, Jules J; Gilbertson, John R

2007-01-01

Shared Pathology Informatics Network (SPIN) is a tissue resource initiative that utilizes clinical reports of the vast amount of paraffin-embedded tissues routinely stored by medical centers. SPIN has an informatics component (sending tissue-related queries to multiple institutions via the internet) and a service component (providing histopathologically annotated tissue specimens for medical research). This paper examines if tissue blocks, identified by localized computer searches at participating institutions, can be retrieved in adequate quantity and quality to support medical researchers. Four centers evaluated pathology reports (1990–2005) for common and rare tumors to determine the percentage of cases where suitable tissue blocks with tumor were available. Each site generated a list of 100 common tumor cases (25 cases each of breast adenocarcinoma, colonic adenocarcinoma, lung squamous carcinoma, and prostate adenocarcinoma) and 100 rare tumor cases (25 cases each of adrenal cortical carcinoma, gastro-intestinal stromal tumor [GIST], adenoid cystic carcinoma, and mycosis fungoides) using a combination of Tumor Registry, laboratory information system (LIS) and/or SPIN-related tools. Pathologists identified the slides/blocks with tumor and noted first 3 slides with largest tumor and availability of the corresponding block. Common tumors cases (n = 400), the institutional retrieval rates (all blocks) were 83% (A), 95% (B), 80% (C), and 98% (D). Retrieval rate (tumor blocks) from all centers for common tumors was 73% with mean largest tumor size of 1.49 cm; retrieval (tumor blocks) was highest-lung (84%) and lowest-prostate (54%). Rare tumors cases (n = 400), each institution's retrieval rates (all blocks) were 78% (A), 73% (B), 67% (C), and 84% (D). Retrieval rate (tumor blocks) from all centers for rare tumors was 66% with mean largest tumor size of 1.56 cm; retrieval (tumor blocks) was highest for GIST (72%) and lowest for adenoid cystic carcinoma (58

Trust in the institutions of the European Union: A cross-country examination

OpenAIRE

Eliyahu V. Sapir and Galina Zapryanova Christine Arnold

2012-01-01

Trust in political institutions is one of the key elements which make representative democracies work. Trust creates a connection between citizens and representative political institutions. Democratic governments which enjoy a large degree of trust also tend to have higher degrees of legitimacy and policy efficacy. In Europe’s multi-level governance structure, it is imperative to understand the determinants of trust in the institutions of the European Union. With the increasing salience of ...

Twin cities institutional issues study cogenerated hot water district heating

Energy Technology Data Exchange (ETDEWEB)

Sundberg, R. E.; Leas, R.; Kolb, J. O.

1979-01-01

Community district heating, utilizing hot water produced through electrical/thermal cogeneration, is seen as an integral part of Minnesota's Energy Policy and Conservation Plan. Several studies have been conducted which consider the technical and institutional issues affecting implementation of cogenerated district heating in the Minneapolis and St. Paul Metropolitan Area. The state of the technical art of cogenerated hot water district heating is assumed to be transferable from European experience. Institutional questions relating to such factors as the form of ownership, financing, operation, regulation, and product marketability cannot be transferred from the European experience, and have been the subject of an extensive investigation. The form and function of the Institutional Issues Study, and some of the preliminary conclusions and recommendations resulting from the study are discussed.

Retransplantation in 7,290 primary transplant patients: a 10-year multi-institutional study.

Science.gov (United States)

Radovancevic, Branislav; McGiffin, David C; Kobashigawa, Jon A; Cintron, Guillermo B; Mullen, G Martin; Pitts, Douglas E; O'Donnell, Jacqueline; Thomas, Cindi; Bourge, Robert C; Naftel, David C

2003-08-01

Cardiac retransplantation is a controversial procedure due to the disparity between donor heart demand and supply. Of 7,290 patients undergoing primary cardiac transplantation between January 1990 and December 1999 at 42 institutions contributing to the Cardiac Transplant Research Database (CTRD), 106 patients later underwent a second and 1 patient a third cardiac transplant procedure. The actuarial freedom from retransplantation was 99.2% and 96.8% at 1 and 10 years, respectively. Reasons for retransplantation included early graft failure (n = 34), acute cardiac rejection (n = 15), coronary allograft vasculopathy (CAV, n = 39), non-specific graft failure (n = 7), and miscellaneous (n = 10). The only risk factor associated with retransplantation was younger age, reflecting the policy of preferential retransplantation of younger patients. Survival after retransplantation was inferior to that after primary transplantation (56% and 38% at 1 and 5 years, respectively). Risk factors associated with death after retransplantation included retransplantation for acute rejection (p = 0.0005), retransplantation for early graft failure (p = 0.03), and use of a female donor (p = 0.005). Survival after retransplantation for acute rejection was poorest (32% and 8% at 1 and 5 years, respectively) followed by retransplantation for early graft failure (50% and 39% at 1 and 5 years, respectively). Survival after retransplantation for CAV has steadily improved with successive eras. The results of retransplantation for acute rejection and early graft failure are poor enough to suggest that this option is not advisable. However, retransplantation for CAV is currently associated with satisfactory survival and should continue to be offered to selected patients.

OSiRIS: a distributed Ceph deployment using software defined networking for multi-institutional research

Science.gov (United States)

McKee, Shawn; Kissel, Ezra; Meekhof, Benjeman; Swany, Martin; Miller, Charles; Gregorowicz, Michael

2017-10-01

We report on the first year of the OSiRIS project (NSF Award #1541335, UM, IU, MSU and WSU) which is targeting the creation of a distributed Ceph storage infrastructure coupled together with software-defined networking to provide high-performance access for well-connected locations on any participating campus. The projects goal is to provide a single scalable, distributed storage infrastructure that allows researchers at each campus to read, write, manage and share data directly from their own computing locations. The NSF CC*DNI DIBBS program which funded OSiRIS is seeking solutions to the challenges of multi-institutional collaborations involving large amounts of data and we are exploring the creative use of Ceph and networking to address those challenges. While OSiRIS will eventually be serving a broad range of science domains, its first adopter will be the LHC ATLAS detector project via the ATLAS Great Lakes Tier-2 (AGLT2) jointly located at the University of Michigan and Michigan State University. Part of our presentation will cover how ATLAS is using the OSiRIS infrastructure and our experiences integrating our first user community. The presentation will also review the motivations for and goals of the project, the technical details of the OSiRIS infrastructure, the challenges in providing such an infrastructure, and the technical choices made to address those challenges. We will conclude with our plans for the remaining 4 years of the project and our vision for what we hope to deliver by the projects end.

Knowledge repositories in knowledge cities: institutions, conventions and knowledge subnetworks

NARCIS (Netherlands)

Cheng, P.; Choi, C.J.; Chen, Shu; Eldomiaty, T.I.; Millar-Schijf, Carla C.J.M.

2004-01-01

Abstract: Suggests another dimension of research in, and application of, knowledge management. This theoretical paper adopts a conceptual, multi-disciplinary approach. First, knowledge can be stored and transmitted via institutions. Second, knowledge "subnetworks" or smaller groupings within larger

Establishment of an Institute for Fusion Studies

International Nuclear Information System (INIS)

Hazeltine, R.D.

1992-07-01

The Institute for Fusion Studies is a national center for theoretical fusion plasma physics research. Its purposes are: (1) to conduct research on theoretical questions concerning the achievement of controlled fusion energy by means of magnetic confinement--including both fundamental problems of long-range significance, as well as shorter-term issues; (2) to serve as a center for information exchange, nationally and internationally, by hosting exchange visits, conferences, and workshops; (3) and to train students and postdoctoral research personnel for the fusion energy program and plasma physics research areas. The theoretical research results that are obtained by the Institute contribute mainly to the progress of national and international efforts in nuclear fusion research, whose goal is the development of fusion power.as a basic energy source. In addition to its primary focus on fusion physics, the Institute is also involved with research in related fields, such as advanced computing techniques, nonlinear dynamics, plasma astrophysics, and accelerator physics. The work of EFS scientists continued to receive national and international recognition. Numerous invited papers were given during the past year at workshops, conferences, and scientific meetings. Last year IFS scientists published 95 scientific articles in technical journals and monographs

The multi-disciplinary role of 'pion factories'

International Nuclear Information System (INIS)

Davies, J.D.; Batty, C.J.; Green, K.

1977-01-01

The multi-disciplinary role of intermediate energy proton accelerators in pure and applied nuclear physics is discussed with particular reference to the experimental programmes at LAMPF (Los Alamos Meson Physics Facility) and SIN (Swiss Institute for Nuclear Research, Zurich). (author)

Forschungszentrum Rossendorf, Institute of Safety Research. Annual report 1997

Energy Technology Data Exchange (ETDEWEB)

Weiss, F P; Rindelhardt, U [eds.

1998-10-01

The research work of the institute aims at the assessment and increase of the safety of technical facilities. Subject of the investigation are equally nuclear plants and installations of process industries. To analyse thermo-fluiddynamic phenomena of accident scenarios physical models and computer codes are developed as well for multi-phase and multi-component flows as for the time and space dependent power release (neutron kinetics in light water reactors, reaction kinetics of exothermic chemical reactions). Emphasis is put on the description of spatial flows and the transient evolution of flow patterns. (orig.)

The NASA Astrobiology Institute: early history and organization

Science.gov (United States)

Blumberg, Baruch S.

2003-01-01

The NASA Astrobiology Institute (NAI) was established as a means to advance the field of astrobiology by providing a multidisciplinary, multi-institution, science-directed program, executed by universities, research institutes, and NASA and other government laboratories. The scientific community and NASA defined the science content at several workshops as summarized in the NASA Astrobiology Roadmap. Teams were chosen nationwide, following the recommendations of external review groups, and the research program began in 1998. There are now 16 national Teams and five international affiliated and associated astrobiology institutions. The NAI has attracted an outstanding group of scientific groups and individuals. The Institute facilitates the involvement of the scientists in its scientific and management vision. Its goal is to support basic research and allow the scientists the freedom to select their projects and alter them as indicated by new research. Additional missions include the education of the public, the involvement of students who will be the astrobiologists of future generations, and the development of a culture of collaboration in NAI, a "virtual institute," spread across many sites nationally and internationally.

Concordant, non-atypical breast papillomas do not require surgical excision: A 10-year multi-institution study and review of the literature.

Science.gov (United States)

Grimm, Lars J; Bookhout, Christine E; Bentley, Rex C; Jordan, Sheryl G; Lawton, Thomas J

2018-05-01

Non-atypical papillomas (NAPs) diagnosed on core needle biopsy (CNB) frequently undergo surgical excision due to highly variable upstaging rates. The purpose of this study is to document our dual-institution upgrade rates of NAPs diagnosed on core needle biopsy and review the upgrade rates reported in the literature. Following IRB approval, CNB results from Duke University (7/1/2004-6/30/2014) and the University of North Carolina Chapel Hill (1/1/04-6/30/2013) were reviewed to identify non-atypical papillomas. All cases with surgical excision or 2 years of imaging follow up were included. In addition, a literature review identified 60 published studies on upgrades of NAPs diagnosed at CNB. Cases in our cohort and the published literature were reviewed for confounding factors: [1] missing radiologic-pathologic concordance and/or discordance, [2] papillomas included with high-risk lesions, [3] high risk lesions counted as upgrades, [4] review by a nonspecialized breast pathologist, and [5] cancer incidentally detected. Of the 388 CNBs in our dual-institution cohort, 136 (35%) patients underwent surgical excision and 252 (65%) patients had imaging follow up. After controlling for confounders, no cancers (0/388) were found at surgical excision or during follow up imaging. The literature review upstaging rate was 4.0% (166/4157) but 1.8% (4/227) after excluding studies with confounders. The combined upstaging rate from the literature and this study was 0.6% (4/615). The upstaging rate for CNB diagnosed NAPs was 0% in our cohort and 0.6% overall after adjusting for confounders. This low rate does not warrant reflexive surgical excision and diagnostic imaging follow up should be discretionary. Copyright © 2018 Elsevier Inc. All rights reserved.

Study the multi-photon absorption process in two types of molecules

International Nuclear Information System (INIS)

Al-azawi, H.R.

1986-01-01

The aim of the present work was to study the multi-photon absorption process in two types of molecules; spherical top such as SF 6 molecules and assymetric top such as CHOOH and C 2 H 4 molecules. This work also aimed to study the effect of buffer gas pressure (Ar), which is transparent to the infrared (IR) laser on the multiphoton absorption of both types of molecules. A pulsed (TEA) CO 2 laser was used as a source which generates multi-lines in the IR-region of the spectrum and an optoacoustic detector was used to detect the energy absorbed by the molecules. In this study, the relaxation process was found to be faster in the heavy molecules than that in the light ones. A limit in the Ar pressure was observed. Below this limit, the gas acted as an active buffer gas and above it, the multi-photon absorption process was quenched. This work also aimed to study the multi-photon absorption spectrum for the CHOOH molecules in the range (1067-1090 cm -1 ). This spectrum was found to be consistent with the linear absorption spectrum obtained for the same range. The density of the vibrational states as a function of the vibrational energy was studied for the molecules SF 6 , CHOOH and C 2 H 4 . The results were used to interpret (i) the difference in the energy absorbed by difference molecules at the same energy density and (ii) the non-linearity in the multi-photon absorption for CHOOH molecules. 1 tab.; 40 figs.; 70 refs

1988 Pilot Institute on Global Change on trace gases and the biosphere

Energy Technology Data Exchange (ETDEWEB)

Eddy, J.A.; Moore, B. III

1998-07-01

This proposal seeks multi-agency funding to conduct an international, multidisciplinary 1988 Pilot Institute on Global Change to take place from August 7 through 21, 1988, on the topic: Trace Gases and the Biosphere. The institute, to be held in Snowmass, Colorado, is envisioned as a pilot version of a continuing series of institutes on Global Change (IGC). This proposal seeks support for the 1988 pilot institute only. The concept and structure for the continuing series, and the definition of the 1988 pilot institute, were developed at an intensive and multidisciplinary Summer Institute Planning Meeting in Boulder, Colorado, on August 24--25, 1987. The theme for the 1988 PIGC, Trace Gases and the Biosphere, will focus a concerted, high-level multidisciplinary effort on a scientific problem central to the Global Change Program. Dramatic year-to-year increases in the global concentrations of radiatively-active trace gases such as methane and carbon dioxide are now well documented. The predicted climatic effects of these changes lend special urgency to efforts to study the biospheric sources and sinks of these gases and to clarify their interactions and role in the geosphere-biosphere system.

The multi-level perspective analysis: Indonesia geothermal energy transition study

Science.gov (United States)

Wisaksono, A.; Murphy, J.; Sharp, J. H.; Younger, P. L.

2018-01-01

The study adopts a multi-level perspective in technology transition to analyse how the transition process in the development of geothermal energy in Indonesia is able to compete against the incumbent fossil-fuelled energy sources. Three levels of multi-level perspective are socio-technical landscape (ST-landscape), socio-technical regime (ST-regime) and niche innovations in Indonesia geothermal development. The identification, mapping and analysis of the dynamic relationship between each level are the important pillars of the multi-level perspective framework. The analysis considers the set of rules, actors and controversies that may arise in the technological transition process. The identified geothermal resource risks are the basis of the emerging geothermal technological innovations in Indonesian geothermal. The analysis of this study reveals the transition pathway, which yields a forecast for the Indonesian geothermal technology transition in the form of scenarios and probable impacts.

Research into care quality criteria for long-term care institutions.

Science.gov (United States)

Wang, Wen-Liang; Chang, Hong-Jer; Liu, An-Chi; Chen, Yu-Wen

2007-12-01

The purpose of this paper was to determine the criteria that reflect the quality of care provided by long-term care institutions. Research was conducted using a two-step procedure that first utilized the SERVQUAL model with Fuzzy Delphi Method to establish the proper criteria by which service quality could be measured. A total of 200 questionnaires were mailed to expert respondents, of which 89 were returned and 77 deemed valid for use in this study. We then applied the Multi-Criteria Decision Making Process to determine the degree of importance of each criterion to long-term care institution service quality planning work. Secondly, 200 questionnaires were distributed and 74 valid responses were returned. Based on the 5 SERVQUAL model constructs, this study found 17 of the 28 criteria, to be pertinent to nursing care quality, with those in the Responsiveness and Empathy domains being the ones most critical.

Temporal trends in pharmacology publications by pharmacy institutes: A deeper dig.

Science.gov (United States)

Bhatt, Parloop Amit; Patel, Zarana

2016-10-01

Publications in Indian Journal of Pharmacology (IJP) are the face of contemporary pharmacology practices followed in health-care profession - a knowledge-based profession. It depicts trends in terms of quantity (proportions), quality, type (preclinical/clinical), thrust areas, etc., of pharmacology followed by biomedical community professions both nationally and internationally. This article aims to establish temporal trends in pharmacology research by pharmacy institutes in light of its publications to IJP from 2010 to 2015. The website of IJP was searched for publications year and issue wise for contributing authors from pharmacy institutions and analyzed for types of publications, their source and the categories of research documented in these publications. A total of 1034 articles were published, of which 189 (18%) articles were published by pharmacy institutes, of which 90% ( n = 170) were contributed from pharmacy institutes within India whereas 10% ( n = 19) from international pharmacy institutes. 75% of these were research publication, the majority of which (65%) were related to preclinical screening of phytochemical constituents from plants. With multi and interdisciplinary collaborations in pharmacy profession the trend needs to improve toward molecular and cellular pharmacology and clinical studies.

The Global Tracheostomy Collaborative: one institution's experience with a new quality improvement initiative.

Science.gov (United States)

Lavin, Jennifer; Shah, Rahul; Greenlick, Hannah; Gaudreau, Philip; Bedwell, Joshua

2016-01-01

Given the low frequency of adverse events after tracheostomy, individual institutions struggle to collect outcome data to generate effective quality improvement protocols. The Global Tracheostomy Collaborative (GTC) is a multi-institutional, multi-disciplinary organization that utilizes a prospective database to collect data on patients undergoing tracheostomy. We describe our institution's preliminary experience with this collaborative. It was hypothesized that entry into the database would be non-burdensome and could be easily and accurately initiated by skilled specialists at the time of tracheostomy placement and completed at time of patient discharge. Demographic, diagnostic, and outcome data on children undergoing tracheostomy at our institution from January 2013 to June 2015 were entered into the GTC database, a database collected and managed by REDCap (Research Electronic Data Capture). All data entry was performed by pediatric otolaryngology fellows and all post-operative updates were completed by a skilled tracheostomy nurse. Tracked outcomes included accidental decannulation, failed decannulation, tracheostomy tube obstruction, bleeding/tracheoinnominate fistula, and tracheocutaneous fistula. Data from 79 patients undergoing tracheostomy at our institution were recorded. Database entry was straightforward and entry of patient demographic information, medical comorbidities, surgical indications, and date of tracheostomy placement was completed in less than 5min per patient. The most common indication for surgery was facilitation of ventilation in 65 patients (82.3%). Average time from admission to tracheostomy was 62.6 days (range 0-246). Stomal breakdown was seen in 1 patient. A total of 72 patients were tracked to hospital discharge with 53 patients surviving (88.3%). No mortalities were tracheostomy-related. The Global Tracheostomy Collaborative is a multi-institutional, multi-disciplinary collaborative that collects data on patients undergoing

Study of the equilibrium of a multi-polar discharge

International Nuclear Information System (INIS)

Gauthereau, Christian

1983-01-01

As previous studies showed that the increase of electronic density in plasmas is not due to plasma confinement which is rather poor, but to the confinement of primary electrons, this research thesis addresses the issue of uniformity of multi-polar plasmas. The author first shows that noticed density profiles can be explained if the ionisation term is assumed to be non uniform and to be strongly increasing at the vicinity of walls where the magnetic field governs. Trajectories of primary electrons in the multi-polar field are studied. Then, the author shows that the increase of the ionisation term at the vicinity of walls is related to the existence of an important population of primary electrons trapped in the magnetic field. A similar situation is indeed noticed near the Earth where Van Allen belts are made of particles emitted by the Sun and trapped by the bipolar Earth magnetic field. The problem of particle trapping by the multi-polar field is then addressed, and a trapping mechanism is proposed. Finally, some experimental results show the existence of trapped particles and the instability [fr

Importance of the multi-modules study in PSA

International Nuclear Information System (INIS)

Gonzalez R, V. J.; Nelson E, P. F.

2015-09-01

The current approach that has taken the Probabilistic Safety Analysis (PSA) consists of doing all the APS analysis including the existence of multi-units in the nuclear power plants (NPP), this new approach seeks to analyze the risk of site, evaluating all reactors together. The main reasons for this trend are: the accident occurred on March 2011 in Fukushima Daiichi in Japan, with serious consequences in more than one reactor of the NPP and the current planning and construction of new Small Modular Reactors, which host more than one module on the same NPP and are connected to a single control room. This study analyzes how to model the risk of a multi-module NPP. In 2013, the ASME/ANS standard for advanced reactors that are not light-water reactors was published, in which the requirements to realize a PSA including multi-units or modules are shown; however, does not describe the methodology to do that. This article presents a methodology to calculate the risk of the site in a PBMR plant with two modules. This methodology consists of two models of trees of different events, one that evaluates to a single PBMR module and another that evaluates the two modules together. Both models are responsible to show their differences and compare results to finally demonstrate the need for new methodologies for risk analysis site in multi-modules and units. (Author)

The current status of treatment for oropharyngeal cancer in Japan. A multi-institutional retrospective observation study

International Nuclear Information System (INIS)

Homma, Akihiro; Hayashi, Ryuichi; Kawabata, Kazuyoshi

2013-01-01

The purpose of this study was to assess the current status of the treatment for oropharyngeal cancer (OPC) in Japan to assist the planning of clinical trials in the future. The data for 523 patients with previously untreated OPC were obtained from 12 institutions from April 2005 to N/larch 2007. Of the 523 patients, 471 patients with squamous cell carcinoma and with curative intent were included in an analysis of the treatment and its results. Of the 471 patients with OPC treated with curative intent, 186 patients (39.5%) were treated with surgery, 118 (25.1%) with radiotherapy (RT) alone and 167 (355%) with CRT. Surgery was indicated for 60.4% of the patients with stage I, 47.8% in stage II, 29.4% in stage III, and 36.44% in stage IV. CRT was indicated for 8.3% in stage II, but the percentage increased with higher stage. The percentage of RT was around 30% among stage I-III, but in stage IV, 21.3% of the patients were indicated for RT. The median follow-up period was 4 years and 5 months. The 2-year and 5-year overall survival rates for the 471 patients were 85% and 69.9%, respectively. The 5-year overall survival rates for patients treated initially with surgery, RT and CRT were 73%, 69.1% and 65.6%, respectively. The 5-year overall survival rates for patients with stage I, II, III, IVA, and IVB were 78.9%. 87.3%, 69.7%, 66.6%, and 47.7%, respectively. Although this study was retrospective, we could understand the tendency of treatment choice according to various factors and treatment results. The information will be useful for planning clinical trials in the future. (author)

Institutional Linkage Support for Quality Development of Educational Physical Planning and Building in Nepal

DEFF Research Database (Denmark)

Vagnby, Bo Hellisen

Terms of Reference for an institutional linkage support project to further develop the education sector?s capacity to improve the physical learning and teaching environment. The TORs calls, inter alia, for the undertaking of relevant studies regarding utilisation of school facilities; user......-reaction studies (e.g. multi-purpose school blocks vs. specialised buildings); studies of girl?s and boy?s special requirements etc.. The project includes a pilot school improvement scheme based on improved designs developed under the project....

Faculty development to enhance humanistic teaching and role modeling: a collaborative study at eight institutions.

Science.gov (United States)

Branch, William T; Chou, Calvin L; Farber, Neil J; Hatem, David; Keenan, Craig; Makoul, Gregory; Quinn, Mariah; Salazar, William; Sillman, Jane; Stuber, Margaret; Wilkerson, LuAnn; Mathew, George; Fost, Michael

2014-09-01

There is increased emphasis on practicing humanism in medicine but explicit methods for faculty development in humanism are rare. We sought to demonstrate improved faculty teaching and role modeling of humanistic and professional values by participants in a multi-institutional faculty development program as rated by their learners in clinical settings compared to contemporaneous controls. Blinded learners in clinical settings rated their clinical teachers, either participants or controls, on the previously validated 10-item Humanistic Teaching Practices Effectiveness (HTPE) questionnaire. Groups of 7-9 participants at 8 academic medical centers completed an 18-month faculty development program. Participating faculty were chosen by program facilitators at each institution on the basis of being promising teachers, willing to participate in the longitudinal faculty development program. Our 18-month curriculum combined experiential learning of teaching skills with critical reflection using appreciative inquiry narratives about their experiences as teachers and other reflective discussions. The main outcome was the aggregate score of the ten items on the questionnaire at all institutions. The aggregate score favored participants over controls (P = 0.019) independently of gender, experience on faculty, specialty area, and/or overall teaching skills. Longitudinal, intensive faculty development that employs experiential learning and critical reflection likely enhances humanistic teaching and role modeling. Almost all participants completed the program. Results are generalizable to other schools.

Spinal Cord Subependymoma Surgery : A Multi-Institutional Experience.

Science.gov (United States)

Yuh, Woon Tak; Chung, Chun Kee; Park, Sung-Hye; Kim, Ki-Jeong; Lee, Sun-Ho; Kim, Kyoung-Tae

2018-03-01

A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas. We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21-77) from four institutions. The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8-89). Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.

Association between HIV/AIDS and multi-drug resistance tuberculosis: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Yonatan Moges Mesfin

Full Text Available BACKGROUND: Human immunodeficiency virus (HIV, multi-drug resistant tuberculosis (MDR is emerging as major challenge facing tuberculosis control programs worldwide particularly in Asia and Africa. Findings from different studies on associations of HIV co-infection and drug resistance among patients with TB have been contradictory (discordant. Some institution based studies found strongly increased risks for multi-drug resistant TB (MDR TB among patients co-infected with TB and HIV, whereas other studies found no increased risk (it remains less clear in community based studies. The aim was to conduct a systematic review and meta-analysis of the association between multi-drug resistant tuberculosis and HIV infection. METHODS AND FINDINGS: Systematic review of the published literature of observational studies was conducted. Original studies were identified using databases of Medline/Pubmed, Google Scholar and HINARI. The descriptions of original studies were made using frequency and forest plot. Publication bias was assessed using Funnel plot graphically and Egger weighted and Begg rank regression tests statistically. Heterogeneity across studies was checked using Cochrane Q test statistic and I(2. Pool risk estimates of MDR-TB and sub-grouping analysis were computed to analyze associations with HIV. Random effects of the meta-analysis of all 24 observational studies showed that HIV is associated with a marginal increased risk of multi-drug resistant tuberculosis (estimated Pooled OR 1.24; 95%, 1.04-1.43. Subgroup analyses showed that effect estimates were higher (Pooled OR 2.28; 95%, 1.52-3.04 for primary multi-drug resistance tuberculosis and moderate association between HIV/AIDS and MDR-TB among population based studies and no significant association in institution settings. CONCLUSIONS: This study demonstrated that there is association between MDR-TB and HIV. Capacity for diagnosis of MDR-TB and initiating and scale up of antiretroviral

Institute of Chemical Process Fundamentals of the ASCR: State of the Art

Czech Academy of Sciences Publication Activity Database

Hanika, Jiří

2013-01-01

Roč. 62, 5-6 (2013), s. 210-241 ISSN 0022-9830 Institutional support: RVO:67985858 Keywords : fundamental research * multi-disciplinary character * external cooperation Subject RIV: CI - Industrial Chemistry, Chemical Engineering

Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

Science.gov (United States)

Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

2016-04-01

Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

Mainstreaming conservation agriculture in Malawi: Knowledge gaps and institutional barriers.

Science.gov (United States)

Dougill, Andrew J; Whitfield, Stephen; Stringer, Lindsay C; Vincent, Katharine; Wood, Benjamin T; Chinseu, Edna L; Steward, Peter; Mkwambisi, David D

2017-06-15

Conservation agriculture (CA) practices of reduced soil tillage, permanent organic soil coverage and intercropping/crop rotation, are being advocated globally, based on perceived benefits for crop yields, soil carbon storage, weed suppression, reduced soil erosion and improved soil water retention. However, some have questioned their efficacy due to uncertainty around the performance and trade-offs associated with CA practices, and their compatibility with the diverse livelihood strategies and varied agro-ecological conditions across African smallholder systems. This paper assesses the role of key institutions in Malawi in shaping pathways towards more sustainable land management based on CA by outlining their impact on national policy-making and the design and implementation of agricultural development projects. It draws on interviews at national, district and project levels and a multi-stakeholder workshop that mapped the institutional landscape of decision-making for agricultural land management practices. Findings identify knowledge gaps and institutional barriers that influence land management decision-making and constrain CA uptake. We use our findings to set out an integrated roadmap of research needs and policy options aimed at supporting CA as a route to enhanced sustainable land management in Malawi. Findings offer lessons that can inform design, planning and implementation of CA projects, and identify the multi-level institutional support structures required for mainstreaming sustainable land management in sub-Saharan Africa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Student-Athletes' Perceptions of Coaches' Coaching Competency at the Malaysian Public Institution of Higher Learning

Science.gov (United States)

Chiu, Lim Khong; Mahat, Nor Idayu; Hua, Khor Phoy; Radzuwan, Radzliyana Bt.

2013-01-01

This study was designed to evaluate the competency level of coaches at the higher institutions' sports competitions organized by the Universities Sports Council of Malaysia. Multi-dimensional model of leadership behaviors and models of coaching effectiveness were used as the basis for the theoretical framework. A total of 322 student-athletes…

Second-degree Stokes coefficients from multi-satellite SLR

Czech Academy of Sciences Publication Activity Database

Blossfeld, M.; Mueller, H.; Gerstl, M.; Štefka, Vojtěch; Bouman, J.; Goettl, F.; Horwath, M.

2015-01-01

Roč. 89, č. 9 (2015), s. 857-871 ISSN 0949-7714 Institutional support: RVO:67985815 Keywords : multi-satellite SLR * stokes coefficients * equatorial excitation functions Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 2.486, year: 2015

Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

Science.gov (United States)

Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

2011-11-01

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

The Master model on multi-actor and multilevel social responsibilities

OpenAIRE

Ashley, P.A.

2011-01-01

This working paper contributes to a collective discussion in a workshop occurring in January 2011 at the International Institute of Social Studies, bringing scholars from Europe and Brazil and aiming inter-university research collaboration on linking policies on social responsibility to development and equity. The paper serves as an introductory discussion for reframing the concept of corporate social responsibility into a broader umbrella concept of multi-actor and multilevel social responsi...

Effectiveness and side-effects of peptide receptor radionuclide therapy for neuroendocrine neoplasms in Germany: A multi-institutional registry study with prospective follow-up.

Science.gov (United States)

Hörsch, Dieter; Ezziddin, Samer; Haug, Alexander; Gratz, Klaus Friedrich; Dunkelmann, Simone; Miederer, Matthias; Schreckenberger, Mathias; Krause, Bernd Joachim; Bengel, Frank M; Bartenstein, Peter; Biersack, Hans-Jürgen; Pöpperl, Gabriele; Baum, R P

2016-05-01

Monocentric and retrospective studies indicate effectiveness of peptide receptor radionuclide therapy targeting somatostatin receptors of neuroendocrine neoplasms. We assessed overall and progression-free survival and adverse events of peptide receptor radionuclide therapy by a multi-institutional, board certified registry with prospective follow-up in five centres in Germany. A total of 450 patients were included and followed for a mean of 24.4 months. Most patients had progressive low- or intermediate grade neuroendocrine neoplasms and 73% were pretreated with at least one therapy. Primary neuroendocrine neoplasms were mainly derived of pancreas (38%), small bowel (30%), unknown primary (19%) or bronchial system (4%). Patients were treated with Lutetium-177 in 54%, with Yttrium-90 in 17% and with both radionuclides in 29%. Overall and progression-free survival was determined with Kaplan-Meier curves and uni-variate log rank test Cox models. Median overall survival of all patients was 59 (95% confidence interval [CI] 49-68.9) months. Overall survival was significantly inferior in the patients treated with Yttrium-90 solely (hazard ratio, 3.22; 95% CI, 1.83-5.64) compared to any peptide receptor radionuclide therapy with Lutetium-177. Grade II (hazard ratio, 2.06; 95% CI, 0.79-5.32) and grade III (hazard ratio, 4.22; 95% CI, 1.41-12.06) neuroendocrine neoplasms had significantly worse overall survival than grade I neuroendocrine neoplasms. Patients with small neuroendocrine neoplasms of small bowel had significantly increased survival (hazard ratio, 0.39; 95% CI, 0.18-0.87) compared to neuroendocrine neoplasms of other locations. Median progression-free survival was 41 (35.9-46.1) months and significantly inferior in patients treated with Yttrium solely (hazard ratio, 2.7; 95% CI, 1.71-4.55). Complete remission was observed in 5.6% of patients, 22.4% had a partial remission, 47.3% were stable and 4% were progressive as best response. Adverse events of bone marrow

Security and privacy requirements for a multi-institutional cancer research data grid: an interview-based study.

Science.gov (United States)

Manion, Frank J; Robbins, Robert J; Weems, William A; Crowley, Rebecca S

2009-06-15

Data protection is important for all information systems that deal with human-subjects data. Grid-based systems--such as the cancer Biomedical Informatics Grid (caBIG)--seek to develop new mechanisms to facilitate real-time federation of cancer-relevant data sources, including sources protected under a variety of regulatory laws, such as HIPAA and 21CFR11. These systems embody new models for data sharing, and hence pose new challenges to the regulatory community, and to those who would develop or adopt them. These challenges must be understood by both systems developers and system adopters. In this paper, we describe our work collecting policy statements, expectations, and requirements from regulatory decision makers at academic cancer centers in the United States. We use these statements to examine fundamental assumptions regarding data sharing using data federations and grid computing. An interview-based study of key stakeholders from a sample of US cancer centers. Interviews were structured, and used an instrument that was developed for the purpose of this study. The instrument included a set of problem scenarios--difficult policy situations that were derived during a full-day discussion of potentially problematic issues by a set of project participants with diverse expertise. Each problem scenario included a set of open-ended questions that were designed to elucidate stakeholder opinions and concerns. Interviews were transcribed verbatim and used for both qualitative and quantitative analysis. For quantitative analysis, data was aggregated at the individual or institutional unit of analysis, depending on the specific interview question. Thirty-one (31) individuals at six cancer centers were contacted to participate. Twenty-four out of thirty-one (24/31) individuals responded to our request- yielding a total response rate of 77%. Respondents included IRB directors and policy-makers, privacy and security officers, directors of offices of research, information

Security and privacy requirements for a multi-institutional cancer research data grid: an interview-based study

Directory of Open Access Journals (Sweden)

Weems William A

2009-06-01

Full Text Available Abstract Background Data protection is important for all information systems that deal with human-subjects data. Grid-based systems – such as the cancer Biomedical Informatics Grid (caBIG – seek to develop new mechanisms to facilitate real-time federation of cancer-relevant data sources, including sources protected under a variety of regulatory laws, such as HIPAA and 21CFR11. These systems embody new models for data sharing, and hence pose new challenges to the regulatory community, and to those who would develop or adopt them. These challenges must be understood by both systems developers and system adopters. In this paper, we describe our work collecting policy statements, expectations, and requirements from regulatory decision makers at academic cancer centers in the United States. We use these statements to examine fundamental assumptions regarding data sharing using data federations and grid computing. Methods An interview-based study of key stakeholders from a sample of US cancer centers. Interviews were structured, and used an instrument that was developed for the purpose of this study. The instrument included a set of problem scenarios – difficult policy situations that were derived during a full-day discussion of potentially problematic issues by a set of project participants with diverse expertise. Each problem scenario included a set of open-ended questions that were designed to elucidate stakeholder opinions and concerns. Interviews were transcribed verbatim and used for both qualitative and quantitative analysis. For quantitative analysis, data was aggregated at the individual or institutional unit of analysis, depending on the specific interview question. Results Thirty-one (31 individuals at six cancer centers were contacted to participate. Twenty-four out of thirty-one (24/31 individuals responded to our request- yielding a total response rate of 77%. Respondents included IRB directors and policy-makers, privacy and

Security and privacy requirements for a multi-institutional cancer research data grid: an interview-based study

Science.gov (United States)

2009-01-01

Background Data protection is important for all information systems that deal with human-subjects data. Grid-based systems – such as the cancer Biomedical Informatics Grid (caBIG) – seek to develop new mechanisms to facilitate real-time federation of cancer-relevant data sources, including sources protected under a variety of regulatory laws, such as HIPAA and 21CFR11. These systems embody new models for data sharing, and hence pose new challenges to the regulatory community, and to those who would develop or adopt them. These challenges must be understood by both systems developers and system adopters. In this paper, we describe our work collecting policy statements, expectations, and requirements from regulatory decision makers at academic cancer centers in the United States. We use these statements to examine fundamental assumptions regarding data sharing using data federations and grid computing. Methods An interview-based study of key stakeholders from a sample of US cancer centers. Interviews were structured, and used an instrument that was developed for the purpose of this study. The instrument included a set of problem scenarios – difficult policy situations that were derived during a full-day discussion of potentially problematic issues by a set of project participants with diverse expertise. Each problem scenario included a set of open-ended questions that were designed to elucidate stakeholder opinions and concerns. Interviews were transcribed verbatim and used for both qualitative and quantitative analysis. For quantitative analysis, data was aggregated at the individual or institutional unit of analysis, depending on the specific interview question. Results Thirty-one (31) individuals at six cancer centers were contacted to participate. Twenty-four out of thirty-one (24/31) individuals responded to our request- yielding a total response rate of 77%. Respondents included IRB directors and policy-makers, privacy and security officers, directors of

Institutions and Regulation for Economic Growth ? : public interests versus public incentives

NARCIS (Netherlands)

Wubben, E.F.M.

2011-01-01

Realizing institutions and regulations that foster economic growth is an essential asset for contemporary economies. This book investigates practices and options for steering individual and firm behaviour that prevents unacceptable externalities and boosts public interests. These multi-dimensional

Study of multi-quasiparticle band structures in 197Tl using α beam

International Nuclear Information System (INIS)

Mukherjee, G.; Nandi, S.; Pai, H.

2016-01-01

Study of the multi-quasiparticle (qp) states and the band structures built on them in the neutron deficient Tl nuclei in A ∼ 190 mass region provides useful information on particle-hole interaction in the heavy nuclei. In order to investigate the multi-qp band structures we have studied the excited states in 197 Tl by gamma ray spectroscopy

A multi-institution evaluation of MLC log files and performance in IMRT delivery

International Nuclear Information System (INIS)

Kerns, James R; Childress, Nathan; Kry, Stephen F

2014-01-01

The multileaf collimator (MLC) is a critical component to accurate intensity-modulated radiotherapy (IMRT) delivery. This study examined MLC positional accuracy via MLC logs from Varian machines from six institutions and three delivery techniques to evaluate typical positional accuracy and treatment and mechanical parameters that affect accuracy. Typical accuracy achieved was compared against TG-142 recommendations for MLC performance; more appropriate recommendations are suggested. Over 85,000 Varian MLC treatment logs were collected from six institutions and analyzed with FractionCHECK. Data were binned according to institution and treatment type to determine overall root mean square (RMS) and 95 th percentile error values, and then to look for correlations between those errors and with mechanical and treatment parameters including mean and maximum leaf speed, gantry angle, beam-on time, mean leaf error, and number of segments. Results of treatment logs found that leaf RMS error and 95 th percentile leaf error were consistent between institutions, but varied by treatment type. The step and shoot technique had very small errors: the mean RMS leaf error was 0.008 mm. For dynamic treatments the mean RMS leaf error was 0.32 mm, while volumetric-modulated arc treatment (VMAT) showed an RMS leaf error of 0.46 mm. Most MLC leaf errors were found to be well below TG-142 recommended tolerances. For the dynamic and VMAT techniques, the mean and maximum leaf speeds were significantly linked to the leaf RMS error. Additionally, for dynamic delivery, the mean leaf error was correlated with RMS error, whereas for VMAT the average gantry speed was correlated. For all treatments, the RMS error and the 95 th percentile leaf error were correlated. Restricting the maximum leaf speed can help improve MLC performance for dynamic and VMAT deliveries. Furthermore, the tolerances of leaf RMS and error counts for all treatment types should be tightened from the TG-142 values to make them

Study of plutonium multi-recycle in high moderation LWR cores

International Nuclear Information System (INIS)

Iwata, Yutaka; Yamamoto, Toru; Ueji, Masao; Hibi, Koki; Aoyama, Motoo; Sakurada, Koichi

2000-01-01

Nuclear Power Engineering Corporation (NUPEC) has been studying advanced cores that are dedicated to enhance the plutonium consumption per recycling for effective use of plutonium. In this study, a fissile plutonium consumption rate is adopted as an index of the effective use of plutonium, which is defined as a ratio of consumption to loading of fissile plutonium in a core. High moderation core concepts have been studied in order to increase this index based on full MOX cores in the latest designs of LWRs in Japan that are the Advanced Boiling Water Reactor (ABWR) and the Advanced Pressurized Water Reactor (APWR). As a part of this study, core performance in the case of plutonium multi-recycling has been surveyed with these higher moderation cores aiming further effective use of plutonium. The design and analyses for equilibrium cores show that nuclear and thermal hydraulics parameters satisfy design criteria, and a fissile plutonium consumption rate increases up to 20% for ABWRs and 30% for APWRs even in plutonium multi-recycling condition. It was confirmed that the high moderation cores are feasible from a viewpoint of nuclear and thermal hydraulics, safety and plutonium consumption in the condition of plutonium multi-recycling. (author)

Emerging Economies, Institutional Voids, and Innovation Drivers : A Study in India

NARCIS (Netherlands)

Voeten, Jaap; Saiyed, Abrar Ali; Dutta, Dev K.

Research has highlighted the importance of the institutional context on innovation and entrepreneurship. The focus of this qualitative research was to study small and medium enterprises (SMEs) in the manufacturing sector in India with the purpose of understanding how institutional voids affect the

Closure relations for the multi-species Euler system. Construction and study of relaxation schemes for the multi-species and multi-components Euler systems; Relations de fermeture pour le systeme des equations d'Euler multi-especes. Construction et etude de schemas de relaxation en multi-especes et en multi-constituants

Energy Technology Data Exchange (ETDEWEB)

Dellacherie, St. [CEA Saclay, Dir. de l' Energie Nucleaire DEN/SFNME/LMPE, Lab. de Modelisation Physique et de l' Enrichissement, 91 - Gif sur Yvette (France); Rency, N. [Paris-11 Univ., CNRS UMR 8628, 91 - Orsay (France)

2001-07-01

After having recalled the formal convergence of the semi-classical multi-species Boltzmann equations toward the multi-species Euler system (i.e. mixture of gases having the same velocity), we generalize to this system the closure relations proposed by B. Despres and by F. Lagoutiere for the multi-components Euler system (i.e. mixture of non miscible fluids having the same velocity). Then, we extend the energy relaxation schemes proposed by F. Coquel and by B. Perthame for the numerical resolution of the mono-species Euler system to the multi-species isothermal Euler system and to the multi-components isobar-isothermal Euler system. This allows to obtain a class of entropic schemes under a CFL criteria. In the multi-components case, this class of entropic schemes is perhaps a way for the treatment of interface problems and, then, for the treatment of the numerical mixture area by using a Lagrange + projection scheme. Nevertheless, we have to find a good projection stage in the multi-components case. At last, in the last chapter, we discuss, through the study of a dynamical system, about a system proposed by R. Abgrall and by R. Saurel for the numerical resolution of the multi-components Euler system.

Multi-Metric Sustainability Analysis

Energy Technology Data Exchange (ETDEWEB)

Cowlin, Shannon [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mann, Margaret [National Renewable Energy Lab. (NREL), Golden, CO (United States); Pless, Jacquelyn [National Renewable Energy Lab. (NREL), Golden, CO (United States); Munoz, David [Colorado School of Mines, Golden, CO (United States)

2014-12-01

A readily accessible framework that allows for evaluating impacts and comparing tradeoffs among factors in energy policy, expansion planning, and investment decision making is lacking. Recognizing this, the Joint Institute for Strategic Energy Analysis (JISEA) funded an exploration of multi-metric sustainability analysis (MMSA) to provide energy decision makers with a means to make more comprehensive comparisons of energy technologies. The resulting MMSA tool lets decision makers simultaneously compare technologies and potential deployment locations.

The Readiness of Lecturers in Embedding Soft Skills in the Bachelor's Degree Program in Malaysian Institutes of Teacher Education

Science.gov (United States)

Hassan, Aminuddin; Maharoff, Marina; Abiddin, Norhasni Zainal

2014-01-01

This is a preliminary research to obtain information to formulate a problem statement for an overall study of the embedding of soft skills in the program courses in higher learning institutions. This research was conducted in the form of single case and multi-case studies. The research data was attained through mixed methods; the quantitative…

Assessment of berberine as a multi-target antimicrobial: a multi-omics study for drug discovery and repositioning.

Science.gov (United States)

Karaosmanoglu, Kubra; Sayar, Nihat Alpagu; Kurnaz, Isil Aksan; Akbulut, Berna Sariyar

2014-01-01

Postgenomics drug development is undergoing major transformation in the age of multi-omics studies and drug repositioning. Rather than applications solely in personalized medicine, omics science thus additionally offers a better understanding of a broader range of drug targets and drug repositioning. Berberine is an isoquinoline alkaloid found in many medicinal plants. We report here a whole genome microarray study in tandem with proteomics techniques for mining the plethora of targets that are putatively involved in the antimicrobial activity of berberine against Escherichia coli. We found DNA replication/repair and transcription to be triggered by berberine, indicating that nucleic acids, in general, are among its targets. Our combined transcriptomics and proteomics multi-omics findings underscore that, in the presence of berberine, cell wall or cell membrane transport and motility-related functions are also specifically regulated. We further report a general decline in metabolism, as seen by repression of genes in carbohydrate and amino acid metabolism, energy production, and conversion. An involvement of multidrug efflux pumps, as well as reduced membrane permeability for developing resistance against berberine in E. coli was noted. Collectively, these findings offer original and significant leads for omics-guided drug discovery and future repositioning approaches in the postgenomics era, using berberine as a multi-omics case study.

Multi-Dimensional Impact of the Public-Private Center for Translational Molecular Medicine (CTMM) in the Netherlands: Understanding New 21(st) Century Institutional Designs to Support Innovation-in-Society.

Science.gov (United States)

Steuten, Lotte M

2016-05-01

Knowledge translation is at the epicenter of 21st century life sciences and integrative biology. Several innovative institutional designs have been formulated to cultivate knowledge translation. One of these organizational innovations has been the Center for Translational Molecular Medicine (CTMM), a multi-million public-private partnership in the Netherlands. The CTMM aims to accelerate molecular diagnostics and imaging technologies to forecast disease susceptibilities in healthy populations and early diagnosis and personalized treatment of patients. This research evaluated CTMM's impact on scientific, translational, clinical, and economic dimensions. A pragmatic, operationally-defined process indicators approach was used. Data were gathered from CTMM administrations, through a CTMM-wide survey (n = 167) and group interviews. We found that the CTMM focused on disease areas with high human, clinical, and economic burden to society (i.e., oncology, cardiovascular, neurologic, infection, and immunity diseases). CTMM displayed a robust scientific impact that rests 15%-80% above international reference values regarding publication volume and impact. Technology translation to the clinic was accelerated, with >50% of projects progressing from pre-clinical development to clinical testing within 5 years. Furthermore, CTMM has generated nearly 1500 Full Time Equivalent (FTE) of translational R&D capacity. Its positive impact on translational, (future) clinical, and economic aspects is recognized across all surveyed stakeholders. As organizational innovation is increasingly considered critical to forge linkages between life sciences discoveries and innovation-in-society, lessons learned from this study may inform other institutions with similar objectives such as the Clinical and Translational Science Awards (CTSA) Program of the National Institutes of Health (NIH) in the United States.

Outcomes in a Multi-institutional Cohort of Patients Treated With Intraoperative Radiation Therapy for Advanced or Recurrent Renal Cell Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Paly, Jonathan J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Biggs, Peter J.; Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Roeder, Falk [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Martínez-Monge, Rafael [Radiation Oncology Division, University of Navarre, Pamplona (Spain); Whitson, Jared [Department of Urology, University of California San Francisco, San Francisco, California (United States); Calvo, Felipe A. [Departamento de Oncología, Hospital General Universitario Gregorio Marañón, Madrid (Spain); Fastner, Gerd; Sedlmayer, Felix [Department of Radiotherapy and Radio-Oncology, Paracelsus Medical University Clinics, Salzburg (Austria); Wong, William W. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States); Ellis, Rodney J. [Department of Radiation Oncology, Seidman Cancer Center University Hospitals Case Medical Center, Cleveland, Ohio (United States); Haddock, Michael G.; Choo, Richard [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Shipley, William U.; Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Efstathiou, Jason A., E-mail: jefstathiou@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2014-03-01

Purpose/Objective(s): This study aimed to analyze outcomes in a multi-institutional cohort of patients with advanced or recurrent renal cell carcinoma (RCC) who were treated with intraoperative radiation therapy (IORT). Methods and Materials: Between 1985 and 2010, 98 patients received IORT for advanced or locally recurrent RCC at 9 institutions. The median follow-up time for surviving patients was 3.5 years. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method. Chained imputation accounted for missing data, and multivariate Cox hazards regression tested significance. Results: IORT was delivered during nephrectomy for advanced disease (28%) or during resection of locally recurrent RCC in the renal fossa (72%). Sixty-nine percent of the patients were male, and the median age was 58 years. At the time of primary resection, the T stages were as follows: 17% T1, 12% T2, 55% T3, and 16% T4. Eighty-seven percent of the patients had a visibly complete resection of tumor. Preoperative or postoperative external beam radiation therapy was administered to 27% and 35% of patients, respectively. The 5-year OS was 37% for advanced disease and 55% for locally recurrent disease. The respective 5-year DSS was 41% and 60%. The respective 5-year DFS was 39% and 52%. Initial nodal involvement (hazard ratio [HR] 2.9-3.6, P<.01), presence of sarcomatoid features (HR 3.7-6.9, P<.05), and higher IORT dose (HR 1.3, P<.001) were statistically significantly associated with decreased survival. Adjuvant systemic therapy was associated with decreased DSS (HR 2.4, P=.03). For locally recurrent tumors, positive margin status (HR 2.6, P=.01) was associated with decreased OS. Conclusions: We report the largest known cohort of patients with RCC managed by IORT and have identified several factors associated with survival. The outcomes for patients receiving IORT in the setting of local recurrence compare favorably to

Residency characteristics that matter most to plastic surgery applicants: a multi-institutional analysis and review of the literature.

Science.gov (United States)

Sinno, Sammy; Mehta, Karan; Squitieri, Lee; Ranganathan, Kavitha; Koeckert, Michael S; Patel, Ashit; Saadeh, Pierre B; Thanik, Vishal

2015-06-01

The National Residency Matching Program Match is a very unique process in which applicants and programs are coupled to each other based on a ranking system. Although several studies have assessed features plastic surgery programs look for in applicants, no study in the present plastic surgery literature identifies which residency characteristics are most important to plastic surgery applicants. Therefore, we sought to perform a multi-institutional assessment as to which factors plastic surgery residency applicants consider most important when applying for residency. A validated and anonymous questionnaire containing 37 items regarding various program characteristics was e-mailed to 226 applicants to New York University, Albany, University of Michigan, and University of Southern California plastic surgery residency programs. Applicants were asked to rate each feature on a scale from 1 to 10, with 10 being the most important. The 37 variables were ranked by the sum of the responses. The median rating and interquartile range as well as the mean for each factor was then calculated. A Wilcoxon signed rank test was used to compare medians in rank order. A total of 137 completed questionnaires were returned, yielding a 61% response rate. The characteristics candidates considered most important were impressions during the interview, experiences during away rotations, importance placed on resident training/support/mentoring by faculty, personal experiences with residents, and the amount of time spent in general surgery. The characteristics candidates considered least important were second-look experiences, compensation/benefits, program reputation from Internet forums, accessibility of program coordinator, opportunity for laboratory research, and fellowship positions available at the program. Applicants value personal contact and time spent in general surgery when selecting residency programs. As the number of integrated programs continues to grow, programs will benefit

Experimental Study of Multi-Walled Composite Shell Fragments under Thermal Force Effects

Directory of Open Access Journals (Sweden)

L. P. Tairova

2015-01-01

Full Text Available Multi-walled composite shells are a relatively new prospective type of load carrying structures for rocket and space engineering. These CFRP structures are produced by injection and infusion methods and have several advantages in comparison with common structures such as stringer-frame, grid and sandwich structures with a light core. In particular, those have more structural parameters, which enable one to control mechanical properties of the structure, and this is important in designing the load carrying structures of different purpose.Presently, there are few national and foreign publications on experimental investigations of mechanical properties of multi-walled shells. That is why the objective of the paper is to conduct the experimental study of deformation and failure processes of a multi-walled panel both under steady-state heating and under unsteady-state one.The paper presents the results of two tests: (1 the study of deformation and failure modes under compression and complete heating up to a specified temperature and (2 validation of working capability of multi-walled samples under single-side heating and compression simulating a start and flight version of the “ Proton” launch vehicle.Experimental results have shown that average elastic properties of multi-walled samples slightly depend on temperature for the studied range (from room temperature up to 195C while strength properties considerably decrease with increasing temperature, and this is typical for CFRP structures under compression. However, under unsteady-state short-term heating the structure has a strength that exceeds the minimal necessary strength of load carrying structures of the “Proton” launch vehicle (the samples satisfy simulated start conditions of the “Proton” launch vehicle. This is because of a low heat conductivity of the multi-walled core: an unheated sheet holds a low temperature and high load carrying capacity.Obtained results can be used in

Empirical Study on Multi-Channel Service Quality and Customer Loyalty of Retailers

OpenAIRE

Qi Yong-zhi

2014-01-01

This paper studies the influence of offline RSSQ (retailing store service quality), online store ESQ (E-service quality) and O2O MCISQ (multi-channel integration service quality) on traditional retailers' customer loyalty as well as the relation of them three in multi-channel retailing. 380 customers with both offline and online shopping experience at the same retailer's store are investigated. Through the structural equation model, we find out that in multi-channel retailing, RSSQ and MCISQ ...

Student Perceptions of Service Quality in a Multi-Campus Higher Education System in Spain

Science.gov (United States)

Gallifa, Josep; Batalle, Pere

2010-01-01

Purpose: This paper aims to present an in-depth case study with student perceptions of service quality, discussing the relevance of these perceptions for the important issue of quality improvement in higher education. Design/methodology/approach: The paper presents institutional research carried out in a multi-campus system in Spain made up of…

Governing the energy challenge : Canada and Germany in a multi-level regional and global context

International Nuclear Information System (INIS)

Eberlein, B.; Doern, G.B.; Exeter Univ.,

2009-01-01

This book features essays by leading energy and public policy specialists from Canada and Germany. It originated in the Transatlantic Energy Conference which was hosted by the Canadian Centre for German and European Studies at Toronto's York University in September 2005. The conference was attended by leading energy scholars and experts from Canadian and European universities, research institutes and governmental and non-governmental organizations. The purpose of this book was to compare the dynamics of multi-level energy regulatory governance in Germany and Canada, notably the energy policy challenges that include energy security, environmental sustainability and a competitive resource economy. Many strategies to produce more efficient and sustainable energy are presented in the book. Part 1 of the book focuses on the energy industry, with particular emphasise on electricity, nuclear energy and natural gas. Part 2 of the book focuses on domestic patterns of multi-level energy governance and regulation in the two countries. As a member of the European Union, Germany is more advanced in dealing with multi-level governmental and sustainability constraints than Canada is as a member of the North American Free Trade Agreement (NAFTA). The book focuses on the influence that the energy sector and multi-level institutional arrangements have on energy governance, with particular attention to the link between environmental study, climate change issues and economic market reforms. The growing differences between NAFTA and European Union member countries were highlighted. refs., tabs., figs.

Importance of the multi-modules study in PSA; Importancia del estudio de multi-modulos en APS

Energy Technology Data Exchange (ETDEWEB)

Gonzalez R, V. J.; Nelson E, P. F., E-mail: judith_gonzalez_rodriguez@outlook.es [UNAM, Facultad de Ingenieria, Departamento de Sistemas Energeticos, Paseo Cuauhnahuac 8532, 62550 Jiutepec, Morelos (Mexico)

2015-09-15

The current approach that has taken the Probabilistic Safety Analysis (PSA) consists of doing all the APS analysis including the existence of multi-units in the nuclear power plants (NPP), this new approach seeks to analyze the risk of site, evaluating all reactors together. The main reasons for this trend are: the accident occurred on March 2011 in Fukushima Daiichi in Japan, with serious consequences in more than one reactor of the NPP and the current planning and construction of new Small Modular Reactors, which host more than one module on the same NPP and are connected to a single control room. This study analyzes how to model the risk of a multi-module NPP. In 2013, the ASME/ANS standard for advanced reactors that are not light-water reactors was published, in which the requirements to realize a PSA including multi-units or modules are shown; however, does not describe the methodology to do that. This article presents a methodology to calculate the risk of the site in a PBMR plant with two modules. This methodology consists of two models of trees of different events, one that evaluates to a single PBMR module and another that evaluates the two modules together. Both models are responsible to show their differences and compare results to finally demonstrate the need for new methodologies for risk analysis site in multi-modules and units. (Author)

Diffusion of elements and vacancies in multi-component systems

Czech Academy of Sciences Publication Activity Database

Fischer, F. D.; Svoboda, Jiří

2014-01-01

Roč. 60, MAR (2014), s. 338-367 ISSN 0079-6425 Institutional support: RVO:68081723 Keywords : multi-component diffusion * vacancy activity * manning theory * stress-driven diffusion Subject RIV: BJ - Thermodynamics Impact factor: 27.417, year: 2014

The Institute on Climate and Planets (ICP): A Research Education Program

Science.gov (United States)

Carlson, Barbara (Technical Monitor)

2003-01-01

Giving students a fair start to become productive and responsible contributors in the 21st century workforce and society depends on our ability to help them develop: (1) A global view of the world; (2) Problem-solving and/or reasoning abilities; (3) Basic scientific and technical literacy; and (4) A multi-disciplinary understanding of how humans and nature interact with the earth system. The Institute on Climate and Planets (ICP) in New York City is NASA Goddard Institute for Space Studies' (GISS) response to the national challenge to give students a fair start to become productive in America's workforce and society, GISS is part of the Earth Science Director at NASA Goddard Space Flight Center in Maryland and a component of Columbia University's Earth Institute, a university-wide initiative whose mission is to understand our planet so as to enhance its sustainability. In 1994 Jim Hansen, several of his GISS and Columbia University colleagues and Fitzgerald Bramwell, the former Director of the New York City Alliance for Minority Participation at City University of New York, launched the ICP. ICP contributes to NASA education and minority outreach goals by directly involving underrepresented college, high school and junior high school students and their educators in research. ICP takes advantage of the interest of many civil servants and Columbia University research scientists at GISS to involve students and educators on multi-level research teams working on problems at the core of NASA's Earth Science Enterprise - advancing our understanding of Earth s climate, climate variability, and climate impacts.

Gaps in Radiation Therapy Awareness: Results From an Educational Multi-institutional Survey of US Internal Medicine Residents.

Science.gov (United States)

Shaverdian, Narek; Yoo, Sun Mi; Cook, Ryan; Chang, Eric M; Jiang, Naomi; Yuan, Ye; Sandler, Kiri; Steinberg, Michael; Lee, Percy

2017-08-01

Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs. The survey evaluated trainee demographic characteristics, baseline radiation oncology awareness, knowledge of the role of SBRT for early-stage NSCLC, and whether the survey successfully improved awareness. Thirty US internal medicine programs participated, with an overall participant response rate of 46% (1177 of 2551). Of the trainees, 93% (n=1076) reported no radiation oncology education in their residency, 39% (n=452) reported confidence in knowing when to consult radiation oncology in an oncologic emergency, and 26% (n=293) reported confidence in knowing when to consult radiation oncology in the setting of a newly diagnosed cancer. Of the participants, 76% (n=850) correctly identified that surgical resection is the standard treatment in operable early-stage NSCLC, but only 50% (n=559) of participants would recommend SBRT to a medically inoperable patient, followed by 31% of participants (n=347) who were unsure of the most appropriate treatment, and 10% (n=117) who recommended waiting to offer palliative therapy. Ninety percent of participants (n=1029) agreed that they would benefit from further training on when to consult radiation oncology. Overall, 96% (n=1072) indicated that the survey increased their knowledge and awareness of the role of SBRT. The majority of participating trainees received no education in radiation oncology in their residency, reported a lack of confidence regarding when to consult radiation oncology, and overwhelmingly agreed that they would benefit from further training. These findings

Reusable Learning Objects for Medical Education: Evolving a Multi-institutional Collaboration

NARCIS (Netherlands)

D. Leeder; T. Davies; A. Hall

2004-01-01

textabstractIn early 2002 a number of UK HE institutions founded a collaborative project to produce a bank of high quality e-learning resources to support and enhance teaching in the traditionally difficult area of statistics, epidemiology and research skills. Creation of these resources is very

LORIS: A web-based data management system for multi-center studies.

Directory of Open Access Journals (Sweden)

Samir eDas

2012-01-01

Full Text Available LORIS (Longitudinal Online Research and Imaging System is a modular and extensible web-based data management system that integrates all aspects of a multi-center study: from heterogeneous data acquisition (imaging, clinical, behavior, genetics to storage, processing and ultimately dissemination. It provides a secure, user-friendly, and streamlined platform to automate the flow of clinical trials and complex multi-center studies. A subject-centric internal organization allows researchers to capture and subsequently extract all information, longitudinal or cross-sectional, from any subset of the study cohort. Extensive error-checking and quality control procedures, security, data management, data querying and administrative functions provide LORIS with a triple capability (i continuous project coordination and monitoring of data acquisition (ii data storage/cleaning/querying, (iii interface with arbitrary external data processing pipelines. LORIS is a complete solution that has been thoroughly tested through the full life cycle of a multi-center longitudinal project# and is now supporting numerous neurodevelopment and neurodegeneration research projects internationally.

[Current status of bacteriological studies at prefectural and municipal public health institutes in Japan].

Science.gov (United States)

Shinomiya, Hiroto; Seto, Kazuko; Kawase, Jun; Arikawa, Kentaro; Funatogawa, Keiji; Suzuki, Masahiro; Kubota, Hiroaki; Shirabe, Komei

2015-01-01

Prefectural and municipal public health institutes are located in prefectures and ordinance-designated cities in Japan, and play a vital role in the regional surveillance of infectious diseases and foodborne illnesses. These institutes, in close cooperation with national institutes such as the National Institute of Infectious Diseases and the National Institute of Health Sciences, construct the national surveillance network for infectious diseases and their causative agents. Bacteriological examinations and studies on a variety of infectious diseases and foodborne illnesses are core activities of prefectural and municipal public health institutes, through which novel and important bacteriological findings have been acquired. In this article, we report the latest findings regarding bacteriological examinations/studies and interesting cases at these institutes, especially concerning foodborne illnesses, tuberculosis, and antimicrobial resistances.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

OpenAIRE

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are ...

Issues with performance measures for dynamic multi-objective optimisation

CSIR Research Space (South Africa)

Helbig, M

2013-06-01

Full Text Available Symposium on Computational Intelligence in Dynamic and Uncertain Environments (CIDUE), Mexico, 20-23 June 2013 Issues with Performance Measures for Dynamic Multi-objective Optimisation Mard´e Helbig CSIR: Meraka Institute Brummeria, South Africa...

Conceptual Provisions for Conducting the Institutional Reform of the National Labor Market in Ukraine

Directory of Open Access Journals (Sweden)

Sybirtsev Volodymyr V.

2017-09-01

Full Text Available The aim of the study is to substantiate and develop conceptual provisions for conducting the institutional reform of the national labor market. There singled out aspects of implementing the operation and development of the labor market in the context of manifestation of the internal complexity and multi-functionality inherent to it. The existence of regularities in the increase of the need for development of the institutional structure of the labor market under conditions of transforming and restructuring the system of socio-economic relations is proved. The presence of a multiplicative effect from the spread of the new institutional practices being introduced in the labor market on the institutional regulation of a wide range of economic operations, phenomena and processes is revealed. There defined the content of the process of developing the institutional space of the national labor market, which involves institutionalizing the processes of socialization of the socio-economic relations associated with productive employment, in the context of which there occurs an increase in the importance and role of human resources in the creation of economic goods, expanded social reproduction.

Credible baseline analysis for multi-model public policy studies

Energy Technology Data Exchange (ETDEWEB)

Parikh, S.C.; Gass, S.I.

1981-01-01

The nature of public decision-making and resource allocation is such that many complex interactions can best be examined and understood by quantitative analysis. Most organizations do not possess the totality of models and needed analytical skills to perform detailed and systematic quantitative analysis. Hence, the need for coordinated, multi-organization studies that support public decision-making has grown in recent years. This trend is expected not only to continue, but to increase. This paper describes the authors' views on the process of multi-model analysis based on their participation in an analytical exercise, the ORNL/MITRE Study. One of the authors was the exercise coordinator. During the study, the authors were concerned with the issue of measuring and conveying credibility of the analysis. This work led them to identify several key determinants, described in this paper, that could be used to develop a rating of credibility.

Stochastic multi-period multi-product multi-objective Aggregate Production Planning model in multi-echelon supply chain

Directory of Open Access Journals (Sweden)

Kaveh Khalili-Damghani

2017-07-01

Full Text Available In this paper a multi-period multi-product multi-objective aggregate production planning (APP model is proposed for an uncertain multi-echelon supply chain considering financial risk, customer satisfaction, and human resource training. Three conflictive objective functions and several sets of real constraints are considered concurrently in the proposed APP model. Some parameters of the proposed model are assumed to be uncertain and handled through a two-stage stochastic programming (TSSP approach. The proposed TSSP is solved using three multi-objective solution procedures, i.e., the goal attainment technique, the modified ε-constraint method, and STEM method. The whole procedure is applied in an automotive resin and oil supply chain as a real case study wherein the efficacy and applicability of the proposed approaches are illustrated in comparison with existing experimental production planning method.

Prognostic Significance of Nodal Location and Ratio in Stage IIIC Endometrial Carcinoma Among a Multi-Institutional Academic Collaboration.

Science.gov (United States)

Mayadev, Jyoti; Elshaikh, Mohamed A; Christie, Alana; Nagel, Christa; Kennedy, Vanessa; Khan, Nadia; Lea, Jayanthi; Ghanem, Ahmad; Miller, David; Xie, Xian-Jin; Folkert, Michael; Albuquerque, Kevin

2018-04-20

Stage IIIC endometrial carcinoma (EC) represents pathologically heterogenous patients with single/multiple pelvic (stage IIIC1) or paraaortic (stage IIIC2) lymph nodes (LNs). There is an increasing trend to offer adjuvant chemotherapy (CT) +/- radiation (RT) uniformly to these patients, regardless of substage. We investigate the prognostic significance of positive LN (pLN) number, ratio (%pLN), location (IIC1 vs. IIC2), and adjuvant treatment on patterns of failure and survival in a large collaborative multi-institutional series. Clinical data for stage III EC patients such as patient characteristics, surgery/pathologic details, adjuvant therapies (including CT, RT, and chemotherapy and radiation), and outcomes (including pelvic control [PC], disease-free survival [DFS], distant DFS, and overall survival [OS]) were collected from 3 academic institutions. Log-rank analyses, Cox regression univariate and multivariate analyses were performed. Of the 264 patients queried for stage III disease, 237 (73%) had pLN, and complete LN sampling for analysis. The mean number of pLN in the combined data were 3.9, with 26.1% of all LN sampled positive; 121 patients (51%) staged IIIC1, and 116 patients (49%) staged IIIC2. There was a significant difference in number of pLN (P=0.0006) and total LN sampled by institution (range, 13 to 35; P=0.0004), without a difference in %pLN (P=0.35). Ninety-seven of 220 (44.1%) have ≥20% pLN. While controlling for substage and institution, a decrease in DFS (hazard ratio [HR], 1.1; P=0.007), and OS (HR, 1.1; P=0.01) was observed with every increase of 10% in the pLN ratio. There was a significant difference in DFS (HR, 1.8; P=0.003), PC (HR, 1.9; P=0.004), and distant DFS (HR, 1.6; P=0.03), as well as a trend for decreased OS (HR, 1.6; P=0.08) for substage IIIC2 versus IIIC1 disease; 5 years DFS 40% versus 45%, OS 50% versus 57%. Patients received no adjuvant therapy (10%), CT alone (27%), RT alone (16%), or chemotherapy and radiation (47

Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis

International Nuclear Information System (INIS)

Guckenberger, Matthias; Mantel, Frederick; Gerszten, Peter C; Flickinger, John C; Sahgal, Arjun; Létourneau, Daniel; Grills, Inga S; Jawad, Maha; Fahim, Daniel K; Shin, John H; Winey, Brian; Sheehan, Jason; Kersh, Ron

2014-01-01

To evaluate patient selection criteria, methodology, safety and clinical outcomes of stereotactic body radiotherapy (SBRT) for treatment of vertebral metastases. Eight centers from the United States (n = 5), Canada (n = 2) and Germany (n = 1) participated in the retrospective study and analyzed 301 patients with 387 vertebral metastases. No patient had been exposed to prior radiation at the treatment site. All patients were treated with linac-based SBRT using cone-beam CT image-guidance and online correction of set-up errors in six degrees of freedom. 387 spinal metastases were treated and the median follow-up was 11.8 months. The median number of consecutive vertebrae treated in a single volume was one (range, 1-6), and the median total dose was 24 Gy (range 8-60 Gy) in 3 fractions (range 1-20). The median EQD2 10 was 38 Gy (range 12-81 Gy). Median overall survival (OS) was 19.5 months and local tumor control (LC) at two years was 83.9%. On multivariate analysis for OS, male sex (p < 0.001; HR = 0.44), performance status <90 (p < 0.001; HR = 0.46), presence of visceral metastases (p = 0.007; HR = 0.50), uncontrolled systemic disease (p = 0.007; HR = 0.45), >1 vertebra treated with SBRT (p = 0.04; HR = 0.62) were correlated with worse outcomes. For LC, an interval between primary diagnosis of cancer and SBRT of ≤30 months (p = 0.01; HR = 0.27) and histology of primary disease (NSCLC, renal cell cancer, melanoma, other) (p = 0.01; HR = 0.21) were correlated with worse LC. Vertebral compression fractures progressed and developed de novo in 4.1% and 3.6%, respectively. Other adverse events were rare and no radiation induced myelopathy reported. This multi-institutional cohort study reports high rates of efficacy with spine SBRT. At this time the optimal fractionation within high dose practice is unknown

Development Strategy of Microtakaful Institutions: Case Study Working Group Indonesia

Directory of Open Access Journals (Sweden)

Aam Slamet Rusydiana

2017-07-01

Full Text Available Indonesia is becoming one of potential countries in microtakaful institutions development. One of the expert in microtakaful is Takmin Working Group. TWG is a group of initiators who have commitment to develop micro takaful in Indonesia. Its members consist ofexperts in Islamic insurance, micro finance and accounting. The research objectives of this study are to identify and analyze the problems faced by TWG in developing of microtakaful institutions and identify the solutions to solve those kinds of problems, by using AnalticHierarchy Process (AHP method. The finding of this study shows the most priority solutions that can be undertake by Takmin Working Group to solve these both internal and external problem is information system development, and then followed by innovative product development. Communication & visitation to Islamic micro finance institutions and socialization about micro takaful product to society are being less priority on this matter.DOI: 10.15408/etk.v16i2.5267

Faculty Study: New Mexico Higher Education Institutions Compared with Regional Peers. Gap Analysis

Science.gov (United States)

McClure, Beverlee J.

2006-01-01

This study addresses concerns regarding compensation disparities between New Mexico institutions and their peers. A recommended adjustment schedule with fiscal requirements is included, but not specific recommendations for faculty at individual institutions. The average salaries for New Mexico institutions were compared with regional peers to…

North american natural gas supply forecast: the Hubbert method including the effects of institutions

International Nuclear Information System (INIS)

Reynolds, D. B.; Kolodziej, M.

2009-01-01

In this article, the U.S. and southern Canadian natural gas supply market is considered. An important model for oil and natural gas supply is the Hubbert curve. Not all regions of the world are producing oil or natural gas following a Hubbert curve, even when price and market conditions are accounted for. One reason is that institutions are affecting supply. We investigate the possible effects of oil and gas market institutions in North America on natural gas supply. A multi-cycle Hubbert curve with inflection points similar to the Soviet Union's oil production multi-cycle Hubbert curve is used to determine North American natural gas discovery rates and to analyze how market specific institutions caused the inflection points. In addition, we analyze the latest shale natural gas projections critically. While currently, unconventional resources of natural gas suggest that North American natural gas production will increase without bound, the model here suggests a peak in North American natural gas supplies could happen in 2013. (author)

Multi-disciplinary data organization and visualization models for clinical and pre-clinical studies: A case study in the application of proton beam radiosurgery for treating spinal cord injury related pain

Science.gov (United States)

Verma, Sneha K.; Liu, Brent J.

2016-03-01

An increasing adoption of electronic medical records has made information more accessible to clinicians and researchers through dedicated systems such as HIS, RIS and PACS. The speed and the amount at which information are generated in a multi-institutional clinical study make the problem complicated compared to day-to-day hospital workflow. Often, increased access to the information does not translate into the efficient use of that information. Therefore, it becomes crucial to establish models which can be used to organize and visualize multi-disciplinary data. Good visualization in turn makes it easy for clinical decision-makers to reach a conclusion within a small span of time. In a clinical study involving multi-disciplinary data and multiple user groups who need access to the same data and presentation states based on the stage of the clinical trial or the task are crucial within the workflow. Therefore, in order to demonstrate the conceptual system design and system workflow, we will be presenting a clinical trial based on application of proton beam for radiosurgery which will utilize our proposed system. For demonstrating user role and visualization design purposes, we will be focusing on three different user groups which are researchers involved in patient enrollment and recruitment, clinicians involved in treatment and imaging review and lastly the principle investigators involved in monitoring progress of clinical study. Also datasets for each phase of the clinical study including preclinical and clinical data as it related to subject enrollment, subject recruitment (classifier), treatment (DICOM), imaging, and pathological analysis (protein staining) of outcomes.

Indian Institutional Repositories: A Study of User's Perspective

Science.gov (United States)

Sawant, Sarika

2012-01-01

Purpose: The present study aims to investigate the experience, contribution and opinions of users of respective institutional repositories (IRs) developed in India. Design/methodology/approach: The survey method was used. The data collection tool was a web questionnaire, which was created with the help of software provided by surveymonkey.com…

Employee Retention Factors For South African Higher Education Institutions: A Case Study

Directory of Open Access Journals (Sweden)

F. G. Netswera

2005-11-01

Full Text Available The success of the most competitive companies throughout the world, including higher education institutions, lies in their highly skilled employees on which these institutions spend millions to retain. Literature reveals the cost of losing best employees to be enormous – beyond monetary quantification. Also worth noting is that the loss of one competent employee to a competitor institution strengthens the competitor’s advantage. This case study analysed human resources turnover data, and interviewed academic managers and employees in order to examine the possible employee retention factors for a higher education institution in South Africa. The findings reveal different institutional interests between institutional managers and employees. The former are concerned more about profits, business sustenance and justification for spending, while the latter are driven by introverted interests such as development, monetary rewards and personal fulfilment.

Multi-scale graphene patterns on arbitrary substrates via laser-assisted transfer-printing process

KAUST Repository

Park, J. B.

2012-01-01

A laser-assisted transfer-printing process is developed for multi-scale graphene patterns on arbitrary substrates using femtosecond laser scanning on a graphene/metal substrate and transfer techniques without using multi-step patterning processes. The short pulse nature of a femtosecond laser on a graphene/copper sheet enables fabrication of high-resolution graphene patterns. Thanks to the scale up, fast, direct writing, multi-scale with high resolution, and reliable process characteristics, it can be an alternative pathway to the multi-step photolithography methods for printing arbitrary graphene patterns on desired substrates. We also demonstrate transparent strain devices without expensive photomasks and multi-step patterning process. © 2012 American Institute of Physics.

Institutional arrangements in the emerging biodiesel industry: Case studies from Minas Gerais—Brazil

International Nuclear Information System (INIS)

Watanabe, Kassia; Bijman, Jos; Slingerland, Maja

2012-01-01

Connecting (small) family farmers to the emerging biodiesel industry requires careful design of the institutional arrangements between the producers of oil crops and the processing companies. According to institutional economics theory, the design of effective and efficient arrangements depends on production and transaction characteristics, the institutional environment, and the organizational environment supporting the transaction between producers and the industry. This paper presents a comparative study on two cases in the feedstock-for-biodiesel industry in the state of Minas Gerais, Brazil. The two case studies represent the production and transaction system of soybeans (Glycine max L. Merrill) and castor beans (Ricinus communis L.). Important elements of effective and efficient institutional arrangements are farmer collective action, availability of technical and financial support, and farmer experience with particular crops. - Highlights: ► We study institutional arrangements for feedstock transactions between family farmers and the biodiesel industry. ► We focussed on soybean and castor bean production and transaction systems. ► Institutional arrangements are affected by product and production characteristics. ► They are also affected by collective actions organizations such as cooperatives. ► Soybean involves lower transaction costs and therefore more simple arrangement than castor bean.

NATO Advanced Study Institute on Advances in Microlocal Analysis

CERN Document Server

1986-01-01

The 1985 Castel vecchio-Pas coli NATO Advanced Study Institute is aimed to complete the trilogy with the two former institutes I organized : "Boundary Value Problem for Evolution Partial Differential Operators", Liege, 1976 and "Singularities in Boundary Value Problems", Maratea, 1980. It was indeed necessary to record the considerable progress realized in the field of the propagation of singularities of Schwartz Distri­ butions which led recently to the birth of a new branch of Mathema­ tical Analysis called Microlocal Analysis. Most of this theory was mainly built to be applied to distribution solutions of linear partial differential problems. A large part of this institute still went in this direction. But, on the other hand, it was also time to explore the new trend to use microlocal analysis In non linear differential problems. I hope that the Castelvecchio NATO ASI reached its purposes with the help of the more famous authorities in the field. The meeting was held in Tuscany (Italy) at Castelvecchio-P...

Multi-criteria objective based climate change impact assessment for multi-purpose multi-reservoir systems

Science.gov (United States)

Müller, Ruben; Schütze, Niels

2014-05-01

Water resources systems with reservoirs are expected to be sensitive to climate change. Assessment studies that analyze the impact of climate change on the performance of reservoirs can be divided in two groups: (1) Studies that simulate the operation under projected inflows with the current set of operational rules. Due to non adapted operational rules the future performance of these reservoirs can be underestimated and the impact overestimated. (2) Studies that optimize the operational rules for best adaption of the system to the projected conditions before the assessment of the impact. The latter allows for estimating more realistically future performance and adaption strategies based on new operation rules are available if required. Multi-purpose reservoirs serve various, often conflicting functions. If all functions cannot be served simultaneously at a maximum level, an effective compromise between multiple objectives of the reservoir operation has to be provided. Yet under climate change the historically preferenced compromise may no longer be the most suitable compromise in the future. Therefore a multi-objective based climate change impact assessment approach for multi-purpose multi-reservoir systems is proposed in the study. Projected inflows are provided in a first step using a physically based rainfall-runoff model. In a second step, a time series model is applied to generate long-term inflow time series. Finally, the long-term inflow series are used as driving variables for a simulation-based multi-objective optimization of the reservoir system in order to derive optimal operation rules. As a result, the adapted Pareto-optimal set of diverse best compromise solutions can be presented to the decision maker in order to assist him in assessing climate change adaption measures with respect to the future performance of the multi-purpose reservoir system. The approach is tested on a multi-purpose multi-reservoir system in a mountainous catchment in Germany. A

Revenue and efficiency in multi-unit uniform-price auctions

Czech Academy of Sciences Publication Activity Database

Břeský, Michal

-, č. 384 (2009), s. 1-39 ISSN 1211-3298 Institutional research plan: CEZ:MSM0021620846 Keywords : multi-unit auction * multiple-object auction * market efficiency * optimal selling mechanism Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp384.pdf

Introducing nerve-sparing approach during minimally invasive radical hysterectomy for locally-advanced cervical cancer: A multi-institutional experience.

Science.gov (United States)

Raspagliesi, Francesco; Bogani, Giorgio; Spinillo, Arsenio; Ditto, Antonino; Bogliolo, Stefano; Casarin, Jvan; Leone Roberti Maggiore, Umberto; Martinelli, Fabio; Signorelli, Mauro; Gardella, Barbara; Chiappa, Valentina; Scaffa, Cono; Ferrero, Simone; Cromi, Antonella; Lorusso, Domenica; Ghezzi, Fabio

2017-11-01

To evaluate the impact of nerve-sparing (NS) approach on outcomes of patients undergoing minimally invasive radical hysterectomy (MRH) for locally advanced stage cervical cancer (LACC). Data of consecutive patients undergoing minimally invasive surgery for LACC were retrospectively retrieved in a multi-institutional setting from 2009 to 2016. All patients included had minimally invasive class III radical hysterectomy (MRH or NS-MRH). Propensity matching algorithm was used to decrease possible allocation bias when comparing outcomes between groups. Overall, 83 patients were included. The prevalence of patients undergoing NS approach increased aver the study period (from 7% in the year 2009-2010 to 97% in the year 2015-2016; p-for-trend < 0.001). NS-MRH and MRH were performed in 47 (57%) and 36 (43%) patients, respectively. After the application the propensity-matching algorithm, we compared 35 patients' pair (total 70 patients). Postoperative complications rate was similar between groups. Patients undergoing NS-LRH experienced shorter hospital stay than patients undergoing LRH (3.6 vs. 5.0 days). 60-day pelvic floor dysfunction rates, including voiding, fecal and sexual alterations, were lower in the NS group in comparison to control group (p = 0.02). Five-year disease-free (p = 0.77) and overall (p = 0.36) survivals were similar comparing NS-MRH with MRH. The implementation of NS approach in the setting of LACC improves patients' outcomes, minimizing pelvic dysfunction rates. NS approach has not detrimental effects on survival outcomes. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

ECORS Truc Vert'08: a Multi-Institutional International Nearshore Field Experiment

Science.gov (United States)

Senechal, N.; Ardhuin, F.

2008-12-01

A large multi-institutional international field experiment (ECORS Truc Vert'08) was conducted Feb-April 2008 on the southern part of the French Atlantic coastline. More than 120 scientists, students and technicians participated to this effort coming from 3 continents and 6 countries : Australia (University of New South Wales), France (SHOM, University Bordeaux I, University Pau et Pays de l'Adour, University Sud-Toulon Var, University Joseph Fourier, University Perpignan, BRGM, University Lyon 1), Great Britain (Plymouth University), New Zealand (NIWA), The Netherlands (Delft University of Technology, University of Utrecht) and USA (Naval Postgraduate School, University of Miami, Franklin and Marshall College). Truc Vert beach is a high-energy, dynamic, macrotidal, double-barred beach representative of most of the beaches on this 250 km long coastline. The inner bar can go through all the states within the intermediate classification and usually exhibits a transverse bar and rip morphology (380 m alongshore wavelength). The outer bar is changeable from linear to crescentic (720 m alongshore wavelength). The goals were to measure the hydrodynamic processes, sedimentary processes and morphologic responses on a macrotidal beach during energetic wave conditions and covering a large spectrum of spatial and temporal scales. This dataset will facilitate the validation of surf zone wave, hydrodynamic and morphodynamic models, it will lend insight into the morphodynamic evolution of three dimensional beaches and it will fill the gaps in previous nearshore data sets. A wide range of unique instrumentation was used including continuously sampled 2Hz high-resolution surfzone video cameras, daily topographic surveys, bathymetric surveys from the French naval vessels and personal watercrafts, high frequency velocity and pressure sensors, acoustic Doppler current profilers, sediment transport devices, sand porosity and grain size devices, and position-tracking drifters

Preliminary study for a nuclear multi-cycle reload optimization system

International Nuclear Information System (INIS)

Baptista, Rafael Pereira; Lima, Alan Miranda M. de; Medeiros, Jose Antonio Carlos Canedo; Schirru, Roberto

2007-01-01

Fuel assemblies in a reactor are discharged normally after several fuel cycles. This happens because of the concentration of fissile material existing in the fuel assemblies in the core decreases to values such that it is not more possible to keep the reactor operating producing energy at normal rated power. Therefore, the refueling optimization for a nuclear power plant is in fact a multi-cycle problem. A typical multi-cycle reload optimization depends on several kinds of relationships: one is the relationship between the locations where the fuel assemblies are placed for a specified fuel cycle; another is the relationship between fuel loading patterns for the subsequent fuel cycles. This makes the problem very complex and difficult to solve. Until the moment, all the presented proposals for solution are far from solving the multi-cycle optimization problems in reactor fuel management. In this work, we will show preliminary studies of possible solutions for a typical multi-cycle reload optimization problem trying to consider most important restrictions of a real model. In the initial comparisons, the optimization results will be compared with those obtained by the successive single cycle optimizations. (author)

Control of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a day-care institution

DEFF Research Database (Denmark)

Jensen, Jens Ulrik; Jensen, ET; Larsen, AR

2006-01-01

in the study: 38 children, 60 staff members and 12 close relatives of colonized subjects. Infection control measures included screening all individuals. When MRSA infection or colonization was found, an attempt was made to eradicate MRSA, staff education was undertaken and attempts were made to determine...... the route of transmission. Eleven individuals were found to be positive for MRSA (10.0%). All isolates were identical by pulsed-field gel electrophoresis and harboured the staphylococcal cassette chromosome mec (SCCmec) type IV. All colonized and infected individuals were associated with a single room...... in one of the institutions. MRSA was eradicated from all the colonized and infected subjects. This study shows that it is possible to control an MRSA outbreak in institutions for multi-handicapped children where there is a high degree of physical contact....

Development of a virtual private database for a multi-institutional internet-based radiation oncology database overcoming differences in protocols

International Nuclear Information System (INIS)

Harauchi, Hajime; Kondo, Takashi; Kumasaki, Yu

2002-01-01

A multi-institutional Radiation Oncology Greater Area Database (ROGAD) was started in 1991 under the direction of the Japanese Society for Therapeutic Radiology and Oncology (JASTRO). Use of ROGAD was intended to allow reflection of results of data analysis into treatment strategy and treatment planning for individual cases, to provide quality assurance, to maximize the efficacy of radiotherapy, to allow assessment of new technologies or new modalities, and to optimize medical decision making. ROGAD collected 13,448 radiotherapy treatment cases from 325 facilities during the period from 1992 to 2001. In 2000, questionnaires were sent to 725 radiotherapy facilities throughout Japan, to further obtain the situation of the radiation oncology database. Workers at 179 facilities replied that ''the protocol of my facility is different from ROGAD protocol and I must send data according to the ROGAD protocol''. So, we developed the Virtual Private Database System (VPDS) which is operated as if an oncologist had a database solely owned by his own facility, in spite of actually operating ROGAD. VPDS realizes integration of different plural databases, regardless of differences in entry methods, protocols, definitions and interpretations of contents of clinical data elements between facilities. (author)

An exploratory study on awareness towards institutional social responsibility in Indian higher education institutions

Directory of Open Access Journals (Sweden)

Richa Mishra

2016-06-01

Full Text Available Institutional Social responsibility (ISR in context to a Higher Educational Institution has been defined as the ethical practice in transference of knowledge, and the active participation in betterment of quality of life in the society. It is an offshoot of the concept of Corporate Social responsibility (CSR, but unlike CSR, it is neither mandatory nor actively monitored or researched in Indian context. However, awareness towards aspects of ISR has been increasing, especially in Indian Universities. Indian Universities adopt practices related to Adoption of Villages, Awareness Drives, Environmental Care and rural Education initiatives. Critics often see ISR as an unnecessary burden; review of literature from around the world suggests that ISR practices contribute to increased accountability towards exploitation of resources by Educational Institutes as well as better reputation of Educational Institutes in the society. The purpose of this paper is to examine the perception towards the concept of ISR in Educational Institutes in India. The paper opted for a questionnaire-based exploratory survey of 50 faculty members, across Private Universities in Rajasthan. The findings suggest lacking awareness but a significant acceptance of need of ISR practices. The paper includes implications for the Universities to include ISR practices in their strategy to address its obligations to the society and simultaneously gain a competitive advantage.

Medical student storytelling on an institutional blog: a case study analysis.

Science.gov (United States)

Becker, Katherine A; Freberg, Karen

2014-05-01

Despite the proclivity and proliferation of blogs on the Internet, the use of blogs at medical institutions is not well documented. In examining the structured stories that medical students share with the digital community, we may better understand how students use institutional blogs to discuss their medical school experiences while maintaining their role as a medical student ambassador for the program. We conducted a case study to analyze the stories within 309 medical student blogs from one medical institution in the United States. In an attempt to communicate their experiences to different benefactors, student bloggers engaged in structured and personal storytelling. Structured stories offered medical school advice to prospective students, while personal stories embodied features of a personal diary where students recounted significant milestones, talked about personal relationships and engaged in emotional reflection and disclosure. Institutional blogs may provide social marketing for medical institutions, as students strategically framed their experiences to reflect a positive attitude about the medical institution and focused on providing advice to prospective students. Although these structured stories limit complete disclosure, students may still achieve benefits by engaging in emotional disclosure and personal reflection.

Evolution of nuclear spectroscopy at Saha Institute of Nuclear Physics

Indian Academy of Sciences (India)

Currently Saha Institute is building a multi-element gamma heavy ion neutron array detector (MEGHNAD), which will have six high efficiency clover Ge detector together with charged particle ball and other accessories. The system is expected to be usable in 2002 and will be used in experiments using high energy heavy ...

Risk assessment in infrastructure in educational institution: A study in Malaysia

Science.gov (United States)

Rasdan Ismail, Ahmad; Adilah Hamzah, Noor; Kamilah Makhtar, Nor; Azhar Mat Daud, Khairul; Zulkarnaen Khidzir, Nik; Husna Che Hassan, Nurul; Arifpin Mansor, Muhamad

2017-10-01

This particular study was conducted to assess the hazard exposure in education institution and to highlight the possible risk level available. The assessment utilised is Hazard Identification, Risk Assessment and Risk Control (HIRARC). There was a 2008’s form in order to determine the risk level of the hazard. There were over 111 of education institutions were selected around Malaysia to perform this assessment. Area chosen for each institution was office, playing field, canteen, classroom, toilet and drainage. By referring HIRARC Guideline 2008, the determination of risk rank is measure based on the formula likelihood multiply severity and the rank need to refer from risk matrix standard. There are several hazard have be found and shows the high, medium and low of risk level. The higher level of risk was discussed in the study which is hazard found in playing field and hazard in office. There several hazard that need to be control by education management to avoid increase of case accident in Education Sector, Malaysia. As conclusion, the exposure hazard among the staff and educators is high and further action and control are needed. Further study need to explore the best recommendation for control measure of the hazard exposed by education institution.

Conversation analysis and the study of social institutions: methodological, socio-cultural and epistemic considerations

OpenAIRE

Roca-Cuberes, Carles

2014-01-01

The objective of this study is to show how conversation analysis, a sociological discipline, approaches the study of social institutions. Social institutions are conceived as the crystallization of members’ communicative, interactional practices. Two institutional domains—psychiatric interviews and broadcast news interviews —and a specific interactional practice—‘formulations’—are examined in this study. The results show that (1) in psychiatric interviews the psychiatrist uses formulations to...

Commerical electric power cost studies. Capital cost addendum multi-unit coal and nuclear stations

International Nuclear Information System (INIS)

1977-09-01

This report is the culmination of a study performed to develop designs and associated capital cost estimates for multi-unit nuclear and coal commercial electric power stations, and to determine the distribution of these costs among the individual units. This report addresses six different types of 2400 MWe (nominal) multi-unit stations as follows: Two Unit PWR Station-1139 MWe Each, Two Unit BWR Station-1190 MWe Each, Two Unit High Sulfur Coal-Fired Station-1232 MWe Each, Two Unit Low Sulfur Coal-Fired Station-1243 MWe Each, Three Unit High Sulfur Coal-Fired Station-794 MWe Each, Three Unit Low Sulfur Coal-Fired Station-801 MWe Each. Recent capital cost studies performed for ERDA/NRC of single unit nuclear and coal stations are used as the basis for developing the designs and costs of the multi-unit stations. This report includes the major study groundrules, a summary of single and multi-unit stations total base cost estimates, details of cost estimates at the three digit account level and plot plan drawings for each multi-unit station identified

Hosting an eConference: Interactive video conference grand rounds between two institutions

Directory of Open Access Journals (Sweden)

Jeffrey Rixe

2018-01-01

Full Text Available Audience: The eConference is an interactive video conference grand rounds innovation to augment the didactic curriculum provided for medical students, interns, residents, fellows, and attending physicians. Introduction: Formal education during emergency medicine (EM training has historically emphasized aspects of humanism and constructivism; the former through self-directed reading in books and journals, the latter through the content and discussion during resident didactics.1 However, some studies suggest that the current generation of EM learners are increasingly using digital and internet technologies to connect with online peer networks, a phenomenon known as connectivism.2 As such, contemporary EM learners are increasingly utilizing social media and Free Open Access Medical Education (FOAM to supplement traditional learning resources. The eConference was developed to be an interactive, virtual grand rounds that marries the merits of constructivism with connectivism; a new format of EM didactics that goes beyond the “typical lecture” model to incorporate the changing landscape in technology and medical education by combining classroom teaching at multiple institutions alongside digital learning tools. This manuscript outlines how to plan and execute a joint video conference with another institution. Objectives: Our objectives were to create and implement a novel virtual conference format through the integration of social media tools which allows for interdisciplinary and multi-site participation to enhance EM resident education. We wish to outline the steps required to reproduce this innovative session and share lessons learned. Conclusion: We designed and executed a multi-centered, novel form of virtual conference into the EM residency curriculum at two participating institutions. The virtual conference took place during a routine conference day for both programs, an hour in duration. The format utilized a hybrid of live and virtual

Comparison of a fast 5-min knee MRI protocol with a standard knee MRI protocol. A multi-institutional multi-reader study

Energy Technology Data Exchange (ETDEWEB)

FitzGerald Alaia, Erin; Beltran, Luis S.; Garwood, Elisabeth; Burke, Christopher J.; Gyftopoulos, Soterios [NYU Langone Medical Center, Department of Radiology, Musculoskeletal Division, New York, NY (United States); Benedick, Alex [Case Western Reserve University, School of Medicine, Cleveland, OH (United States); Obuchowski, Nancy A. [Cleveland Clinic, Department of Quantitative Health Sciences, Cleveland, OH (United States); Polster, Joshua M.; Schils, Jean; Subhas, Naveen [Cleveland Clinic, Department of Radiology, Musculoskeletal Division, Cleveland, OH (United States); Chang, I. Yuan Joseph [Texas Scottish Rite Hospital for Children, Dallas, TX (United States)

2018-01-15

To compare diagnostic performance of a 5-min knee MRI protocol to that of a standard knee MRI. One hundred 3 T (100 patients, mean 38.8 years) and 50 1.5 T (46 patients, mean 46.4 years) MRIs, consisting of 5 fast, 2D multi-planar fast-spin-echo (FSE) sequences and five standard multiplanar FSE sequences, from two academic centers (1/2015-1/2016), were retrospectively reviewed by four musculoskeletal radiologists. Agreement between fast and standard (interprotocol agreement) and between standard (intraprotocol agreement) readings for meniscal, ligamentous, chondral, and bone pathology was compared for interchangeability. Frequency of major findings, sensitivity, and specificity was also tested for each protocol. Interprotocol agreement using fast MRI was similar to intraprotocol agreement with standard MRI (83.0-99.5%), with no excess disagreement (≤ 1.2; 95% CI, -4.2 to 3.8%), across all structures. Frequency of major findings (1.1-22.4% across structures) on fast and standard MRI was not significantly different (p ≥ 0.215), except more ACL tears on fast MRI (p = 0.021) and more cartilage defects on standard MRI (p < 0.001). Sensitivities (59-100%) and specificities (73-99%) of fast and standard MRI were not significantly different for meniscal and ligament tears (95% CI for difference, -0.08-0.08). For cartilage defects, fast MRI was slightly less sensitive (95% CI for difference, -0.125 to -0.01) but slightly more specific (95% CI for difference, 0.01-0.5) than standard MRI. A fast 5-min MRI protocol is interchangeable with and has similar accuracy to a standard knee MRI for evaluating internal derangement of the knee. (orig.)

Comparison of a fast 5-min knee MRI protocol with a standard knee MRI protocol. A multi-institutional multi-reader study

International Nuclear Information System (INIS)

FitzGerald Alaia, Erin; Beltran, Luis S.; Garwood, Elisabeth; Burke, Christopher J.; Gyftopoulos, Soterios; Benedick, Alex; Obuchowski, Nancy A.; Polster, Joshua M.; Schils, Jean; Subhas, Naveen; Chang, I. Yuan Joseph

2018-01-01

To compare diagnostic performance of a 5-min knee MRI protocol to that of a standard knee MRI. One hundred 3 T (100 patients, mean 38.8 years) and 50 1.5 T (46 patients, mean 46.4 years) MRIs, consisting of 5 fast, 2D multi-planar fast-spin-echo (FSE) sequences and five standard multiplanar FSE sequences, from two academic centers (1/2015-1/2016), were retrospectively reviewed by four musculoskeletal radiologists. Agreement between fast and standard (interprotocol agreement) and between standard (intraprotocol agreement) readings for meniscal, ligamentous, chondral, and bone pathology was compared for interchangeability. Frequency of major findings, sensitivity, and specificity was also tested for each protocol. Interprotocol agreement using fast MRI was similar to intraprotocol agreement with standard MRI (83.0-99.5%), with no excess disagreement (≤ 1.2; 95% CI, -4.2 to 3.8%), across all structures. Frequency of major findings (1.1-22.4% across structures) on fast and standard MRI was not significantly different (p ≥ 0.215), except more ACL tears on fast MRI (p = 0.021) and more cartilage defects on standard MRI (p < 0.001). Sensitivities (59-100%) and specificities (73-99%) of fast and standard MRI were not significantly different for meniscal and ligament tears (95% CI for difference, -0.08-0.08). For cartilage defects, fast MRI was slightly less sensitive (95% CI for difference, -0.125 to -0.01) but slightly more specific (95% CI for difference, 0.01-0.5) than standard MRI. A fast 5-min MRI protocol is interchangeable with and has similar accuracy to a standard knee MRI for evaluating internal derangement of the knee. (orig.)

Study of land surface temperature and spectral emissivity using multi ...

Indian Academy of Sciences (India)

tral emissivities over a hard rock terrain using multi-sensor satellite data. The study area, of .... Georeferenced MODIS level 1B data (bands 31 and. 32) and Landsat ETM+ data .... the optical properties of the atmosphere. In the present study ...

Institutional advantage

NARCIS (Netherlands)

Martin, Xavier

Is there such a thing as institutional advantage—and what does it mean for the study of corporate competitive advantage? In this article, I develop the concept of institutional competitive advantage, as distinct from plain competitive advantage and from comparative institutional advantage. I first

Smithsonian Institution. Opportunities for Research and Advanced Study 1970-1971.

Science.gov (United States)

Smithsonian Institution, Washington, DC. Office of Academic Programs.

This book describes study and research programs and facilities at the Smithsonian Institution in 9 academic areas: 1) History of Science and Technology; 2) American Studies; 3) Cultural Studies; 4) Museum Studies; 5) Anthropology; 6) Evolutionary and Systematic Biology; 7) Environmental Biology; 8) Evolutionary and Behavioral Biology, Tropical…

Analysis of 2000 cases treated with gamma knife surgery: validating eligibility criteria for a prospective multi-institutional study of stereotactic radiosurgery alone for treatment of patients with 1-10 brain metastases (JLGK0901) in Japan

Science.gov (United States)

Higuchi, Yoshinori; Nagano, Osamu; Sato, Yasunori; Yamamoto, Masaaki; Ono, Junichi; Saeki, Naokatsu; Miyakawa, Akifumi; Hirai, Tatsuo

2012-01-01

Objective The Japan Leksell Gamma Knife (JLGK) Society has conducted a prospective multi-institute study (JLGK0901, UNIN000001812) for selected patients in order to prove the effectiveness of stereotactic radiosurgery (SRS) alone using the gamma knife (GK) for 1-10 brain lesions. Herein, we verify the validity of 5 major patient selection criteria for the JLGK0901 trial. Materials and Methods Between 1998 and 2010, 2246 consecutive cases with 10352 brain metastases treated with GK were analyzed to determine the validity of the following 5 major JLGK0901 criteria; 1) 1-10 brain lesions, 2) less than 10 cm3 volume of the largest tumor, 3) no more than 15 cm3 total tumor volume, 4) no cerebrospinal fluid (CSF) dissemination, 5) Karnofsky performance status (KPS) score ≥70. Results For cases with >10 brain metastases, salvage treatments for new lesions were needed more frequently. The tumor control rate for lesions larger than 10 cm3 was significantly lower than that of tumors 15 cm3 total tumor volume or positive magnetic resonance imaging findings of CSF were significantly poorer. Outcomes in cases with KPS <70 were significantly poorer in terms of OS. Conclusion Our retrospective results of 2246 GK-treated cases verified the validity of the 5 major JLGK0901 criteria. The inclusion criteria for the JLGK0901 study are appearently good indications for SRS. PMID:29296339

TU-G-BRD-05: Results From Multi-Institutional Measurements with An Anthropomorphic Spine Phantom

International Nuclear Information System (INIS)

Molineu, A; Hernandez, N; Alvarez, P; Followill, D

2015-01-01

Purpose: To analyze the results from an anthropomorphic spine phantom used for credentialing institutions for National Cancer Institute (NCI) sponsored clinical trial. Methods: An anthropomorphic phantom that contains left and right lungs, a heart, an esophagus, spinal cord, bony material and a PTV was sent to institutions wishing to be credentialed for NCI trials. The PTV holds 4 TLD and radiochromic film in the axial and sagittal planes. The heart holds one TLD. Institutions created IMRT plans to cover ≥90% of the PTV with 6 Gy and limit the cord dose to <0.35cc receiving 3.75 Gy and <1.2cc receiving 2.63 Gy. They were instructed to treat the phantom as they would a patient, including making plan specific IMRT/SBRT QA measurements before treatment. The TLD results in the PTV were required to be within ±7% of the plan dose. A gamma calculation was performed using the film results and the submitted DICOM plan. ≥85% of the analyzed region was required to pass a 5%/3 mm criteria. Results: 176 institutions irradiated the spine phantom for a total of 255 results. The pass rate was 73% (187 irradiations) overall. 44 irradiations failed only the gamma criteria, 2 failed only the dose criteria and 22 failed both. The most used planning systems were Eclipse (116) and Pinnacle (52) and they had pass rates of 76% and 71%, respectively. The AAA algorithm had a pass rate of 77% while superposition type algorithms had a 71% pass rate. The average TLD measurement to institution calculation ratio was 0.99 (0.04 std dev.). The average percent pixels passing the gamma criteria for films was 89% (12% std dev.) Conclusion: Results show that this phantom is an important part of credentialing and that we have room for improvement in IMRT/SBRT spine treatments. This work was supported by PHS CA180803 and CA037422 awarded by NCI, DHHS

Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol.

Science.gov (United States)

Simons, Inge; Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

2016-09-12

Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the

Energy market integration and regional institutions in east Asia

International Nuclear Information System (INIS)

Aalto, Pami

2014-01-01

This article assesses the case made for energy market integration in East Asia by comparing the role of institutions in South East Asia and North East Asia. The types and functions of institutions and their overall structure are examined in light of global energy market trends. In South East Asia, the shift attempted by ASEAN towards more competitive markets is hampered by the remaining statist variants of the trade institution and bilateral energy diplomacy, which, as regards transaction cost functions, are sub-optimal. As for institutions with order-creating functions, the unresolved status of sovereignty within ASEAN hampers regulatory harmonisation; the great power management institution has since ASEAN's establishment reduced conflicts without providing decisive leadership conducive to integration. North East Asia's dependence on global energy markets overshadows the regional integration potential of the diverse liberalisation efforts and interconnection projects. Bilateral energy diplomacies, new trilateral institutions combined with ‘Track Two’ institutions and remaining great power competition co-exist. In both regions the institutional structure allows for step-wise, technical infrastructure integration. The environmental stewardship institution co-exists with statist energy security and development objectives while it supports cooperation on green energy. The overall structure of informal institutions constrains deeper energy market integration in several ways. - Highlights: • The structures of institutions explain East Asian energy market integration. • Transaction costs are increased by statist trade institutions and bilateralism. • Order-creating institutions are sub-optimal for energy market integration. • Multi-level great power management offers limited leadership for integration. • The environmental stewardship institution supports cooperation on green energy

Results of a dummy run of postimplant dosimetry between multi-institutional centers in prostate brachytherapy with 125I seeds

International Nuclear Information System (INIS)

Aoki, Manabu; Yorozu, Atsunori; Dokiya, Takushi

2009-01-01

The purpose of this study was to determine the reproducibility and precision of postimplant dosimetry following 125 I prostate brachytherapy (PB) and to evaluate the effects of learning and experience in CT-based postimplant dosimetry. One-month postimplant CT data from two patients who underwent PB alone or combined therapy (PB+external beam radiation therapy (EBRT)) were sent to 28 institutions for postimplant dosimetry and analyzed in 2006 (study 1). Similarly, 1-month postimplant CT data from two other patients were also analyzed in 2008 (study 2; 23 institutions). For both modalities in studies 1 and 2, the variance of the difference between CT-based D90 at each institution and CT/MRI fusion-based D90 was estimated. In monotherapy, F test and Mann-Whitney U test revealed no significant difference in the variance in studies 1 and 2 (P=0.72, 0.46). In combined therapy, the variance significantly converged in study 2 compared with study 1 (P<0.05). Even in the two studies, however, the difference between the median CT-based D90 and fusion-based D90 was at least 20-30 Gy. Marked interobserver variability was seen in the prostate volume and D90 with CT alone. The precision of postimplant dosimetry based on CT alone was revealed to be limited. (author)

The outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence : A multi-level meta-analysis

NARCIS (Netherlands)

Strijbosch, E.L.L.; Huijs, J.A.M.; Stams, G.J.J.M.; Wissink, I.B.; van der Helm, G.H.P.; de Swart, J.J.W.; van der Veen, Z.

2015-01-01

Objective: The outcome of institutional youth care for children is heavily debated. This multilevel meta-analysis aims to address the outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence in economically developed

Bidding behaviour in multi-unit auctions – an experimental investigation

Czech Academy of Sciences Publication Activity Database

Engelmann, Dirk; Grimm, V.

2009-01-01

Roč. 119, č. 537 (2009), s. 855-882 ISSN 0013-0133 Institutional research plan: CEZ:AV0Z70850503 Keywords : multi-unit auctions * bidding behavior * laboratory experiments Subject RIV: AH - Economics Impact factor: 1.902, year: 2009

Integration of multi-omics techniques and physiological phenotyping within a holistic phenomics approach to study senescence in model and crop plants

Czech Academy of Sciences Publication Activity Database

Großkinsky, D.K.; Syaifullah, S. J.; Roitsch, Thomas

2017-01-01

Roč. 99, č. 99 (2017), s. 1-20 ISSN 0022-0957 R&D Projects: GA MŠk(CZ) LO1415 Institutional support: RVO:67179843 Keywords : integrated approaches * multi-omics * phenomics * plant development * plant–environment interactions * plant phenotyping * plant physiology * plant senescence * senescence programme * systems biology Subject RIV: EH - Ecology, Behaviour OBOR OECD: Environmental sciences (social aspects to be 5.7) Impact factor: 5.830, year: 2016

Comparative Analysis of Institutional Policy Definitions of Plagiarism: A Pan-Canadian University Study

Science.gov (United States)

Eaton, Sarah Elaine

2017-01-01

This article shares the findings of a study investigating institutional policy definitions of plagiarism at twenty English-speaking Canadian universities. The types of primary sources consulted for this study included: (1) university academic calendars for 2016-2017, (2) institutional policies on academic misconduct, and (3) student academic codes…

Revenue and efficiency in multi-unit uniform-price auctions

Czech Academy of Sciences Publication Activity Database

Břeský, Michal

2013-01-01

Roč. 82, November (2013), s. 205-217 ISSN 0899-8256 R&D Projects: GA ČR(CZ) GAP402/11/1531 Institutional support: RVO:67985998 Keywords : multi-unit auction * multiple-object auction * market efficiency Subject RIV: AH - Economics Impact factor: 1.025, year: 2013

Sequential Participation in a Multi-Institutional Mock Oral Examination Is Associated With Improved American Board of Surgery Certifying Examination First-Time Pass Rate.

Science.gov (United States)

Fingeret, Abbey L; Arnell, Tracey; McNelis, John; Statter, Mindy; Dresner, Lisa; Widmann, Warren

We sought to determine whether sequential participation in a multi-institutional mock oral examination affected the likelihood of passing the American Board of Surgery Certifying Examination (ABSCE) in first attempt. Residents from 3 academic medical centers were able to participate in a regional mock oral examination in the fall and spring of their fourth and fifth postgraduate year from 2011 to 2014. Candidate׳s highest composite score of all mock orals attempts was classified as risk for failure, intermediate, or likely to pass. Factors including United States Medical Licensing Examination steps 1, 2, and 3, number of cases logged, American Board of Surgery In-Training Examination performance, American Board of Surgery Qualifying Examination (ABSQE) performance, number of attempts, and performance in the mock orals were assessed to determine factors predictive of passing the ABSCE. A total of 128 mock oral examinations were administered to 88 (71%) of 124 eligible residents. The overall first-time pass rate for the ABSCE was 82%. There was no difference in pass rates between participants and nonparticipants. Of them, 16 (18%) residents were classified as at risk, 47 (53%) as intermediate, and 25 (29%) as likely to pass. ABSCE pass rate for each group was as follows: 36% for at risk, 84% for intermediate, and 96% for likely pass. The following 4 factors were associated with first-time passing of ABSCE on bivariate analysis: mock orals participation in postgraduate year 4 (p = 0.05), sequential participation in mock orals (p = 0.03), ABSQE performance (p = 0.01), and best performance on mock orals (p = 0.001). In multivariable logistic regression, the following 3 factors remained associated with ABSCE passing: ABSQE performance, odds ratio (OR) = 2.9 (95% CI: 1.3-6.1); mock orals best performance, OR = 1.7 (1.2-2.4); and participation in multiple mock oral examinations, OR = 1.4 (1.1-2.7). Performance on a multi-institutional mock oral examination can identify

Can internationalisation really lead to institutional competitive advantage? : a study of 16 Dutch public higher education institutions

NARCIS (Netherlands)

dr. Haijing de Haan

2014-01-01

Public higher education institutions (PHEIs) have widely acknowledged a positive relationship between internationalization and their institutional competitive advantage enhancement. Although some concerns have been raised by practitioners and researchers about whether institutional competitive

Device for multi-dimensional γ-γ-coincidence study

International Nuclear Information System (INIS)

Gruzinova, T.M.; Erokhina, K.I.; Kutuzov, V.I.; Lemberg, I.Kh.; Petrov, S.A.; Revenko, V.S.; Senin, A.T.; Chugunov, I.N.; Shishlinov, V.M.

1977-01-01

A device for studying multi-dimensional γ-γ coincidences is described which operates on-line with the BESM-4 computer. The device comprises Ge(Li) detectors, analog-to-digital converters, shaper discriminators and fast amplifiers. To control the device operation as a whole and to elaborate necessary commands, an information distributor has been developed. The following specific features of the device operation are noted: the device may operate both in the regime of recording spectra of direct γ radiation in the block memory of multi-channel analyzer, and in the regime of data transfer to the computer memory; the device performs registration of coincidences; it transfers information to the computer which has a channel of direct access to the memory. The procedure of data processing is considered, the data being recorded on a magnetic tape. Partial spectra obtained are in a good agreement with data obtained elsewhere

Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation seeking.

Science.gov (United States)

Sanbonmatsu, David M; Strayer, David L; Medeiros-Ward, Nathan; Watson, Jason M

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants' perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation--high levels of impulsivity and sensation seeking--reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control--low scorers on the Operation Span task and persons high in impulsivity--tended to report higher levels of multi-tasking activity.

Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation seeking.

Directory of Open Access Journals (Sweden)

David M Sanbonmatsu

Full Text Available The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants' perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation--high levels of impulsivity and sensation seeking--reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control--low scorers on the Operation Span task and persons high in impulsivity--tended to report higher levels of multi-tasking activity.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

Science.gov (United States)

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants’ perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation – high levels of impulsivity and sensation seeking – reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control - low scorers on the Operation Span task and persons high in impulsivity - tended to report higher levels of multi-tasking activity. PMID:23372720

The path dependency theory: analytical framework to study institutional integration. The case of France.

Science.gov (United States)

Trouvé, Hélène; Couturier, Yves; Etheridge, Francis; Saint-Jean, Olivier; Somme, Dominique

2010-06-30

The literature on integration indicates the need for an enhanced theorization of institutional integration. This article proposes path dependence as an analytical framework to study the systems in which integration takes place. PRISMA proposes a model for integrating health and social care services for older adults. This model was initially tested in Quebec. The PRISMA France study gave us an opportunity to analyze institutional integration in France. A qualitative approach was used. Analyses were based on semi-structured interviews with actors of all levels of decision-making, observations of advisory board meetings, and administrative documents. Our analyses revealed the complexity and fragmentation of institutional integration. The path dependency theory, which analyzes the change capacity of institutions by taking into account their historic structures, allows analysis of this situation. The path dependency to the Bismarckian system and the incomplete reforms of gerontological policies generate the coexistence and juxtaposition of institutional systems. In such a context, no institution has sufficient ability to determine gerontology policy and build institutional integration by itself. Using path dependence as an analytical framework helps to understand the reasons why institutional integration is critical to organizational and clinical integration, and the complex construction of institutional integration in France.

MULTI-RATER FEEDBACK - IN PROMOTING AND STIMULATING AN INSTITUTION OR ORGANISATION EMPLOYEES

Directory of Open Access Journals (Sweden)

LĂPĂDUŞI MIHAELA LOREDANA

2015-12-01

Full Text Available In order to improve the performance of employees of an institution, regardless of its profile method is applicable 360º Feedback. This is one of the most modern and current performance appraisal methods and motivating them to get professional results set. This is a system or process by which employees are aware of an anonymous feedbeck from some stakeholders of the organization. The method shows a high degree of objectivity and requires the acquisition of various assessments from a large number of assessors, both within the institution and outside it. By applying the method 360 may pursue the evaluation of any type of objective pursued by performance management is applied in particular to the improvement and development of employees an organization. The purpose of this article is to highlight the role, importance and advantages of this method can be successfully applied.

Availability and Accessibility in an Open Access Institutional Repository: A Case Study

Science.gov (United States)

Lee, Jongwook; Burnett, Gary; Vandegrift, Micah; Baeg, Jung Hoon; Morris, Richard

2015-01-01

Introduction: This study explores the extent to which an institutional repository makes papers available and accessible on the open Web by using 170 journal articles housed in DigiNole Commons, the institutional repository at Florida State University. Method: To analyse the repository's impact on availability and accessibility, we conducted…

Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study.

Directory of Open Access Journals (Sweden)

Nguyen-Toan Tran

Full Text Available Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS, yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.Descriptive study using an online questionnaire tool.Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%, but was also embraced by development organizations (25% and institutions with dual humanitarian and development mandates (50%. Agencies reported working with refugees (81%, internally-displaced (87% and stateless persons (20%, in camp-based settings (78%, and in urban (83% and rural settings (78%. Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR, emergency management and coordination, delivery of the Minimum Initial Services Package (MISP for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections

Multi-institutional Nomogram Predicting Survival Free From Salvage Whole Brain Radiation After Radiosurgery in Patients With Brain Metastases

International Nuclear Information System (INIS)

Gorovets, Daniel; Ayala-Peacock, Diandra; Tybor, David J.; Rava, Paul; Ebner, Daniel; Cielo, Deus; Norén, Georg; Wazer, David E.; Chan, Michael; Hepel, Jaroslaw T.

2017-01-01

Purpose: Optimal patient selection for stereotactic radiosurgery (SRS) as the initial treatment for brain metastases is complicated and controversial. This study aimed to develop a nomogram that predicts survival without salvage whole brain radiation therapy (WBRT) after upfront SRS. Methods and Materials: Multi-institutional data were analyzed from 895 patients with 2095 lesions treated with SRS without prior or planned WBRT. Cox proportional hazards regression model was used to identify independent pre-SRS predictors of WBRT-free survival, which were integrated to build a nomogram that was subjected to bootstrap validation. Results: Median WBRT-free survival was 8 months (range, 0.1-139 months). Significant independent predictors for inferior WBRT-free survival were age (hazard ratio [HR] 1.1 for each 10-year increase), HER2(−) breast cancer (HR 1.6 relative to other histologic features), colorectal cancer (HR 1.4 relative to other histologic features), increasing number of brain metastases (HR 1.09, 1.32, 1.37, and 1.87 for 2, 3, 4, and 5+ lesions, respectively), presence of neurologic symptoms (HR 1.26), progressive systemic disease (HR 1.35), and increasing extracranial disease burden (HR 1.31 for oligometastatic and HR 1.56 for widespread). Additionally, HER2(+) breast cancer (HR 0.81) and melanoma (HR 1.11) trended toward significance. The independently weighted hazard ratios were used to create a nomogram to display estimated probabilities of 6-month and 12-month WBRT-free survival with a corrected Harrell's C concordance statistic of 0.62. Conclusions: Our nomogram can be used at initial evaluation to help select patients best suited for upfront SRS for brain metastases while reducing expense and morbidity in patients who derive minimal or no benefit.

Multi-institutional Nomogram Predicting Survival Free From Salvage Whole Brain Radiation After Radiosurgery in Patients With Brain Metastases

Energy Technology Data Exchange (ETDEWEB)

Gorovets, Daniel [Department of Radiation Oncology, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island (United States); Department of Radiation Oncology, Perlmutter Cancer Center, NYU School of Medicine, New York, New York (United States); Ayala-Peacock, Diandra [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Tybor, David J. [Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts (United States); Rava, Paul [Department of Radiation Oncology, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island (United States); Department of Radiation Oncology, UMass Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts (United States); Ebner, Daniel [Department of Radiation Oncology, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island (United States); Cielo, Deus; Norén, Georg [Department of Neurosurgery, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island (United States); Wazer, David E. [Department of Radiation Oncology, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island (United States); Chan, Michael [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Hepel, Jaroslaw T., E-mail: jhepel@lifespan.org [Department of Radiation Oncology, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island (United States)

2017-02-01

Purpose: Optimal patient selection for stereotactic radiosurgery (SRS) as the initial treatment for brain metastases is complicated and controversial. This study aimed to develop a nomogram that predicts survival without salvage whole brain radiation therapy (WBRT) after upfront SRS. Methods and Materials: Multi-institutional data were analyzed from 895 patients with 2095 lesions treated with SRS without prior or planned WBRT. Cox proportional hazards regression model was used to identify independent pre-SRS predictors of WBRT-free survival, which were integrated to build a nomogram that was subjected to bootstrap validation. Results: Median WBRT-free survival was 8 months (range, 0.1-139 months). Significant independent predictors for inferior WBRT-free survival were age (hazard ratio [HR] 1.1 for each 10-year increase), HER2(−) breast cancer (HR 1.6 relative to other histologic features), colorectal cancer (HR 1.4 relative to other histologic features), increasing number of brain metastases (HR 1.09, 1.32, 1.37, and 1.87 for 2, 3, 4, and 5+ lesions, respectively), presence of neurologic symptoms (HR 1.26), progressive systemic disease (HR 1.35), and increasing extracranial disease burden (HR 1.31 for oligometastatic and HR 1.56 for widespread). Additionally, HER2(+) breast cancer (HR 0.81) and melanoma (HR 1.11) trended toward significance. The independently weighted hazard ratios were used to create a nomogram to display estimated probabilities of 6-month and 12-month WBRT-free survival with a corrected Harrell's C concordance statistic of 0.62. Conclusions: Our nomogram can be used at initial evaluation to help select patients best suited for upfront SRS for brain metastases while reducing expense and morbidity in patients who derive minimal or no benefit.

Data management, documentation and analysis systems in radiation oncology: a multi-institutional survey

International Nuclear Information System (INIS)

Kessel, Kerstin A.; Combs, Stephanie E.

2015-01-01

Recently, information availability has become more elaborate and widespread, and treatment decisions are based on a multitude of factors. Gathering relevant data, also referred to as Big Data, is therefore critical for reaching the best patient care, and enhancing interdisciplinary and clinical research. Combining patient data from all involved systems is essential to prepare unstructured data for analyses. This demands special coordination in data management. Our study aims to characterize current developments in German-speaking hospital departments and practices. We successfully conducted the survey with the members of the Deutsche Gesellschaft für Radioonkologie (DEGRO). A questionnaire was developed consisting of 17 questions related to data management, documentation and clinical trial analyses, reflecting the clinical topics such as basic patient information, imaging, follow-up information as well as connection of documentation tools with radiooncological treatment planning machines. A total of 44 institutions completed the online survey (University hospitals n = 17, hospitals n = 13, practices/institutes n = 14). University hospitals, community hospitals and private practices are equally equipped concerning IT infrastructure for clinical use. However, private practices have a low interest in research work. All respondents stated the biggest obstacles about introducing a documentation system into their unit lie in funding and support of the central IT departments. Only 27 % (12/44) of responsible persons are specialists for documentation and data management. Our study gives an understanding of the challenges and solutions we need to be looking at for medical data storage. In the future, inter-departmental cross-links will enable the radiation oncology community to generate large-scale analyses. The online version of this article (doi:10.1186/s13014-015-0543-0) contains supplementary material, which is available to authorized users

From institutional merger integration to institutional strategic transformation: A case study of the strategic management paradigm at Shanghai Library

Institute of Scientific and Technical Information of China (English)

CHEN Chao

2010-01-01

This article attempts to apply the strategic management theory to the subsequent shaping up of a readjusted strategic development policy for Shanghai Library after its merger with the Institute of Scientific and Technological Information of Shanghai (ISTIS) in 1995.It also tries to analyze and explicate such an empirical implementation of institutional reintegration process through strategic management at Shanghai Metropolitan Library.By doing so,it aims to present an objective case study of activities based on the strategic management paradigm at a major Chinese metropolitan public library.

From institutional merger integration to institutional strategic transformation:A case study of the strategic management paradigm at Shanghai Library

Institute of Scientific and Technical Information of China (English)

CHEN; Chao

2010-01-01

This article attempts to apply the strategic management theory to the subsequent shaping up of a readjusted strategic development policy for Shanghai Library after its merger with the Institute of Scientific and Technological Information of Shanghai(ISTIS)in 1995.It also tries to analyze and explicate such an empirical implementation of institutional reintegration process through strategic management at Shanghai Metropolitan Library.By doing so,it aims to present an objective case study of activities based on the strategic management paradigm at a major Chinese metropolitan public library.

Assessing the scientific research productivity of a Brazilian healthcare institution: a case study at the heart institute of São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Beatriz Helena Tess

2009-06-01

Full Text Available INTRODUCTION: The present study was motivated by the need to systematically assess the research productivity of the Heart Institute (InCor, Medical School of the University of São Paulo, Brazil. OBJECTIVE: To explore methodology for the assessment of institutional scientific research productivity. MATERIALS AND METHODS: Bibliometric indicators based on searches for author affiliation of original scientific articles or reviews published in journals indexed in the databases Web of Science, MEDLINE, EMBASE, LILACS and SciELO from January 2000 to December 2003 were used in this study. The retrieved records were analyzed according to the index parameters of the journals and modes of access. The number of citations was used to calculate the institutional impact factor. RESULTS: Out of 1253 records retrieved from the five databases, 604 original articles and reviews were analyzed; of these, 246 (41% articles were published in national journals and 221 (90% of those were in journals with free online access through SciELO or their own websites. Of the 358 articles published in international journals, 333 (93% had controlled online access and 223 (67% were available through the Capes Portal of Journals. The average impact of each article for InCor was 2.224 in the period studied. CONCLUSION: A simple and practical methodology to evaluate the scientific production of health research institutions includes searches in the LILACS database for national journals and in MEDLINE and the Web of Science for international journals. The institutional impact factor of articles indexed in the Web of Science may serve as a measure by which to assess and review the scientific productivity of a research institution.

Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

Energy Technology Data Exchange (ETDEWEB)

Miller, Julie M.; Vavere, Andrea L.; Arbab-Zadeh, Armin; Bush, David E.; Lardo, Albert C.; Texter, John; Brinker, Jeffery; Lima, Joao A.C. [Johns Hopkins Hospital, Johns Hopkins University, Department of Medicine, Division of Cardiology, Baltimore, MD (United States); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Medical School, Humboldt-Universitaet und Freie Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany); Rochitte, Carlos E.; Lemos, Pedro A. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo (Brazil); Niinuma, Hiroyuki [Iwate Medical University, Department of Cardiology, Morioka (Japan); Paul, Narinder [Toronto General Hospital, Department of Medical Imaging, Toronto (Canada); Hoe, John [Medi-Rad Associates Ltd, CT Centre, Mt Elizabeth Hospital, Singapore (Singapore); Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Yoshioka, Kunihiro [Iwate Medical University, Department of Radiology, Morioka (Japan); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Clouse, Melvin E. [Harvard University, Department of Radiology, Beth Israel Deaconess, Boston, MA (United States)

2009-04-15

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

USAF Institute for National Security Studies 1998 Research Results Conference

National Research Council Canada - National Science Library

1998-01-01

The USAF Institute for National Security Studies (INSS), in cooperation with HQ USAF Nuclear and Counterproliferation Directorate, sponsored its 6th annual Research Results Conference on 19 - 20 November 1998...

Dosimetry intercomparison of four proton therapy institutions in Germany employing spot scanning

Energy Technology Data Exchange (ETDEWEB)

Baeumer, Christian; Koska, Benjamin [Westdeutsches Protonentherapiezentrum, Essen (Germany); Ackermann, Benjamin; Latzel, Harald [Heidelberger Ionenstrahl-Therapiezentrum, Heidelberg (Germany); Heidelberg Institute for Radiation Oncology (Germany); Hillbrand, Martin; Kaiser, Franz-Joachim [Rinecker Proton Therapy Center, Muenchen (Germany); Luehr, Armin [German Cancer Consortium (DKTK), Heidelberg (Germany); Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; German Cancer Research Center (DKFZ), Heidelberg (Germany); Menkel, Stefan [Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; Timmermann, Beate [Westdeutsches Protonentherapiezentrum, Essen (Germany); German Cancer Consortium (DKTK), Heidelberg (Germany); Essen Univ. Hospital (Germany). West German Cancer Center (WTZ)

2017-08-01

To verify the consistency of dose and range measurement in an interinstitution comparison among proton therapy institutions in Germany which use the pencil-beam scanning technique. Following a peer-to-peer approach absorbed dose and range have been intercompared in several missions at two hosting centers with two or three visiting physics teams of participating institutions using their own dosimetry equipment. A meta-analysis has been performed integrating the results of the individual missions. Dose has been determined with ionization chambers according to the dosimetry protocol IAEA TRS-398. For determination of the depth of the distal 80% dose the teams used either a scanning water phantom, a variable water column or a multi-layer ionization chamber. The systematic deviation between measured doses of the participating institutions is less than 1%. Ranges differ systematically less than 0.4 mm. The match of measured dose and range is better than expected from the respective uncertainties. As all physics teams agree on the assessment of absorbed dose and range, an important prerequisite for a start of joint clinical studies is fulfilled.

Can Internationalisation Really Lead to Institutional Competitive Advantage?--A Study of 16 Dutch Public Higher Education Institutions

Science.gov (United States)

De Haan, Haijing

2014-01-01

Public higher education institutions (PHEIs) have widely acknowledged a positive relationship between internationalization and their institutional competitive advantage enhancement. Although some concerns have been raised by practitioners and researchers about whether institutional competitive advantage can be enhanced given the current ways of…

Entrepreneurship as institutional change

DEFF Research Database (Denmark)

Bjerregaard, Toke; Lauring, Jakob

2012-01-01

This paper responds to calls to make more explicit linkages between institutional theory and entrepreneurship research through studies on how entrepreneurs navigate and work with institutions. The research examines the micro-strategies and activities through which small-scale entrepreneurs maneuver...... between and exploit the multiple, potentially contradictory institutional logics of the different spheres in which they operate. While much research has elucidated how institutional entrepreneurs effect change, this study illustrates how effective entrepreneurs managing and exploiting institutional...... contradictions engage simultaneously in practices of maintaining and changing institutions to establish a balance between the poles on which their ventures depend. We illustrate this by two cases of small-scale entrepreneurship bridging institutional contradictions from an ethnographic study conducted under...

Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan.

Science.gov (United States)

Tatekawa, H; Sakamoto, S; Hori, M; Kaichi, Y; Kunimatsu, A; Akazawa, K; Miyasaka, T; Oba, H; Okubo, T; Hasuo, K; Yamada, K; Taoka, T; Doishita, S; Shimono, T; Miki, Y

2018-05-03

Both clinical and imaging criteria must be met to diagnose neuromyelitis optica spectrum disorders and multiple sclerosis. However, neuromyelitis optica spectrum disorders are often misdiagnosed as MS because of an overlap in MR imaging features. The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data. We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16-85 years; females, 77; aquaporin 4 immunoglobulin G-positive, 93%) and 89 with MS (median age, 36 years; range, 18-67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney U test or the Fisher exact test. We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, P optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders ( P = .001), but not in MS ( P = .80). Visually detailed

Language Planning and the Programs in Filipino of Higher Education Institutions

Directory of Open Access Journals (Sweden)

Jaine Z. Tarun

2016-11-01

Full Text Available This study was focused on the language planning and the programs in Filipino of Higher Education Institutions (HEIs in Region 02, Philippines. It aimed to evaluate the extent of contributions in the implementation of national and institutional academic language policies and programs on Filipino in the General Education Curriculum (GEC, Bilingual / Multilingual Education, translation of books and articles, instructional materials development using Filipino and other languages in the region, having published books, scholarly articles and theses in other disciplines and journals written in Filipino and the attitudes of administrators, faculty and students. This evaluative study applied both the quantitative analysis of data using the survey method and qualitative analysis using the multi-method approach or triangulation. A total of 216 respondents from other disciplines, except Filipino, randomly selected among the administrators, faculty and students were utilized. The results confirmed that the minimum required GEC courses in Filipino as stipulated in CHED Memorandum Order No. 59 s. 1996 were implemented in their curricular programs while as a medium of instruction in Humanities, Social Sciences and Communications (HUSOCOM courses, Filipino was not used. Result substantiated that Filipino aided instruction in classroom discourses both in HUSOCOM and Non – HUSOCOM courses was commonly practiced. Result also vouched the non-existence of institutional policies and programs in Filipino. However, there were no significant differences in the positive attitudes among administrators, faculty and students of Higher Education Institutions.

Multi-target consensus circle pursuit for multi-agent systems via a distributed multi-flocking method

Science.gov (United States)

Pei, Huiqin; Chen, Shiming; Lai, Qiang

2016-12-01

This paper studies the multi-target consensus pursuit problem of multi-agent systems. For solving the problem, a distributed multi-flocking method is designed based on the partial information exchange, which is employed to realise the pursuit of multi-target and the uniform distribution of the number of pursuing agents with the dynamic target. Combining with the proposed circle formation control strategy, agents can adaptively choose the target to form the different circle formation groups accomplishing a multi-target pursuit. The speed state of pursuing agents in each group converges to the same value. A Lyapunov approach is utilised to analyse the stability of multi-agent systems. In addition, a sufficient condition is given for achieving the dynamic target consensus pursuit, and which is then analysed. Finally, simulation results verify the effectiveness of the proposed approaches.

Experimental study of implosion dynamics of multi-material nested wire-arrays on S-300 pulsed power generator

International Nuclear Information System (INIS)

Chernenko, A.S.; Smirnov, V.P.; Kingsep, A.S.

2004-01-01

On 'S-300' generator (700 kV, 4 MA, 70 ns) at the Kurchatov Institute, the experimental studies with multi-material wire array units are carried on aimed at creating the powerful X-ray source. The development of new diagnostic methods would definitely contribute to attain new data, which could help in explanation of X-ray emission mechanism of imploding multi-wire arrays that has not well understood yet. The experimental study of soft X-ray emission of different wire sets, different in both mass and composition, has been carried on in the same geometry. One of the purposes of these experiments was investigation of the wire array chemical composition influence on the implosion dynamics and stability. Study of the nested (cascade) liner dynamics shows that the minimal liner radius at the stagnation moment of time (2r ∼ 3 - 3.5 mm) recorded in the visible range by the streak camera fairly coincides with the outer diameter of the inner tungsten array of 4 mm. The same size is shown by the integral pinhole pictures obtained in the SXR range, without a filter. Unlike all these pictures, images obtained in the range E > 2 keV demonstrate the resulting state of Z-pinch in the form of a thin (∼ 0.2 mm) twisting filament. In addition, small space scales are typical of the liner pictures taken in the range of He- and H-like aluminum ions by means of a spectrograph. Thus, one may conclude that Al plasma of the outer liner passes into the inner space of the almost immovable W array where becomes trapped and compressed by the magnetic field. (author)

SU-F-P-35: A Multi-Institutional Plan Quality Checking Tool Built On Oncospace: A Shared Radiation Oncology Database System

International Nuclear Information System (INIS)

Bowers, M; Robertson, S; Moore, J; Wong, J; Phillips, M; Hendrickson, K; Evans, K; McNutt, T

2016-01-01

Purpose: Late toxicity from radiation to critical structures limits the possible dose in Radiation Therapy. Perfectly conformal treatment of a target is not realizable, so the clinician must accept a certain level of collateral radiation to nearby OARs. But how much? General guidelines exist for healthy tissue sparing which guide RT treatment planning, but are these guidelines good enough to create the optimal plan given the individualized patient anatomy? We propose a means to evaluate the planned dose level to an OAR using a multi-institutional data-store of previously treated patients, so a clinician might reconsider planning objectives. Methods: The tool is built on Oncospace, a federated data-store system, which consists of planning data import, web based analysis tools, and a database containing:1) DVHs: dose by percent volume delivered to each ROI for each patient previously treated and included in the database.2) Overlap Volume Histograms (OVHs): Anatomical measure defined as the percent volume of an ROI within a given distance to target structures.Clinicians know what OARs are important to spare. For any ROI, Oncospace knows for which patients’ anatomy that ROI was harder to plan in the past (the OVH is less). The planned dose should be close to the least dose of previous patients. The tool displays the dose those OARs were subjected to, and the clinician can make a determination about the planning objectives used.Multiple institutions contribute to the Oncospace Consortium, and their DVH and OVH data are combined and color coded in the output. Results: The Oncospace website provides a plan quality display tool which identifies harder to treat patients, and graphically displays the dose delivered to them for comparison with the proposed plan. Conclusion: The Oncospace Consortium manages a data-store of previously treated patients which can be used for quality checking new plans. Grant funding by Elekta.

SU-F-P-35: A Multi-Institutional Plan Quality Checking Tool Built On Oncospace: A Shared Radiation Oncology Database System

Energy Technology Data Exchange (ETDEWEB)

Bowers, M; Robertson, S; Moore, J; Wong, J [Johns Hopkins University, Baltimore, MD (United States); Phillips, M [University Washington, Seattle, WA (United States); Hendrickson, K; Evans, K [University of Washington, Seattle, WA (United States); McNutt, T [Johns Hopkins University, Severna Park, MD (United States)

2016-06-15

Purpose: Late toxicity from radiation to critical structures limits the possible dose in Radiation Therapy. Perfectly conformal treatment of a target is not realizable, so the clinician must accept a certain level of collateral radiation to nearby OARs. But how much? General guidelines exist for healthy tissue sparing which guide RT treatment planning, but are these guidelines good enough to create the optimal plan given the individualized patient anatomy? We propose a means to evaluate the planned dose level to an OAR using a multi-institutional data-store of previously treated patients, so a clinician might reconsider planning objectives. Methods: The tool is built on Oncospace, a federated data-store system, which consists of planning data import, web based analysis tools, and a database containing:1) DVHs: dose by percent volume delivered to each ROI for each patient previously treated and included in the database.2) Overlap Volume Histograms (OVHs): Anatomical measure defined as the percent volume of an ROI within a given distance to target structures.Clinicians know what OARs are important to spare. For any ROI, Oncospace knows for which patients’ anatomy that ROI was harder to plan in the past (the OVH is less). The planned dose should be close to the least dose of previous patients. The tool displays the dose those OARs were subjected to, and the clinician can make a determination about the planning objectives used.Multiple institutions contribute to the Oncospace Consortium, and their DVH and OVH data are combined and color coded in the output. Results: The Oncospace website provides a plan quality display tool which identifies harder to treat patients, and graphically displays the dose delivered to them for comparison with the proposed plan. Conclusion: The Oncospace Consortium manages a data-store of previously treated patients which can be used for quality checking new plans. Grant funding by Elekta.

Review on study of multi-physics in environment engineering

International Nuclear Information System (INIS)

Liu Shanli; Zhao Jian; Sheng Jinchang

2006-01-01

This paper analyzes some problems on multi-field coupling ones between seepage mechanics and other physical and chemical processes (such as temperature field. stress field, solute transport. chemical action and so on) in environment engineering, it explains the research theory of multi-field coupling, it summarizes the abroad and domestic research about the model of multi-field problem and finally it looks into the future of research tendency in environment engineering. (authors)

Integration of least angle regression with empirical Bayes for multi-locus genome-wide association studies

Science.gov (United States)

Multi-locus genome-wide association studies has become the state-of-the-art procedure to identify quantitative trait loci (QTL) associated with traits simultaneously. However, implementation of multi-locus model is still difficult. In this study, we integrated least angle regression with empirical B...

A case study on business model innovations using Blockchain: focusing on financial institutions

Directory of Open Access Journals (Sweden)

JaeShup Oh

2017-12-01

Full Text Available Purpose - Blockchain is a distributed ledger, in which the blocks containing transaction details are connected chronologically to form a series of chains, thus raising the possibility of improving the process and innovating business model for the financial institutions. The purpose of this paper is to study the actual cases of Blockchain applied in Korea in 2017, so that a vision of business model innovation of financial institutions can be drawn. Design/methodology/approach - The financial institutions in Korea are in the technology verification stage to introduce Blockchain technology. Since there is an insufficient amount of actual measurement data, case study method was adopted. The authors interviewed ICT officers of major banks in Korea. The purpose of the interview was to understand the relationship between Blockchain and business models of financial institutions, and the effects and challenges that Blockchain has on the business model of financial institutions. Findings - From the perspective of financial institutions, the emergence of Blockchain does not just have technical significance – emergence of highly efficient database system – but has the possibility that if the business model of existing financial intermediaries disappears or get reduced, the financial services relying on them can disappear altogether, or some of them can be replaced, and financial transaction patterns of consumers can be changed. As a case studies researched for this paper, it was discovered that the distributed characteristic of Blockchain cannot be applied when actually developing financial services.

Study on Quantification for Multi-unit Seismic PSA Model using Monte Carlo Sampling

International Nuclear Information System (INIS)

Oh, Kyemin; Han, Sang Hoon; Jang, Seung-cheol; Park, Jin Hee; Lim, Ho-Gon; Yang, Joon Eon; Heo, Gyunyoung

2015-01-01

In existing PSA, frequency for accident sequences occurred in single-unit has been estimated. While multi-unit PSA has to consider various combinations because accident sequence in each units can be different. However, it is difficult to quantify all of combination between inter-units using traditional method such as Minimal Cut Upper Bound (MCUB). For this reason, we used Monte Carlo sampling as a method to quantify multi-unit PSA model. In this paper, Monte Carlo method was used to quantify multi-unit PSA model. The advantage of this method is to consider all of combinations by the increase of number of unit and to calculate nearly exact value compared to other method. However, it is difficult to get detailed information such as minimal cut sets and accident sequence. To solve partially this problem, FTeMC was modified. In multi-unit PSA, quantification for both internal and external multi-unit accidents is the significant issue. Although our result above mentioned was one of the case studies to check application of method suggested in this paper, it is expected that this method can be used in practical assessment for multi-unit risk

Research Review of the Institute of African Studies: Contact

African Journals Online (AJOL)

Principal Contact. Prof. M.E. Kropp Dakubu Editor-in-Chief University of Ghana. Research Review. Institute of African Studies. P.O.Box LG73 Legon, Ghana. Phone: 211-24-4764006. Fax: 233-21-500512. Email: medakubu@ug.edu.gh. Support Contact. Dr Stephen Acheampong Phone: 211-24-4979233

TTI Phase 2 Institutional Support: Institute of Policy Studies of Sri ...

International Development Research Centre (IDRC) Digital Library (Canada)

For IPS, this project will help enhance its research quality, organizational performance, and policy engagement. Enhancing research ... -consolidate the institutional transformations made to achieve improved performance ... -influence policies based on its work to place Sri Lanka on a smarter growth path -have an impact on ...

Evolutionary institutionalism.

Science.gov (United States)

Fürstenberg, Dr Kai

Institutions are hard to define and hard to study. Long prominent in political science have been two theories: Rational Choice Institutionalism (RCI) and Historical Institutionalism (HI). Arising from the life sciences is now a third: Evolutionary Institutionalism (EI). Comparative strengths and weaknesses of these three theories warrant review, and the value-to-be-added by expanding the third beyond Darwinian evolutionary theory deserves consideration. Should evolutionary institutionalism expand to accommodate new understanding in ecology, such as might apply to the emergence of stability, and in genetics, such as might apply to political behavior? Core arguments are reviewed for each theory with more detailed exposition of the third, EI. Particular attention is paid to EI's gene-institution analogy; to variation, selection, and retention of institutional traits; to endogeneity and exogeneity; to agency and structure; and to ecosystem effects, institutional stability, and empirical limitations in behavioral genetics. RCI, HI, and EI are distinct but complementary. Institutional change, while amenable to rational-choice analysis and, retrospectively, to criticaljuncture and path-dependency analysis, is also, and importantly, ecological. Stability, like change, is an emergent property of institutions, which tend to stabilize after change in a manner analogous to allopatric speciation. EI is more than metaphorically biological in that institutional behaviors are driven by human behaviors whose evolution long preceded the appearance of institutions themselves.

Institutional Churn: Institutional Change in United Kingdom Higher Education

Science.gov (United States)

Tight, Malcolm

2013-01-01

This article considers how higher education institutions change over time, using the United Kingdom system as an exemplar, and focusing on the 15-year period between 1994/95 and 2009/10. While there are many aspects of institutional change worthy of study, the focus here is on how institutions appear to others. Thus, the article examines the…

Cooperative Institute for Dynamic Earth Research (CIDER): Contributions to Education (Invited)

Science.gov (United States)

Romanowicz, B. A.

2010-12-01

The Cooperative Institute for Dynamic Earth Research (http://www.deep-earth.org) began its activities in 2003 and has so far held four summer programs of duration ranging from 3 to 7 weeks, funded by the NSF/CSEDI program, with support from and at the Kavli Institute for Theoretical Physics in Santa Barbara. CIDER's goals are twofold: (1) as a "synthesis center", to provide an environment for transformative studies of Earth's internal dynamics, requiring a concerted multi-disciplinary effort of leading researchers, and (2) to educate a new generation of Earth scientists with a breadth of competence across the disciplines required to understand the dynamic earth: mineral physics, geodynamics, geochemistry and geomagnetism. CIDER summer programs, so far, have focused on themes related to the Deep Earth: "Reconciling seismic and geochemical heterogeneity in the Earth", "The Earth's transition zone", "Boundary layers in the Earth" and "Fluids and volatiles in the Earth's mantle and core". These programs typically include three weeks of unstructured program designed for senior (assistant professor level and higher) researchers, and a 3-4 weeks "tutorial and workshop" part geared towards advanced graduate students and post-docs, but open also to more senior participants. The first two weeks of the tutorial part include lectures and practical exercises in the different disciplines aimed at providing participants with a basic understanding of the fundamentals and current challenges in disciplines other than their own. During the second week, topics related to the summer program's theme are proposed for further study in a workshop mode by multi-disciplinary groups formed on the fly, continued through the last week or two of the program. These activities often lead to the development of new collaborations and research proposals to the CSEDI program. In 2011, CIDER will hold a summer program at UC Berkeley on the theme "Mountain Building", expanding the scope of the Institute

NATO Advanced Study Institute on Methods in Computational Molecular Physics

CERN Document Server

Diercksen, Geerd

1992-01-01

This volume records the lectures given at a NATO Advanced Study Institute on Methods in Computational Molecular Physics held in Bad Windsheim, Germany, from 22nd July until 2nd. August, 1991. This NATO Advanced Study Institute sought to bridge the quite considerable gap which exist between the presentation of molecular electronic structure theory found in contemporary monographs such as, for example, McWeeny's Methods 0/ Molecular Quantum Mechanics (Academic Press, London, 1989) or Wilson's Electron correlation in moleeules (Clarendon Press, Oxford, 1984) and the realization of the sophisticated computational algorithms required for their practical application. It sought to underline the relation between the electronic structure problem and the study of nuc1ear motion. Software for performing molecular electronic structure calculations is now being applied in an increasingly wide range of fields in both the academic and the commercial sectors. Numerous applications are reported in areas as diverse as catalysi...

The current status of the treatment for T4 maxillary sinus cancer in Japan. A multi-institutional retrospective observation study

International Nuclear Information System (INIS)

Homma, Akihiro; Hayashi, Ryuichi; Matsuura, Kazuto

2013-01-01

The purpose of this study was to assess the current status in Japan of the treatment for squamous cell carcinoma of the T4 maxillary sinus (MS-SCC) and its use to plan clinical trials in the future. The data for 128 patients with previously untreated MS-SCC were obtained from 28 institutions from 2006 to 2007. Of the 128 patients, 118 patients with curative intent were included in an analysis of the treatment and its results. Of the 118 patients, 73 patients had T4a disease, and 45 with T4b. Thirty-nine patients (33.1%) were treated with total maxillectomy, 25 (21.2%) with partial maxillectomy, 22 patients (18.6%) with RADPLAT, 19 patients (16.1%) with IV-CRT, and 13 patients (11.0%) with others. The 5-year overall survival rate and local control rate for 118 patients were 49.8% and 48.9%, respectively. The 5-year overall survival rates for patients with T4aN0M0 and T4bN0M0 were 67.5% and 29.8%, respectively. This study was retrospective, but we could understand the tendency of treatment choice and treatment results. It will be useful information to plan clinical trials in the future. (author)

Equity in Elementary Science Education: A Study of Institutional and Policy Factors

Science.gov (United States)

Hayes, Kathryn N.

Despite recognition that the foundation for interest in science is laid down at the elementary level (Tai, et al., 2006), in the last ten years elementary science instruction time has declined in K-6 schooling (Center on Education Policy, 2007). A lack of access to excellent science education is exacerbated for low-income students, prompting significant questions regarding inequities within the science education pipeline (Maulucci, 2010). The critical factors needed to address these inequities include teacher preparation, access to resources, and instructional leadership, as well as a supportive policy and institutional milieu. However, although the former three have been studied extensively, the role of policy and institutions in creating the conditions for equity in science education are little understood despite their likely significant role (Lemke, 2001). This mixed methods study addressed this gap by examining the role the policy and institutional milieu play in constraining or supporting equitable elementary science education. Institutional theory provides the framework for understanding how various institutional logics and regulatory pressures permeate schools and districts across contexts, influencing science education implementation (Scott, 2014). Two distinct approaches were used to first quantitatively examine the predictors of differentiation in elementary science education instructional time and methods, and second qualitatively analyze the nature and process by which these mechanisms exert influence. Data for the first two papers was derived from a case study of a purposively sampled district, including surveys of 200 teachers and embedded case studies of four schools. Analysis consisted of multi-level models of teacher attributes and school and policy factors in predicting differential distribution of science education instructional time and methods (Raudenbush & Bryk, 2002). Data for the third paper arose out of a series of principal, administrator

Iontophoretic transdermal drug delivery: a multi-layered approach.

Science.gov (United States)

Pontrelli, Giuseppe; Lauricella, Marco; Ferreira, José A; Pena, Gonçalo

2017-12-11

We present a multi-layer mathematical model to describe the transdermal drug release from an iontophoretic system. The Nernst-Planck equation describes the basic convection-diffusion process, with the electric potential obtained by solving the Laplace's equation. These equations are complemented with suitable interface and boundary conditions in a multi-domain. The stability of the mathematical problem is discussed in different scenarios and a finite-difference method is used to solve the coupled system. Numerical experiments are included to illustrate the drug dynamics under different conditions. © The authors 2016. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

Case Study of a Post-Secondary Institution and Its Response to Student Homelessness

NARCIS (Netherlands)

K. Kovacs Burns (Kathy); M.S. Richter (Magdalena); Y. Mao (Yuping); S. Mogale (Shirley); M. Danko (Margaret)

2016-01-01

textabstractFrom the moment students are accepted into post-secondary institutions, the focus is on their studies and successful completion. Far less is known about what institutions understand about students’ personal stresses and issues with their finances, housing and especially student

NATO Advanced Study Institute on Physics of New Laser Sources

CERN Document Server

Arecchi, F; Mooradian, Aram; Sona, Alberto

1985-01-01

This volume contains the lectures and seminars presented at the NATO Advanced Study Institute on "Physics of New Laser Sources", the twelfth course of the Europhysics School of Quantum Electronics, held under the supervision of the Quantum Electronics Division of the European Physical Society. The Institute was held at Centro "I Cappuccini" San Miniato, Tuscany, July 11-21, 1984. The Europhysics School of Quantum Electronics was started in 1970 with the aim of providing instruction for young researchers and advanced students already engaged in the area of quantum electronics or for those wishing to switch into this area after working previously in other areas. From the outset, the School has been under the direction of Prof. F. T. Arecchi, then at the University of Pavia, now at the University of Florence, and Dr. D. Roess of Heraeus, Hanau. In 1981, Prof. H. Walther, University of Munich and Max-Planck Institut fur Quantenoptik joined as co-director. Each year the Directors choose a subj~ct of particular int...

Study on the Application of the Prudence Principle in Accounting of Credit Institutions

Directory of Open Access Journals (Sweden)

Riana Iren RADU

2014-08-01

Full Text Available With effect from 1 January 2012, according to The NATIONAL BANK of ROMANIA No. 27/2010, International Financial reporting standards (IFRS have become the basis of the accounting system used by credit institutions in Romania. In this context, the regulatory framework relating to the adjustments for impairment of financial assets other than loans and securities is given by IAS39 and IAS 37. In this paper I propose to develop a study on the application of the prudence principle in accounting of credit institutions, a study, which will be the main issues of taxation and accounting implementation of prudent credit institutions.

Multi-Core Processor Memory Contention Benchmark Analysis Case Study

Science.gov (United States)

Simon, Tyler; McGalliard, James

2009-01-01

Multi-core processors dominate current mainframe, server, and high performance computing (HPC) systems. This paper provides synthetic kernel and natural benchmark results from an HPC system at the NASA Goddard Space Flight Center that illustrate the performance impacts of multi-core (dual- and quad-core) vs. single core processor systems. Analysis of processor design, application source code, and synthetic and natural test results all indicate that multi-core processors can suffer from significant memory subsystem contention compared to similar single-core processors.

A case study of a Cuban government institution

International Nuclear Information System (INIS)

Nunez, A.L.

2004-01-01

The aim of this contribution is to present a case study on the partial implementation of a knowledge management system in an institution. In this case the knowledge management has been directed toward the best performance of the organization. This organization is a non- profit one and its functions are the promotion, support and supervision of issues related to science, technology and environment for the economic development of a region. This case study can be implemented at any institution, including institutions of nuclear or radiological profiles. Many nuclear and radiological facilities have as a purpose the promotion, support and supervision of the nuclear applications for the biggest economic development. And this should be oriented to the implementation of best practices. The main author designed the methodology employed. The attention was centered in the objectives to be achieved for an efficient organization and the competence that should be possessed, were also identified. This study was developed with an expert group. Directive personnel, the total of advisory of institution and some selected workers formed it. 12 members integrated the overall group. They pondered the incidence of each one of the competencies in the functional objectives of the organization. The approach of the beneficiaries to this issue was also considered. In a second place a study was carried out about the competencies possessed by all the workers of the organization, and according to this the convergence-divergence matrix was created. The utility indexes for the necessary competence and for the possessed competence were calculated, as well as the satisfaction ratio between them. This ratio identifies how were the necessary competencies satisfied by the possessed competencies. It was determined in the study that the key competencies of the organization are No. 1, 2, 35, 37, 38, 39, 40, 41, 42, 43, 44, 45, 48, 50, 52, 53, 54, 55, 56 and 58. In general there are no difficulties for a

Information and communication technologies in a multi-sector endogenous growth model

Czech Academy of Sciences Publication Activity Database

Vourvachaki, Evangelia

-, č. 386 (2009), s. 1-56 ISSN 1211-3298 Institutional research plan: CEZ:MSM0021620846 Keywords : multi-sector economy * endogenous growth * information and communication technologies Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp386.pdf

An Empirical Study on Green Innovation Efficiency in the Green Institutional Environment

Directory of Open Access Journals (Sweden)

Yang Gao

2018-03-01

Full Text Available Previous studies have found that reverse technology spillover effects can promote industrial technology modernization in developing countries. However, it is still unknown whether reverse technology spillover effects can improve green innovation efficiency in developing countries. In particular, institutional uncertainties characteristic of transition economies have a significant impact on industrial modernization. Therefore, researching the impact of the institutional environment on the relationship between reverse technology spillover effects and green innovation efficiency is of great significance. In this paper, we use data from G20 countries as well as China’s foreign direct investment (FDI data to measure the effects of reverse technology spillovers and adopt the threshold effect model to explore the relationship between reverse technology spillover effects and green innovation efficiency as well as the influence of the institutional environment on this relationship, based on China’s provincial panel data from 2003 to 2015. The empirical results show that the reverse technology spillover effects can effectively improve green innovation efficiency. There is a threshold for the influence of the institutional environment on the relationship between reverse technology spillover effects and green innovation efficiency. When the institutional development level surpasses the threshold value, an acceleration effect is generated. In addition, we find that the legal system is the key bottleneck in terms of improving green innovation efficiency. How to improve and perfect the path of institutional construction in China and how to enable institutions to gain threshold speed-up effects have become the major problems the Chinese government faces in institutional construction. The research results of this paper offer a reference to developing countries in regard to improving their institutions and enhancing their green innovation efficiency.

Informal institutions and radical ideologies under institutional transformation

Directory of Open Access Journals (Sweden)

Irina Starodubrovskaya

2015-06-01

Full Text Available This article questions one of the central postulates of institutional economic theory, i.e., that of the sustainability and purely evolutionary changes of informal institutions. To study the phenomenon of the destruction of informal institutions and its consequences, we use the tools of sociological theory, which acknowledge that a period of intensive urbanization is characterized by anomie, i.e., a lack of norms, in which traditional institutions are destroyed, while new urban institutions have not yet taken shape. We reviewed the possible reactions of communities and individuals to the conditions of anomie, including the compensatory mechanisms of ideologies. In the case of the Dagestan Republic, we show how the proliferation of fundamentalist Islamic ideology is associated with the state of anomie and the consequences to which it could lead from an institutional point of view. The analysis of the situation in Dagestan is based on long-term field research conducted in the region.

Estimating risk of atherosclerotic cardiovascular diseases in non-atherosclerotic Pakistani patients: Study conducted at National Institute of Cardiovascular Diseases, Karachi, Pakistan

International Nuclear Information System (INIS)

Ashraf, T.; Achakzai, A.S.; Farooq, F.; Memon, M.A.

2017-01-01

This cross-sectional study was carried out at the National Institute of Cardiovascular Disease, Karachi, from July 2014 to March 2015, and comprised male and female subjects with multi-ethnic background, aged 20-79 years and having non-atherosclerotic disease. SPSS 22 was used for data analysis. Results: Of the 437 participants, 174(39.8%) were men and 263(60.2%) were women. The overall mean age was 42.65+-11.45 years. The mean age of men was 43.3+-12.1 years and that of women was 42.2+-10.8 years. Moreover, ten-year and lifetime risk assessment rates were higher in men (50[28.2%] and 86[49.4%] respectively) compared to women (28[10.6%] and 84[31.9%], respectively). Conclusion: Urdu-speaking Pakistanis were found to be at higher risk from atherosclerotic cardiovascular disease.

Multi-View Multi-Instance Learning Based on Joint Sparse Representation and Multi-View Dictionary Learning.

Science.gov (United States)

Li, Bing; Yuan, Chunfeng; Xiong, Weihua; Hu, Weiming; Peng, Houwen; Ding, Xinmiao; Maybank, Steve

2017-12-01

In multi-instance learning (MIL), the relations among instances in a bag convey important contextual information in many applications. Previous studies on MIL either ignore such relations or simply model them with a fixed graph structure so that the overall performance inevitably degrades in complex environments. To address this problem, this paper proposes a novel multi-view multi-instance learning algorithm (MIL) that combines multiple context structures in a bag into a unified framework. The novel aspects are: (i) we propose a sparse -graph model that can generate different graphs with different parameters to represent various context relations in a bag, (ii) we propose a multi-view joint sparse representation that integrates these graphs into a unified framework for bag classification, and (iii) we propose a multi-view dictionary learning algorithm to obtain a multi-view graph dictionary that considers cues from all views simultaneously to improve the discrimination of the MIL. Experiments and analyses in many practical applications prove the effectiveness of the M IL.

Quality Assurance Issues in Conducting Multi-Institutional Advanced Technology Clinical Trials

International Nuclear Information System (INIS)

Purdy, James A.

2008-01-01

The National Cancer Institute-sponsored Advanced Technology Quality Assurance (QA) Consortium, which consisted of the Image-Guided Therapy QA Center, Radiation Therapy Oncology Group, Radiological Physics Center, Quality Assurance Review Center, and Resource Center for Emerging Technologies, has pioneered the development of an infrastructure and QA method for advanced technology clinical trials that requires volumetric digital data submission of a protocol patient's treatment plan and verification data. In particular, the Image-Guided Therapy QA Center has nearly 15 years experience in facilitating QA review for Radiation Therapy Oncology Group advanced technology clinical trials. This QA process includes (1) a data integrity review for completeness of protocol required elements, the format of data, and possible data corruption, and recalculation of dose-volume histograms; (2) a review of compliance with target volume and organ-at-risk contours by study chairs; and (3) a review of dose prescription and dose heterogeneity compliance by the Radiation Therapy Oncology Group Headquarters Dosimetry Group or the Radiological Physics Center dosimetrists (for brachytherapy protocols). This report reviews the lessons learned and the QA challenges presented by the use of advanced treatment modalities in clinical trials requiring volumetric digital data submission

An Empirical Study on Green Innovation Efficiency in the Green Institutional Environment

OpenAIRE

Yang Gao; Sang-Bing Tsai; Xingqun Xue; Tingzhen Ren; Xiaomin Du; Quan Chen; Jiangtao Wang

2018-01-01

Previous studies have found that reverse technology spillover effects can promote industrial technology modernization in developing countries. However, it is still unknown whether reverse technology spillover effects can improve green innovation efficiency in developing countries. In particular, institutional uncertainties characteristic of transition economies have a significant impact on industrial modernization. Therefore, researching the impact of the institutional environment on the rela...

Development of multi-functional streetscape green infrastructure using a performance index approach

Czech Academy of Sciences Publication Activity Database

Tiwary, A.; Williams, L. D.; Heidrich, O.; Namdeo, A.; Bandaru, V.; Calfapietra, Carlo

2016-01-01

Roč. 208, jan (2016), s. 209-220 ISSN 0269-7491 Institutional support: RVO:67179843 Keywords : Green infrastructure * Multi-functional * Pollution * Performance index * Streetscape Subject RIV: EH - Ecology, Behaviour Impact factor: 5.099, year: 2016

Institutional Logics in Inter-institutional Temporary Organizations

DEFF Research Database (Denmark)

Pemsel, Sofia; Söderlund, Jonas

-cognitive, normative, and regulative – are unfolding and evolving in such contexts. The case study addresses the integration and disintegration of logics and normative orders in an ongoing process characterized by the co-mingling, co-existence, creation and resolutions of hybrid logics and creation of institutional...... exceptions throughout the life of the studied temporary organization. In that respect, this paper contributes with a more nuanced view on the evolution, dynamics, and co-existence of pressures from multiple institutional demands at the organizational level....

Institutional And Non-Institutional Credit Supply Services To Fisher ...

African Journals Online (AJOL)

Women in the study area prefer the informal, non institutional credit sources than the formal, institutional source as the poor fisher-folk require collateral for this which in most cases was not available. From the study, adequate finance with more relax conditions will go a long way in alleviating poverty and improving ...

Operational validation of a multi-period and multi-criteria model conditioning approach for the prediction of rainfall-runoff processes in small forest catchments

Science.gov (United States)

Choi, H.; Kim, S.

2012-12-01

Most of hydrologic models have generally been used to describe and represent the spatio-temporal variability of hydrological processes in the watershed scale. Though it is an obvious fact that hydrological responses have the time varying nature, optimal values of model parameters were normally considered as time invariants or constants in most cases. The recent paper of Choi and Beven (2007) presents a multi-period and multi-criteria model conditioning approach. The approach is based on the equifinality thesis within the Generalised Likelihood Uncertainty Estimation (GLUE) framework. In their application, the behavioural TOPMODEL parameter sets are determined by several performance measures for global (annual) and short (30-days) periods, clustered using a Fuzzy C-means algorithm, into 15 types representing different hydrological conditions. Their study shows a good performance on the calibration of a rainfall-runoff model in a forest catchment, and also gives strong indications that it is uncommon to find model realizations that were behavioural over all multi-periods and all performance measures, and multi-period model conditioning approach may become new effective tool for predictions of hydrological processes in ungauged catchments. This study is a follow-up study on the Choi and Beven's (2007) model conditioning approach to test how the approach is effective for the prediction of rainfall-runoff responses in ungauged catchments. To achieve this purpose, 6 small forest catchments are selected among the several hydrological experimental catchments operated by Korea Forest Research Institute. In each catchment, long-term hydrological time series data varying from 10 to 30 years were available. The areas of the selected catchments range from 13.6 to 37.8 ha, and all areas are covered by coniferous or broad-leaves forests. The selected catchments locate in the southern coastal area to the northern part of South Korea. The bed rocks are Granite gneiss, Granite or

Strategic Management in Hospitals: Tensions between the Managerial and Institutional Lens

Directory of Open Access Journals (Sweden)

Lucilaine Maria Pascuci

2017-07-01

Full Text Available The relationship between organizations and their environments has been object of study by scholars of the theory of organizations and in discussions concerning organizational strategy. When these perspectives come together, two sets of different but overlapping forces in the strategy formation process are highlighted. The purpose of this study is to analyze how strategic management contributed to reducing tensions derived from managerial and institutional logics in philanthropic hospitals. It is a comparative case study, with a multi-method approach. The data were examined using narrative and document analysis techniques. The analysis indicated that integrating organizational-managerialist and institutional perspectives raises continuous tensions within organizations with a direct impact on managerial decisions, strategic actions and performance. The strategic management approach should be sensitive enough to recognize and reduce these tensions and find ways to integrate them more effectively. This effort requires a combination of strong leadership skills and appropriate managerial tools. Flexibility, adaptability, creativity and informal interactions should be the basis of any strategic initiatives. Daring and innovation of the hospitals - more than acquiescence - are essential to their social and financial sustainability.

Long working hours and cancer risk: a multi-cohort study

NARCIS (Netherlands)

Heikkila, K.; Nyberg, S.T.; Madsen, I.E.; Vroome, E. de; Alfredsson, L.; Bjorner, J.B.; Borritz, M.; Burr, H.; Erbel, R.; Ferrie, J.E.; Fransson, E.; Geuskens, G.A.; Hooftman, W.E.; Houtman, I.L.; Jöckel, K.H.; Knutsson, A.; Koskenvuo, M.; Lunau, T.; Nielsen, M.L.; Nordin, M.; Oksanen, T.; Pejtersen, J.H.; Pentti, J.; Shipley, M.J.; Steptoe, A.; Suominen, S.B.; Theorell, T.; Vahtera, J.; Westerholm, P.J.M.; Westerlund, H.; Dragano, N.; Rugulies, R.; Kawachi, I.; Batty, G.D.; Singh-Manoux, A.; Virtanen, M.; Kivimäki, M.

2016-01-01

Background: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Methods: This multi-cohort study examined the association between working hours and cancer risk

77 FR 5261 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

Science.gov (United States)

2012-02-02

...)(6), Title 5 U.S.C., as amended. The contract proposals and the discussions could disclose... concerning individuals associated with the contract proposals, the disclosure of which would constitute a... Institute Special Emphasis Panel; SBIR Topic 68: Multi-Layer Coated Gratings for CT (Contract Review). Date...

Dose mapping of the multi-purpose gamma irradiation facility

Energy Technology Data Exchange (ETDEWEB)

Cabalfin, E G; Lanuza, L G; Villamater, D T [Irradiation Services, Nuclear Services and Training Division, Philippine Nuclear Research Institute, Quezon City (Philippines)

1989-12-01

In radiation processing, reliable dosimetry constitutes a very important part of process control and quality assurance. Radiation dosimetry is the only acceptable method to guarantee that the irradiated product has undergone the correct radiation treatment. In preparation therefore, for the routine operation of the newly installed multi-purpose gamma irradiation facility at the Philippine Nuclear Research Institute (PNRI), dose mapping distribution studies were undertaken. Results of dose distribution in air as well as in dummy product are presented. The effects of product bulk density, product geometry and product to source distance on minimum absorbed dose and uniformity ratio have been determined. (Author).

Dose mapping of the multi-purpose gamma irradiation facility

International Nuclear Information System (INIS)

Cabalfin, E.G.; Lanuza, L.G.; Villamater, D.T.

1989-01-01

In radiation processing, reliable dosimetry constitutes a very important part of process control and quality assurance. Radiation dosimetry is the only acceptable method to guarantee that the irradiated product has undergone the correct radiation treatment. In preparation therefore, for the routine operation of the newly installed multi-purpose gamma irradiation facility at the Philippine Nuclear Research Institute (PNRI), dose mapping distribution studies were undertaken. Results of dose distribution in air as well as in dummy product are presented. The effects of product bulk density, product geometry and product to source distance on minimum absorbed dose and uniformity ratio have been determined. (Author)

Helmholtz-Zentrum Dresden-Rossendorf, Institute of Safety Research. Annual report 2010

International Nuclear Information System (INIS)

Gerbeth, Gunter; Schaefer, Frank

2011-01-01

The Institute of Safety Research (ISR) was over the past 20 years one of the six Research Institutes of Forschungszentrum Dresden-Rossendorf e.V. (FZD), which in 2010 belonged to the Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz. Together with the Institutes of Radiochemistry and Radiation Physics, ISR implements the research programme ''Nuclear Safety Research'' (NSR), which was during last years one of the three scientific programmes of FZD. NSR involves two main topics, i.e. ''Safety Research for Radioactive Waste Disposal'' and ''Safety Research for Nuclear Reactors''. The research of ISR aims at assessing and enhancing the safety of current and future reactors, the development of advanced simulation tools including their validation against experimental data, and the development of the appropriate measuring techniques for multi-phase flows and liquid metals.

Photoemission spectroscopy study of a multi-alkali photocathode

CERN Document Server

Ettema, A R H

2000-01-01

In this paper a photoemission study of the highest core levels of the elements and the electron escape barrier (work function) in a multi-alkali photocathode are presented. The core levels indicate that the alkali atoms are in an oxidized state and therefore the compound Na sub 2 KSb can be regarded as an ionic semiconductor. The measured escape barrier of the Cs sub 2 O surface layer is determined as 2.3 eV.

Limited Scope Design Study for Multi-Sensor Towbody

Science.gov (United States)

2016-06-01

ports 2 Leak sensors 1 Electrical Surface supply voltage 300 V nominal (250–425 Vdc) Towbody output voltages 48/24/12 Vdc Load power...shallow water (អ m) at thousands of current and former Department of Defense (DoD) sites encompassing millions of acres. This design study...addresses the munitions remediation in shallow water problem with a system that uses a Multi-Sensor Towbody (MuST) and surface vessel with support

ICT-Aided Engineering Courses: A Multi-Campus Course Management

Science.gov (United States)

Dana-Picard, Thierry; Kidron, Ivy; Komar, Meir; Steiner, Joseph

2006-01-01

Jerusalem College of Technology (JCT) is a multi-campus institution with identical syllabi for courses in every campus. Moreover, learning at JCT requires at the same time synchronous and asynchronous learning and teaching. For some introductory courses in Mathematics for Engineering students, websites have been built and now upgraded in order to…

Institutional Repositories at Small Institutions in America: Some Current Trends

Science.gov (United States)

Nykanen, Melissa

2011-01-01

The research reported in this article was undertaken to determine the level of implementation of institutional repositories (IRs) at small institutions enrolling fewer than 10,000 students. The study analyzed quantitative and qualitative data from IRs at a number of small institutions with the aim of observing relevant patterns and trends that may…

Institutional Distance and International Business Strategies in Emerging Economies

DEFF Research Database (Denmark)

Ionascu, Delia Simona; Meyer, Klaus E.; Estrin, Saul

2004-01-01

The concept of `distance' has been used by international business scholars to explain variations in international business strategies and operations across countries. The more distant a host country is from the organizational centre of a multinational enterprise (MNE), the more it has to manage...... for the investing MNE. Using a unique dataset of foreign direct investment in emerging economies that incorporates multi-host as well as multi-home countries, we find empirical support for our propositions, and provide an explanation for apparently inconsistent results in the previous literature....... on Hofstede's work on culture. However, these measures capture only very partially the dimensions of distance of concern to international business. In this paper, we show how the broader theoretical concept of institutional distance, which incorporates normative, regulatory and cognitive aspects, affects...

A Multi-scale Modeling System with Unified Physics to Study Precipitation Processes

Science.gov (United States)

Tao, W. K.

2017-12-01

In recent years, exponentially increasing computer power has extended Cloud Resolving Model (CRM) integrations from hours to months, the number of computational grid points from less than a thousand to close to ten million. Three-dimensional models are now more prevalent. Much attention is devoted to precipitating cloud systems where the crucial 1-km scales are resolved in horizontal domains as large as 10,000 km in two-dimensions, and 1,000 x 1,000 km2 in three-dimensions. Cloud resolving models now provide statistical information useful for developing more realistic physically based parameterizations for climate models and numerical weather prediction models. It is also expected that NWP and mesoscale model can be run in grid size similar to cloud resolving model through nesting technique. Recently, a multi-scale modeling system with unified physics was developed at NASA Goddard. It consists of (1) a cloud-resolving model (Goddard Cumulus Ensemble model, GCE model), (2) a regional scale model (a NASA unified weather research and forecast, WRF), and (3) a coupled CRM and global model (Goddard Multi-scale Modeling Framework, MMF). The same microphysical processes, long and short wave radiative transfer and land processes and the explicit cloud-radiation, and cloud-land surface interactive processes are applied in this multi-scale modeling system. This modeling system has been coupled with a multi-satellite simulator to use NASA high-resolution satellite data to identify the strengths and weaknesses of cloud and precipitation processes simulated by the model. In this talk, a review of developments and applications of the multi-scale modeling system will be presented. In particular, the results from using multi-scale modeling system to study the precipitation, processes and their sensitivity on model resolution and microphysics schemes will be presented. Also how to use of the multi-satellite simulator to improve precipitation processes will be discussed.

Contribution to fundraising process at higher education institutions in Brazil

Directory of Open Access Journals (Sweden)

Valéria Riscarolli

2010-09-01

Full Text Available The target of this paper is to verify the usefulness of fundraising strategies of North-American Higher Education Institutions in the context of their Brazilian counterparts, in the view of latest managers. The research, qualitative in nature, was carried out within three North-American institutions and three Brazilian ones, using the multi-case research method, at an exploratory level. Twelve social subjects were interviewed and data were complemented through official documents. Main results indicate that fundraising in the researched North-American institutions is centralized, favored by proper culture and legislation, focuses individuals, is independent on geographical location of donors and is aligned to institutional attributes such as credibility, flexibility, convenience and interest of donors. Also, we found that volunteers are an essential ingredient to fundraising activities. In the Brazilian researched institutions, fundraising is still incipient, focuses on corporations, is still not a budget itemand volunteers are not used in the process. Due to the fundraising nature in the view of the Brazilian managers interviewed, there is no restriction to the use of the fundraising strategies from North-American institutions at Brazilian counterparts. We proposed, as a contribution, a model displaying the elements and its implications for the success of the fundraising process

International financial institutes and multipolarity challenges

Directory of Open Access Journals (Sweden)

Aleksei Vladimirovich Kuznetsov

2017-12-01

Full Text Available The world is changing, moving towards multi-polarity. However, despite the explicit shifting of the center of economic gravity from the West to the East, the dominance of the West in establishing the rules of conduct in the global economy and global finance remain virtually immutable. The author argues that the widely-discussed reform of the IMF quota and governance has not led to a significant strengthening of the role of the most dynamically developing emerging economies in the Fund’s decision-making. Regional economic players (such as the BRICS have been actively involved in the international division of labor. However, the existence of institutional financial monopolies hinders the redistribution of global value added. Armed with the advanced information technologies and financial innovations, the leaders of financial globalization are redirecting scarce global resources in favor of the world-systemic core. The study is based on comparative methods and system analysis and aims to provide a comprehensive view on the way of involvement of global financial institutions in the control of the processes of financial globalization. US dominance in international financial institutions contribute to the further advancement of the global role of dollar as reserve currency of central banks, the currency of international settlements, deposits, loans and investments. It’s shown that the implementation of financial globalization is strongly correlated with the concept of the «center-periphery» model, on which the functioning of the global capital market is dependent. The features of the modern structure of the global currency market are summarized. The article reveals some legal aspects of global governance, in particular the role of the Anglo-American law in the global economy and global finance. It is concluded that for full participation of emerging markets, particularly the BRICS countries, in the processes of globalization, it is necessary to

Institutional failures and transaction costs of Bulgarian private research institutes

OpenAIRE

Nozharov, Shteryo

2016-01-01

The paper analyses the reasons for poor performance of private research institutes in Bulgaria. In this regard the Institutional Economics methods are used. A connection between smart growth policy goals and Bulgarian membership in EU is made. The gaps in the institutional environment are identified as well as measures for their elimination are proposed. The main accent of the study is put on the identification of transaction costs, arisen as a result of the failures of the institutional envi...

Multi-Objective Optimization for Energy Performance Improvement of Residential Buildings: A Comparative Study

Directory of Open Access Journals (Sweden)

Kangji Li

2017-02-01

Full Text Available Numerous conflicting criteria exist in building design optimization, such as energy consumption, greenhouse gas emission and indoor thermal performance. Different simulation-based optimization strategies and various optimization algorithms have been developed. A few of them are analyzed and compared in solving building design problems. This paper presents an efficient optimization framework to facilitate optimization designs with the aid of commercial simulation software and MATLAB. The performances of three optimization strategies, including the proposed approach, GenOpt method and artificial neural network (ANN method, are investigated using a case study of a simple building energy model. Results show that the proposed optimization framework has competitive performances compared with the GenOpt method. Further, in another practical case, four popular multi-objective algorithms, e.g., the non-dominated sorting genetic algorithm (NSGA-II, multi-objective particle swarm optimization (MOPSO, the multi-objective genetic algorithm (MOGA and multi-objective differential evolution (MODE, are realized using the propose optimization framework and compared with three criteria. Results indicate that MODE achieves close-to-optimal solutions with the best diversity and execution time. An uncompetitive result is achieved by the MOPSO in this case study.

Comparative study of EBE (Equivalent Bilateral Exchanges) multi-area and Zbus multi-area methods to allocate costs by using the transmission system; Estudo comparativo dos metodos EBE multi-area e Zbus multi-area para alocacao de custos pelo uso do sistema de transmissao

Energy Technology Data Exchange (ETDEWEB)

Caparo, J.L.Ch.; Lima, D.A. [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil). Dept. de Engenharia Eletrica], Emails: jluis@ele.puc-rio.br, delberis@ele.puc-rio.br

2009-07-01

This work is dedicated to study and discuss two methods to solve the problem of cost allocation by the use of the transmission system in multi-areas for generators and loads. The EBE multi-area method (EBE MA), which is based on EBE, and the Zbus multi-area method (Zbus MA), which is based on Zbus method to allocate costs by using the transmission system, are presented and discussed. Results, analysis and conclusions were made with the 8-bar system, which allows a good interpretation of the behavior of methods.

In Good Company? A Multi-Study, Multi-Level Investigation of the Effects of Coworker Relationships on Employee Well-Being

Science.gov (United States)

Simon, Lauren S.; Judge, Timothy A.; Halvorsen-Ganepola, Marie D. K.

2010-01-01

Two multi-level studies were conducted to examine the effects of attitudes towards coworkers on daily well-being. Study 1 linked daily levels of coworker satisfaction to job satisfaction and life satisfaction and examined the extent to which job satisfaction mediated the relationship between coworker satisfaction and life satisfaction among 33…

The greening of higher education: A case study in three institutions in Medellin, Colombia

International Nuclear Information System (INIS)

Gomez, Catherine; Botero, Camilo M

2012-01-01

Incorporation of environmental variable (greening) in the daily routine of universities has taken force from the ends of the 20th century and nowadays its implementation in Colombia is a fact. This research project evaluated the grade of incorporation of such a variable in mission purposes of three higher education institutions in Medellin (Colombia). It included two different education levels (professional and technical) and used qualitative techniques (interviews to two teachers in each institution, one hour visits to two courses in each institution, and checklists for every visit as well as for the institutional analysis). In all the three study cases the environment is part of the institutional commitments, including their education, research, management processes, as well as activities with the society. This was reflected in the integration of greening in the curricula, the promotion of the research in environmental topics, the interdisciplinary cooperation and the adoption of internal policies. This work identifies some elements to develop the environmental education as a tool to comprehend the society and its environment as a whole; it constitutes a base for discussions, shows the advance of the three studied institutions, and discovers that shortcomings, that should be addressed, still exist.

Spinal cord gliomas: A multi-institutional retrospective analysis

International Nuclear Information System (INIS)

Abdel-Wahab, May; Etuk, Blessing; Palermo, James; Shirato, Hiroki; Kresl, John; Yapicier, Ozlem; Walker, Gail; Scheithauer, Bernd W.; Shaw, Edward; Lee, Charles; Curran, Walter; Thomas, Terry; Markoe, Arnold

2006-01-01

Purpose: To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas. Patients and Methods: Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed. Results: A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01). Conclusion: Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS

Multi-institutional application of Failure Mode and Effects Analysis (FMEA) to CyberKnife Stereotactic Body Radiation Therapy (SBRT).

Science.gov (United States)

Veronese, Ivan; De Martin, Elena; Martinotti, Anna Stefania; Fumagalli, Maria Luisa; Vite, Cristina; Redaelli, Irene; Malatesta, Tiziana; Mancosu, Pietro; Beltramo, Giancarlo; Fariselli, Laura; Cantone, Marie Claire

2015-06-13

A multidisciplinary and multi-institutional working group applied the Failure Mode and Effects Analysis (FMEA) approach to assess the risks for patients undergoing Stereotactic Body Radiation Therapy (SBRT) treatments for lesions located in spine and liver in two CyberKnife® Centres. The various sub-processes characterizing the SBRT treatment were identified to generate the process trees of both the treatment planning and delivery phases. This analysis drove to the identification and subsequent scoring of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system. Novel solutions aimed to increase patient safety were accordingly considered. The process-tree characterising the SBRT treatment planning stage was composed with a total of 48 sub-processes. Similarly, 42 sub-processes were identified in the stage of delivery to liver tumours and 30 in the stage of delivery to spine lesions. All the sub-processes were judged to be potentially prone to one or more failure modes. Nineteen failures (i.e. 5 in treatment planning stage, 5 in the delivery to liver lesions and 9 in the delivery to spine lesions) were considered of high concern in view of the high RPN and/or severity index value. The analysis of the potential failures, their causes and effects allowed to improve the safety strategies already adopted in the clinical practice with additional measures for optimizing quality management workflow and increasing patient safety.

South-East Asia: Emerging Regional Identity. Interview with prof. Dmitry Mosyakov (Institute of Oriental Studies of the Russian Academy of Sciences

Directory of Open Access Journals (Sweden)

Н С Куклин

2017-12-01

Full Text Available Dmitry Mosyakov, leading Russian expert on South-East Asia, graduated from the History and Philology Department of Institute of Asian and African Countries at Lomonosov Moscow State Uni-versity, majoring as an interpreter of the Khmer language in 1979. In 1979-1983 he studied in the post-graduate school of the Institute of Oriental Studies of the Academy of Sciences of the USSR. In 1983 he defended his thesis on the problems of the Pol Pot regime in Cambodia. He works for the Institute of Oriental Studies (IOS since 1985. In 1991, he was trained at the Yale University (USA. In 1994 he defended his doctoral dissertation on the modern history of Cambodia. He is the organizer of the multi-year project “Monitoring of the Modern History of Southeast Asian Countries”, within which the IOS hosts the annual inter-institute conference and, according to the results of the conferences, its materials are published in the peer-reviewed academic journal “Southeast Asia: To-pical Problems of Development”. Dmitry Mosyakov is an editor-in-chief of this journal. He is also the head of the center of South-Eastern Asia, Australia and Oceania of IOS, a member of the Academic Council of the IOS. He is a member of the dissertation council for historical sciences at the IOS, Moscow State Uni-versity, and of the editorial board of the journal “Asia and Africa Today”. Since 2001 he is a Professor and the head of the department of regional studies at the Moscow Humanitarian University (part-time. In 2015, Dmitry Mosyakov was the provisional director of the IOS. Since 2013 he is a member of Editorial Board of Vestnik RUDN. International Relations. The interview includes following topics: the state of development of the South-East Asian studies in Russia and abroad, the perception of international processes in the region, the contemporary problems of the South-East Asia, and the cooperation of Russia and the Eurasian Economic Union countries and integration

Strategies for Business Schools in a Multi-Polar World

Science.gov (United States)

Dameron, Stephanie; Durand, Thomas

2013-01-01

Purpose: The purpose of this paper is to examine the contours of the emerging business education and institutions in a multi-polar world and to identify the causes of the strategic convergence of management education, to explore the limitations of the dominant models of management education and to propose a range of strategic alternatives for…

EAGLE 2006 – Multi-purpose, multi-angle and multi-sensor in-situ and airborne campaigns over grassland and forest

Directory of Open Access Journals (Sweden)

Z. Su

2009-06-01

Full Text Available EAGLE2006 – an intensive field campaign for the advances in land surface hydrometeorological processes – was carried out in the Netherlands from 8th to 18th June 2006, involving 16 institutions with in total 67 people from 16 different countries. In addition to the acquisition of multi-angle and multi-sensor satellite data, several airborne instruments – an optical imaging sensor, an imaging microwave radiometer, and a flux airplane – were deployed and extensive ground measurements were conducted over one grassland site at Cabauw and two forest sites at Loobos and Speulderbos in the central part of the Netherlands. The generated data set is both unique and urgently needed for the development and validation of models and inversion algorithms for quantitative land surface parameter estimation and land surface hydrometeorological process studies. EAGLE2006 was led by the Department of Water Resources of the International Institute for Geo-Information Science and Earth Observation (ITC and originated from the combination of a number of initiatives supported by different funding agencies. The objectives of the EAGLE2006 campaign were closely related to the objectives of other European Space Agency (ESA campaign activities (SPARC2004, SEN2FLEX2005 and especially AGRISAR2006. However, one important objective of the EAGLE2006 campaign is to build up a data base for the investigation and validation of the retrieval of bio-geophysical parameters, obtained at different radar frequencies (X-, C- and L-Band and at hyperspectral optical and thermal bands acquired simultaneously over contrasting vegetated fields (forest and grassland. As such, all activities were related to algorithm development for future satellite missions such as the Sentinels and for validation of retrievals of land surface parameters with optical and thermal and microwave sensors onboard current and future satellite missions. This contribution describes the campaign objectives and

The challenges of multi-layered security governance in Ituri

DEFF Research Database (Denmark)

Hoffmann, Kasper; Vlassenroot, Koen

governance is that the inclusion of local non-state actors in security governance will improve security provision to people because they have more legitimacy. But in reality ‘multi-layered’ security governance is often marked by conflict and competition as much as by collaboration and common solutions......There has been a slow, but growing awareness among external actors that some local non-state security actors should be involved in security governance in conflict-affected situations. Already in 2006, the OECD published a report that called for a ‘multi-layered’ approach to reforming actors...... and institutions that provide security and justice services (Scheye and McLean, 2006). Often these actors consist of local authorities, such as customary chiefs, village elders, or business people working in collaboration with different kinds of self-defense groups. The idea behind ‘multi-layered’ security...

Software network analyzer for computer network performance measurement planning over heterogeneous services in higher educational institutes

OpenAIRE

Ismail, Mohd Nazri

2009-01-01

In 21st century, convergences of technologies and services in heterogeneous environment have contributed multi-traffic. This scenario will affect computer network on learning system in higher educational Institutes. Implementation of various services can produce different types of content and quality. Higher educational institutes should have a good computer network infrastructure to support usage of various services. The ability of computer network should consist of i) higher bandwidth; ii) ...

Marketing within higher education institutions - A case study of two private Thai universities

OpenAIRE

Starck, Kristian; Zadeh, Shahriyar Hossein

2013-01-01

Date of final seminar: 2013-05-29. Academic level: Master Thesis in Business Administration, 15 ECTS. University: Mälardalen University, Västerås, Sweden. Institution: The School of Business, Science and Engineering. Authors: Kristian Starck and Shahriyar Hossein Zadeh. Title: Marketing within higher education institutions - A case study of two private Thai universities. Supervisor: Peter Ekman. Examiner: Eva Manninen Olsson. Purpose: The purpose of this study is to describe and analyze what ...

Multi-population genomic prediction using a multi-task Bayesian learning model.

Science.gov (United States)

Chen, Liuhong; Li, Changxi; Miller, Stephen; Schenkel, Flavio

2014-05-03

Genomic prediction in multiple populations can be viewed as a multi-task learning problem where tasks are to derive prediction equations for each population and multi-task learning property can be improved by sharing information across populations. The goal of this study was to develop a multi-task Bayesian learning model for multi-population genomic prediction with a strategy to effectively share information across populations. Simulation studies and real data from Holstein and Ayrshire dairy breeds with phenotypes on five milk production traits were used to evaluate the proposed multi-task Bayesian learning model and compare with a single-task model and a simple data pooling method. A multi-task Bayesian learning model was proposed for multi-population genomic prediction. Information was shared across populations through a common set of latent indicator variables while SNP effects were allowed to vary in different populations. Both simulation studies and real data analysis showed the effectiveness of the multi-task model in improving genomic prediction accuracy for the smaller Ayshire breed. Simulation studies suggested that the multi-task model was most effective when the number of QTL was small (n = 20), with an increase of accuracy by up to 0.09 when QTL effects were lowly correlated between two populations (ρ = 0.2), and up to 0.16 when QTL effects were highly correlated (ρ = 0.8). When QTL genotypes were included for training and validation, the improvements were 0.16 and 0.22, respectively, for scenarios of the low and high correlation of QTL effects between two populations. When the number of QTL was large (n = 200), improvement was small with a maximum of 0.02 when QTL genotypes were not included for genomic prediction. Reduction in accuracy was observed for the simple pooling method when the number of QTL was small and correlation of QTL effects between the two populations was low. For the real data, the multi-task model achieved an

Aerolization During Boron Nanoparticle Multi-Component Fuel Group Burning Studies

Science.gov (United States)

2014-02-03

overall energy density of the multi-component fuel mixture. Boron nanoparticle- doped multi-component hydrocarbon fuels represent a potential high...addressed, Boron nanoparticle- doped multi-component hydrocarbon fuels represent a potential high-efficiency, tactical fuel that could increase thrust...and micron-sized aluminum particles. Combustion and Flame 158(2): 354-368. Gan, Y., Y. S. Lim, and L. Qiao. 2012. Combustion of nanofluid fuels

A study on multi-cultural family wives adapting to Korean cuisine and dietary patterns

OpenAIRE

Park, Youngil; Jeong, Hee Sun; Joo, Nami

2010-01-01

With the increase in multi-cultural families, Korea is seeing a rapid increase in immigrated housewives, who are closely related to food culture. However, studies for the diet of multi-cultural families, which is most closely related to our lives have not been sufficiently researched. With this background, this study conducted research for immigrated women nationwide about food cultures to provide the possibility which Korean food culture would be developed harmoniously with various foreign f...

Is an institute for the study of high-level radioactive waste disposal needed in southern Nevada?

International Nuclear Information System (INIS)

Blanchard, M.B.; Robison, A.C.; Baepler, D.H.

1993-01-01

This paper examines key questions about the need for a formal institute that would study storage and disposal concepts for high-level radioactive waste (HLRW) in the United States and throughout the world. The questions that have been analyzed so far include: Why is an institute needed? What could this institute do to achieve the goal? How could an institute of this nature work? When could an institute form and begin functioning to meet the goals? Where could an institute be located?

Multi-institutional collaborating study on CT scan of schizophrenia

International Nuclear Information System (INIS)

Takahashi, Ryo; Sato, Tokijiro; Okuma, Teruo

1984-01-01

More abnormal CT findings were observed in nuclear schizophrenic patients (55%) than in the matchable controls with a statistically significant difference. According to the site of the brain, these were marked in the whole ventricle (especially the third ventricle) and in the cortex including the longitudinal fissure, frontal lobe, temporal lobe, and sylvian fissure (especially of the left hemisphere). There was no correlation between the cerebral ventricular enlargement and the patient's age, the duration of illness or drug dosage, suggesting that the enlargement may exist from the onset of the disease. Aging or taking drug(s) were also not responsible for the cortical atrophy. CT findings were associated mainly with negative symptoms. In particular, the association between abnormalities of the left hemisphere and psychiatric symptoms was marked. Direct measurements of CT images revealed significantly higher incidences only in the third ventricular enlargement in schizophrenic patients. These results suggest the possibility that subtypes of schizophrenia can be classified. (Namekawa, K.)

MUSE: the Multi-Slit Solar Explorer

Science.gov (United States)

Tarbell, Theodore D.; De Pontieu, Bart

2017-08-01

The Multi-Slit Solar Explorer is a proposed Small Explorer mission for studying the dynamics of the corona and transition region using both conventional and novel spectral imaging techniques. The physical processes that heat the multi-million degree solar corona, accelerate the solar wind and drive solar activity (CMEs and flares) remain poorly known. A breakthrough in these areas can only come from radically innovative instrumentation and state-of-the-art numerical modeling and will lead to better understanding of space weather origins. MUSE’s multi-slit coronal spectroscopy will use a 100x improvement in spectral raster cadence to fill a crucial gap in our knowledge of Sun-Earth connections; it will reveal temperatures, velocities and non-thermal processes over a wide temperature range to diagnose physical processes that remain invisible to current or planned instruments. MUSE will contain two instruments: an EUV spectrograph (SG) and EUV context imager (CI). Both have similar spatial resolution and leverage extensive heritage from previous high-resolution instruments such as IRIS and the HiC rocket payload. The MUSE investigation will build on the success of IRIS by combining numerical modeling with a uniquely capable observatory: MUSE will obtain EUV spectra and images with the highest resolution in space (1/3 arcsec) and time (1-4 s) ever achieved for the transition region and corona, along 35 slits and a large context FOV simultaneously. The MUSE consortium includes LMSAL, SAO, Stanford, ARC, HAO, GSFC, MSFC, MSU, ITA Oslo and other institutions.

A Study on Course Management System Implementation in Indonesian Higher Education Institutions

Science.gov (United States)

Saputra, Y. A.; Singgih, M. L.; Latiffianti, E.; Suryani, E.; Mudjahidin

2018-04-01

Information technology development nowadays has brought new colors in the higher education learning process. In Indonesia, the current trend showed a higher use of CMS to support the existing conventional learning method in the classrooms. This paper attempts to understand the characteristics of CMS implementation based on a survey at several higher education institutions in Indonesia. There were 9 selected higher education institutions observed in this study. The objectives were to find out the CMS implementation in terms of: 1) the management of CMS implementation, 2) the evaluation, 3) originality of materials, platform, and feature; and 4) participation level. The result showed that the use of CMS in these institutions, in general, was to support the classroom conventional learning method by providing a repository of lecture notes and communication forum/media outside the classroom. The management task mostly was taken care by a specific unit. A Moodle (freeware) was found as a typical platform in use, and none of the institutions chose to use paid platform i.e. Blackboard. The accessibility of CMS used was kept closed for limited group of people due to high cost of material originality assurance. Observation also found that there was not much attempts in evaluating the success of CMS implementation in each institution, whereas the success measurement was limited to the users’ satisfaction level. The majority of institutions claimed a good internal participation level (with lecturers and students as the main users), but in general we found that lecturer participation in most institutions were low or even very low.

Regional hyperthermia combined with radiotherapy for locally advanced non-small cell lung cancers. A multi-institutional prospective randomized trial of the International Atomic Energy Agency

International Nuclear Information System (INIS)

Mitsumori, Michihide; Hiraoka, Masahiro; Zeng Zhifan; Oliynychenko, P.; Park, Jeong-Ho; Choi, Ihl-Bohng; Tatsuzaki, Hideo; Tanaka, Yoshiaki

2007-01-01

An International Atomic Energy Agency (IAEA)-sponsored, multi-institutional prospective randomized trial was conducted to clarify whether the combination of hyperthermia and radiotherapy improves the local response rate of locally advanced non-small cell lung cancer (NSCLC) compared with that obtained by radiotherapy alone. Between October 1998 and April 2002, 80 patients with locally advanced NSCLC were randomized to receive either standard radiation therapy alone (RT) or radiation therapy combined with hyperthermia (RT+HT). The primary endpoint was the local response rate. The secondary endpoints were local progression-free survival and overall survival. The median follow-up period was 204 days for all patients and 450 days for surviving patients. There were no significant differences between the two arms with regard to local response rate (P=0.49) or overall survival rate (P=0.868). However, local progression-free survival was significantly better in the RT+HT arm (P=0.036). Toxicity was generally mild and no grade 3 late toxicity was observed in either arm. Although improvement of local progression-free survival was observed in the RT+HT arm, this prospective randomized study failed to show any substantial benefit from the addition of hyperthermia to radiotherapy in the treatment of locally advanced NSCLC. (author)

NATO Advanced Study Institute and International School of Materials Science and Technology

CERN Document Server

Balkanski, Minko; 15th Course on Solid State Microbatteries

1990-01-01

This Advanced Study Institute on the topic of SOLID STATE MICROBATTERIES is the third and final institute on the general theme of a field of study now termed "SOLID STATE IONICS". The institute was held in Erice, Sicily, Italy, 3 - 15 July 1988. The objective was to assemble in one location individuals from industry and academia expert in the fields of microelectronics and solid state ionics to determine the feasibility of merging a solid state microbattery with microelectronic memory. Solid electrolytes are in principle amenable to vapor deposition, RF or DC sputtering, and other techniques used to fabricate microelectronic components. A solid state microbattery 1 1 mated on the same chip carrier as the chip can provide on board memory backup power. A solid state microbattery assembled from properly selected anode/solid electrolyte/cathode materials could have environmental endurance properties equal or superior to semiconductor memory chips. Lectures covering microelectronics, present state-of-art solid sta...

The nitrogen footprint tool network: a multi-institution program to reduce nitrogen pollution

Science.gov (United States)

Anthropogenic sources of reactive nitrogen have local and global impacts on air and water quality and detrimental effects on human and ecosystem health. This paper uses the nitrogen footprint tool (NFT) to determine the amount of nitrogen (N) released as a result of institutional...

Circulation Policies for External Users: A Comparative Study of Public Urban Research Institutions

Science.gov (United States)

Weare, William H., Jr.; Stevenson, Matthew

2012-01-01

This article is a study of the policies that govern the use of the university library by external users at Indiana University-Purdue University Indianapolis (IUPUI) and 12 peer institutions used by IUPUI for comparative purposes. A search of each institution's Web site was conducted as well as interviews with circulation librarians and managers.…

Colonial Institutions

DEFF Research Database (Denmark)

McAtackney, Laura; Palmer, Russell

2016-01-01

and the USA which reveal that the study of colonial institutions should not be limited to the functional life of these institutions—or solely those that take the form of monumental architecture—but should include the long shadow of “imperial debris” (Stoler 2008) and immaterial institutions....

Factors Affecting Women Enrolment In Technical Institutions In Tanzania A Case Study Of Arusha Technical College

OpenAIRE

Glory B. Kaaya; Dr. Esther Waiganjo

2015-01-01

Abstract The purpose of this study was to investigate the factors affecting women enrolment in Technical Institutions in Tanzania by focusing on the women. The study examined in detail the factors affecting women enrolment in Technical institutions and Arusha Technical College in particular as well as exploring sexual dynamics within Technical Institutions. Moreover a number of theoretical frameworks were concerned basing on the objectives a case study design was employed involving both qua...

Helmholtz-Zentrum Dresden-Rossendorf, Institute of Safety Research. Annual report 2010

Energy Technology Data Exchange (ETDEWEB)

Gerbeth, Gunter; Schaefer, Frank (eds.)

2011-07-01

The Institute of Safety Research (ISR) was over the past 20 years one of the six Research Institutes of Forschungszentrum Dresden-Rossendorf e.V. (FZD), which in 2010 belonged to the Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz. Together with the Institutes of Radiochemistry and Radiation Physics, ISR implements the research programme ''Nuclear Safety Research'' (NSR), which was during last years one of the three scientific programmes of FZD. NSR involves two main topics, i.e. ''Safety Research for Radioactive Waste Disposal'' and ''Safety Research for Nuclear Reactors''. The research of ISR aims at assessing and enhancing the safety of current and future reactors, the development of advanced simulation tools including their validation against experimental data, and the development of the appropriate measuring techniques for multi-phase flows and liquid metals.

INTRODUCING INSTITUTIONAL VARIABLES IN THE ENVIRONMENTAL KUZNETS CURVE (EKC: A LATIN AMERICAN STUDY

Directory of Open Access Journals (Sweden)

ITALO ARBULÚ VILLANUEVA

2012-03-01

Full Text Available Several studies have examined the relationship between environmental degradation and per capita income.However, most of them did not take into account institutional quality and just focused on macroeconomicdeterminants. The purpose of this paper is to fill this gap in the literature by assessing the effects on theEnvironmental Kuznets Curve (EKC when institutional quality variables are introduced, especially those related tocorruption and rent-seeking behavior.This study considers 18 Latin American economies and panel data for 1998–2005. A standard reducedformmodeling approach with pool estimation was employed and, in order to introduce the heterogeneity of thedifferent countries, three different models were estimated. The first model corresponds to the basic EnvironmentalKuznets Curve (Basic Model, the second model introduced a sets of additional economic variables (ExtendedModel Nº 1, and finally, the third one introduced institutional variables into the previous formulation (ExtendedModel Nº 2.The expected results from this investigation lead us to support the EKC hypothesis while confirming theimportance of improvements in political institutions and governance for better environmental performances in theregion.

Cluster Policy in the Light of Institutional Context—A Comparative Study of Transition Countries

Directory of Open Access Journals (Sweden)

Tine Lehmann

2015-10-01

Full Text Available The business environment in transition countries is often extraordinarily challenging for companies. The transition process these countries find themselves in leads to constant changes in the institutional environment. Hence, institutional voids prevail. These institutional voids cause competitive disadvantages for small and medium enterprises. Cluster policy can address these competitive disadvantages. As cluster policy generally aims at supporting companies’ competitive advantage by spurring innovation and productivity, it can help to bridge institutional voids. This article’s research question aims at analyzing and comparing cluster policies in the institutional context of two transition countries (Serbia and Tunisia and analyzes to what extent cluster policies in these two countries are adapted to institutional voids prevailing there. The case studies offer insights into apparent difficulties of clusters in bridging formal institutional voids, as well as, notably, into the informal void of skill mismatches in the labor market. Still, for some specific voids, clusters do at least implicitly assume a bridging role. While the cluster policies examined do not explicitly target the institutional voids identified, cluster management can—in the course of time—align its service offering more closely with these voids. Bottom-up designed cluster policies can play an especially important role in such an evolution towards bridging institutional voids.

What are Institutional Logics

DEFF Research Database (Denmark)

Berg Johansen, Christina; Waldorff, Susanne Boch

This study presents new insights into the explanatory power of the institutional logics perspective. With outset in a discussion of seminal theory texts, we identify two fundamental topics that frame institutional logics: overarching institutional orders guides by institutional logics, as well...... as change and agency generated by friction between logics. We use these topics as basis for an analysis of selected empirical papers, with the aim of understanding how institutional logics contribute to institutional theory at large, and which social matters institutional logics can and cannot explore...

Case study: Accelerated schedule for MULTI LIMS installation

International Nuclear Information System (INIS)

Ibsen, T.G.

1994-05-01

This presentation focuses on the steps taken by the Westinghouse Hanford Company to meet an accelerated schedule for configuration and implementation of the MULTI LIMS in a multiple laboratory environment. The Westinghouse Hanford Company purchased the MULTI LIMS Laboratory Information Management System in August, 1993. Hardware delivery began in October, 1993. Less than four months later, the initial configuration was released for use in two Westinghouse Hanford Company laboratories. Several major obstacles were overcome during implementation. These include information gathering for base table loading, user training, acceptance of the new system by users of a legacy system, and hardware configuration issues. In summary, steps needed to be taken to meet the accelerated implementation schedule of the MULTI LIMS at the Hanford Site. The obstacles faced were overcome through the in-depth knowledge and help of the vendor and the dedication and drive of the technical staff

Multi-parameter observation of environmental asbestos pollution at the Institut de Physique du Globe de Paris (Jussieu Campus, France).

Science.gov (United States)

Besson, P; Lalanne, F X; Wang, Y; Guyot, F

1999-11-01

An original multi-parameter system has been used to study the nature of dust in the ambient air, particularly the total fibers and asbestos fibers, in eight areas of the Institut de Physique de Globe de Paris (France). These analyses provide a detailed case study of environmental pollution by asbestos fibers at low levels. The levels of total fibers with a length greater than 3 microns, measured with a real time fiber analyser monitor (FAM), give a baseline of 2.5 fibers per l., throughout the duration of sampling. The same levels, calculated during periods of effective presence of staff, are smaller than 10 fb per l. During these periods, the instantaneous value can show high peaks, reaching a maximum of 60 fb per l., but more often of about 5 to 10 fb per l. A direct cause and effect relationship exists between fiber concentrations and the presence of people, and indirectly with the variation of the other environmental parameters (temperature, humidity, air velocity). The baseline concentration of asbestos fibers, determined by analytical transmission electron microscopy (ATEM), is about 10(-1) fb per l., with a mean value during the presence of people always less than 1.5 fb per l. The low levels of asbestos fibers do not allow us to establish a precise correlation between the concentration of total fibers and the asbestos concentration, but a rough estimate suggests that asbestos could represent 10-20% of the airborne fibers monitored with the FAM. The statistical study of fiber sizes shows that 70 and 55% of analyzed chrysotile and amosite fibers respectively are smaller than 5 microns. These numbers are 40 and 35% for fibers smaller than 3 microns, which are undetected by the FAM. Amosite, which characterizes most of the asbestos-containing materials (ACM) in the analyzed areas, is detected in the ambient air in quantities ten times less important than chrysotile. The low asbestos levels and the difference between the nature of building asbestos and airborne

Performance evaluation of open core gasifier on multi-fuels

Energy Technology Data Exchange (ETDEWEB)

Bhoi, P.R.; Singh, R.N.; Sharma, A.M.; Patel, S.R. [Thermo Chemical Conversion Division, Sardar Patel Renewable Energy Research Institute (SPRERI), Vallabh Vidyanagar 388 120, Gujarat (India)

2006-06-15

Sardar Patel renewable energy research institute (SPRERI) has designed and developed open core, throat-less, down draft gasifier and installed it at the institute. The gasifier was designed for loose agricultural residues like groundnut shells. The purpose of the study is to evaluate the gasifier on multi-fuels such as babul wood (Prosopis juliflora), groundnut shell briquettes, groundnut shell, mixture of wood (Prosopis juliflora) and groundnut shell in the ratio of 1:1 and cashew nut shell. The gasifier performance was evaluated in terms of fuel consumption rate, calorific value of producer gas and gasification efficiency. Gasification efficiency of babul wood (Prosopis juliflora), groundnut shell briquettes, groundnut shell, mixture of Prosopis juliflora and groundnut shell in the ratio of 1:1 and cashew nut shell were 72%, 66%, 70%, 64%, 70%, respectively. Study revealed that babul wood (Prosopis juliflora), groundnut shell briquettes, groundnut shell, mixture of wood (Prosopis juliflora) and groundnut shell in the ratio of 1:1 and cashew nut shell were satisfactorily gasified in open core down draft gasifier. The study also showed that there was flow problem with groundnut shell. (author)

Factors associated with institutional delivery in Dangila district, North West Ethiopia: a cross-sectional study.

Science.gov (United States)

Demilew, Yeshalem Mulugeta; Gebregergs, Gebremedhin Berhe; Negusie, Azezu Asres

2016-03-01

Childbirth in a health institution has been shown to be associated with lower rates of maternal and neonatal mortality. However, about 85% of mothers in Ethiopia deliver at home. To assess factors associated with institutional delivery service utilization among women who gave birth within one year prior to the study in Dangila district. A cross-sectional study was conducted from February 01-28, 2015. A total of 763 mothers were interviewed using structured questionnaire. SPSS version 20 was used for analysis. Crude and adjusted Odds ratios were computed for selected variables. A P-value less than 0.05 was considered statistical significant. Only 18.3% of mothers gave birth at health facilities. Knowledge on danger signs [AOR=2.0, 95% CI: (1.1, 3.4)], plan to give birth at health institution [AOR=5.4, 95% CI: (3.0, 9.6)], having ANC follow up during pregnancy [AOR=12.9, 95% CI: (5.0, 33.3)] and time taken to get to a nearby health institution [AOR=5.1, 95% CI: (2.9, 9.1)] were associated with institutional delivery service utilization. Institutional delivery was very low. Knowledge about danger signs, having ANC visits, and time were factors associated with institutional delivery service utilization. Thus, the findings recommend repeated re-enforcement of institutional delivery service utilization through professionals. And also, the findings recommend promotion of institutional delivery service utilization through mass media.

Understanding Indian Institutional Networks and Participation in Water Management Adaptation to Climate Change

Science.gov (United States)

Azhoni, A.; Holman, I.; Jude, S.

2014-12-01

Adaptation to climate change for water management involves complex interactions between different actors and sectors. The need to understand the relationships between key stakeholder institutions (KSIs) is increasingly recognized. The complexity of water management in India has meant that enhancing adaptive capacity through improved inter-institutional networks remains a challenge for both government and non-governmental institutions. To analyse such complex inter-actions this study has used Social Network and Stakeholder Analysis tools to quantify the participation of, and interactions between, each KSI in the climate change adaptation and water discourse based on keyword analysis of their online presence. Using NodeXL, a Social Network Analysis tool, network diagrams have been used to evaluate the inter-relationships between these KSIs. Semi-structured interviews were conducted with twenty-five KSIs to identify the main barriers to adaptation and to triangulate the findings of the e-documents analysis. The analysis found that there is an inverse relationship between institutions' reference to water and climate change in their web-documents. Most institutions emphasize mitigation rather than adaptation. Bureaucratic delays, poor coordination between the KSIs, unclear policies and systemic deficiencies are identified as key barriers to improving adaptive capacity within water management to climate change. However, the increasing attention being given to the perceived climate change impacts on the water sector and improving the inter-institutional networks are some of the opportunities for Indian water institutions. Although websites of Union Government Institutions seldom directly hyperlink to one another, they are linked through "bridging" websites which have the potential to act as brokers for enhancing adaptive capacity. The research has wider implications for analysis of complex inter-disciplinary and inter-institutional issues involving multi stakeholders.

Behavioural Biometrics for Multi-factor Authentication in Biomedicine

Czech Academy of Sciences Publication Activity Database

Schlenker, Anna; Šárek, M.

2012-01-01

Roč. 8, č. 5 (2012), s. 19-24 ISSN 1801-5603 Grant - others:GA MŠk(CZ) LM2010005; GA UK(CZ) SVV-2012-264513 Institutional support: RVO:67985807 Keywords : biometric s * anatomical-physiological biometric s * behavioural biometric s * multi-factor authentication * keystroke dynamics * mouse dynamics Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/img/ejbi/2012/5/Schlenker_en.pdf

Approaches to developing the capacity of health policy analysis institutes: a comparative case study

Directory of Open Access Journals (Sweden)

Bennett Sara

2012-03-01

Full Text Available Abstract Objectives To review and assess (i the factors that facilitate the development of sustainable health policy analysis institutes in low and middle income countries and (ii the nature of external support for capacity development provided to such institutes. Methods Comparative case studies of six health policy analysis institutes (3 from Asia and 3 from Africa were conducted. In each region an NGO institute, an institute linked to government and a university based institute were included. Data collection comprised document review, semi-structured interviews with stakeholders and discussion of preliminary findings with institute staff. Findings The findings are organized around four key themes: (i Financial resources: three of the institutes had received substantial external grants at start-up, however two of these institutes subsequently collapsed. At all but one institute, reliance upon short term, donor funding, created high administrative costs and unpredictability. (ii Human resources: the retention of skilled human resources was perceived to be key to institute success but was problematic at all but one institute. In particular staff often moved to better paid positions elsewhere once having acquired necessary skills and experience, leaving remaining senior staff with heavy workloads. (iii Governance and management: board structures and roles varied according to the nature of institute ownership. Boards made important contributions to organizational capacity through promoting continuity, independence and fund raising. Routine management systems were typically perceived to be strong. (iv Networks: linkages to policy makers helped promote policy influences. External networks with other research organizations, particularly where these were longer term institutional collaborations helped promote capacity. Conclusions The development of strong in-country analytical and research capacity to guide health policy development is critical, yet

Determinants of organizational citizenship behavior: A case study of higher education institutes in Pakistan

Directory of Open Access Journals (Sweden)

Nazia Bashir

2012-01-01

Full Text Available This study empirically examines the relationship between altruism, conscientiousness, and civic virtue, three of the antecedents of organizational citizenship behavior, in higher education institutes in the Khyber Pakhtonkhuwa Province (KPK of Pakistan. The study is based on primary data collected from ninety-five employees of various institutes in Pakistan. The data is analyzed using the techniques of rank correlation coefficient and multiple regression analysis. All the findings are tested at 0.01 and 0.05 levels of significance. The result concludes that altruism, conscientiousness, and civic virtue have strong positive impacts on the organizational citizenship behavior in the context of higher education institutes in Pakistan.

Comparison of observed and modeled seasonal crustal vertical displacements derived from multi-institution GPS and GRACE solutions

Science.gov (United States)

Gu, Yanchao; Fan, Dongming; You, Wei

2017-07-01

Eleven GPS crustal vertical displacement (CVD) solutions for 110 IGS08/IGS14 core stations provided by the International Global Navigation Satellite Systems Service Analysis Centers are compared with seven Gravity Recovery and Climate Experiment (GRACE)-modeled CVD solutions. The results of the internal comparison of the GPS solutions from multiple institutions imply large uncertainty in the GPS postprocessing. There is also evidence that GRACE solutions from both different institutions and different processing approaches (mascon and traditional spherical harmonic coefficients) show similar results, suggesting that GRACE can provide CVD results of good internal consistency. When the uncertainty of the GPS data is accounted for, the GRACE data can explain as much as 50% of the actual signals and more than 80% of the GPS annual signals. Our study strongly indicates that GRACE data have great potential to correct the nontidal loading in GPS time series.

[Establishing and hosting an Institute for Fusion Studies

International Nuclear Information System (INIS)

Baldwin, D.E.

1989-07-01

Significant progress was made during the past year in carrying out theoretical investigations pursuant to the scientific mission of the Institute. These achievements may be approximately classified in terms of the following categories (often with considerable overlap): sawteeth and MHD studies, turbulence theory and plasma transport, computational plasma physics, stability theory, mathematical physics, advanced ideas, and space plasma physics-related problems. An overview of this work is contained in this report. Detailed summaries of IFS Reports written during FY 89 are given in abstract form

A study on multi-data source fusion method for petroleum pipeline leak detection

Energy Technology Data Exchange (ETDEWEB)

Liang, Wei; Zhang, Laibin [Research Center of Oil and Gas Safety Engineering Technology, China University of Petroleum, Beijing, (China)

2010-07-01

The detection of leaks on petroleum pipeline is a very important safety issue. Several studies were commissioned to develop new monitoring procedures for leakage detection. This paper sets out a new leak detection process. The approach developed took into consideration steady and transient states. The study investigated leak diagnosis problems in product pipelines using multi-sensor measurements (pressure, flux, density and temperature). The information collected from each sensor was considered as pieces of evidence that describe the operational conditions of the pipeline. The Dempster-Shafer (D-S) theory is used to associate multi-sensor data to pipe health indices. Experimental pressure and flow rate data were recorded using a Pipeline Leak Detection System (PLDS) acquisition card and used to verify the accuracy and reliability of this new detection method. The results showed that the degree of credibility was a high as 0.877. It was also found that multi-feature information fusion improves recognition of pipeline conditions.

Reflective Practice in the Clinical Setting: A Multi-Institutional Qualitative Study of Pediatric Faculty and Residents.

Science.gov (United States)

Plant, Jennifer; Li, Su-Ting T; Blankenburg, Rebecca; Bogetz, Alyssa L; Long, Michele; Butani, Lavjay

2017-11-01

To explore when and in what form pediatric faculty and residents practice reflection. From February to June 2015, the authors conducted focus groups of pediatric faculty and residents at the University of California, Davis; Stanford University; and the University of California, San Francisco, until thematic saturation occurred. Transcripts were analyzed based on Mezirow's and Schon's models of reflection, using the constant comparative method associated with grounded theory. Two investigators independently coded transcripts and reconciled codes to develop themes. All investigators reviewed the codes and developed a final list of themes through consensus. Through iterative discussions, investigators developed a conceptual model of reflection in the clinical setting. Seventeen faculty and 20 residents from three institutions participated in six focus groups. Five themes emerged: triggers of reflection, intrinsic factors, extrinsic factors, timing, and outcome of reflection. Various triggers led to reflection; whether a specific trigger led to reflection depended on intrinsic and extrinsic factors. When reflection occurred, it happened in action or on action. Under optimal conditions, this reflection was goal and action directed and became critical reflection. In other instances, this process resulted in unproductive rumination or acted as an emotional release or supportive therapy. Participants reflected in clinical settings, but did not always explicitly identify it as reflection or reflect in growth-promoting ways. Strategies to enhance critical reflection include developing knowledge and skills in reflection, providing performance data to inform reflection, creating time and space for safe reflection, and providing mentorship to guide the process.

Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram.

Science.gov (United States)

Ayala-Peacock, Diandra N; Attia, Albert; Braunstein, Steve E; Ahluwalia, Manmeet S; Hepel, Jaroslaw; Chung, Caroline; Contessa, Joseph; McTyre, Emory; Peiffer, Ann M; Lucas, John T; Isom, Scott; Pajewski, Nicholas M; Kotecha, Rupesh; Stavas, Mark J; Page, Brandi R; Kleinberg, Lawrence; Shen, Colette; Taylor, Robert B; Onyeuku, Nasarachi E; Hyde, Andrew T; Gorovets, Daniel; Chao, Samuel T; Corso, Christopher; Ruiz, Jimmy; Watabe, Kounosuke; Tatter, Stephen B; Zadeh, Gelareh; Chiang, Veronica L S; Fiveash, John B; Chan, Michael D

2017-11-01

Stereotactic radiosurgery (SRS) without whole brain radiotherapy (WBRT) for brain metastases can avoid WBRT toxicities, but with risk of subsequent distant brain failure (DBF). Sole use of number of metastases to triage patients may be an unrefined method. Data on 1354 patients treated with SRS monotherapy from 2000 to 2013 for new brain metastases was collected across eight academic centers. The cohort was divided into training and validation datasets and a prognostic model was developed for time to DBF. We then evaluated the discrimination and calibration of the model within the validation dataset, and confirmed its performance with an independent contemporary cohort. Number of metastases (≥8, HR 3.53 p = 0.0001), minimum margin dose (HR 1.07 p = 0.0033), and melanoma histology (HR 1.45, p = 0.0187) were associated with DBF. A prognostic index derived from the training dataset exhibited ability to discriminate patients' DBF risk within the validation dataset (c-index = 0.631) and Heller's explained relative risk (HERR) = 0.173 (SE = 0.048). Absolute number of metastases was evaluated for its ability to predict DBF in the derivation and validation datasets, and was inferior to the nomogram. A nomogram high-risk threshold yielding a 2.1-fold increased need for early WBRT was identified. Nomogram values also correlated to number of brain metastases at time of failure (r = 0.38, p < 0.0001). We present a multi-institutionally validated prognostic model and nomogram to predict risk of DBF and guide risk-stratification of patients who are appropriate candidates for radiosurgery versus upfront WBRT.

Surgical outcomes of robot-assisted rectal cancer surgery using the da Vinci Surgical System: a multi-center pilot Phase II study.

Science.gov (United States)

Tsukamoto, Shunsuke; Nishizawa, Yuji; Ochiai, Hiroki; Tsukada, Yuichiro; Sasaki, Takeshi; Shida, Dai; Ito, Masaaki; Kanemitsu, Yukihide

2017-12-01

We conducted a multi-center pilot Phase II study to examine the safety of robotic rectal cancer surgery performed using the da Vinci Surgical System during the introduction period of robotic rectal surgery at two institutes based on surgical outcomes. This study was conducted with a prospective, multi-center, single-arm, open-label design to assess the safety and feasibility of robotic surgery for rectal cancer (da Vinci Surgical System). The primary endpoint was the rate of adverse events during and after robotic surgery. The secondary endpoint was the completion rate of robotic surgery. Between April 2014 and July 2016, 50 patients were enrolled in this study. Of these, 10 (20%) had rectosigmoid cancer, 17 (34%) had upper rectal cancer, and 23 (46%) had lower rectal cancer; six underwent high anterior resection, 32 underwent low anterior resection, 11 underwent intersphincteric resection, and one underwent abdominoperineal resection. Pathological stages were Stage 0 in 1 patient, Stage I in 28 patients, Stage II in 7 patients and Stage III in 14 patients. Pathologically complete resection was achieved in all patients. There was no intraoperative organ damage or postoperative mortality. Eight (16%) patients developed complications of all grades, of which 2 (4%) were Grade 3 or higher, including anastomotic leakage (2%) and conversion to open surgery (2%). The present study demonstrates the feasibility and safety of robotic rectal cancer surgery, as reflected by low morbidity and low conversion rates, during the introduction period. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Comparative Study of Evolutionary Multi-objective Optimization Algorithms for a Non-linear Greenhouse Climate Control Problem

DEFF Research Database (Denmark)

Ghoreishi, Newsha; Sørensen, Jan Corfixen; Jørgensen, Bo Nørregaard

2015-01-01

Non-trivial real world decision-making processes usually involve multiple parties having potentially conflicting interests over a set of issues. State-of-the-art multi-objective evolutionary algorithms (MOEA) are well known to solve this class of complex real-world problems. In this paper, we...... compare the performance of state-of-the-art multi-objective evolutionary algorithms to solve a non-linear multi-objective multi-issue optimisation problem found in Greenhouse climate control. The chosen algorithms in the study includes NSGAII, eNSGAII, eMOEA, PAES, PESAII and SPEAII. The performance...... of all aforementioned algorithms is assessed and compared using performance indicators to evaluate proximity, diversity and consistency. Our insights to this comparative study enhanced our understanding of MOEAs performance in order to solve a non-linear complex climate control problem. The empirical...

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

Science.gov (United States)

2015-10-01

provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently ...biomarker platforms in our multi-center, prospectively accrued prostate cancer active surveillance cohort – the Canary Prostate Active Surveillance...prostate cancers currently diagnosed are low risk tumors for which there is substantial evidence that the cancer will not cause harm if left untreated

Multi-stage decoding for multi-level block modulation codes

Science.gov (United States)

Lin, Shu

1991-01-01

In this paper, we investigate various types of multi-stage decoding for multi-level block modulation codes, in which the decoding of a component code at each stage can be either soft-decision or hard-decision, maximum likelihood or bounded-distance. Error performance of codes is analyzed for a memoryless additive channel based on various types of multi-stage decoding, and upper bounds on the probability of an incorrect decoding are derived. Based on our study and computation results, we find that, if component codes of a multi-level modulation code and types of decoding at various stages are chosen properly, high spectral efficiency and large coding gain can be achieved with reduced decoding complexity. In particular, we find that the difference in performance between the suboptimum multi-stage soft-decision maximum likelihood decoding of a modulation code and the single-stage optimum decoding of the overall code is very small: only a fraction of dB loss in SNR at the probability of an incorrect decoding for a block of 10(exp -6). Multi-stage decoding of multi-level modulation codes really offers a way to achieve the best of three worlds, bandwidth efficiency, coding gain, and decoding complexity.

Social Factors of the Evolution of State Institutions

Directory of Open Access Journals (Sweden)

Zhukova Larysa M.

2017-06-01

Full Text Available The aim of the article is a comprehensive study of social factors in the evolution of state institutions. By analyzing, systematizing and summarizing the scientific works of many scientists, the process of transformation of state institutions is considered in view of the features of Ukraine’s social and economic development and the impact of institutional changes on the social needs of society. As a result of the research, it is revealed that one of the main factors of social evolution is the culture of relations between the state, business and society. The logical and contradictory interaction of these subjects is analyzed, since based on them there formed an economy aimed at reviving social resources and ensuring both the stability of the social system and the dynamism of its development. It is determined that Ukraine requires urgent development of an integrated socio-economic development strategy that would include specific measures that can ensure improvement of the living standards of citizens, creation of a competitive economy, successful integration into the world and European space. It is substantiated that the system of relations “state – business – society” should be revised from the position of strengthening the importance of both social values and the business community facing the challenges of globalization. Prospects for further research in this area are justification of the strategic goals of the state social policy as a multi-level and multifunctional system that can ensure the country’s social and economic development by activating human capital and maximizing its innovative potential.

Institutional Investors

DEFF Research Database (Denmark)

Birkmose, Hanne Søndergaard; Strand, Therese

Research Question/Issue: Institutional investors are facing increased pressure and threats of legislation from the European Union to abandon passive ownership strategies. This study investigates the prerequisites for – and potential dissimilarities in the practice of, active ownership among...... institutional investors in two Scandinavian countries with diminutive legal and cultural distance in general. Research Findings/Insights: Using data on shareholder proposals from Danish and Swedish annual general meetings from 2006 throughout 2010, we find that institutional investors are approximately....../Policy Implications: Regulators should be aware of the impact by local governance mechanisms, and how shareholders react under different legal and practical prerequisites. The paper also highlights legal elements that differ between Denmark and Sweden, and which might affect institutional activism....

Which Is More Consequential: Fields of Study or Institutional Selectivity?

Science.gov (United States)

Ma, Yingyi; Savas, Gokhan

2014-01-01

The persisting gender pay gap favoring men among college graduates is a puzzle given women's remarkable success in postsecondary education. This article examines income disparities among recent college graduates by intersecting gender and social class and evaluating the relative importance of fields of study and institutional selectivity.…

A study of institutional environment and household food security at ...

African Journals Online (AJOL)

The study looked into the current scenario of food security in Rwanda. After analysing the national level institutional and food security scenarios by using available secondary data, the researchers used primary data that have been collected from a random sample of 200 households spreading over six sectors of the Huye ...