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Sample records for multi-institutional case-control study

  1. Leadership Development Institute: A California Community College Multi-College District Case Study

    Science.gov (United States)

    Leon, Bianca R.

    2016-01-01

    The purpose of this study is to examine a community college district Grow Your Own (GYO) leadership program in the Western United States, the Multi College Leadership Development Institute (MCLDI). The MCLDI was developed in-house for a multi-campus community college district and offered to interested employees at all position levels with the…

  2. Retrospective exposure assessment and quality control in an international multi-centre case-control study

    DEFF Research Database (Denmark)

    Tinnerberg, H; Heikkilä, P; Huici-Montagud, A

    2003-01-01

    The paper presents the exposure assessment method and quality control procedure used in an international, multi-centre case-control study within a joint Nordic and Italian cohort. This study was conducted to evaluate whether occupational exposure to carcinogens influenced the predictivity of high...... was higher among the original assessors (the assessor from the same country as the subject) than the average prevalence assessed by the other four in the quality control round. The original assessors classified more job situations as exposed than the others. Several reasons for this are plausible: real...... country-specific differences, differences in information available to the home assessor and the others and misunderstandings or difficulties in translation of information. To ensure the consistency of exposure assessments in international retrospective case-control studies it is important to have a well...

  3. 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

  4. 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)

  5. Colorectal cancer and its association with the metabolic syndrome: a Malaysian multi-centric case-control study.

    Science.gov (United States)

    Ulaganathan, V; Kandiah, M; Zalilah, M S; Faizal, J A; Fijeraid, H; Normayah, K; Gooi, B H; Othman, R

    2012-01-01

    Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

  6. Mild asthma and chronic bronchitis seem to influence functional exercise capacity: a multi-case control study.

    Science.gov (United States)

    Marcon, Alessandro; Girardi, Paolo; Ferrari, Marcello; Olivieri, Mario; Accordini, Simone; Bombieri, Cristina; Bortolami, Oscar; Braggion, Marco; Cappa, Veronica; Cazzoletti, Lucia; Locatelli, Francesca; Nicolis, Morena; Perbellini, Luigi; Sembeni, Silvia; Verlato, Giuseppe; Zanolin, Maria Elisabetta; de Marco, Roberto

    2013-01-01

    In the Genes Environment Interaction in Respiratory Diseases population-based multi-case control study, we investigated whether asthma, chronic bronchitis (CB) and rhinitis were associated with a reduced 6-minute walk distance (6MWD), and whether the 6MWD determinants were similar for subjects with/without respiratory diseases. Cases of asthma (n = 360), CB (n = 120), rhinitis (n = 203) and controls (no respiratory diseases: n = 302) were recruited. The variation in the 6MWD across the groups was analyzed by ANCOVA, adjusting for gender, age, height, weight and comorbidity. The 6MWD determinants were studied by linear regression, and heterogeneity across the cases and controls was investigated. The 6MWD differed across cases and controls (p = 0.01). It was shorter for cases of asthma (-17.1, 95% CI -28.3 to -5.8 m) and CB (-20.7, 95% CI: -36.6 to -4.8 m) than for controls (604 ± 68 m on average), but not for cases of rhinitis. The negative association between age and the 6MWD was significant for cases of CB, but not for the other groups (p = 0.001). Even at the level of severity found in the general population, asthma and CB could influence the 6MWD, which seems to reflect the functional exercise level for daily physical activities. The negative association between ageing and the 6MWD was particularly strong in subjects with CB. Our report adds to the mounting evidence that CB is not a trivial condition, especially in the ageing adult population, and it supports the importance of monitoring functional capacity and of physical reconditioning in mild asthma. Copyright © 2013 S. Karger AG, Basel.

  7. The study of multi-institutional collaborations in high-energy physics

    International Nuclear Information System (INIS)

    1991-01-01

    Since World War II, the organizational framework for scientific research is increasingly the multi-institutional collaboration, especially in high-energy physics. A broad preliminary survey, into the functioning of research collaborations involving three or more institutions is described. The study is designed to identify patterns of collaborations, define the scope of the documentation problems, field-test possible solutions, recommend future actions, and build an archives of oral history interviews and other resources for scholarly use. Once the study is completed, its findings will be used to promote systems to document significant collaborative research

  8. The study of multi-institutional collaborations in high-energy physics

    Energy Technology Data Exchange (ETDEWEB)

    Warnow-Blewett, Joan

    1991-01-01

    Since World War II, the organizational framework for scientific research is increasingly the multi-institutional collaboration, especially in high-energy physics. A broad preliminary survey, into the functioning of research collaborations involving three or more institutions is described. The study is designed to identify patterns of collaborations, define the scope of the documentation problems, field-test possible solutions, recommend future actions, and build an archives of oral history interviews and other resources for scholarly use. Once the study is completed, its findings will be used to promote systems to document significant collaborative research.

  9. Improving tuberculosis case detection in underdeveloped multi-ethnic regions with high disease burden: a case study of integrated control program in China.

    Science.gov (United States)

    Li, Jun; Liu, Xiao-Qiu; Jiang, Shi-Wen; Li, Xue; Yu, Fei; Wang, Yan; Peng, Yong; Gu, Xiao-Ming; Sun, Yan-Ni; Zhang, Hui; Wang, Li-Xia

    2017-11-29

    In the underdeveloped multi-ethnic regions of China, high tuberculosis (TB) burden and regional inequity in access to healthcare service increase the challenge of achieving the End TB goals. Among all the provinces, the highest TB burden is reported in Xinjiang, where ethnic minorities and older people have suffered most. However, current case-finding strategy is inadequate given the complex social determinants and suboptimal case detection rates. Thus, we developed an integrated TB control program to improve case detection and conducted a pilot in Xinjiang from 2014 to 2015. In this case study, we summarized the activities and key findings. We also shared the experiences and challenges of implementing interventions and provided recommendations to inform the TB control program in the future. The pilot interventions were implemented in one selected town in Yining based on local TB control programs. By applying tailor-made educational materials, outreach TB educational activities were conducted in diverse ways. In 22 Masjids, the trained imams promoted TB education to the Muslims, covering 20,440 person-times in 88 delivered preaching sessions. In seven schools, 1944 students were educated by the teachers and contributed to educating 6929 family members. In the village communities, 13,073 residents participated in household education and screening. Among them, 12,292 people aged under 65 years were investigated for suspicious pulmonary TB symptoms, where six TB patients were diagnosed out of 89 TB suspects; 781 older people were mobilized for screening directly by chest X-ray, where 10 patients were diagnosed out of 692 participants. Supportive healthcare system, multi-sectoral cooperation and multi-channel financing mechanism were the successful experiences of implementation. The interventions were proved to be more effective than the previous performance: the number of TB suspects consulting doctors and patients detected increased by 50% and 26%, respectively

  10. 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.

  11. 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.

  12. 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

  13. Characteristics and outcomes of patients with multiple myeloma aged 21-40 years versus 41-60 years: a multi-institutional case-control study.

    Science.gov (United States)

    Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit; Gozzetti, Alessandro; Niesvizky, Ruben; Yadlapati, Sujitha; Jayabalan, David S; Robak, Paweł; Pika, Tomas; Andersen, Kristian T; Rasche, Leo; Mądry, Krzysztof; Woszczyk, Dariusz; Raźny, Małgorzata; Usnarska-Zubkiewicz, Lidia; Knopińska-Posłuszny, Wanda; Wojciechowska, Małgorzata; Guzicka-Kazimierczak, Renata; Joks, Monika; Grosicki, Sebastian; Ciepłuch, Hanna; Rymko, Marcin; Vesole, David H; Castillo, Jorge J

    2016-12-01

    We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60 years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 patients in the younger group and 916 patients in the older group. Younger patients presented with a higher incidence of lytic lesions (82% vs. 72%; P = 0·04) and high-risk cytogenetic abnormalities (83% vs. 68%; P = 0·007), but lower rate of elevated lactate dehydrogenase (21% vs. 44%; P < 0·001). Five- and 10-year overall survival (OS) in younger versus older patients was 83% vs. 67% and 56% vs. 39%, respectively (P < 0·001). Similar results were seen when studying the subset of 780 patients who underwent autologous transplantation. Younger patients with ISS stage 1 had a better OS than older patients (P < 0·001). There was no survival difference between younger and older patients with ISS stage 2 or 3. Younger MM patients, aged 21-40 years, treated in the era of novel agents have a better OS than their counterparts aged 41-60 years, but the survival advantage observed in younger patients was lost in more advanced stages of MM. © 2016 John Wiley & Sons Ltd.

  14. Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective study

    International Nuclear Information System (INIS)

    Vidali, Cristiana; Neri, Stefano; Pietta, Nicoletta; Caffo, Orazio; Aristei, Cynthia; Bertoni, Filippo; Bonetta, Alberto; Guenzi, Marina; Iotti, Cinzia; Leonardi, Maria Cristina; Mussari, Salvatore

    2012-01-01

    The incidence of ductal carcinoma in situ (DCIS) has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy (RT) has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very long period of accrual, from February 1985 to March 2000, and a median follow-up longer than 11 years. A collaborative multi-institutional study was conducted in Italy in 10 Radiation Oncology Departments. A consecutive series of 586 women with DCIS histologically confirmed, treated between February 1985 and March 2000, was retrospectively evaluated. Median age at diagnosis was 55 years (range: 29–84); 32 patients were 40 years old or younger. All women underwent conservative surgery followed by whole breast RT. Irradiation was delivered to the entire breast, for a median total dose of 50 Gy; the tumour bed was boosted in 295 cases (50%) at a median dose of 10 Gy. After a median follow-up of 136 months (range: 16–292 months), 59/586 patients (10%) experienced a local recurrence: invasive in 37 cases, intraductal in 20 and not specified in two. Salvage mastectomy was the treatment of choice in 46 recurrent patients; conservative surgery in 10 and it was unknown in three patients. The incidence of local recurrence was significantly higher in women younger than 40 years (31.3%) (p= 0.0009). Five patients developed distant metastases. Furthermore 40 patients developed a contralateral breast cancer and 31 a second primary tumour in a different site. The 10-year actuarial overall survival (OS) was 95.5% and the 10-year actuarial disease-specific survival (DSS) was 99%. Our results are consistent with those reported in the literature. In particular it has been defined the importance of young age (40

  15. 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)

  16. 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…

  17. 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.

  18. Determinants of institutional delivery among childbearing age women in Western Ethiopia, 2013: unmatched case control study.

    Directory of Open Access Journals (Sweden)

    Tesfaye Regassa Feyissa

    Full Text Available BACKGROUND: Place of delivery is a crucial factor which affects the health and wellbeing of the mother and newborn. Institutional delivery helps the women to access skilled assistance, drugs, equipment, and referral transport. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia. METHODS: Retrospective unmatched case control study design was used to assess determinants of institutional delivery in Western Ethiopia from September to October 2013. A total of 320 respondents from six districts of East Wollega zone, West Ethiopia were included. Data were collected using pretested and structured questionnaires. Data were entered and cleaned by Epi-info then exported and analyzed using SPSS software. Statistical significance was determined through a 95% confidence level. RESULTS: Education [Adjusted Odds Ratio (AOR (95% Confidence Interval (CI = 2.754(1.510-8.911], family size [AOR (95% CI = .454(.209-.984], residence [AOR (95% CI = 3.822 (1.766-8.272] were important predictors of place of delivery. Four or more antenatal care [(ANC (AOR (95% CI = 2.914(1.105-7.682], birth order [(AOR (95% CI = .136(.054-.344, age at last delivery [(AOR (95% CI = 9.995(2.101-47.556], birth preparedness [AOR (95% CI = 6.957(2.422-19.987], duration of labour [AOR (95% CI = 3.541(1.732-7.239] were significantly associated with institutional delivery. Moreover service related factors such as distance from health institutions [AOR (95% CI = .665(.173-.954], respondents' awareness of skill of health care professionals [AOR (95% CI = 2.454 (1.663-6.255], mode of transportations [AOR (95% CI = .258(.122-.549] were significantly associated with institutional delivery. CONCLUSIONS AND RECOMMENDATIONS: Policy makers, health service

  19. Determinants of institutional delivery among childbearing age women in Western Ethiopia, 2013: unmatched case control study.

    Science.gov (United States)

    Feyissa, Tesfaye Regassa; Genemo, Gebi Agero

    2014-01-01

    Place of delivery is a crucial factor which affects the health and wellbeing of the mother and newborn. Institutional delivery helps the women to access skilled assistance, drugs, equipment, and referral transport. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia. Retrospective unmatched case control study design was used to assess determinants of institutional delivery in Western Ethiopia from September to October 2013. A total of 320 respondents from six districts of East Wollega zone, West Ethiopia were included. Data were collected using pretested and structured questionnaires. Data were entered and cleaned by Epi-info then exported and analyzed using SPSS software. Statistical significance was determined through a 95% confidence level. Education [Adjusted Odds Ratio (AOR) (95% Confidence Interval (CI)) = 2.754(1.510-8.911)], family size [AOR (95% CI) = .454(.209-.984)], residence [AOR (95% CI) = 3.822 (1.766-8.272)] were important predictors of place of delivery. Four or more antenatal care [(ANC) (AOR (95% CI) = 2.914(1.105-7.682)], birth order [(AOR (95% CI) = .136(.054-.344), age at last delivery [(AOR (95% CI) = 9.995(2.101-47.556)], birth preparedness [AOR (95% CI) = 6.957(2.422-19.987)], duration of labour [AOR (95% CI) = 3.541(1.732-7.239)] were significantly associated with institutional delivery. Moreover service related factors such as distance from health institutions [AOR (95% CI) = .665(.173-.954)], respondents' awareness of skill of health care professionals [AOR (95% CI) = 2.454 (1.663-6.255)], mode of transportations [AOR (95% CI) = .258(.122-.549)] were significantly associated with institutional delivery. Policy makers, health service organizations, community leaders and other concerned bodies have

  20. Multi-Institution Research Centers: Planning and Management Challenges

    Science.gov (United States)

    Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

    2016-01-01

    Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

  1. Hospital visitors as controls in case-control studies

    Directory of Open Access Journals (Sweden)

    Gulnar Azevedo S Mendonça

    2001-10-01

    Full Text Available OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" -- INCA (National Cancer Institute in Rio de Janeiro (Brazil. METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.

  2. A multi-institutional Stellarator Configuration Study

    Science.gov (United States)

    Gates, David

    2017-10-01

    A multi-institutional study aimed at mapping the space of quasi-axisymmetric stellarators has begun. The goal is to gain improved understanding of the dependence of important physics and engineering parameters (e.g. bootstrap current, stability, coil complexity, etc.) on plasma shape (average elongation, aspect ratio, number of periods). In addition, the stellarator optimization code STELLOPT will be upgraded with new capabilities such as improved coil design algorithms such as COILOPT + + and REGCOIL, divertor optimization options, equilibria with islands using the SPEC code, and improved bootstrap current calculations with the SFINCS code. An effort is underway to develop metrics for divertor optimization. STELLOPT has also had numerous improvements to numerical algorithms and parallelization capabilities. Simultaneously, we also are pursuing the optimization of turbulent transport according to the method of proxy functions. Progress made to date includes an elongation scan on quasi-axisymmetric equilibria and an initial comparison between the SFINCS code and the BOOTSJ calculation of bootstrap current currently available in STELLOPT. Further progress on shape scans and subsequent physics analysis will be reported. The status of the STELLOPT upgrades will be described. The eventual goal of this exercise is to identify attractive configurations for future US experimental facilities.. This work is supported by US DoE Contract Number DE-AC02-09CH11466.

  3. Management of information security risks in a federal public institution: a case study

    Directory of Open Access Journals (Sweden)

    Jackson Gomes Soares Souza

    2016-11-01

    Full Text Available Public institutions bound to the Brazilian federal public sector must apply security measures, policies, procedures and guidelines as information assets protection measures. This case study sought to determine whether the management of information security risks is applied in a federal public institution according to Information Technology (I.T. managers perceptions and the results expose the importance of the roles played by people, responsibilities, policies, standards, procedures and their implementation aiming greater control of information security risks and opportunities related to information technology security.

  4. AIP study of multi-institutional collaborations: Phase 1, high-energy physics

    International Nuclear Information System (INIS)

    Warnow-Blewett, J.; Weart, S.R.

    1992-01-01

    Although the multi-institutional collaboration is increasingly the organizational framework for scientific research, it has received only incidental attention from scholars. Without a dedicated effort to understand the process of collaborative research, even the records necessary for efficient administration, for historical and: studies, and for posterity, will be largely scattered or destroyed. The Center for History of Physics of the American Institute of Physics (AIP) is working to redress this situation with a multi-stage investigation. The aim is to identify patterns of collaborations, define the scope of the documentation problems, field test possible solutions, and recommend future actions. The first phase of the study addressed high-energy physics. The two-year study of high-energy physics research focused on experiments approved between 1973 and 1984 at five of the world's major accelerator laboratories. A broad-scale picture of changes in the structure of collaborations was obtained by using databases on high energy physics experiments and publications, At a more detailed level, the project conducted interviews on 24 selected experimental collaborations. Still more detailed ''probes'' of some highly significant collaborations featured historical research as well as many additional interviews and work to preserve records. Some 300 interviews were analyzed to identify patterns of collaborative research and records creation, retention, and location. Meanwhile project staff surveyed the records-keeping practices of key physicists and made numerous site visits to accelerator facilities and university archives to discuss archival issues and records policies

  5. 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 ...

  6. Optimizing the construction of devices to control inaccesible surfaces - case study

    Science.gov (United States)

    Niţu, E. L.; Costea, A.; Iordache, M. D.; Rizea, A. D.; Babă, Al

    2017-10-01

    The modern concept for the evolution of manufacturing systems requires multi-criteria optimization of technological processes and equipments, prioritizing associated criteria according to their importance. Technological preparation of the manufacturing can be developed, depending on the volume of production, to the limit of favourable economical effects related to the recovery of the costs for the design and execution of the technological equipment. Devices, as subsystems of the technological system, in the general context of modernization and diversification of machines, tools, semi-finished products and drives, are made in a multitude of constructive variants, which in many cases do not allow their identification, study and improvement. This paper presents a case study in which the multi-criteria analysis of some structures, based on a general optimization method, of novelty character, is used in order to determine the optimal construction variant of a control device. The rational construction of the control device confirms that the optimization method and the proposed calculation methods are correct and determine a different system configuration, new features and functions, and a specific method of working to control inaccessible surfaces.

  7. Case-control studies in neurosurgery.

    Science.gov (United States)

    Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

    2014-08-01

    Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

  8. 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

  9. [A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954].

    Science.gov (United States)

    Häßler, Frank; Weirich, Steffen

    2017-09-01

    A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954 Glutamic acid was commonly used in the treatment of intellectually disabled children in the 50s. Koch reported first results of an observation of 140 children treated with glutamic acid in 1952. In this line is the multi-arm placebo-controlled study reported here. The original study protocols were available. 58 children with speech problems who attending a school of special needs received glutamic acid, or vitamin B, or St.-John's-wort. The effect of glutamic acid was in few cases an improvement of attention. On the other hand restlessness and stutter increased. The majority of all reported a weight loss. The treatment with vitamin B showed a positive effect concerning concentration. The treatment with St.-John's wort was stopped caused by headache and vomiting in eight of nine cases. The results of the study reported here are unpublished. The reason may be that until the 60s the effects of glutamic acid in the treatment of intellectually disabled children were in generally overestimated.

  10. The study of multi-institutional collaborations in high-energy physics. Progress report, January 1989--March 1991

    Energy Technology Data Exchange (ETDEWEB)

    1991-12-31

    Since World War II, the organizational framework for scientific research is increasingly the multi-institutional collaboration, especially in high-energy physics. A broad preliminary survey, into the functioning of research collaborations involving three or more institutions is described. The study is designed to identify patterns of collaborations, define the scope of the documentation problems, field-test possible solutions, recommend future actions, and build an archives of oral history interviews and other resources for scholarly use. Once the study is completed, its findings will be used to promote systems to document significant collaborative research.

  11. 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.

  12. 34 CFR 675.34 - Multi-Institutional job location and development programs.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Multi-Institutional job location and development... Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An... location programs for its students with other participating institutions. (b) The agreement described in...

  13. 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.)

  14. Comprehensive review of the literature on institutional controls to limit land use

    International Nuclear Information System (INIS)

    1997-08-01

    A literature search was conducted to identify case studies that would provide a basis for establishing the effective duration of institutional controls to limit land use and to identify the attributes that contribute to their effectiveness. The literature on a variety of active and passive institutional controls to limit land use on government lands and on private lands adjacent to government lands was reviewed. No case studies and little detailed information were found concerning the periods for which the institutional controls remained effective over the long-term or the aspects of the controls that contributed to their effectiveness in limiting land use. The information available in the literature is discussed and an extensive bibliography and recommendations regarding future work are provided. (author)

  15. Comprehensive review of the literature on institutional controls to limit land use

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    A literature search was conducted to identify case studies that would provide a basis for establishing the effective duration of institutional controls to limit land use and to identify the attributes that contribute to their effectiveness. The literature on a variety of active and passive institutional controls to limit land use on government lands and on private lands adjacent to government lands was reviewed. No case studies and little detailed information were found concerning the periods for which the institutional controls remained effective over the long-term or the aspects of the controls that contributed to their effectiveness in limiting land use. The information available in the literature is discussed and an extensive bibliography and recommendations regarding future work are provided. (author).

  16. Local knowledge, science, and institutional change: the case of desertification control in Northern China.

    Science.gov (United States)

    Yang, Lihua

    2015-03-01

    This article studies the influence of local knowledge on the impact of science on institutional change in ecological and environmental management. Based on an empirical study on desertification control in 12 counties in north China, the study found the following major results: (1) although there was a cubic relationship between the extent and effect of local knowledge, local knowledge significantly influenced the impact of science on institutional change; (2) local knowledge took effect mainly through affecting formal laws and regulations, major actors, and methods of desertification control in institutional change but had no significant impact on the types of property rights; and (3) local knowledge enhanced the impact of science on the results of desertification control through affecting the impact of science on institutional change. These findings provide a reference for researchers, policy makers, and practitioners, both in China and in other regions of the world, to further explore the influence of local knowledge on the impact of science on institutional change and the roles of local knowledge or knowledge in institutional change and governance.

  17. A Multi-Institution Study of Student Demographics and Outcomes in Chemical Engineering

    Science.gov (United States)

    Lord, Susan M.; Layton, Richard A.; Ohland, Matthew W.; Brawner, Catherine E.; Long, Russell A.

    2014-01-01

    Using a large multi-institutional dataset, we describe demographics and outcomes for students starting in and transferring into chemical engineering (ChE). In this dataset, men outnumber women in ChE except among black students. While ChE starters graduate in ChE at rates comparable to or above their racial/ethnic population average for…

  18. Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.

    Directory of Open Access Journals (Sweden)

    Philly O'Riordan

    2008-09-01

    Full Text Available Multi-drug resistant tuberculosis (MDR-TB is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis has traditionally relied upon clinical suspicion, based on risk factors and culture with sensitivity testing, a process that can take weeks or months. Rapid diagnostic molecular techniques have the potential to shorten the time to commencing appropriate therapy, but have not been put to the test under field conditions.This retrospective case-control study aimed to identify risk factors for MDR-TB, and analyse the impact of testing for rifampicin resistance using RNA polymerase B (rpoB mutations as a surrogate for MDR-TB. Forty two MDR-TB cases and 84 fully sensitive TB controls were matched by date of diagnosis; and factors including demographics, clinical presentation, microbiology findings, management and outcome were analysed using their medical records. Conventionally recognised risk factors for MDR-TB were absent in almost half (43% of the cases, and 15% of cases were asymptomatic. A significant number of MDR-TB cases were identified in new entrants to the country. Using rpoB mutation testing, the time to diagnosis of MDR-TB was dramatically shortened by a median of 6 weeks, allowing patients to be commenced on appropriate therapy a median of 51days earlier than those diagnosed by conventional culture and sensitivity testing.MDR-TB is frequently an unexpected finding, may be asymptomatic, and is particularly prevalent among TB infected new entrants to the country. Molecular resistance testing of all acid fast bacilli positive specimens has the potential to rapidly identify MDR-TB patients and commence them on appropriate therapy significantly earlier than by conventional methods.

  19. European multi-centre case-control study on risk factors for rare cancers of unknown aetiology

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Afonso, Noemia; Kaerlev, Linda

    2005-01-01

    To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany...... recruited 3374 population (61% interviewed) and 1284 colon cancer controls (86% interviewed). It was possible to undertake this complicated study across Europe, but we encountered three main problems. It was difficult to ensure complete case ascertainment, for population controls, we found a clear divide......, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed). Numbers identified corresponded to those in the EUROCIM database for Denmark, but were below those observed for France, Italy and Sweden in the database. We...

  20. Calculation of controllability and observability matrices for special case of continuous-time multi-order fractional systems.

    Science.gov (United States)

    Hassanzadeh, Iman; Tabatabaei, Mohammad

    2017-03-28

    In this paper, controllability and observability matrices for pseudo upper or lower triangular multi-order fractional systems are derived. It is demonstrated that these systems are controllable and observable if and only if their controllability and observability matrices are full rank. In other words, the rank of these matrices should be equal to the inner dimension of their corresponding state space realizations. To reduce the computational complexities, these matrices are converted to simplified matrices with smaller dimensions. Numerical examples are provided to show the usefulness of the mentioned matrices for controllability and observability analysis of this case of multi-order fractional systems. These examples clarify that the duality concept is not necessarily true for these special systems. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  1. I-MOVE multi-centre case control study 2010-11: overall and stratified estimates of influenza vaccine effectiveness in Europe.

    Directory of Open Access Journals (Sweden)

    Esther Kissling

    Full Text Available BACKGROUND: In the third season of I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in eight European Union (EU member states to estimate 2010/11 influenza vaccine effectiveness (VE against medically-attended influenza-like illness (ILI laboratory-confirmed as influenza. METHODS: Using systematic sampling, practitioners swabbed ILI/ARI patients within seven days of symptom onset. We compared influenza-positive to influenza laboratory-negative patients among those meeting the EU ILI case definition. A valid vaccination corresponded to > 14 days between receiving a dose of vaccine and symptom onset. We used multiple imputation with chained equations to estimate missing values. Using logistic regression with study as fixed effect we calculated influenza VE adjusting for potential confounders. We estimated influenza VE overall, by influenza type, age group and among the target group for vaccination. RESULTS: We included 2019 cases and 2391 controls in the analysis. Adjusted VE was 52% (95% CI 30-67 overall (N = 4410, 55% (95% CI 29-72 against A(H1N1 and 50% (95% CI 14-71 against influenza B. Adjusted VE against all influenza subtypes was 66% (95% CI 15-86, 41% (95% CI -3-66 and 60% (95% CI 17-81 among those aged 0-14, 15-59 and ≥60 respectively. Among target groups for vaccination (N = 1004, VE was 56% (95% CI 34-71 overall, 59% (95% CI 32-75 against A(H1N1 and 63% (95% CI 31-81 against influenza B. CONCLUSIONS: Results suggest moderate protection from 2010-11 trivalent influenza vaccines against medically-attended ILI laboratory-confirmed as influenza across Europe. Adjusted and stratified influenza VE estimates are possible with the large sample size of this multi-centre case-control. I-MOVE shows how a network can provide precise summary VE measures across Europe.

  2. Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study.

    Science.gov (United States)

    Li, Cheng; Zhao, Wei-Hong; Meng, Chun-Xia; Ping, Hua; Qin, Guo-Juan; Cao, Shu-Jun; Xi, Xiaowei; Zhu, Qian; Li, Xiao-Cui; Zhang, Jian

    2014-01-01

    To evaluate the association between the risk of ectopic pregnancy (EP) and the use of common contraceptives during the previous and current conception/menstrual cycle. A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411). Women with intrauterine pregnancy (IUP) (n = 2,416) and non-pregnant women (n = 2,419) were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and the corresponding 95% confidential intervals (CIs). Previous use of intrauterine devices (IUDs) was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27]), and the risk increased with the duration of previous use (P1 for trend contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022]) and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]). However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07]), LNG-EC (AOR2 = 4.87 [3.88-6.10]), IUDs (AOR2 = 21.08 [13.44-33.07]), and tubal sterilization (AOR2 = 7.68 [1.69-34.80]) increased the risk of EP compared with the non-use of contraceptives. Current use of most contraceptives reduce the risk of both IUP and EP. However, if the

  3. Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Cheng Li

    Full Text Available To evaluate the association between the risk of ectopic pregnancy (EP and the use of common contraceptives during the previous and current conception/menstrual cycle.A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411. Women with intrauterine pregnancy (IUP (n = 2,416 and non-pregnant women (n = 2,419 were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs and the corresponding 95% confidential intervals (CIs.Previous use of intrauterine devices (IUDs was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27], and the risk increased with the duration of previous use (P1 for trend <10-4, P2 for trend <10-4. The current use of most contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022] and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]. However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07], LNG-EC (AOR2 = 4.87 [3.88-6.10], IUDs (AOR2 = 21.08 [13.44-33.07], and tubal sterilization (AOR2 = 7.68 [1.69-34.80] increased the risk of EP compared with the non-use of contraceptives.Current use of most

  4. Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

    Science.gov (United States)

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

  5. Second-Order Controllability of Multi-Agent Systems with Multiple Leaders

    International Nuclear Information System (INIS)

    Liu Bo; Han Xiao; Shi Yun-Tao; Su Hou-Sheng

    2016-01-01

    This paper proposes a new second-order continuous-time multi-agent model and analyzes the controllability of second-order multi-agent system with multiple leaders based on the asymmetric topology. This paper considers the more general case: velocity coupling topology is different from location coupling topology. Some sufficient and necessary conditions are presented for the controllability of the system with multiple leaders. In addition, the paper studies the controllability of the system with velocity damping gain. Simulation results are given to illustrate the correctness of theoretical results. (paper)

  6. Reliability of diffusion-weighted imaging in acute ischemic stroke. A multi-institutional multivendor validation study

    International Nuclear Information System (INIS)

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

    2006-01-01

    Diffusion-weighted imaging (DWI) is widely applied for evaluating patients with acute ischemic stroke. However, its display conditions are different among institutions, and reliability of the apparent diffusion coefficient (ADC) has not been validated enough. Recently, we proposed an easy-to-use technique to standardize display conditions, in which window width and level are normalized by the signal intensity of brain tissue on b0 images. We carried out a multi-institutional multivendor study, and revealed that the technique successfully minimized difference in the display condition among institutions and vendors. On the other hand, we found that the ADC value is significantly different among vendors and static magnetic fields, suggesting that the ADC should be evaluated semiquantitatively. Standardization and technical advancement are considered to be necessary to improve reliability of DWI in acute stroke managements. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. Methodology Series Module 2: Case-control Studies.

    Science.gov (United States)

    Setia, Maninder Singh

    2016-01-01

    Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

  13. Role of institutional controls in selection of remedial measures

    International Nuclear Information System (INIS)

    Bakr, A.A.; Agoston, E.N.; McLeod, R.V.; Hicks, H.T.

    1992-01-01

    This paper explores the regulatory intent of CERCLA's definition and applicability of institutional controls at hazardous substance release sites undergoing remedial action and institutional controls that have been defined and implemented at selected CERCLA (Superfund) sites in the United States. Under provisions of CERCLA, institutional controls can be components of, or supplements to, interim or final remedial measures for hazardous substance [as defined under CERCLA 101(14)] releases. The use of institutional controls has been proposed in a number of RODs for large Superfund sites (e.g., Times Beach, Missouri; the Clothier Disposal Site in Oswego County, New York; and the Wildcat Landfill in Kent County, Delaware). In these cases, the selected remedial actions combine active response measures with institutional controls to protect human health and the environment. These RODs provide insight to how widely the concept of institutional controls is used and under what conditions. The use of institutional controls at large federal facilities is also discussed

  14. Developing and implementing institutional controls for ground water remediation

    International Nuclear Information System (INIS)

    Ulland, L.M.; Cooper, M.G.

    1995-01-01

    The US DOE has initiated its Ground Water Project as the second phase of the Uranium Mill Tailings Remedial Action (UMTRA) Project authorized under the Uranium Mill Tailings Radiation Control Act (UMTRCA). In the Ground Water Project, the DOE must reduce risk from ground water contaminated by uranium mill processing activities at 24 inactive processing sites by meeting the US EPA standards. The UMTRCA also requires consistency with federal statutes such as the Resource Conservation and Recovery Act (RCRA). The use of institutional controls to reduce risk from contaminated ground water is one element of compliance with standards and the protection of public health and the environment. Institutional controls are active or passive measures that reduce exposure to risks by preventing intrusion or restricting direct access to an area, or restricting access to the contamination through secondary means. Because of inconsistent regulations and multi-party authorities for ground water management, the key to selecting and implementing effective institutional controls lies with developing a consensus between the parties responsible for ground water remediation; those with authority to implement, monitor, and maintain institutional controls; and those facing the risks from contaminated ground water. These parties must develop a consensus for an institutional control program that meets minimum regulatory requirements and protects public health and the environment. Developing consensus and implementing a successful institutional controls program was achieved by the DOE during the cleanup of uranium mill tailings. An effective institutional controls program can also be developed to protect against risks from contaminated ground water. Consensus building and information transmission are the critical elements of an institutional control program that protects human health and the environment from risks associated with ground water contamination

  15. 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

  16. Qat use and esophageal cancer in Ethiopia: A pilot case-control study.

    Directory of Open Access Journals (Sweden)

    Maria E Leon

    Full Text Available Qat (Catha edulis chewing is reported to induce lesions in the buccal mucosa, irritation of the esophagus, and esophageal reflux. Case series suggest a possible etiological role in oral and esophageal cancers. This pilot study aimed to generate preliminary estimates of the magnitude and direction of the association between qat use and esophageal cancer (EC risk and to inform the logistics required to conduct a multi-center case-control study.Between May 2012 and May 2013, 73 EC cases (including 12 gastro-esophageal junction cases and 133 controls matched individually on sex, age, and residence were enrolled at two endoscopy clinics and a cancer treatment hospital in Addis Ababa. A face-to-face structured questionnaire was administered. Qat use was defined as ever having chewed qat once a week or more frequently for at least one year. Odds ratios were calculated using conditional logistic regression.Only 8% of cases resided in Addis Ababa. Qat use was more frequent in cases (36% than in controls (26%. A 2-fold elevation in EC risk was observed in ever qat chewers compared with never users in unadjusted conditional logistic regression (OR = 2.12; 95% CI = 0.94, 4.74, an association that disappeared after adjusting for differences in tobacco use, consumption of alcohol and green vegetables, education level, and religion (OR = 0.95; 0.22, 4.22. Among never tobacco users, however, a non-significant increase in EC risk was suggested in ever qat users also after adjustment. Increases in EC risk were observed with ever tobacco use, alcohol consumption, low consumption of green vegetables, a salty diet, illiteracy, and among Muslims; the four latter associations were significant.This pilot study generated EC risk estimates in association with a habit practiced by millions of people and never before studied in a case-control design. Results must be interpreted cautiously in light of possible selection bias, with some demographics such as education level

  17. Case-control studies in diabetes. Do they really use a case-control design?

    Science.gov (United States)

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  18. A Case Study of an Internationalization Process of a Private Higher Education Institution in Malaysia

    Directory of Open Access Journals (Sweden)

    Abu Bakar Abdul Rahim

    2013-12-01

    Full Text Available The increasing competition and commercialization of higher education has led to the internationalization of Higher Education Institutions (HEIs around the world. While internationalization appears to be inevitable, differences are apparent in its definitions, depth, scope and mode. The main aim of this paper is to assess the internationalization efforts of Malaysian HEIs through a case study on the internationalization process of one private HEI. The case highlights various weaknesses of the internationalization effort in the institution. The symptoms and the causes of the problems in the institution corroborate similar findings in other studies involving the internationalization of HEIs. Suggestions and recommendations are presented to enable other organizations that wish to undertake similar internationalization efforts to learn from the case study institution’s experience.

  19. Co-Prevalence of Tremor with Spasmodic Dysphonia: A Case-Control Study

    Science.gov (United States)

    White, Laura; Klein, Adam; Hapner, Edie; Delgaudio, John; Hanfelt, John; Jinnah, H. A.; Johns, Michael

    2011-01-01

    OBJECTIVES/HYPOTHESIS The aim of this study was to define the co-prevalence of tremor with spasmodic dysphonia (SD). STUDY DESIGN A single institution prospective, case-control study was performed from May 2010 to July 2010. METHODS Consecutive patients with SD (cases) and other voice disorders (controls) were enrolled prospectively. Each participant underwent a voice evaluation and an evaluation for tremor. RESULTS 146 voice disorder controls and 128 patients with SD were enrolled. 26% of patients with SD had vocal tremor, 21% had non-vocal tremor. Patients with SD were 2.8 times more likely to have co-prevalent tremor than the control group (OR = 2.81; 95% CI, 1.55 to 5.08) and only 35% of patients with SD had been seen by a neurologist for the evaluation of dystonia and tremor. CONCLUSIONS Tremor is highly prevalent in patients with SD. It is important for each patient diagnosed with SD to undergo an evaluation for tremor, this is especially important in patients diagnosed with vocal tremor. Level of evidence 3b. PMID:21792965

  20. 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.

  1. 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 ...

  2. 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.

  3. The Effectiveness of Simulated Robots for Supporting the Learning of Introductory Programming: A Multi-Case Case Study

    Science.gov (United States)

    Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

    2014-01-01

    This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants…

  4. 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

  5. MULTI-LOOP CONTROL DESIGN IN MULTIVARIABLE (2X2 CONTINUOUS STIRRED TANK REACTOR

    Directory of Open Access Journals (Sweden)

    Abdul Wahid

    2015-06-01

    Full Text Available With this study, the design and tuning of multi-loop for multivariable (2x2 CSTR will be made in order to achieve optimum CSTR control performance. This study used Bequette model reactor and MATLAB software and is expected to be able to cope with disturbances in the reactor so that the reactor system is able to stabilize quickly despite the distractions. In this study, the design will be made using multi-loop approach, along with PI controller as the next step. Then, BLT and auto-tune tuning method will be used in PI controller and given disturbances to both of tuning method. The controller performances are then compared. Results of the study are then analyzed for discussions and conclusions. Results from this study have shown that in terms of disturbance rejection, BLT is better than auto-tune based on comparison between both of controller performances. For IAE for the case of temperature, BLT is 30% better than auto-tune, but it is almost the same for the case of concentration. For settling time for the case of concentration, BLT is 30% better than auto-tune, and for the case of temperature, BLT is 18% better than auto-tune. For rise time for the case of concentration and temperature, BLT is 30% better than auto-tune.

  6. Accounting for control mislabeling in case-control biomarker studies.

    Science.gov (United States)

    Rantalainen, Mattias; Holmes, Chris C

    2011-12-02

    In biomarker discovery studies, uncertainty associated with case and control labels is often overlooked. By omitting to take into account label uncertainty, model parameters and the predictive risk can become biased, sometimes severely. The most common situation is when the control set contains an unknown number of undiagnosed, or future, cases. This has a marked impact in situations where the model needs to be well-calibrated, e.g., when the prediction performance of a biomarker panel is evaluated. Failing to account for class label uncertainty may lead to underestimation of classification performance and bias in parameter estimates. This can further impact on meta-analysis for combining evidence from multiple studies. Using a simulation study, we outline how conventional statistical models can be modified to address class label uncertainty leading to well-calibrated prediction performance estimates and reduced bias in meta-analysis. We focus on the problem of mislabeled control subjects in case-control studies, i.e., when some of the control subjects are undiagnosed cases, although the procedures we report are generic. The uncertainty in control status is a particular situation common in biomarker discovery studies in the context of genomic and molecular epidemiology, where control subjects are commonly sampled from the general population with an established expected disease incidence rate.

  7. 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.

  8. 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.

  9. 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

  10. 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 ...

  11. Development and Evaluation of a Multi-Institutional Case Studies-Based Course in Food Safety

    Science.gov (United States)

    Pleitner, Aaron M.; Chapin, Travis K.; Hammons, Susan R.; Stelten, Anna Van; Nightingale, Kendra K.; Wiedmann, Martin; Johnston, Lynette M.; Oliver, Haley F.

    2015-01-01

    Developing novel, engaging courses in food safety is necessary to train professionals in this discipline. Courses that are interactive and case-based encourage development of critical thinking skills necessary for identifying and preventing foodborne disease outbreaks. The purpose of this study was to assess the efficacy of a case study…

  12. 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.

  13. Cumulative occupational lumbar load and lumbar disc disease – results of a German multi-center case-control study (EPILIFT

    Directory of Open Access Journals (Sweden)

    Michaelis Martina

    2009-05-01

    Full Text Available Abstract Background The to date evidence for a dose-response relationship between physical workload and the development of lumbar disc diseases is limited. We therefore investigated the possible etiologic relevance of cumulative occupational lumbar load to lumbar disc diseases in a multi-center case-control study. Methods In four study regions in Germany (Frankfurt/Main, Freiburg, Halle/Saale, Regensburg, patients seeking medical care for pain associated with clinically and radiologically verified lumbar disc herniation (286 males, 278 females or symptomatic lumbar disc narrowing (145 males, 206 females were prospectively recruited. Population control subjects (453 males and 448 females were drawn from the regional population registers. Cases and control subjects were between 25 and 70 years of age. In a structured personal interview, a complete occupational history was elicited to identify subjects with certain minimum workloads. On the basis of job task-specific supplementary surveys performed by technical experts, the situational lumbar load represented by the compressive force at the lumbosacral disc was determined via biomechanical model calculations for any working situation with object handling and load-intensive postures during the total working life. For this analysis, all manual handling of objects of about 5 kilograms or more and postures with trunk inclination of 20 degrees or more are included in the calculation of cumulative lumbar load. Confounder selection was based on biologic plausibility and on the change-in-estimate criterion. Odds ratios (OR and 95% confidence intervals (CI were calculated separately for men and women using unconditional logistic regression analysis, adjusted for age, region, and unemployment as major life event (in males or psychosocial strain at work (in females, respectively. To further elucidate the contribution of past physical workload to the development of lumbar disc diseases, we performed lag

  14. How does leadership education shape students’ definitions of leadership? Insights from the Multi-institutional Study of Leadership

    OpenAIRE

    Kaufman, EK; Thornton, J; Coartney, J

    2017-01-01

    The Multi-institutional Study of Leadership (MSL) is an international research program focused on understanding the influences of higher education in shaping socially responsible leadership capacity and other related student outcomes. While there have been numerous reports on the quantitative findings from the MSL, the published research tends to ignore data from the qualitative prompt: “Please provide a brief definition of what the term leadership means to you.” By coding and categorizing th...

  15. Identifying risk factors for blindness from primary open-angle glaucoma by race: a case-control study.

    Science.gov (United States)

    Williams, Andrew M; Huang, Wei; Muir, Kelly W; Stinnett, Sandra S; Stone, Jordan S; Rosdahl, Jullia A

    2018-01-01

    To examine the factors associated with blindness from primary open-angle glaucoma (POAG) among black and white patients at our institution. For this retrospective, case-control study, patients legally blind from POAG ("cases") were matched on age, race, and gender with non-blind POAG patients ("controls"). Thirty-seven black case-control pairs and 19 white case-control pairs were included in this study. Clinical variables were compared at initial presentation and over the course of follow-up. Black case-control pairs and white case-control pairs had similar characteristics at presentation, including cup-to-disc ratio and number of glaucoma medications. However, over the course of follow-up, black cases underwent significantly more glaucoma surgeries than matched controls (2.4 versus 1.2, p =0.001), whereas white cases and controls had no significant difference in glaucoma operations (0.9 versus 0.6, p =0.139). Our analysis found that glaucoma surgery is associated with blindness in black patients (odds ratio [OR] 1.6, 95% CI 1.1-2.2) but not in white patients (OR 1.5, 95% CI 0.7-3.2). Black and white case-control pairs with POAG shared similar risk factors for blindness at presentation. However, over the follow-up period, black cases required significantly more glaucoma surgeries compared to black controls, whereas there was no significant difference in surgery between white cases and controls. There was no difference in medication changes in either case-control set.

  16. 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.

  17. A Case Study of Organizational Collaboration in an Institution of Higher Education

    Science.gov (United States)

    Schmaltz, Sarah Katherine Abrams

    2010-01-01

    The study, A Case Study of Organizational Collaboration in an Institution of Higher Education, is a look into what is working and what is not working inside a collaborative initiative at the University of Virginia called the Partners for Leadership in Education. The Partners for Leadership in Education is one of the longest lasting collaborations…

  18. 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....

  19. Exploring Curricular Transformation to Promote Innovation and Entrepreneurship: An Institutional Case Study

    Science.gov (United States)

    McClure, Kevin R.

    2015-01-01

    Colleges and universities in the United States have developed and implemented a wide array of opportunities for undergraduate students to learn about innovation and entrepreneurship. Drawing upon an institutional case study, this article examines why one public research university initiated and supported curricular and co-curricular offerings in…

  20. CONTROL ENVIRONMENT IN KOSOVO PUBLIC INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Shaqir M. REXHEPI

    2015-06-01

    Full Text Available The study on how is Internal Control System developed in public institutions is of a special importance for modalities, forms and the manner of the application of relevant strategies for the functioning of internal control environment in public institutions. In this paper, there is treated the existing situation of internal control system environment of public finances and its implementation in public sector. For internal control system environment in public finances to function effectively, there should exist a coherent control environment which includes responsibilities for financial management from managers of Publicly Owned Enterprises and with complete functioning of internal audit, which exists in the function of development to add value. In Kosovo public institutions, this framework is offered by legislation and by institutional mechanism for the implementation of legislation according to these parameters.

  1. 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...

  2. A Qualitative Multi-Site Case Study: Examining Principals' Leadership Styles and School Performance

    Science.gov (United States)

    Preyear, Loukisha

    2015-01-01

    The purpose of this qualitative multi-site case study was to explore the impact of principals' leadership styles on student academic achievement in a high-poverty low-performing school district in Louisiana. A total of 17 participants, principals and teachers, from this school district were used in this study. Data source triangulation of…

  3. 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.

  4. Intersection signal control multi-objective optimization based on genetic algorithm

    Directory of Open Access Journals (Sweden)

    Zhanhong Zhou

    2014-04-01

    Full Text Available A signal control intersection increases not only vehicle delay, but also vehicle emissions and fuel consumption in that area. Because more and more fuel and air pollution problems arise recently, an intersection signal control optimization method which aims at reducing vehicle emissions, fuel consumption and vehicle delay is required heavily. This paper proposed a signal control multi-object optimization method to reduce vehicle emissions, fuel consumption and vehicle delay simultaneously at an intersection. The optimization method combined the Paramics microscopic traffic simulation software, Comprehensive Modal Emissions Model (CMEM, and genetic algorithm. An intersection in Haizhu District, Guangzhou, was taken for a case study. The result of the case study shows the optimal timing scheme obtained from this method is better than the Webster timing scheme.

  5. 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.

  6. 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.

  7. 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.

  8. Inter-Institutional Comparison on Working Power Loss Evaluated Cases

    Directory of Open Access Journals (Sweden)

    Volkan Ünal

    2016-04-01

    Full Text Available Objective: In Turkey, individuals who want to retire due to illness and determined within the provisions of the relevant rules and regulations are defined as 'retirement due to disability1. When the insured apply with a petition, describing that s/he cannot work because of the diseases, retirement process begins. First Social Security Institution in case of objection Social Security Supreme Council of Health prepares reports about individuals. Third Specialization Board of the Council of Forensic Medicine is the final expertise authority on these cases. With this study it is aimed to reveal the decision differences on 'retirement due to disability1 cases between the Third Specialization Board of the Council of Forensic Medicine and the other institutions and, guided with the findings, to provide the standardization in practical implementation. Materials and Methods: For this study; the reports of the 3rd Specialization Board of The Council of Forensic Medicine were retrospectively investigated and the cases who were reported as not suitable for the retirement due to diseases by Social Security Institution and Social Security Supreme Council of Health but reported as suitable for the retirement due to diseases by the 3”1 Specialization Board were included. Results: Totally sixty four cases were determined. Fifty seven of the cases were male and seven ofthem were female. Average age of female cases was 50.71, male cases were 49.89 and average age of all cases was 49.98. Conclusion: Even the rules and regulations are same, there are differences between institutions. While rules and regulations are constituted, taking common decisions by negotiating on practice principles should reduce the differences between institutions and provide faster decision makings. Institutions should arrange routine meetings and discuss about the cases and present assessments interactively. Keywords: Working Power Loss, Inter-Instutional Comparison, Forensic medicine.

  9. Fulfilling an Institutional and Public Good Mission: A Case Study of Access

    Science.gov (United States)

    Batman, Renee F.

    2013-01-01

    Access to higher education has been and remains a critical issue, yet research typically focuses on students and programs which may overlook the role of the faculty. Through an in-depth case study, the perspectives of tenured and tenure-track faculty at a predominately White, Midwestern land-grant, research institution are described as they relate…

  10. Application of multi-locus analytical methods to identify interacting loci in case-control studies.

    NARCIS (Netherlands)

    Vermeulen, S.; Heijer, M. den; Sham, P.; Knight, J.

    2007-01-01

    To identify interacting loci in genetic epidemiological studies the application of multi-locus methods of analysis is warranted. Several more advanced classification methods have been developed in the past years, including multiple logistic regression, sum statistics, logic regression, and the

  11. Studies on the coordinated operation and autonomous control for multi-modular nuclear power plants

    International Nuclear Information System (INIS)

    Hui Chao; Huang Xiaojin; Wang Jie

    2011-01-01

    The tendency has always been to build ever larger single-modular reactor plants with the objective of benefiting from economies of scale. These plants have compiled admirable safety records. Nevertheless, there is concern that conventional large single reactors have become too complex by reason of placing too much reliance on engineered safeguards. The multi-modular approach offers a solution in that its use of many small reactors in conjunction with several shared turbines permits a simpler core design while, at the same time, at least partially retaining economies of scale by increasing the number of modules. Specific advantages to the multi-modular approach are as follows. First, the small-sized of the reactor core may allow the incorporation of passive safety features such as natural circulation cooling on loss of off-site electricity. Second, the individual modules are to be sized so that components related to nuclear safety can be factory-fabricated. Moreover, once the major components are made, they are to be transported to the site for rapid installation. This construction method is expected to reduce the licensing effort because the modules will be pre-licensed, and only site-specific issues will have to be considered in the final licensing process. At present, related studies show that the multi-modular approach for Generation IV can retain both the inherent safety and good economies of scale. However, the unbalanced load operation of the multi-modular power plant in which each module operates at a different power level and strong coupling between multi modules creates a complex control challenge to safe operation and control. Firstly, this paper summarizes the unbalanced load operation characteristics and challenges faced by operation and control of multi-modular power plant in the dynamic operational characteristics and requirements of coordinated control between multi modules. Secondly, detailed analysis and comparison are given in the integral

  12. 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.

  13. From "fixing women" to "institutional transformation": An ADVANCE case study

    Science.gov (United States)

    Yennello, Sherry; Kaunas, Christine

    2015-12-01

    The United States' position in the global economy requires an influx of women into science, technology, engineering, and mathematics (STEM) fields in order to remain competitive. Despite this, the representation of women in STEM continues to be low. The National Science Foundation's ADVANCE Program addresses this issue by funding projects that aim to increase the representation of women in academic STEM fields through transformation of institutional structures that impede women's progress in academic STEM fields. This paper includes a case study of the Texas A&M University ADVANCE Program.

  14. Nuclear forensics case studies

    International Nuclear Information System (INIS)

    Fedchenko, Vitaly

    2016-01-01

    The objective of this presentation is to share three case studies from the Institute of Transuranium Elements (ITU) which describe the application of nuclear forensics to events where nuclear and other radioactive material was found to be out of regulatory control

  15. Coordinated Control of Multi-terminal DC Grid for Wind Power Integration

    DEFF Research Database (Denmark)

    Hao, Yu; Zhao, Haoran; Wu, Qiuwei

    2016-01-01

    Multi-terminal HVDC (MTDC) technology using voltage source converter (VSC) is a good option for wind power integration. Compared with point to point DC connection, MTDC provide better controllability based on different control strategies. In this paper, proportional-integral (PI) controllers...... with tuned PI parameters are designed to coordinate DC flow among the DC grid with good dynamic performance. In order to overcome the disadvantages of the conventional PI control, a simple adaptive PI control strategy is proposed based on the system transfer function. Case studies were conducted with PowerFactory....

  16. A case-control study of visual acuity in onychocryptosis.

    LENUS (Irish Health Repository)

    Hogan, Aisling M

    2012-02-01

    BACKGROUND: There are many theories surrounding the etiology of ingrown toenails (IGTN). Few factors have been formally assessed, but it is widely accepted that a poor nail cutting technique has a causative role. AIM: To investigate the hypothesis that decreased visual acuity may lead to inadequate nail cutting and the formation of IGTN. METHODS: A prospective case-control study was performed. Near and distance visual acuity were tested on a population with IGTN (n = 19) and compared with that of an age- and sex-matched control cohort (n = 24) who underwent epidermal cyst excision in the same tertiary referral center. Comparisons of visual acuity were made between groups by Mann-Whitney U-test. Differences were taken to be significant if P < 0.05. Institutional Review Board approval was sought and granted. RESULTS: No significant difference in visual acuity (near or distance) was demonstrated between patients with IGTN and the control group (P = 0.33). CONCLUSION: Visual acuity does not appear to play a significant role in the development of IGTN.

  17. Risk factors for fatality among confirmed adult dengue inpatients in Singapore: a matched case-control study.

    Directory of Open Access Journals (Sweden)

    Tun-Linn Thein

    Full Text Available OBJECTIVES: To identify demographic, clinical and laboratory risk factors for death due to dengue fever in adult patients in Singapore. METHODS: Multi-center retrospective study of hospitalized adult patients with confirmed dengue fever in Singapore between 1 January 2004 and 31 December 2008. Non-fatal controls were selected by matching age and year of infection with fatal cases. World Health Organization 1997, 2009 criteria were applied to define dengue hemorrhagic fever (DHF, warning signs and severe dengue. Statistical significance was assessed by conditional logistic regression modeling. RESULTS: Significantly more fatal cases than matched controls had pre-existing co-morbid conditions, and presented with abdominal pain/tenderness. Median pulse rates were significantly higher while myalgia was significantly less frequent in cases. . Fatal cases also had higher leucocyte counts, platelet counts, serum sodium, potassium, urea, creatine and bilirubin levels on admission compared to controls. There was no statistical significant difference between the prevalence of DHF and hematocrit level among cases and controls. Multivariate analysis showed myalgia and leucocyte count at presentation were independent predictors of fatality (adjusted odds ratios 0.09 and 2.94 respectively. None of the controls was admitted to intensive care unit (ICU or given blood transfusion, while 71.4% and 28.6% of fatal cases received ICU admission and blood transfusion. CONCLUSIONS: Absence of myalgia and leucocytosis on admission were independently associated with fatality in our matched case-control study. Fatalities were also commonly associated with co-morbidities and clinicians should be alarmed if dengue patients fulfilled severe dengue case definition on admission.

  18. Case Studies in Modelling, Control in Food Processes.

    Science.gov (United States)

    Glassey, J; Barone, A; Montague, G A; Sabou, V

    This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

  19. Case-Control Studies - An Efficient Observational Study Design

    NARCIS (Netherlands)

    van Stralen, Karlijn J.; Dekker, Friedo W.; Zoccali, Carmine; Jager, Kitty J.

    2010-01-01

    Case-control studies are an efficient research method for investigating risk factors of a disease. The method involves the comparison of the odds of exposure in a patient group with that of the odds of exposure in a control group. As only a minority of the population is included in the study, less

  20. Radiomic features for prostate cancer detection on MRI differ between the transition and peripheral zones: Preliminary findings from a multi-institutional study.

    Science.gov (United States)

    Ginsburg, Shoshana B; Algohary, Ahmad; Pahwa, Shivani; Gulani, Vikas; Ponsky, Lee; Aronen, Hannu J; Boström, Peter J; Böhm, Maret; Haynes, Anne-Maree; Brenner, Phillip; Delprado, Warick; Thompson, James; Pulbrock, Marley; Taimen, Pekka; Villani, Robert; Stricker, Phillip; Rastinehad, Ardeshir R; Jambor, Ivan; Madabhushi, Anant

    2017-07-01

    To evaluate in a multi-institutional study whether radiomic features useful for prostate cancer (PCa) detection from 3 Tesla (T) multi-parametric MRI (mpMRI) in the transition zone (TZ) differ from those in the peripheral zone (PZ). 3T mpMRI, including T2-weighted (T2w), apparent diffusion coefficient (ADC) maps, and dynamic contrast-enhanced MRI (DCE-MRI), were retrospectively obtained from 80 patients at three institutions. This study was approved by the institutional review board of each participating institution. First-order statistical, co-occurrence, and wavelet features were extracted from T2w MRI and ADC maps, and contrast kinetic features were extracted from DCE-MRI. Feature selection was performed to identify 10 features for PCa detection in the TZ and PZ, respectively. Two logistic regression classifiers used these features to detect PCa and were evaluated by area under the receiver-operating characteristic curve (AUC). Classifier performance was compared with a zone-ignorant classifier. Radiomic features that were identified as useful for PCa detection differed between TZ and PZ. When classification was performed on a per-voxel basis, a PZ-specific classifier detected PZ tumors on an independent test set with significantly higher accuracy (AUC = 0.61-0.71) than a zone-ignorant classifier trained to detect cancer throughout the entire prostate (P  0.14) were obtained for all institutions. A zone-aware classifier significantly improves the accuracy of cancer detection in the PZ. 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:184-193. © 2016 International Society for Magnetic Resonance in Medicine.

  1. Variable cycle control model for intersection based on multi-source information

    Science.gov (United States)

    Sun, Zhi-Yuan; Li, Yue; Qu, Wen-Cong; Chen, Yan-Yan

    2018-05-01

    In order to improve the efficiency of traffic control system in the era of big data, a new variable cycle control model based on multi-source information is presented for intersection in this paper. Firstly, with consideration of multi-source information, a unified framework based on cyber-physical system is proposed. Secondly, taking into account the variable length of cell, hysteresis phenomenon of traffic flow and the characteristics of lane group, a Lane group-based Cell Transmission Model is established to describe the physical properties of traffic flow under different traffic signal control schemes. Thirdly, the variable cycle control problem is abstracted into a bi-level programming model. The upper level model is put forward for cycle length optimization considering traffic capacity and delay. The lower level model is a dynamic signal control decision model based on fairness analysis. Then, a Hybrid Intelligent Optimization Algorithm is raised to solve the proposed model. Finally, a case study shows the efficiency and applicability of the proposed model and algorithm.

  2. Pilot case-control study of paediatric falls from windows.

    Science.gov (United States)

    Johnston, Brian D; Quistberg, D Alexander; Shandro, Jamie R; Partridge, Rebecca L; Song, Hyun Rae; Ebel, Beth E

    2011-12-01

    Unintentional falls from windows are an important cause of paediatric morbidity. There have been no controlled studies to identify modifiable environmental risk factors for window falls in young children. The authors have piloted a case-control study to test procedures for case identification, subject enrolment, and environmental data collection. Case windows were identified when a child 0-9 years old presented for care after a fall from that window. Control windows were identified (1) from the child's home and (2) from the home of an age- and gender-matched child seeking care for an injury diagnosis not related to a window fall. Study staff visited enrolled homes to collect window measurements and conduct window screen performance tests. The authors enrolled and collected data on 18 case windows, 18 in-home controls, and 14 matched community controls. Six potential community controls were contacted for every one enrolled. Families who completed the home visit viewed study procedures positively. Case windows were more likely than community controls to be horizontal sliders (100% vs 50%), to have deeper sills (6.28 vs 4.31 inches), to be higher above the exterior surface (183 vs 82 inches), and to have screens that failed below a threshold derived from the static pressure of a 3-year-old leaning against the mesh (60.0% vs 16.7%). Case windows varied very little from in-home controls. Case-control methodology can be used to study risk factors for paediatric falls from windows. Recruitment of community controls is challenging but essential, because in-home controls tend to be over-matched on important variables. A home visit allows direct measurement of window type, height, sill depth, and screen performance. These variables should all be investigated in subsequent, larger studies covering major housing markets.

  3. Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran.

    Science.gov (United States)

    Naghavi-Behzad, Mohammad; Alizadeh, Mahasti; Azami, Saber; Foroughifar, Shirin; Ghasempour-Dabbaghi, Khazar; Karzad, Nazila; Ahadi, Hamid-Reza; Naghavi-Behzad, Ali

    2013-01-01

    Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD) in newborn infants of Northwest Iran. A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman's correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI), using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA), fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (Prelationship with CHD incidence. Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers' illnesses, improving pregnancy health care and mothers' health status for the purpose of better well-being of newborn infants.

  4. Risk Factors of Congenital Heart Diseases: A Case-Control Study in Northwest Iran

    Directory of Open Access Journals (Sweden)

    Naghavi-Behzad Mohammad

    2013-03-01

    Full Text Available Introduction: Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD in newborn infants of Northwest Iran. Methods: A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman’s correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI, using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Results: Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA, fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (P<0.05. Family history, past cesarean sections history, past medical history and GA had significant relationship with CHD incidence. Conclusion: Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers’ illnesses, improving pregnancy health care and mothers

  5. Institutional control and monitoring

    International Nuclear Information System (INIS)

    Bragg, K.

    2002-01-01

    This paper provides several possible principles to be used to guide future discussions and tries to place the need for institutional control into context for the various waste types. The proposed principles would allow institutional control to be used as one method to provide radiation protection in the future without presenting undue burdens to future generations. It also provides advice on how to apply the proposed principles in a practical manner. The key difference in the approach proposed is that institutional control should be viewed as a need to pass on information, knowledge and skills from one generation to the next. This would allow each successive generation to make its own decision as to whether such controls should be maintained. (author)

  6. 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.

  7. Institutional ethical review and ethnographic research involving injection drug users: a case study.

    Science.gov (United States)

    Small, Will; Maher, Lisa; Kerr, Thomas

    2014-03-01

    Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators' responses to the committee's concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork, and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Multi-Institutional Development of a Mastoidectomy Performance Evaluation Instrument.

    Science.gov (United States)

    Kerwin, Thomas; Hittle, Brad; Stredney, Don; De Boeck, Paul; Wiet, Gregory

    A method for rating surgical performance of a mastoidectomy procedure that is shown to apply universally across teaching institutions has not yet been devised. This work describes the development of a rating instrument created from a multi-institutional consortium. Using a participatory design and a modified Delphi approach, a multi-institutional group of expert otologists constructed a 15-element task-based checklist for evaluating mastoidectomy performance. This instrument was further refined into a 14-element checklist focusing on the concept of safety after using it to rate a large and varied population of performances. Twelve otolaryngological surgical training programs in the United States. A total of 14 surgeons from 12 different institutions took part in the construction of the instrument. By using 14 experts from 12 different institutions and a literature review, individual metrics were identified, rated as to the level of importance and operationally defined to create a rating scale for mastoidectomy performance. Initial use of the rating scale showed modest rater agreement. The operational definitions of individual metrics were modified to emphasize "safe" as opposed to "proper" technique. A second rating instrument was developed based on this feedback. Using a consensus-building approach with multiple rounds of communication between experts is a feasible way to construct a rating instrument for mastoidectomy. Expert opinion alone using a Delphi method provides face and content validity evidence, however, this is not sufficient to develop a universally acceptable rating instrument. A continued process of development and experimentation to demonstrate evidence for reliability and validity making use of a large population of raters and performances is necessary to achieve universal acceptance. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Institutional Controls

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset consists of institutional control data from multiple Superfund sites in U.S. EPA Region 8. These data were acquired from multiple sources at different...

  10. Workplace moral harassment and its consequences: A case study in a federal higher education institution

    Directory of Open Access Journals (Sweden)

    Carmelita Angélica Guimarães

    2016-06-01

    Full Text Available ABSTRACT This paper aims to characterize a case of moral harassment in a federal institution of higher education and to identify its consequences for the different actors. We carried out a descriptive and qualitative case study and collected data by means of documentary research with an analysis of the related administrative process, which includes statements of those involved in the case, and an in-depth interview with the harassed employee. The results revealed the occurrence of vertical descendant moral harassment characterized by abuse of power, authoritarianism and perverse manipulation, with severe consequences for the harassed employee´s physical, mental and emotional health. We found that the institution's human resources management department's non-action in terms of intermediating the conflict and the institutional culture and structure may all have favored the occurrence of the case and the harasser´s impunity. For the organization, the occurrences generated degradation in the workplace and in motivation and the team split, as well as income decline and other financial losses. Beyond the financial issues, there was also even more serious damage to the society, as a public institution should look after citizens´ properties and civil rights, whether concerning finances, productivity or social areas. We can conclude that moral harassment is a multidimensional process that violates the individual´s fundamental rights with severe impact on his/her physical and psychological health, on organizations and on the society in general.

  11. Tuning method for multi-variable control system with PID controllers

    International Nuclear Information System (INIS)

    Fujiwara, Toshitaka

    1983-01-01

    Control systems, including thermal and nuclear power plants, generally and mainly use PID controllers consisting of proportional, integral and differential actions. These systems consist of multiple control loops which interfere with each other. Therefore, it is present status that the fine control of the system is carried out by the trial and error method because the adjusting procedure for a single control loop cannot be applied to a multi-loop system in most cases. In this report, a method to effectively adjust PID controller parameters in a short time in a control system which consists of multi-loops that interfere with each other. This method makes adjustment by using the control area as the evaluation function, which is the time-dependent integration of control deviation, the input to the PID controllers. In other words, the evaluation function is provided for each control result for every parameter (gain constant, reset rate, and differentiation time), and all parameters are simultaneously changed in the direction of minimizing the values of these evaluation functions. In the report, the principle of tuning method, the evaluation function for each of three parameters, and the adjusting system configuration for separately using for actual plant tuning and for control system design are described. It also shows the examples of application to the actual tuning of the control system for a thermal power plant and to a control system design. (Wakatsuki, Y.)

  12. Food and dietary patterns and multiple sclerosis: a case-control study in Belgrade (Serbia

    Directory of Open Access Journals (Sweden)

    Tatjana D. Pekmezovic

    2009-03-01

    Full Text Available

    Background: The aetiology of multiple sclerosis (MS is unclear, but numerous studies suggest that different exogenous factors can lead to the development of the disease in genetically susceptible individuals. The objective of this case-control study was to determine the role of food and dietary patterns in patients with MS in the population of Belgrade (Serbia.

    Methods: In this matched case-control study, we included 110 cases with definite MS according to McDonald’s criteria, in whom the onset symptoms occurred up to 2 years prior to the interview, who were followed-up at the Institute of Neurology, Clinical Centre of Serbia, Belgrade. The identical number of controls from the same institution, individually matched by sex, age and area of residence, was recruited from patients with various non-autoimmune neurological disorders. Dietary information was obtained by using a frequency history approach.

    Results: According to univariate conditional logistic regression analysis the following factors were significantly related to MS: body mass index (BMI less than 25 (OR=2.2, p=0.009, frequent consumption of beef (OR=1.7, p=0.043, chicken (OR=2.0, p=0.045, meat of the lamb (OR=2.1, p=0.013, butter (OR=1.7, p=0.056 and ice-cream (OR=1.8, p=0.031, with dose-response relationship. Consumption of majority of various fruit was more frequently reported by controls. According to multivariate conditional logistic regression analysis, BMI less than 25 (OR=2.3, p=0.008, consumption (weekly of beef (OR=2.0, p=0.017 and butter (OR=1.9, p=0.027 was significantly related to MS, while regular consumption of cherry (OR=0.4, p=0.024 had protective role.

    Conclusions: This study might assist in potential defining of the dietary factors that could contribute to the risk of developing MS.

  13. Serum Antibodies against Genitourinary Infectious Agents in Prostate Cancer and Benign Prostate Hyperplasia Patients: A Case-Control Study

    Czech Academy of Sciences Publication Activity Database

    Hrbáček, J.; Urban, M.; Hamšíková, E.; Tachezy, R.; Eisenbruk, V.; Brabec, Marek; Heráček, J.

    2011-01-01

    Roč. 11, Art.no. 53 (2011), s. 1-10 ISSN 1471-2407 Institutional research plan: CEZ:AV0Z10300504 Keywords : serum antibodies * prostate cancer * case-control study * logistic regression, calibration Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 3.011, year: 2011

  14. Using the CER Hub to ensure data quality in a multi-institution smoking cessation study.

    Science.gov (United States)

    Walker, Kari L; Kirillova, Olga; Gillespie, Suzanne E; Hsiao, David; Pishchalenko, Valentyna; Pai, Akshatha Kalsanka; Puro, Jon E; Plumley, Robert; Kudyakov, Rustam; Hu, Weiming; Allisany, Art; McBurnie, MaryAnn; Kurtz, Stephen E; Hazlehurst, Brian L

    2014-01-01

    Comparative effectiveness research (CER) studies involving multiple institutions with diverse electronic health records (EHRs) depend on high quality data. To ensure uniformity of data derived from different EHR systems and implementations, the CER Hub informatics platform developed a quality assurance (QA) process using tools and data formats available through the CER Hub. The QA process, implemented here in a study of smoking cessation services in primary care, used the 'emrAdapter' tool programmed with a set of quality checks to query large samples of primary care encounter records extracted in accord with the CER Hub common data framework. The tool, deployed to each study site, generated error reports indicating data problems to be fixed locally and aggregate data sharable with the central site for quality review. Across the CER Hub network of six health systems, data completeness and correctness issues were prevalent in the first iteration and were considerably improved after three iterations of the QA process. A common issue encountered was incomplete mapping of local EHR data values to those defined by the common data framework. A highly automated and distributed QA process helped to ensure the correctness and completeness of patient care data extracted from EHRs for a multi-institution CER study in smoking cessation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. H. pylori infection and gastric cancer in Bangladesh: a case-control study.

    Science.gov (United States)

    Sarker, Khandker Kawser; Kabir, Md Jahangir; Bhuyian, A K M Minhaj Uddin; Alam, Md Shahjadul; Chowdhury, Fazle Rabbi; Ahad, M Abdul; Rahman, Md Anisur; Rahman, M Mizanur

    2017-11-01

    Like that of other Asian countries gastric cancer (GC) is also a leading cancer in Bangladesh and also a cause for cancer-related mortality. Infection with Helicobacter pylori ( H. pylori ) is the strongest recognized risk factor for gastric adenocarcinoma. The infection is also prevalent in common people. This case-control study was carried out to find an association between GC and H. pylori infection in the community. To evaluate association of H. pylori and carcinoma of stomach this study was conducted at National Institute of Cancer Research & Hospital, Dhaka from January 2013 to December 2014. H. pylori status was determined serologically by using H. pylori kit in the department of Biochemistry laboratory of Bangabandhu Sheikh Mujib Medical University. In total, 114 patients with GC and 520 patients not having GC were studied as controls. Logistic regression method was used to calculate the odds ratio. Significantly more patients in the case group (86.8%) were found to be seropositive for H. pylori antigen in contrast to the control group (67.5%). All of the cases in the present study were in advanced stage. No significant association between H. pylori seropositivity and tumor location was found. It was noted that undifferentiated gastric carcinoma had slightly more association with H. pylori infection. Younger H. pylori -infected patients had been found to be at higher relative risk for GC than older patients. As there is a strong association found between GC and H. pylori infection special emphasis to eradicate H. pylori infection might reduce the incidence of this dreadly disease.

  16. Developing Multi-Level Institutions from Top-Down Ancestors

    Directory of Open Access Journals (Sweden)

    Martha Dowsley

    2007-11-01

    Full Text Available The academic literature contains numerous examples of the failures of both top-down and bottom-up common pool resource management frameworks. Many authors agree that management regimes instead need to utilize a multi-level governance approach to meet diverse objectives in management. However, many currently operating systems do not have that history. This paper explores the conversion of ancestral top-down regimes to complex systems involving multiple scales, levels and objectives through the management of the polar bear (Ursus maritimus in its five range countries. The less successful polar bear management systems continue to struggle with the challenges of developing institutions with the capacity to learn and change, addressing multiple objectives while recognizing the conservation backbone to management, and matching the institutional scale with biophysical, economic and social scales. The comparatively successful institutions incorporate these features, but reveal on-going problems with vertical links that are partially dealt with through the creation of links to other groups.

  17. 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...

  18. Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies.

    Science.gov (United States)

    Ford, Earl S; Smith, S Jay; Stroup, Donna F; Steinberg, Karen K; Mueller, Patricia W; Thacker, Stephen B

    2002-02-01

    Elevated concentrations of homocyst(e)ine are thought to increase the risk of vascular diseases including coronary heart disease and cerebrovascular disease. We searched MEDLINE (1966-1999), EMBASE (1974-1999), SciSearch (1974- 1999), and Dissertation Abstracts (1999) for articles and theses about homocyst(e)ine concentration and coronary heart disease and cerebrovascular disease. We included 57 publications (3 cohort studies, 12 nested case-control studies, 42 case-control studies) that reported results on 5518 people with coronary heart disease (11,068 control subjects) and 1817 people with cerebrovascular disease (4787 control subjects) in our analysis. For coronary heart disease, the summary odds ratios (OR) for a 5-micromol/l increase in homocyst(e)ine concentration were 1.06 (95% CI : 0.99-1.13) for 2 publications of cohort studies, 1.23 (95% CI : 1.07-1.41) for 10 publications of nested case-control studies, and 1.70 (95% CI : 1.50-1.93) for 26 publications of case-control studies. For cerebrovascular disease, the summary OR for a 5-micromol/l increase in homocyst(e)ine concentration were 1.10 (95% CI : 0.94-1.28) for 2 publications of cohort studies, 1.58 (95% CI : 1.35-1.85) for 5 publications of nested case-control studies, and 2.16 (95% CI : 1.65-2.82) for 17 publications of case-control studies. Prospective studies offer weaker support than case-control studies for an association between homocyst(e)ine concentration and cardiovascular disease. Although other lines of evidence support a role for homocyst(e)ine in the pathogenesis of cardiovascular disease, more information from prospective epidemiological studies or clinical trials is needed to clarify this role.

  19. 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

  20. 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.)

  1. Multi-agent control system with information fusion based comfort model for smart buildings

    International Nuclear Information System (INIS)

    Wang, Zhu; Wang, Lingfeng; Dounis, Anastasios I.; Yang, Rui

    2012-01-01

    Highlights: ► Proposed a model to manage indoor energy and comfort for smart buildings. ► Developed a control system to maximize comfort with minimum energy consumption. ► Information fusion with ordered weighted averaging aggregation is used. ► Multi-agent technology and heuristic intelligent optimization are deployed in developing the control system. -- Abstract: From the perspective of system control, a smart and green building is a large-scale dynamic system with high complexity and a huge amount of information. Proper combination of the available information and effective control of the overall building system turns out to be a big challenge. In this study, we proposed a building indoor energy and comfort management model based on information fusion using ordered weighted averaging (OWA) aggregation. A multi-agent control system with heuristic intelligent optimization is developed to achieve a high level of comfort with the minimum power consumption. Case studies and simulation results are presented and discussed in this paper.

  2. An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study

    Science.gov (United States)

    Drews, Steven J; Richardson, Susan E; Wray, Rick; Freeman, Renee; Goldman, Carol; Streitenberger, Laurie; Stevens, Derek; Goia, Cristina; Kovach, Danuta; Brophy, Jason; Matlow, Anne G

    2008-01-01

    BACKGROUND The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions. PMID:19412380

  3. STUDY ON NEED FOR SUSTAINABLE DEVELOPMENT IN EDUCATIONAL INSTITUTIONS – A CASE STUDY OF COLLEGE OF ENGINEERING- GUINDY, CHENNAI

    Directory of Open Access Journals (Sweden)

    Gobinath Ravindran

    2010-06-01

    Full Text Available Sustainability has become the key word of developing world and it’s evident in many issues, the growing economy is facing nowadays. Sustainability is the need of the hour for Indian economy to support our future generation with a cleaner, safer environment. Legal framework implemented by governing bodies such as Pollution control board is also supporting the implementation of sustainable development by new enforcements introduced then and there, but it is questionable about the effectiveness of this frameworks. Most of the enforcements are focusing to imply the sustainability in industries or equivalent organizations but not putting thrust on all polluting bodies, educational institutions are one among them. Recent growth in educational scenario in India had increased the number of educational institutions to a large extent, also increased the effect on environment by their activities. Growth of educational sector and the number of institutions catering various fields of education is needed for India but the growth should be optimized in a way such that it’s sustainable and eco friendly. Various methods are developed recently to find out the exact problems associated with the environment, Geograpchial Information System (GIS is one among them taking a big leap in the recent years in the area of environmental problem identification. This paper provides the details of the environmental impacts of educational institutions with case studies and also suggests a sustainable framework to make them environmental friendly by the use of (GIS.

  4. Collaborative Teaching and Learning through Multi-Institutional Integrated Group Projects

    Science.gov (United States)

    Long, Suzanna K.; Carlo, Héctor J.

    2013-01-01

    This teaching brief describes an innovative multi-institutional initiative through which integrated student groups from different courses collaborate on a common course project. In this integrated group project, students are asked to design a decentralized manufacturing organization for a company that will manufacture industrial Proton-Exchange…

  5. Multi-criteria selection of offshore wind farms: Case study for the Baltic States

    International Nuclear Information System (INIS)

    Chaouachi, Aymen; Covrig, Catalin Felix; Ardelean, Mircea

    2017-01-01

    This paper presents a multi-criteria selection approach for offshore wind sites assessment. The proposed site selection framework takes into consideration the electricity network’s operating security aspects, economic investment, operation costs and capacity performances relative to each potential site. The selection decision is made through Analytic Hierarchy Process (AHP), with an inherited flexibility that aims to allow end users to adjust the expected benefits accordingly to their respective and global priorities. The proposed site selection framework is implemented as an interactive case study for three Baltic States in the 2020 time horizon, based on real data and exhaustive power network models, taking into consideration the foreseen upgrades and network reinforcements. For each country the optimal offshore wind sites are assessed under multiple weight contribution scenarios, reflecting the characteristics of market design, regulatory aspects or renewable integration targets. - Highlights: • We use a multi-criteria selection approach for offshore wind sites assessment. • Security aspects, economic investment, operation costs and capacity performances are included. • The selection decision is made through an Analytic Hierarchy Process (AHP). • We implement the methodology as a case study for three Baltic States in the 2020 time horizon.

  6. Globally linearized control on diabatic continuous stirred tank reactor: a case study.

    Science.gov (United States)

    Jana, Amiya Kumar; Samanta, Amar Nath; Ganguly, Saibal

    2005-07-01

    This paper focuses on the promise of globally linearized control (GLC) structure in the realm of strongly nonlinear reactor system control. The proposed nonlinear control strategy is comprised of: (i) an input-output linearizing state feedback law (transformer), (ii) a state observer, and (iii) an external linear controller. The synthesis of discrete-time GLC controller for single-input single-output diabatic continuous stirred tank reactor (DCSTR) has been studied first, followed by the synthesis of feedforward/feedback controller for the same reactor having dead time in process as well as in disturbance. Subsequently, the multivariable GLC structure has been designed and then applied on multi-input multi-output DCSTR system. The simulation study shows high quality performance of the derived nonlinear controllers. The better-performed GLC in conjunction with reduced-order observer has been compared with the conventional proportional integral controller on the example reactor and superior performance has been achieved by the proposed GLC control scheme.

  7. Building the Innovative and Entrepreneurial University: An Institutional Case Study of Administrative Academic Capitalism

    Science.gov (United States)

    McClure, Kevin R.

    2016-01-01

    Although researchers have explored dimensions of academic capitalism among students and faculty members, knowledge of the roles of administrators at all levels is underdeveloped in the literature. This institutional case study of a public research-extensive university examines the roles of executive and managerial administrators in bringing a…

  8. Multi-Objective Sensitivity Analyses for Power Generation Mix: Malaysia Case Study

    OpenAIRE

    Siti Mariam Mohd Shokri; Nofri Yenita Dahlan; Hasmaini Mohamad

    2017-01-01

    This paper presents an optimization framework to determine long-term optimal generation mix for Malaysia Power Sector using Dynamic Programming (DP) technique. Several new candidate units with a pre-defined MW capacity were included in the model for generation expansion planning from coal, natural gas, hydro and renewable energy (RE). Four objective cases were considered, 1) economic cost, 2) environmental, 3) reliability and 4) multi-objectives that combining the three cases. Results show th...

  9. Addressing the multi-scale lapsus of landscape : multi-scale landscape process modelling to support sustainable land use : a case study for the Lower Guadalhorce valley South Spain

    NARCIS (Netherlands)

    Schoorl, J.M.

    2002-01-01

    "Addressing the Multi-scale Lapsus of Landscape" with the sub-title "Multi-scale landscape process modelling to support sustainable land use: A case study for the Lower Guadalhorce valley South Spain" focuses on the role of

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

    Science.gov (United States)

    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.

  11. Matched case-control studies: a review of reported statistical methodology

    Directory of Open Access Journals (Sweden)

    Niven DJ

    2012-04-01

    Full Text Available Daniel J Niven1, Luc R Berthiaume2, Gordon H Fick1, Kevin B Laupland11Department of Critical Care Medicine, Peter Lougheed Centre, Calgary, 2Department of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaBackground: Case-control studies are a common and efficient means of studying rare diseases or illnesses with long latency periods. Matching of cases and controls is frequently employed to control the effects of known potential confounding variables. The analysis of matched data requires specific statistical methods.Methods: The objective of this study was to determine the proportion of published, peer reviewed matched case-control studies that used statistical methods appropriate for matched data. Using a comprehensive set of search criteria we identified 37 matched case-control studies for detailed analysis.Results: Among these 37 articles, only 16 studies were analyzed with proper statistical techniques (43%. Studies that were properly analyzed were more likely to have included case patients with cancer and cardiovascular disease compared to those that did not use proper statistics (10/16 or 63%, versus 5/21 or 24%, P = 0.02. They were also more likely to have matched multiple controls for each case (14/16 or 88%, versus 13/21 or 62%, P = 0.08. In addition, studies with properly analyzed data were more likely to have been published in a journal with an impact factor listed in the top 100 according to the Journal Citation Reports index (12/16 or 69%, versus 1/21 or 5%, P ≤ 0.0001.Conclusion: The findings of this study raise concern that the majority of matched case-control studies report results that are derived from improper statistical analyses. This may lead to errors in estimating the relationship between a disease and exposure, as well as the incorrect adaptation of emerging medical literature.Keywords: case-control, matched, dependent data, statistics

  12. Design of an Embedded Multi-Camera Vision System—A Case Study in Mobile Robotics

    Directory of Open Access Journals (Sweden)

    Valter Costa

    2018-02-01

    Full Text Available The purpose of this work is to explore the design principles for a Real-Time Robotic Multi Camera Vision System, in a case study involving a real world competition of autonomous driving. Design practices from vision and real-time research areas are applied into a Real-Time Robotic Vision application, thus exemplifying good algorithm design practices, the advantages of employing the “zero copy one pass” methodology and associated trade-offs leading to the selection of a controller platform. The vision tasks under study are: (i recognition of a “flat” signal; and (ii track following, requiring 3D reconstruction. This research firstly improves the used algorithms for the mentioned tasks and finally selects the controller hardware. Optimization for the shown algorithms yielded from 1.5 times to 190 times improvements, always with acceptable quality for the target application, with algorithm optimization being more important on lower computing power platforms. Results also include a 3-cm and five-degree accuracy for lane tracking and 100% accuracy for signalling panel recognition, which are better than most results found in the literature for this application. Clear results comparing different PC platforms for the mentioned Robotic Vision tasks are also shown, demonstrating trade-offs between accuracy and computing power, leading to the proper choice of control platform. The presented design principles are portable to other applications, where Real-Time constraints exist.

  13. 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.

  14. 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.

  15. Population versus hospital controls for case-control studies on cancers in Chinese hospitals.

    Science.gov (United States)

    Li, Lin; Zhang, Min; Holman, D'Arcy

    2011-12-15

    Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  16. Population versus hospital controls for case-control studies on cancers in Chinese hospitals

    Directory of Open Access Journals (Sweden)

    Li Lin

    2011-12-01

    Full Text Available Abstract Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs and 95% confidence intervals (CIs were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93. For exposure of green tea drinking, the adjusted ORs (95% CIs comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83 and 0.21 (0.27, 0.74 for three cancers combined, 0.06 (0.01, 0.61 and 0.07 (0.01, 0.47 for breast cancer, 0.52 (0.29, 0.94 and 0.45 (0.25, 0.82 for colorectal cancer, 0.65 (0.08, 5.63 and 0.57 (0.07, 4.79 for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  17. Assessment of global phase uncertainty in case-control studies

    Directory of Open Access Journals (Sweden)

    van Houwelingen Hans C

    2009-09-01

    Full Text Available Abstract Background In haplotype-based candidate gene studies a problem is that the genotype data are unphased, which results in haplotype ambiguity. The measure 1 quantifies haplotype predictability from genotype data. It is computed for each individual haplotype, and for a measure of global relative efficiency a minimum value is suggested. Alternatively, we developed methods directly based on the information content of haplotype frequency estimates to obtain global relative efficiency measures: and based on A- and D-optimality, respectively. All three methods are designed for single populations; they can be applied in cases only, controls only or the whole data. Therefore they are not necessarily optimal for haplotype testing in case-control studies. Results A new global relative efficiency measure was derived to maximize power of a simple test statistic that compares haplotype frequencies in cases and controls. Application to real data showed that our proposed method gave a clear and summarizing measure for the case-control study conducted. Additionally this measure might be used for selection of individuals, who have the highest potential for improving power by resolving phase ambiguity. Conclusion Instead of using relative efficiency measure for cases only, controls only or their combined data, we link uncertainty measure to case-control studies directly. Hence, our global efficiency measure might be useful to assess whether data are informative or have enough power for estimation of a specific haplotype risk.

  18. Case-control study of pleural mesothelioma in workers with social security in Mexico.

    Science.gov (United States)

    Aguilar-Madrid, Guadalupe; Robles-Pérez, Eduardo; Juárez-Pérez, Cuauhtémoc Arturo; Alvarado-Cabrero, Isabel; Rico-Méndez, Flavio Gerardo; Javier, Kelly-García

    2010-03-01

    Environmental and occupational exposure to asbestos in Mexico in the past has been a cause of deaths and health damages. Its magnitude is unknown to date. Our objective was to identify the proportion of cases of malignant pleural mesothelioma (MPM) that can be attributed to and occupational exposure to asbestos. We carried out a case-control study of MPM in 472 workers insured by the Mexican Institute of Social Security, all Valley of Mexico residents, with 119 incident cases and 353 controls. Cases were histologically confirmed. Participants were questioned concerning their occupational history and sociodemographic data. Assignment to one of the four exposures was performed qualitatively by an expert hygienist. Odds ratios (ORs) and attributable risks (ARs) were calculated using a non-conditional logistic regression model. A total of 80.6% of cases and 31.5% of controls had occupational exposure to asbestos. ORs were adjusted for age and gender and by exposure category, and exhibited an increase with probability of exposure as follows: 3.7(95% CI 1.3-10.4) for the likely category and 14.3(95% CI 8-26) for the certain category; AR in the group occupationally exposed to asbestos was 83.2%, and the population AR was 44%. Our results show that the relationship between industrial uses of all forms of asbestos is generating an increase in mesothelioma-related diseases and deaths among Mexican workers. As a public health policy, Mexico should prohibit the use of asbestos in all production processes with the aim of controlling the epidemic and preventing the occurrence of new cases of MPM. 2009 Wiley-Liss, Inc.

  19. Impacts of the use of institutional controls on risk assessments at Department of Energy facilities

    International Nuclear Information System (INIS)

    White, R.K.; Swindle, D.W. Jr.; Redfearn, A.; King, A.D.; Shaw, R.A.

    1992-01-01

    The United States Environmental Protection Agency (EPA), in the National Oil and Hazardous Waste Pollution Contingency Plan (NCP), has determined that institutional controls cannot be applied when determining baseline human health risks from exposure to contaminants present at a hazardous waste site. Environmental restoration activities at DOE-OR/ER sites are primarily driven by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). Therefore, the report focuses on the approaches and assumptions relating to institutional controls under CERCLA. In order to demonstrate the implications of the use of institutional controls at DOE facilities, this report summarizes the approaches and results of the recent baseline risk assessment for Solid Waste Storage Area 6 at Oak Ridge National Laboratory. The report concludes with possible options on the use of institutional controls at DOE-OR/ER sites. This report summarizes some of the major issues related to the use of institutional controls at hazardous waste sites under the auspices of DOE-OR/ER. In particular, the report addresses the impacts that assumptions regarding institutional controls have on the results and interpretation of the risk assessment, [in both the Remedial Investigation (RI) and the FS] and provides a case study from an actual DOE site

  20. Managing an Open Access, Multi-Institutional, International Digital Library: The Digital Library of the Caribbean

    Science.gov (United States)

    Wooldridge, Brooke; Taylor, Laurie; Sullivan, Mark

    2009-01-01

    Developing an Open Access, multi-institutional, multilingual, international digital library requires robust technological and institutional infrastructures that support both the needs of individual institutions alongside the needs of the growing partnership and ensure continuous communication and development of the shared vision for the digital…

  1. 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.

  2. SU-E-T-544: A Radiation Oncology-Specific Multi-Institutional Federated Database: Initial Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, K; Phillips, M; Fishburn, M; Evans, K; Banerian, S; Mayr, N [University of Washington, Seattle, WA (United States); Wong, J; McNutt, T; Moore, J; Robertson, S [Johns Hopkins University, Baltimore, MD (United States)

    2014-06-01

    Purpose: To implement a common database structure and user-friendly web-browser based data collection tools across several medical institutions to better support evidence-based clinical decision making and comparative effectiveness research through shared outcomes data. Methods: A consortium of four academic medical centers agreed to implement a federated database, known as Oncospace. Initial implementation has addressed issues of differences between institutions in workflow and types and breadth of structured information captured. This requires coordination of data collection from departmental oncology information systems (OIS), treatment planning systems, and hospital electronic medical records in order to include as much as possible the multi-disciplinary clinical data associated with a patients care. Results: The original database schema was well-designed and required only minor changes to meet institution-specific data requirements. Mobile browser interfaces for data entry and review for both the OIS and the Oncospace database were tailored for the workflow of individual institutions. Federation of database queries--the ultimate goal of the project--was tested using artificial patient data. The tests serve as proof-of-principle that the system as a whole--from data collection and entry to providing responses to research queries of the federated database--was viable. The resolution of inter-institutional use of patient data for research is still not completed. Conclusions: The migration from unstructured data mainly in the form of notes and documents to searchable, structured data is difficult. Making the transition requires cooperation of many groups within the department and can be greatly facilitated by using the structured data to improve clinical processes and workflow. The original database schema design is critical to providing enough flexibility for multi-institutional use to improve each institution s ability to study outcomes, determine best practices

  3. SU-E-T-544: A Radiation Oncology-Specific Multi-Institutional Federated Database: Initial Implementation

    International Nuclear Information System (INIS)

    Hendrickson, K; Phillips, M; Fishburn, M; Evans, K; Banerian, S; Mayr, N; Wong, J; McNutt, T; Moore, J; Robertson, S

    2014-01-01

    Purpose: To implement a common database structure and user-friendly web-browser based data collection tools across several medical institutions to better support evidence-based clinical decision making and comparative effectiveness research through shared outcomes data. Methods: A consortium of four academic medical centers agreed to implement a federated database, known as Oncospace. Initial implementation has addressed issues of differences between institutions in workflow and types and breadth of structured information captured. This requires coordination of data collection from departmental oncology information systems (OIS), treatment planning systems, and hospital electronic medical records in order to include as much as possible the multi-disciplinary clinical data associated with a patients care. Results: The original database schema was well-designed and required only minor changes to meet institution-specific data requirements. Mobile browser interfaces for data entry and review for both the OIS and the Oncospace database were tailored for the workflow of individual institutions. Federation of database queries--the ultimate goal of the project--was tested using artificial patient data. The tests serve as proof-of-principle that the system as a whole--from data collection and entry to providing responses to research queries of the federated database--was viable. The resolution of inter-institutional use of patient data for research is still not completed. Conclusions: The migration from unstructured data mainly in the form of notes and documents to searchable, structured data is difficult. Making the transition requires cooperation of many groups within the department and can be greatly facilitated by using the structured data to improve clinical processes and workflow. The original database schema design is critical to providing enough flexibility for multi-institutional use to improve each institution s ability to study outcomes, determine best practices

  4. Association Between Anemia and Cerebral Venous Thrombosis: Case-Control Study

    NARCIS (Netherlands)

    Coutinho, Jonathan M.; Zuurbier, Susanna M.; Gaartman, Aafke E.; Dikstaal, Arienne A.; Stam, Jan; Middeldorp, Saskia; Cannegieter, Suzanne C.

    2015-01-01

    Anemia is often considered to be a risk factor for cerebral venous thrombosis (CVT), but this assumption is mostly based on case reports. We investigated the association between anemia and CVT in a controlled study. Unmatched case-control study: cases were adult patients with CVT included in a

  5. 'Away Days' in multi-centre randomised controlled trials: a questionnaire survey of their use and a case study on the effect of one Away Day on patient recruitment.

    Science.gov (United States)

    Jefferson, Laura; Cook, Liz; Keding, Ada; Brealey, Stephen; Handoll, Helen; Rangan, Amar

    2015-11-06

    'Away Days' (trial promotion and training events for trial site personnel) are a well-established method used by trialists to encourage engagement of research sites in the recruitment of patients to multi-centre randomised controlled trials (RCTs). We explored the use of Away Days in multi-centre RCTs and analysed the effect on patient recruitment in a case study. Members of the United Kingdom Trial Managers' Network were surveyed in June 2013 to investigate their experiences in the design and conduct of Away Days in RCTs. We used data from a multi-centre pragmatic surgical trial to explore the effects of an Away Day on the screening and recruitment of patients. A total of 94 people responded to the survey. The majority (78%), who confirmed had organised an Away Day previously, found them to be useful. This is despite their costs.. There was no evidence, however, from the analysis of data from a surgical trial that attendance at an Away Day increased the number of patients screened or recruited at participating sites. Although those responsible for managing RCTs in the UK tend to believe that trial Away Days are beneficial, evidence from a multi-centre surgical trial shows no improvement on a key indicator of trial success. This points to the need to carefully consider the aims, design and conduct of Away Days. Further more rigorous research nested within RCTs would be valuable to evaluate the design and conduct of Away Days. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Issues in Institutional Benchmarking of Student Learning Outcomes Using Case Examples

    Science.gov (United States)

    Judd, Thomas P.; Pondish, Christopher; Secolsky, Charles

    2013-01-01

    Benchmarking is a process that can take place at both the inter-institutional and intra-institutional level. This paper focuses on benchmarking intra-institutional student learning outcomes using case examples. The findings of the study illustrate the point that when the outcomes statements associated with the mission of the institution are…

  7. 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.

  8. Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis.

    Science.gov (United States)

    Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

    2015-03-01

    Between April and June, 2012, a reactive cholera vaccination campaign was done in Haiti with an oral inactivated bivalent whole-cell vaccine. We aimed to assess the effectiveness of the vaccine in a case-control study and to assess the likelihood of bias in that study in a bias-indicator study. Residents of Bocozel or Grand Saline who were eligible for the vaccination campaign (ie, age ≥12 months, not pregnant, and living in the region at the time of the vaccine campaign) were included. In the primary case-control study, cases had acute watery diarrhoea, sought treatment at one of three participating cholera treatment units, and had a stool sample positive for cholera by culture. For each case, four control individuals who did not seek treatment for acute watery diarrhoea were matched by location of residence, enrolment time (within 2 weeks of the case), and age (1-4 years, 5-15 years, and >15 years). Cases in the bias-indicator study were individuals with acute watery diarrhoea with a negative stool sample for cholera. Controls were selected in the same manner as in the primary case-control study. Trained staff used standard laboratory procedures to do rapid tests and stool cultures from study cases. Participants were interviewed to collect data on sociodemographic characteristics, risk factors for cholera, and self-reported vaccination. Data were analysed by conditional logistic regression, adjusting for matching factors. From Oct 24, 2012, to March 9, 2014, 114 eligible individuals presented with acute watery diarrhoea and were enrolled, 25 of whom were subsequently excluded. 47 participants were analysed as cases in the vaccine effectiveness case-control study and 42 as cases in the bias-indicator study. 33 (70%) of 47 cholera cases self-reported vaccination versus 167 (89%) of 188 controls (vaccine effectiveness 63%, 95% CI 8-85). 27 (57%) of 47 cases had certified vaccination versus 147 (78%) of 188 controls (vaccine effectiveness 58%, 13-80). Neither self

  9. Diabetes and Other Risk Factors for Multi-drug Resistant Tuberculosis in a Mexican Population with Pulmonary Tuberculosis: Case Control Study.

    Science.gov (United States)

    Gómez-Gómez, Alejandro; Magaña-Aquino, Martin; López-Meza, Salvador; Aranda-Álvarez, Marcelo; Díaz-Ornelas, Dora E; Hernández-Segura, María Guadalupe; Salazar-Lezama, Miguel Ángel; Castellanos-Joya, Martín; Noyola, Daniel E

    2015-02-01

    Multidrug resistant tuberculosis (MDR-TB) poses problems in treatment, costs and treatment outcomes. It is not known if classically described risk factors for MDR-TB in other countries are the same in Mexico and the frequency of the association between diabetes mellitus (DM) and MDR-TB in our country is not clear. We undertook this study to analyze risk factors associated with the development of MDR-TB, with emphasis on DM. A case-control study in the state of San Luis Potosi (SLP), Mexico was carried out. All pulmonary MDR-TB patients diagnosed in the state of SLP between 1998 and 2013 (36 cases) evaluated at a state pharmacoresistant tuberculosis (TB) clinic and committee; 139 controls were randomly selected from all pulmonary non-multidrug-resistant tuberculosis (non-MDR-TB) cases identified between 2003 and 2008. Cases and controls were diagnosed and treated under programmatic conditions. Age, gender, malnutrition, being a health-care worker, HIV/AIDS status, and drug abuse were not significantly different between MDR-TB and non-MDR-TB patients. Significant differences between MDR-TB and non-MDR-TB patients were DM (47.2 vs. 28.1%; p = 0.028); previous anti-TB treatments (3 vs. 0, respectively; p <0.001), and duration of first anti-TB treatment (8 vs. 6 months, respectively; p <0.001). MDR-TB and DM are associated in 47.2% of MDR TB cases (17/36) in this study. Other recognized factors were not found to be significantly different in MDR-TB compared to non-MDR-TB in this study. Cost-feasible strategies must be implemented in the treatment of DM-TB in order to prevent the selection of MDR-TB. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. Fish intake, cooking practices, and risk of prostate cancer: results from a multi-ethnic case-control study.

    Science.gov (United States)

    Joshi, Amit D; John, Esther M; Koo, Jocelyn; Ingles, Sue A; Stern, Mariana C

    2012-03-01

    Studies conducted to assess the association between fish consumption and prostate cancer (PCA) risk are inconclusive. However, few studies have distinguished between fatty and lean fish, and no studies have considered the role of different cooking practices, which may lead to differential accumulation of chemical carcinogens. In this study, we investigated the association between fish intake and localized and advanced PCA taking into account fish types (lean vs. fatty) and cooking practices. We analyzed data for 1,096 controls, 717 localized and 1,140 advanced cases from the California Collaborative Prostate Cancer Study, a multiethnic, population-based case-control study. We used multivariate conditional logistic regression to estimate odds ratios using nutrient density converted variables of fried fish, tuna, dark fish and white fish consumption. We tested for effect modification by cooking methods (high- vs. low-temperature methods) and levels of doneness. We observed that high white fish intake was associated with increased risk of advanced PCA among men who cooked with high-temperature methods (pan-frying, oven-broiling and grilling) until fish was well done (p (trend) = 0.001). No associations were found among men who cooked fish at low temperature and/or just until done (white fish x cooking method p (interaction) = 0.040). Our results indicate that consideration of fish type (oily vs. lean), specific fish cooking practices and levels of doneness of cooked fish helps elucidate the association between fish intake and PCA risk and suggest that avoiding high-temperature cooking methods for white fish may lower PCA risk.

  12. Case-control vaccine effectiveness studies: Data collection, analysis and reporting results.

    Science.gov (United States)

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    The case-control methodology is frequently used to evaluate vaccine effectiveness post-licensure. The results of such studies provide important insight into the level of protection afforded by vaccines in a 'real world' context, and are commonly used to guide vaccine policy decisions. However, the potential for bias and confounding are important limitations to this method, and the results of a poorly conducted or incorrectly interpreted case-control study can mislead policies. In 2012, a group of experts met to review recent experience with case-control studies evaluating vaccine effectiveness; we summarize the recommendations of that group regarding best practices for data collection, analysis, and presentation of the results of case-control vaccine effectiveness studies. Vaccination status is the primary exposure of interest, but can be challenging to assess accurately and with minimal bias. Investigators should understand factors associated with vaccination as well as the availability of documented vaccination status in the study context; case-control studies may not be a valid method for evaluating vaccine effectiveness in settings where many children lack a documented immunization history. To avoid bias, it is essential to use the same methods and effort gathering vaccination data from cases and controls. Variables that may confound the association between illness and vaccination are also important to capture as completely as possible, and where relevant, adjust for in the analysis according to the analytic plan. In presenting results from case-control vaccine effectiveness studies, investigators should describe enrollment among eligible cases and controls as well as the proportion with no documented vaccine history. Emphasis should be placed on confidence intervals, rather than point estimates, of vaccine effectiveness. Case-control studies are a useful approach for evaluating vaccine effectiveness; however careful attention must be paid to the collection

  13. Case-control study on uveal melanoma (RIFA: rational and design

    Directory of Open Access Journals (Sweden)

    Schmidt-Pokrzywniak Andrea

    2004-08-01

    Full Text Available Abstract Background Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. Methods/Design We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups, except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding.

  14. Struggling doctors in specialist training: a case control study

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Norberg, Karen; Thomsen, Maria

    ), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...

  15. A study of pilot modeling in multi-controller tasks

    Science.gov (United States)

    Whitbeck, R. F.; Knight, J. R.

    1972-01-01

    A modeling approach, which utilizes a matrix of transfer functions to describe the human pilot in multiple input, multiple output control situations, is studied. The approach used was to extend a well established scalar Wiener-Hopf minimization technique to the matrix case and then study, via a series of experiments, the data requirements when only finite record lengths are available. One of these experiments was a two-controller roll tracking experiment designed to force the pilot to use rudder in order to coordinate and reduce the effects of aileron yaw. One model was computed for the case where the signals used to generate the spectral matrix are error and bank angle while another model was computed for the case where error and yaw angle are the inputs. Several anomalies were observed to be present in the experimental data. These are defined by the descriptive terms roll up, break up, and roll down. Due to these algorithm induced anomalies, the frequency band over which reliable estimates of power spectra can be achieved is considerably less than predicted by the sampling theorem.

  16. 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...

  17. A Study of the Organizational Culture at a Higher Education Institution [Case Study: Plekhanov Russian University of Economics (PRUE)

    Science.gov (United States)

    Vasyakin, Bogdan S.; Ivleva, Marina I.; Pozharskaya, Yelena L.; Shcherbakova, Olga I.

    2016-01-01

    The article offers an analysis of the organizational culture at a higher education institution as in the case of the Plekhanov Russian University of Economics, conducted in order to study the students' involvement in this culture and to draw conclusions as to what organizational culture principles are internalized by the students. The study used…

  18. Institutional conditions for IWRM: the Israeli case.

    Science.gov (United States)

    Fischhendler, Itay

    2008-01-01

    Many places in the world are experiencing a water crisis. This water crisis is attributed to a governance crisis, whereas often fragmented institutional and physical water structures are used to explain a policy of overexploitation. The Israeli water system, which adopted integrated water resource management (IWRM), is often cited as a model for other countries struggling with fragmented water systems. Yet, despite the exceptional degree of integration, Israel in the past two decades has adopted an unsustainable water policy. The aim of this study is to understand this failure and thereby to postulate on the institutional conditions required for successful implementation of IWRM. The study focuses on the politics of water allocation during the drought of 1999 to 2002. It was found that the failure originates in setting administrative divisions in the decision-making process and in differential checks, with no balances implicitly instituted within the integrated water system. These two factors have resulted in a water system that is physically integrated but is not coupled by a balanced institutional structure. This case study teaches us that when reforming the water sector along IWRM lines, measures must be taken to ensure that the physical integration coincides with a balanced institutional integration-otherwise the results may be worse than if there were no integration at all.

  19. Controllability of multi-partite quantum systems and selective excitation of quantum dots

    International Nuclear Information System (INIS)

    Schirmer, S G; Pullen, I C H; Solomon, A I

    2005-01-01

    We consider the degrees of controllability of multi-partite quantum systems, as well as necessary and sufficient criteria for each case. The results are applied to the problem of simultaneous control of an ensemble of quantum dots with a single laser pulse. Finally, we apply optimal control techniques to demonstrate selective excitation of individual dots for a simultaneously controllable ensemble of quantum dots

  20. Patterned genital injury in cases of rape - A case-control study

    DEFF Research Database (Denmark)

    Astrup, Birgitte Schmidt; Ravn, Pernille; Thomsen, Jørgen Lange

    2013-01-01

    A pattern of genital injury that separates trauma seen in sexual assault cases from trauma seen following consensual sexual intercourse has been a matter of debate. This study aimed at clarifying the question by eliminating as many confounders as possible in a prospective, case-control setup. A t...

  1. A Case Study of Undergraduate Women in a Leadership Development Program at a Coeducational Institution

    Science.gov (United States)

    Haight, Lori P.

    2010-01-01

    The purpose of this interpretive case study was to explore the collegiate experiences of undergraduate women participating in a cohort women's-only leadership development program at a coeducational institution. Using a framework based on Kurt Lewin's psycho-social model of behavior being the function of a person interacting with the environment…

  2. A multi-case study of school gardens in Southwest Montana

    Science.gov (United States)

    Yates, Kimberly Ann

    Many children today spend little time outdoors exploring the natural world and a great deal of time inside viewing the television or playing video games. This new condition of childhood has many negative ramifications, such as poor social development, childhood obesity, and a lack of feeling connected to the environment. One instructional tool being used by some schools to address these rising concerns is a school garden. School gardens can provide an opportunity for students to experience learning in a real-world application, outside of the classroom walls. This qualitative multi-case study explores three school gardens in Southwest Montana and tells each of their unique stories. Through the process of participant observation, interviews, and the collection of multiple data sources, a thorough description is given of the history behind the gardens, how they have impacted the teachers and students, what challenges they have faced, and the common characteristics found in a successful school garden program. During the data analysis process, themes for each case study site were revealed. The results of this study found that each school garden was unique in character and purpose and that a number of dedicated garden supporters are essential to the success of a garden program. In conclusion, suggestions and resources were provided for practitioners interested in pursuing a garden program.

  3. 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.

  4. STUDY ON THE MARKETING STRATEGY OF HIGHER EDUCATION INSTITUTION (CASE COMPANY SAMK INTERNATIONAL BUSINESS)

    OpenAIRE

    Khanal, Ichha; khanal, Ichha

    2017-01-01

    The purpose of conducting this thesis was to study on the marketing strategy of an educational institution. The aim of this thesis was to study on current marketing strategy and suggest the case company with new and effective ideas for marketing. The theoretical part of this thesis hold three main elements with basic knowledge of marketing. Along with marketing mix, this thesis also covered segmentation as well as marketing strategy. For the time being, SWOT approach was utilized to...

  5. 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

  6. STUDY ON NEED FOR SUSTAINABLE DEVELOPMENT IN EDUCATIONAL INSTITUTIONS, AN ECOLOGICAL PERSPECTIVE - A CASE STUDY OF COLLEGE OF ENGINEERING - GUINDY, CHENNAI

    Directory of Open Access Journals (Sweden)

    Gobinath Ravindran

    2010-01-01

    Full Text Available Sustainability has become the key word of developing world and it¿s evident in many issues, the growing economy is facing nowadays. Sustainability is the need of the hour for Indian economy to support our future generation with a cleaner, safer environment. Legal framework implemented by governing bodies such as Pollution control board is also supporting the implementation of sustainable development by new enforcements introduced then and there, but it is questionable about the effectiveness of this frameworks. Most of the enforcements are focusing to imply the sustainability in industries or equivalent organizations but not putting thrust on all polluting bodies, educational institutions are one among them. Recent growth in educational scenario in India had increased the number of educational institutions to a large extent, also increased the effect on environment by their activities. Growth of educational sector and the number of institutions catering various fields of education is needed for India but the growth should be optimized in a way such that it¿s sustainable and eco friendly. Various methods are developed recently to find out the exact problems associated with the environment, Geograpchial Information System (GIS is one among them taking a big leap in the recent years in the area of environmental problem identification. This paper provides the details of the environmental impacts of educational institutions with case studies and also suggests a sustainable framework to make them environmental friendly by the use of (GIS.

  7. Development Impact Assessment (DIA) Case Study. South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Sadie [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Nawaz, Kathleen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sandor, Debra [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2015-05-19

    This case study reviews South Africa’s experience in considering the impacts of climate change action on development goals, focusing on the South African energy sector and development impact assessments (DIAs) that have and could be used to influence energy policy or inform the selection of energy activities. It includes a review of assessments—conducted by government ministries, technical partners, and academic institutes and non-governmental organizations (NGOs)—that consider employment, health, and water implications of possible energy sector actions, as well as multi-criteria impact assessments.

  8. Interaction Control Protocols for Distributed Multi-user Multi-camera Environments

    Directory of Open Access Journals (Sweden)

    Gareth W Daniel

    2003-10-01

    Full Text Available Video-centred communication (e.g., video conferencing, multimedia online learning, traffic monitoring, and surveillance is becoming a customary activity in our lives. The management of interactions in such an environment is a complicated HCI issue. In this paper, we present our study on a collection of interaction control protocols for distributed multiuser multi-camera environments. These protocols facilitate different approaches to managing a user's entitlement for controlling a particular camera. We describe a web-based system that allows multiple users to manipulate multiple cameras in varying remote locations. The system was developed using the Java framework, and all protocols discussed have been incorporated into the system. Experiments were designed and conducted to evaluate the effectiveness of these protocols, and to enable the identification of various human factors in a distributed multi-user and multi-camera environment. This work provides an insight into the complexity associated with the interaction management in video-centred communication. It can also serve as a conceptual and experimental framework for further research in this area.

  9. 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.

  10. Field tests applying multi-agent technology for distributed control. Virtual power plants and wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffer, G.J.; Warmer, C.J.; Hommelberg, M.P.F.; Kamphuis, I.G.; Kok, J.K. [Energy in the Built Environment and Networks, Petten (Netherlands)

    2007-01-15

    Multi-agent technology is state of the art ICT. It is not yet widely applied in power control systems. However, it has a large potential for bottom-up, distributed control of a network with large-scale renewable energy sources (RES) and distributed energy resources (DER) in future power systems. At least two major European R and D projects (MicroGrids and CRISP) have investigated its potential. Both grid-related as well as market-related applications have been studied. This paper will focus on two field tests, performed in the Netherlands, applying multi-agent control by means of the PowerMatcher concept. The first field test focuses on the application of multi-agent technology in a commercial setting, i.e. by reducing the need for balancing power in the case of intermittent energy sources, such as wind energy. In this case the flexibility is used of demand and supply of industrial and residential consumers and producers. Imbalance reduction rates of over 40% have been achieved applying the PowerMatcher, and with a proper portfolio even larger rates are expected. In the second field test the multi-agent technology is used in the design and implementation of a virtual power plant (VPP). This VPP digitally connects a number of micro-CHP units, installed in residential dwellings, into a cluster that is controlled to reduce the local peak demand of the common low-voltage grid segment the micro-CHP units are connected to. In this way the VPP supports the local distribution system operator (DSO) to defer reinforcements in the grid infrastructure (substations and cables)

  11. Field tests applying multi-agent technology for distributed control. Virtual power plants and wind energy

    International Nuclear Information System (INIS)

    Schaeffer, G.J.; Warmer, C.J.; Hommelberg, M.P.F.; Kamphuis, I.G.; Kok, J.K.

    2007-01-01

    Multi-agent technology is state of the art ICT. It is not yet widely applied in power control systems. However, it has a large potential for bottom-up, distributed control of a network with large-scale renewable energy sources (RES) and distributed energy resources (DER) in future power systems. At least two major European R and D projects (MicroGrids and CRISP) have investigated its potential. Both grid-related as well as market-related applications have been studied. This paper will focus on two field tests, performed in the Netherlands, applying multi-agent control by means of the PowerMatcher concept. The first field test focuses on the application of multi-agent technology in a commercial setting, i.e. by reducing the need for balancing power in the case of intermittent energy sources, such as wind energy. In this case the flexibility is used of demand and supply of industrial and residential consumers and producers. Imbalance reduction rates of over 40% have been achieved applying the PowerMatcher, and with a proper portfolio even larger rates are expected. In the second field test the multi-agent technology is used in the design and implementation of a virtual power plant (VPP). This VPP digitally connects a number of micro-CHP units, installed in residential dwellings, into a cluster that is controlled to reduce the local peak demand of the common low-voltage grid segment the micro-CHP units are connected to. In this way the VPP supports the local distribution system operator (DSO) to defer reinforcements in the grid infrastructure (substations and cables)

  12. Environmental Literacy Components and Their Promotion by Institutions of Higher Education: An Israeli Case Study

    Science.gov (United States)

    Arnon, Sara; Orion, Nir; Carmi, Nurit

    2015-01-01

    The recognition of the key role and moral responsibility of higher education institutions (HEIs) in cultivating the environmental literacy (EL) of their students is growing globally. The current research examined the contribution of HEIs to their students' EL by focusing on an Israeli college as a case-study. A survey was conducted among a…

  13. Analysis of Institutional Artifact Cost in Management Control in a Textile Company

    Directory of Open Access Journals (Sweden)

    Rodrigo Barraco Marassi

    2014-08-01

    Full Text Available The present study aimed to analyze the process of institutionalization of artifacts in cost management control of Paraná company in the textile sector. For this, we developed descriptive, qualitative research with development of a case study conducted by semi-structured interviews, questionnaires and document analysis. The company under study was selected for accessibility and intentionally to be in the implementation phase of change in management control practices. Was structured semi-structured interviews and questionnaires based on Burns and Scapens (2000, Guerreiro et al. (2005 and Rock and Warrior (2010. The controller and an employee of the comptroller, as well as two officials involved in the supply of the information system were interviewed. The company seeks to implement new accounting and management reporting system that offers the best timing and management of costs and fixed and variable costs, cost centers, among others. The research results show that the encoding step was performed by the controller and by consulting the codified principles and institutional desires in routines, rules and regulations and so draft the proposed changes. The company has not adequately met some factors of institutionalization listed by Guerreiro et al. (2005, regarding training of the people involved, elements of repetition and perceived consequences of the implementation of change by people. By analyzing the case study and reflect the results with the lens of institutional theory, it follows that to obtain management information artifacts cost depends on appropriate processes for data collection, and even when using updated technologies, needs some several facts that this process becomes institutionalized, which may be better understood based on this lens.

  14. A business case modelling framework for smart multi-energy districts

    OpenAIRE

    Good, Nicholas; Martinez Cesena, Eduardo Alejandro; Liu, Xuezhi; Mancarella, Pierluigi

    2017-01-01

    The potential energy, environmental, technical and economic benefits that might arise from multi-energy systems are increasing interest in smart districts. However, in a liberalised market, it is essential to develop a relevant attractive business case. This paper presents a holistic techno-economic framework that couples building/district, multi-network and business case assessment models for the development of robust business cases for smart multi-energy districts. The framework is demonstr...

  15. From the risk analysis to the development of interventions and training for the prevention and control of healthcare associated infections. The experience of G. Pini Orthopedic Institute.

    Science.gov (United States)

    Navone, P; Conti, C; Domeniconi, G; Nobile, M

    2015-01-01

    Health-care associated infections (HAIs) represents a phenomenon of central importance all over Europe. Every year 4,5 millions cases are detected in European Union, with 37.000 related deaths. Surgical-site infections (SSIs) are one of the most common HAIs, that are associated with an increased length of stay, re-operation rate, intensive care admissions rate, and higher mortality rate. G. Pini Orthopedics Institute implemented in the last two years a multimodal strategy for controlling and preventing HAIs, in particular for SSIs. This paper describes the prevention's strategies adopted for prevention of HAIs, at G. Pini Orthopedic Institute. Our findings show that application of a multi modal promotion strategy was associated with an improvement in HAI prevention.

  16. Accurate Prediction of Motor Failures by Application of Multi CBM Tools: A Case Study

    Science.gov (United States)

    Dutta, Rana; Singh, Veerendra Pratap; Dwivedi, Jai Prakash

    2018-02-01

    Motor failures are very difficult to predict accurately with a single condition-monitoring tool as both electrical and the mechanical systems are closely related. Electrical problem, like phase unbalance, stator winding insulation failures can, at times, lead to vibration problem and at the same time mechanical failures like bearing failure, leads to rotor eccentricity. In this case study of a 550 kW blower motor it has been shown that a rotor bar crack was detected by current signature analysis and vibration monitoring confirmed the same. In later months in a similar motor vibration monitoring predicted bearing failure and current signature analysis confirmed the same. In both the cases, after dismantling the motor, the predictions were found to be accurate. In this paper we will be discussing the accurate predictions of motor failures through use of multi condition monitoring tools with two case studies.

  17. THE ACCOUNTING SYSTEM AND BUDGETARY FUNDING OF PUBLIC INSTITUTIONS. CASE STUDY: INSTITUTIONS FINANCED BY THE LOCAL COUNCIL OF GALATI

    Directory of Open Access Journals (Sweden)

    Radu Riana Iren

    2013-12-01

    Full Text Available Full of reforms, accounting science always tried to approach the concerned user requirements as return on capital employed and the complete picture of the operations that occurred during the financial year. For public sector entities, international financial reporting practices are referring to International Accounting Standards for the Public Sector (IPSAS. In this paper we intend to present a parallel between International Financial Reporting Standards (IFRS and IPSAS conjunction with the main aspects of budgetary lending highlighted through a case study aimed at the budget-funded institutions Galati Local Council in 2011-2013.

  18. Multi-region fuzzy logic controller with local PID controllers for U-tube steam generator in nuclear power plant

    Directory of Open Access Journals (Sweden)

    Puchalski Bartosz

    2015-12-01

    Full Text Available In the paper, analysis of multi-region fuzzy logic controller with local PID controllers for steam generator of pressurized water reactor (PWR working in wide range of thermal power changes is presented. The U-tube steam generator has a nonlinear dynamics depending on thermal power transferred from coolant of the primary loop of the PWR plant. Control of water level in the steam generator conducted by a traditional PID controller which is designed for nominal power level of the nuclear reactor operates insufficiently well in wide range of operational conditions, especially at the low thermal power level. Thus the steam generator is often controlled manually by operators. Incorrect water level in the steam generator may lead to accidental shutdown of the nuclear reactor and consequently financial losses. In the paper a comparison of proposed multi region fuzzy logic controller and traditional PID controllers designed only for nominal condition is presented. The gains of the local PID controllers have been derived by solving appropriate optimization tasks with the cost function in a form of integrated squared error (ISE criterion. In both cases, a model of steam generator which is readily available in literature was used for control algorithms synthesis purposes. The proposed multi-region fuzzy logic controller and traditional PID controller were subjected to broad-based simulation tests in rapid prototyping software - Matlab/Simulink. These tests proved the advantage of multi-region fuzzy logic controller with local PID controllers over its traditional counterpart.

  19. Geodetic Control Points - Multi-State Control Point Database

    Data.gov (United States)

    NSGIC State | GIS Inventory — The Multi-State Control Point Database (MCPD) is a database of geodetic and mapping control covering Idaho and Montana. The control were submitted by registered land...

  20. The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

    Science.gov (United States)

    Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

    2017-06-01

    Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

  1. 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

  2. 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

  3. 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

  4. 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.

  5. A case-control study assessing depression in patients with periodontitis

    Directory of Open Access Journals (Sweden)

    Shiyamali Sundararajan

    2017-01-01

    Full Text Available Background: Chronic periodontitis is an inflammatory disease of the supporting structures of the tooth. One of the important non-oral risk factors for periodontitis is psychosocial stress and depression. Depression affects oral health by affecting the immune system through its effects on hypothalamic pituitary axis system. Periodontal inflammatory surface area (PISA is a system used to assess inflammatory burden in the periodontal tissue. Aim: The aim of this study is to assess the relationship between PISA and depression. Settings and Design: The design of the study is case-control study. Materials and Methods: The study design is a case-control study with forty patients each in case and control groups. The periodontal inflammatory level was assessed by PISA system and the levels of depression was assessed by using Beck's Depression Inventory (BDI. Statistical Analysis: Student's t-test was used to compare PISA and BDI scores. The BDI score (mean ± standard deviation [SD] for controls was 12.75 ± 6.82 compared to 22.73 ± 4.40 for the cases. The comparison (t = 7.78 was statistically significant at P < 0.0001. The PISA score (mean ± SD for controls was 210.47 ± 76.80 compared to the PISA score of 1069.50 ± 204.21 for cases which was statistically significant (t = 24.90; P < 0.0001. Results: Significantly higher BDI scores were observed in patients with chronic periodontitis than healthy controls. Conclusion: This study clearly reveals a significant association between the severity of depression and inflammatory burden.

  6. Eating Patterns in Patients with Compensated Cirrhosis: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Camille Buscail

    2018-01-01

    Full Text Available Background: There is growing evidence suggesting that maintaining an adequate nutritional status for patients with liver cirrhosis (LC is relevant to prevent complications. The present study aimed to describe dietary behaviours of patients with compensated and non-complicated LC and comparing them with those of subjects from the general population. Methods: In this case-control study, patients were volunteers enrolled in the ALICIR (ALImentation et CIRrhose study, an observational survey nested in two French prospective cohorts of patients with biopsy-proven compensated cirrhosis related either to excessive alcohol consumption (CIRRAL or to hepatitis B or C virus infection (CirVir. Controls were selected from the NutriNet-Santé cohort. Dietary data were collected through a semi quantitative food frequency questionnaire. Dietary and nutritional data were compared using multi-adjusted paired Student’s tests. Results: Between June 2014 and February 2016, 174 patients of CirVir (N = 97 or CIRRAL (N = 77 were matched with 348 controls from the NutriNet-Santé cohort, according to gender, age, BMI and educational level. Compared to controls, patients (mean ± SD consumed more sodas (236.0 ± 29.8 mL vs. 83.0 ± 33.0 mL and water (1787.6 ± 80.6 mL vs. 933.6 ± 85.3 mL, and lower amounts of salty snacks (4.2 ± 1.42 g vs. 9.0 ± 1.6 g and alcoholic beverages (71.8 ± 23.4 g vs. 151.2 ± 25.9 g, with all p values < 0.0001. Dietary behaviours differed according to LC aetiology. Conclusions: Dietary behaviour of patients significantly differed from subjects from the general population.

  7. 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

  8. Is case-chaos methodology an appropriate alternative to conventional case-control studies for investigating outbreaks?

    Science.gov (United States)

    Edelstein, Michael; Wallensten, Anders; Kühlmann-Berenzon, Sharon

    2014-08-15

    Case-chaos methodology is a proposed alternative to case-control studies that simulates controls by randomly reshuffling the exposures of cases. We evaluated the method using data on outbreaks in Sweden. We identified 5 case-control studies from foodborne illness outbreaks that occurred between 2005 and 2012. Using case-chaos methodology, we calculated odds ratios 1,000 times for each exposure. We used the median as the point estimate and the 2.5th and 97.5th percentiles as the confidence interval. We compared case-chaos matched odds ratios with their respective case-control odds ratios in terms of statistical significance. Using Spearman's correlation, we estimated the correlation between matched odds ratios and the proportion of cases exposed to each exposure and quantified the relationship between the 2 using a normal linear mixed model. Each case-control study identified an outbreak vehicle (odds ratios = 4.9-45). Case-chaos methodology identified the outbreak vehicle 3 out of 5 times. It identified significant associations in 22 of 113 exposures that were not associated with outcome and 5 of 18 exposures that were significantly associated with outcome. Log matched odds ratios correlated with their respective proportion of cases exposed (Spearman ρ = 0.91) and increased significantly with the proportion of cases exposed (b = 0.054). Case-chaos methodology missed the outbreak source 2 of 5 times and identified spurious associations between a number of exposures and outcome. Measures of association correlated with the proportion of cases exposed. We recommended against using case-chaos analysis during outbreak investigations. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. The Glioma International Case-Control Study

    DEFF Research Database (Denmark)

    Amirian, E. Susan; Armstrong, Georgina N; Zhou, Renke

    2016-01-01

    Decades of research have established only a few etiological factors for glioma, which is a rare and highly fatal brain cancer. Common methodological challenges among glioma studies include small sample sizes, heterogeneity of tumor subtypes, and retrospective exposure assessment. Here, we briefly...... describe the Glioma International Case-Control (GICC) Study (recruitment, 2010-2013), a study being conducted by the Genetic Epidemiology of Glioma International Consortium that integrates data from multiple data collection sites, uses a common protocol and questionnaire, and includes biospecimen...

  10. Reasons for smoking among male teenagers in tehran, iran: two case-control studies using snowball sampling.

    Science.gov (United States)

    Rezaei, Fatemeh; Nedjat, Saharnaz; Golestan, Banafsheh; Majdzadeh, Reza

    2011-10-01

    Identifying the underlying factors contributing to smoking among teenagers is important in establishing smoking control programs. The present study was designed to identify and compare factors revealed in a preceding qualitative study conducted on 13-15 year-old boys living in two different socio-economic districts in the Northern and Southern parts of Tehran. Two completely similar case-control studies, each with 200 subjects, were conducted using a snowball sampling. The case and control subjects were matched based on the intimacy relations, i.e. six smokers were recruited in each of the Northern and Southern districts; they were then asked to introduce one of their smoker friends as a case and a non-smoker one as a control. Multi-variable conditional logistic regression revealed that having a smoker father is the single effective factor in the two districts. As for boys living in the Northern (wealthier) part of the city, social capital (OR: 0.59, 95% CI: 0.43-0.81) played a protective role against smoking, whereas quitting home after a quarrel (OR: 15.07, 95% CI: 1.54-147.25), monthly allowance (OR: 2.22, 95% CI: 1.29-3.82) and hyperactivity (OR: 1.69, 95% CI: 2.64-240.45) were associated with a higher risk of becoming a smoker. The studied variables can be classified as personal, familial, and school-level factors. Familial intervention is effective for all the factors which revealed to be influential on the risk of becoming a smoker. It could be concluded that interventions on the family level should be used to prevent the cigarette use in Tehran.

  11. Colon cancer controls versus population controls in case-control studies of occupational risk factors

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Lynge, Elsebeth; Sabroe, Svend

    2004-01-01

    are interchangeable with the experience for population controls. Patient controls may even be preferable from population controls under certain conditions. In this study we examine if colon cancer patients can serve as surrogates for proper population controls in case-control studies of occupational risk factors...... about occupational, medical and life style conditions. RESULTS: No statistical significant difference for educational level, medical history or smoking status was seen between the two control groups. There was evidence of a higher alcohol intake, less frequent work as a farmer and less exposure...... to pesticides among colon cancer controls. CONCLUSIONS: Use of colon cancer controls may provide valid exposure estimates in studies of many occupational risk factors for cancer, but not for studies on exposure related to farming....

  12. Introduction of shared electronic records: multi-site case study using diffusion of innovation theory.

    Science.gov (United States)

    Greenhalgh, Trisha; Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

    2008-10-23

    the extent to which new routines associated with the SCR aligned with existing organisational routines). The seventh influence was the nature and quality of links between different parts of the system, and the final one was the wider environment (especially the political context of the programme). Shared electronic records are not plug-in technologies. They are complex innovations that must be accepted by individual patients and staff and also embedded in organisational and inter-organisational routines. This process is heavily influenced at the micro-level by the material properties of the technology, individuals' attitudes and concerns, and interpersonal influence; at the meso-level by organisational antecedents, readiness, and operational aspects of implementation; and at the macro-level by institutional and socio-political forces. A case study approach and multi-level theoretical analysis can illuminate how contextual factors shape, enable, and constrain new, technology supported models of patient care.

  13. Institutionalism and culture in strategies of multinational firms: the case of Johnson controls Inc.

    Directory of Open Access Journals (Sweden)

    José G. Vargas-Hernández

    2013-07-01

    Full Text Available The aim of this paper is to analyze both the internal and external aspects that may pose a risk to the operations of the subsidiaries of the multinational Johnson Controls Inc. in the U.S. and Mexico from an institutional point of view. The main challenges are the impact in the achievement of goals both of workers and of the same organization and the influence institutions have on the organizational environment, for the decommissioning of some branch/ subsidiary.

  14. Increasing STEM Exposure in K–5 Schools Through MakerSpace Use: A Multi-Site Early Success Case Study

    OpenAIRE

    Ortega, Veronica Inez

    2017-01-01

    Using Brinkerhoff’s success case methodology, this multi-site case study examined early models of MakerSpace implementation in K–5 schools in a single district. Specifically, this study examined the early use of MakerSpaces as well as the supports and barriers affecting teacher use of these spaces. The study also examined curricular connections and MakerSpace use as a conduit for purveying instruction in the soon-to-be-implemented Next Generation Science Standards. The findings of this stud...

  15. 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

  16. 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…

  17. Risk Factors for Anemia in Pregnancy: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Rutuja Pundkar

    2017-12-01

    Full Text Available Background: Aim of the study was to find the risk factors leading to Anemia in pregnancy. The main objective was to study the various sociodemographic factors leading to anemia. And to assess the knowledge about anemia among study participants. Material and methods: The present Case control study was carried out at Primary Health Centre, to determine the risk factors leading to anemia in pregnancy. A total of 308 pregnant females were registered. Among them two groups were made, group I cases and group II controls. Each group had 50 cases each. Laboratory test were done and females having hemoglobin less than 11mg/dl were considered anemic. Anemic females were considered cases and females having Hb >11mg/dl were considered controls. Data analysis was done using SPSS software. Results: The overall mean haemoglobin (Hb was 11.55g/dL in controls, whereas it was seen that among the cases it was 9.58g/dL.It would seem that diet, family size, education, social class, gravida and parity are associated with anemia in pregnancy. Conclusion: After adjusting for all the possible covariates there seems to be significant association between Hb levels and age group, education level, family size, diet, gravida and parity.

  18. Experimental study of a novel capacity control algorithm for a multi-evaporator air conditioning system

    International Nuclear Information System (INIS)

    Xu Xiangguo; Pan Yan; Deng Shiming; Xia Liang; Chan Mingyin

    2013-01-01

    The use of a multi-evaporator air conditioning (MEAC) system is advantageous in terms of installation convenience, high design flexibility, being easy to maintain and commission, better indoor thermal comfort control and higher energy efficiency. While MEAC units worth billions of dollars are sold worldwide, the detailed accounts on compressor capacity control and refrigeration flow distribution amongst evaporators remain unavailable in public domain, mainly due to commercial confidentiality. Limited control algorithms for MEAC systems have been developed based on system simulation, and no experimental-based capacity controller developments and their controllability tests may be identified in open literature. In the study reported in this paper, a novel capacity control algorithm, which imitated On–Off control of a single evaporator air conditioning (A/C) system in each indoor unit of a MEAC system by using variable speed compressor and electronic expansion valves (EEVs), was developed. Controllability tests under various settings for experimentally validating the novel capacity control algorithm were carried out and the control algorithm was further improved based on the experimental results. - Highlights: ► A capacity control algorithm for a multi-evaporator air conditioning system was developed. ► Experimental controllability tests under various settings were carried out. ► The control algorithm was further improved based on the experimental results.

  19. [Construction and operation status of management system of laboratories of schistosomiasis control institutions in Hubei Province].

    Science.gov (United States)

    Zhao-Hui, Zheng; Jun, Qin; Li, Chen; Hong, Zhu; Li, Tang; Zu-Wu, Tu; Ming-Xing, Zeng; Qian, Sun; Shun-Xiang, Cai

    2016-10-09

    To analyze the construction and operation status of management system of laboratories of schistosomiasis control institutions in Hubei Province, so as to provide the reference for the standardized detection and management of schistosomiasis laboratories. According to the laboratory standard of schistosomiasis at provincial, municipal and county levels, the management system construction and operation status of 60 schistosomiasis control institutions was assessed by the acceptance examination method from 2013 to 2015. The management system was already occupied over all the laboratories of schistosomiasis control institutions and was officially running. There were 588 non-conformities and the inconsistency rate was 19.60%. The non-conformity rate of the management system of laboratory quality control was 38.10% (224 cases) and the non-conformity rate of requirements of instrument and equipment was 23.81% (140 cases). The management system has played an important role in the standardized management of schistosomiasis laboratories.

  20. INTERNAL CONTROL IN PUBLIC HEALTH SERVICES INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Ludmila FRUMUSACHI

    2017-06-01

    Full Text Available Internal control has a special role in the efficient organization of the entity’s management. The components of this control in the institutions of public health service are determined by the specific character of these institutions and National Standards of Internal Control in the Public Sector. The system of internal control in the institutions of public health service has the capacity to canalize the effort of the whole institution for the achievement of proposed objectives, to signalize permanently the dysfunctionalities about the quality of medical services and the deviations and to operate timely corrective measures for eliminating the noticed problems. In this regard the managers are obliged to analyse and to resize the system of internal control when in the organizational structure appear substantial changes.

  1. Range based power control for multi-radio multi-channel wireless mesh networks

    CSIR Research Space (South Africa)

    Olwal, TO

    2009-08-01

    Full Text Available Multi-Radio Multi-Channel (MRMC) systems are key to power control problems in Wireless Mesh Networks (WMNs). In this paper, researchers present a range based dynamic power control for MRMC WMNs. First, WMN is represented as a set of disjoint Unified...

  2. From Marginalized to Validated: An In-Depth Case Study of an Asian American, Native American and Pacific Islander Serving Institution

    Science.gov (United States)

    Nguyen, Thai-Huy; Nguyen, Mike Hoa; Nguyen, Bach Mai Dolly; Gasman, Marybeth; Conrad, Clifton

    2018-01-01

    This article highlights the capacity of an Asian American, Native American and Pacific Islander Institution (AANAPISI) to serve as an institutional convertor--by addressing challenges commonly associated with marginalized students--for low-income, Asian American and Pacific Islander students entering college. Through an in-depth case study, we…

  3. 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…

  4. Hypothyroidism among SLE patients: Case-control study.

    Science.gov (United States)

    Watad, Abdulla; Mahroum, Naim; Whitby, Aaron; Gertel, Smadar; Comaneshter, Doron; Cohen, Arnon D; Amital, Howard

    2016-05-01

    The prevalence of hypothyroidism in SLE patients varies considerably and early reports were mainly based on small cohorts. To investigate the association between SLE and hypothyroidism. Patients with SLE were compared with age and sex-matched controls regarding the proportion of hypothyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. The study included 5018 patients with SLE and 25,090 age and sex-matched controls. The proportion of hypothyroidism in patients with SLE was increased compared with the prevalence in controls (15.58% and 5.75%, respectively, Phypothyroidism (odds ratio 2.644, 95% confidence interval 2.405-2.908). Patients with SLE have a greater proportion of hypothyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of the possibility of thyroid dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Multi-loop control of UPS inverter with a plug-in odd-harmonic repetitive controller.

    Science.gov (United States)

    Razi, Reza; Karbasforooshan, Mohammad-Sadegh; Monfared, Mohammad

    2017-03-01

    This paper proposes an improved multi-loop control scheme for the single-phase uninterruptible power supply (UPS) inverter by using a plug-in odd-harmonic repetitive controller to regulate the output voltage. In the suggested control method, the output voltage and the filter capacitor current are used as the outer and inner loop feedback signals, respectively and the instantaneous value of the reference voltage feedforwarded to the output of the controller. Instead of conventional linear (proportional-integral/-resonant) and conventional repetitive controllers, a plug-in odd-harmonic repetitive controller is employed in the outer loop to regulate the output voltage, which occupies less memory space and offers faster tracking performance compared to the conventional one. Also, a simple proportional controller is used in the inner loop for active damping of possible resonances and improving the transient performance. The feedforward of the converter reference voltage enhances the robust performance of the system and simplifies the system modelling and the controller design. A step-by-step design procedure is presented for the proposed controller, which guarantees stability of the system under worst-case scenarios. Simulation and experimental results validate the excellent steady-state and transient performance of the proposed control scheme and provide the exact comparison of the proposed method with the conventional multi-loop control method. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  6. 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

  7. 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.

  8. Making the business case for enhanced depression care: the National Institute of Mental Health-harvard Work Outcomes Research and Cost-effectiveness Study.

    Science.gov (United States)

    Wang, Philip S; Simon, Gregory E; Kessler, Ronald C

    2008-04-01

    Explore the business case for enhanced depression care and establish a return on investment rationale for increased organizational involvement by employer-purchasers. Literature review, focused on the National Institute of Mental Health-sponsored Work Outcomes Research and Cost-effectiveness Study. This randomized controlled trial compared telephone outreach, care management, and optional psychotherapy to usual care among depressed workers in large national corporations. By 12 months, the intervention significantly improved depression outcomes, work retention, and hours worked among the employed. Results of the Work Outcomes Research and Cost-effectiveness Study trial and other studies suggest that enhanced depression care programs represent a human capital investment opportunity for employers.

  9. Dealing with Multi-Level Governance and Wicked Problems in Urban Transportation Systems: The Case of Palermo Municipality

    Directory of Open Access Journals (Sweden)

    Guido Noto

    2015-06-01

    Full Text Available Italian New Public Management (NPM has been mainly characterized by a political orientation toward power decentralization to local governments and privatization of public companies. Nowadays, local utilities in Italy are often run by joint stock companies controlled by public agencies such as Regional and Municipal Administrations. Due to this transformation, these companies must comply with a set of diverse expectations coming from a wide range of stakeholders, related to their financial, competitive and social performance. Such fragmented governance increases the presence of “wicked” problems in the decision-making sphere of these entities. Given this multi-level governance structure, how do these agents influence public services performance? In recent years, coordination and inter-institutional joint action have been identified as possible approaches for dealing with governance fragmentation and wicked problems deriving from it. How can we adapt a performance management perspective in order to help us reform the system and so have a better collaboration between the stakeholders involved? In order to address and discuss these research questions, a case study will be developed. The case concerns AMAT, the local utility providing the public transportation service in the Municipality of Palermo (Italy. The result of this study is a dynamic model including a set of performance indicators that help us in understanding the impact of the governing structure on the system’s performance.

  10. [Institutional insertion of Chagas' disease control].

    Science.gov (United States)

    Silveira, Antônio Carlos; Pimenta, Fabiano

    2011-01-01

    After the starting of the Center for studies and prophylaxis of Chagas disease in 1943, with the help of Oswaldo Cruz Foundation, in the city of Bambuí, state of Minas Gerais, technological and methodological basis for the extensive control of the disease were conceived. A main step to achieve success was the introduction of a new insecticide (gammexane, P 530) and the demonstration of its efficacy in the vector control. A consequence of these improvements was the official inauguration of the first prophylactic campaign for Chagas disease in Brazil, held in Uberaba in May, 1950. Even with the knowledge of how to control the vectorial transmission, financial resources were not available by this time, at a necessary degree to make it both regularly and in all the affected area. The institutional allocation of these activities is useful to understand the low priority given to them at that time. Several national services were created in 1941, for diseases as malaria, pest, smallpox, among others, but Chagas was included in a group of diseases with lower importance, inside a Division of Sanitary Organization. In 1956, the National Department of Rural endemies (DNERu) allocate all the major endemic diseases in a single institution, however this was not translated in an implementation program for the control of Chagas disease. After profound changes at the Ministry of Health, in 1970, the Superintendência de Campanhas de Saúde Pública (SUCAM) was in charge of all rural endemies including Chagas disease, which now could compete with other diseases transmitted by vectors, formerly priorities, included in the National Division. With this new status, more funds were available, as well as redistribution of personnel and expenses from the malaria program to the vectorial control of Chagas disease. In 1991 the Health National foundation was created to substitute SUCAM in the control of endemic diseases and it included all the units of the Ministry of Health related to

  11. Cytoreductive prostatectomy in metastatic prostate cancer

    DEFF Research Database (Denmark)

    Becker, Joachim Aidt; Berg, Kasper Drimer; Røder, Martin Andreas

    2018-01-01

    The impact of cytoreductive radical prostatectomy on oncological outcome in patients with prostate cancer and limited number of bone metastases is unclear. Data from cancer registries, multi-institutional databases and a single institutional case-control study indicate a possible benefit of combi......The impact of cytoreductive radical prostatectomy on oncological outcome in patients with prostate cancer and limited number of bone metastases is unclear. Data from cancer registries, multi-institutional databases and a single institutional case-control study indicate a possible benefit...

  12. Selective serotonin reuptake inhibitors and gastrointestinal bleeding: a case-control study.

    Directory of Open Access Journals (Sweden)

    Alfonso Carvajal

    Full Text Available BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs have been associated with upper gastrointestinal (GI bleeding. Given their worldwide use, even small risks account for a large number of cases. This study has been conducted with carefully collected information to further investigate the relationship between SSRIs and upper GI bleeding. METHODS: We conducted a case-control study in hospitals in Spain and in Italy. Cases were patients aged ≥18 years with a primary diagnosis of acute upper GI bleeding diagnosed by endoscopy; three controls were matched by sex, age, date of admission (within 3 months and hospital among patients who were admitted for elective surgery for non-painful disorders. Exposures to SSRIs, other antidepressants and other drugs were defined as any use of these drugs in the 7 days before the day on which upper gastrointestinal bleeding started (index day. RESULTS: 581 cases of upper GI bleeding and 1358 controls were considered eligible for the study; no differences in age or sex distribution were observed between cases and controls after matching. Overall, 4.0% of the cases and 3.3% of controls used an SSRI antidepressant in the week before the index day. No significant risk of upper GI bleeding was encountered for SSRI antidepressants (adjusted odds ratio, 1.06, 95% CI, 0.57-1.96 or for whichever other grouping of antidepressants. CONCLUSIONS: The results of this case-control study showed no significant increase in upper GI bleeding with SSRIs and provide good evidence that the magnitude of any increase in risk is not greater than 2.

  13. 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.

  14. Determinants of podoconiosis, a case control study | Feleke ...

    African Journals Online (AJOL)

    The sample size was calculated using Epi-info soft ware: 95% CI, 85% power, control to case ratio of 2:1, expected frequency of barefoot among controls 50%, odds ratio of 1.5 and non-response rate of 10% yielding 1148 study participants. Binary logistic regression was used to identify the determinants of Podoconiosis.

  15. 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

  16. A case-control study of risk factors for epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Ghaem Maghami Noori F

    2001-09-01

    Full Text Available Ovarian cancer is second prevalent cancer among gynecologic malignancies and the most common type of ovarian cancer is epithelial form (85-90 percent. To detect the risk factors for the epithelial ovarian cancer, a case-control study was conducted in Valieasr hospital in 1988. In this study, 118 cases with epithelial ovarian cancer (according histological records and 240 controls without any gynecological cancer in gynecologic clinic had been interviewed. For data analysis, T-test, Chi2 test and logistic regression have been used at a =0.05 as level of significance. The mean age in cases was 50±13 and in controls was 49.9±12 years, without significant different. The mean number of pregnancies and parity in cases was less than controls, significantly (P<0.03. The mean months of breast feeding in cases was less than controls (54.9±71.2 versus 82.4±62.7 (P<0.001. The cases had a lower mean age of menarch than controls (P=0.03. 58 percent of cases and 21.3 percent of controls hadn't used any contraception methods (P=0.00001. The mean years of contraception was significantly less in cases versus controls (P<0.001. The odds ratio for epithelial ovarian cancer was 0.24 (95 percent CI: 0.13-0.48 in OCP users, 0.47 (95 percent CI: 0.005-0.43 in TL method, and was 0.41 (95 percent CI: 0.22-0.76 in other contraception methods, relative to women who hadn't used any contraception methods. This study reveals that epithelial ovarian cancer risk increases significantly with earlier menarch, decreasing number of pregnancy, deliveries duration of breast feeding and use of contraception methods. Use of contraception pill and tubal ligation method decreases risk of epithelial ovarian cancer.

  17. 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

  18. 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

  19. 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)

  20. Study on collaborative optimization control of ventilation and radon reduction system based on multi-agent technology

    International Nuclear Information System (INIS)

    Dai Jianyong; Meng Lingcong; Zou Shuliang

    2015-01-01

    According to the radioactive safety features such as radon and its progeny, combined with the theory of ventilation system, structure of multi-agent system for ventilation and radon reduction system is constructed with the application of multi agent technology. The function attribute of the key agent and the connection between the nodes in the multi-agent system are analyzed to establish the distributed autonomous logic structure and negotiation mechanism of multi agent system of ventilation and radon reduction system, and thus to implement the coordination optimization control of the multi-agent system. The example analysis shows that the system structure of the multi-agent system of ventilation and reducing radon system and its collaborative mechanism can improve and optimize the radioactive pollutants control, which provides a theoretical basis and important application prospect. (authors)

  1. Reducing selection bias in case-control studies from rare disease registries.

    Science.gov (United States)

    Cole, J Alexander; Taylor, John S; Hangartner, Thomas N; Weinreb, Neal J; Mistry, Pramod K; Khan, Aneal

    2011-09-12

    In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example. A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching. The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

  2. Identical, Fraternal, or Separated at Birth: A Case Study of Educator Teams within American-Israeli School Twinning

    Science.gov (United States)

    Chertok, Fern; Mittelberg, David; Laron, Dinah; Koren, Annette

    2013-01-01

    School-to-school collaboration has emerged as a key paradigm for fostering personal and institutional connections between Israeli and Diaspora youth, educators, and schools. Using the findings of a multi-year case study of a high school level twinning initiative, this article describes the challenges to this form of transnational collaboration and…

  3. A prevalence-based association test for case-control studies.

    Science.gov (United States)

    Ryckman, Kelli K; Jiang, Lan; Li, Chun; Bartlett, Jacquelaine; Haines, Jonathan L; Williams, Scott M

    2008-11-01

    Genetic association is often determined in case-control studies by the differential distribution of alleles or genotypes. Recent work has demonstrated that association can also be assessed by deviations from the expected distributions of alleles or genotypes. Specifically, multiple methods motivated by the principles of Hardy-Weinberg equilibrium (HWE) have been developed. However, these methods do not take into account many of the assumptions of HWE. Therefore, we have developed a prevalence-based association test (PRAT) as an alternative method for detecting association in case-control studies. This method, also motivated by the principles of HWE, uses an estimated population allele frequency to generate expected genotype frequencies instead of using the case and control frequencies separately. Our method often has greater power, under a wide variety of genetic models, to detect association than genotypic, allelic or Cochran-Armitage trend association tests. Therefore, we propose PRAT as a powerful alternative method of testing for association.

  4. Polarization control of multi-photon absorption under intermediate femtosecond laser field

    International Nuclear Information System (INIS)

    Cheng Wenjing; Liang Guo; Wu Ping; Liu Pei; Jia Tianqing; Sun Zhenrong; Zhang Shian

    2017-01-01

    It has been shown that the femtosecond laser polarization modulation is a very simple and well-established method to control the multi-photon absorption process by the light–matter interaction. Previous studies mainly focused on the multi-photon absorption control in the weak field. In this paper, we further explore the polarization control behavior of multi-photon absorption process in the intermediate femtosecond laser field. In the weak femtosecond laser field, the second-order perturbation theory can well describe the non-resonant two-photon absorption process. However, the higher order nonlinear effect (e.g., four-photon absorption) can occur in the intermediate femtosecond laser field, and thus it is necessary to establish new theoretical model to describe the multi-photon absorption process, which includes the two-photon and four-photon transitions. Here, we construct a fourth-order perturbation theory to study the polarization control behavior of this multi-photon absorption under the intermediate femtosecond laser field excitation, and our theoretical results show that the two-photon and four-photon excitation pathways can induce a coherent interference, while the coherent interference is constructive or destructive that depends on the femtosecond laser center frequency. Moreover, the two-photon and four-photon transitions have the different polarization control efficiency, and the four-photon absorption can obtain the higher polarization control efficiency. Thus, the polarization control efficiency of the whole excitation process can be increased or decreased by properly designing the femtosecond laser field intensity and laser center frequency. These studies can provide a clear physical picture for understanding and controlling the multi-photon absorption process in the intermediate femtosecond laser field, and also can provide a theoretical guidance for the future experimental realization. (paper)

  5. Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder.

    Science.gov (United States)

    DiGuiseppi, Carolyn G; Daniels, Julie L; Fallin, Daniele M; Rosenberg, Steven A; Schieve, Laura A; Thomas, Kathleen C; Windham, Gayle C; Goss, Cynthia W; Soke, Gnakub N; Currie, Dustin W; Singer, Alison B; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A; Miller, Lisa A; Pinto-Martin, Jennifer A; Young, Lisa M; Schendel, Diana E

    2016-07-01

    The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2-5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Student's Plagiarisms in Higher Learning Institutions in the Era of Improved Internet Access: Case Study of Developing Countries

    Science.gov (United States)

    Anney, Vicent Naano; Mosha, Mary Atanas

    2015-01-01

    This study investigated students' plagiarism practices in Tanzania higher learning institutions by involving two universities-one public and one private university as a case study. The universities involved have honour code and policies for plagiarism detection however they do not employ software for checking students' plagiarism. The study…

  7. Should Controls With Respiratory Symptoms Be Excluded From Case-Control Studies of Pneumonia Etiology? Reflections From the PERCH Study.

    Science.gov (United States)

    Higdon, Melissa M; Hammitt, Laura L; Deloria Knoll, Maria; Baggett, Henry C; Brooks, W Abdullah; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; Murdoch, David R; Scott, J Anthony G; Thea, Donald M; Driscoll, Amanda J; Karron, Ruth A; Park, Daniel E; Prosperi, Christine; Zeger, Scott L; O'Brien, Katherine L; Feikin, Daniel R

    2017-06-15

    Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of pneumonia etiology. We review 3 reasons investigators may choose to exclude controls with respiratory symptoms in light of epidemiologic principles of control selection and present data from the Pneumonia Etiology Research for Child Health (PERCH) study where relevant to assess their validity. We conclude that exclusion of controls with respiratory symptoms will result in biased estimates of etiology. Randomly selected community controls, with or without respiratory symptoms, as long as they do not meet the criteria for case-defining pneumonia, are most representative of the general population from which cases arose and the least subject to selection bias. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  8. Admittance Control of a Multi-Finger Arm Based on Manipulability of Fingers

    Directory of Open Access Journals (Sweden)

    Jian Huang

    2011-09-01

    Full Text Available In the previous studies, admittance control and impedance control for a finger-arm robot using the manipulability of the finger were studied and methods of realizing the controls have been proposed. In this study, two 3-DOF fingers are attached to the end-effector of a 6-DOF arm to configure a multi-finger arm robot. Based on the previous methods, the authors have proposed an admittance control for a multi-finger arm robot using the manipulability of the fingers in this study. Algorithms of the averaging method and the mini-max method were introduced to establish a manipulability criterion of the two fingers in order to generate a cooperative movement of the arm. Comparison of the admittance controls combined with the top search method and local optimization method for the multi-finger arm robot was made and features of the control methods were also discussed. The stiffness control and damping control were experimentally evaluated to demonstrate the effectiveness of the proposed methods.

  9. Federalism, Bicameralism, and Institutional Change: General Trends and One Case-study

    Directory of Open Access Journals (Sweden)

    Marta Arretche

    2010-12-01

    Full Text Available The article distinguishes federal states from bicameralism and mechanisms of territorial representation in order to examine the association of each with institutional change in 32 countries by using constitutional amendments as a proxy. It reveals that bicameralism tends to be a better predictor of constitutional stability than federalism. All of the bicameral cases that are associated with high rates of constitutional amendment are also federal states, including Brazil, India, Austria, and Malaysia. In order to explore the mechanisms explaining this unexpected outcome, the article also examines the voting behavior of Brazilian senators constitutional amendments proposals (CAPs. It shows that the Brazilian Senate is a partisan Chamber. The article concludes that regional influence over institutional change can be substantially reduced, even under symmetrical bicameralism in which the Senate acts as a second veto arena, when party discipline prevails over the cohesion of regional representation.

  10. Case-Based Multi-Sensor Intrusion Detection

    Science.gov (United States)

    Schwartz, Daniel G.; Long, Jidong

    2009-08-01

    Multi-sensor intrusion detection systems (IDSs) combine the alerts raised by individual IDSs and possibly other kinds of devices such as firewalls and antivirus software. A critical issue in building a multi-sensor IDS is alert-correlation, i.e., determining which alerts are caused by the same attack. This paper explores a novel approach to alert correlation using case-based reasoning (CBR). Each case in the CBR system's library contains a pattern of alerts raised by some known attack type, together with the identity of the attack. Then during run time, the alert streams gleaned from the sensors are compared with the patterns in the cases, and a match indicates that the attack described by that case has occurred. For this purpose the design of a fast and accurate matching algorithm is imperative. Two such algorithms were explored: (i) the well-known Hungarian algorithm, and (ii) an order-preserving matching of our own device. Tests were conducted using the DARPA Grand Challenge Problem attack simulator. These showed that the both matching algorithms are effective in detecting attacks; but the Hungarian algorithm is inefficient; whereas the order-preserving one is very efficient, in fact runs in linear time.

  11. Implementation method of multi-terminal DC control system

    Science.gov (United States)

    Yi, Liu; Hao-Ran, Huang; Jun-Wen, Zhou; Hong-Guang, Guo; Yu-Yong, Zhou

    2018-04-01

    Currently the multi-terminal DC system (MTDC) has more stations. Each station needs operators to monitor and control the device. It needs much more operation and maintenance, low efficiency and small reliability; for the most important reason, multi-terminal DC system has complex control mode. If one of the stations has some problem, the control of the whole system should have problems. According to research of the characteristics of multi-terminal DC (VSC-MTDC) systems, this paper presents a strong implementation of the multi-terminal DC Supervisory Control and Data Acquisition (SCADA) system. This system is intelligent, can be networking, integration and intelligent. A master control system is added in each station to communication with the other stations to send current and DC voltage value to pole control system for each station. Based on the practical application and information feedback in the China South Power Grid research center VSC-MTDC project, this system is higher efficiency and save the cost on the maintenance of convertor station to improve the intelligent level and comprehensive effect. And because of the master control system, a multi-terminal system hierarchy coordination control strategy is formed, this make the control and protection system more efficiency and reliability.

  12. Study of environmental and genetic factors in children with craniosynostosis: A case-control study

    Science.gov (United States)

    Barik, Mayadhar; Bajpai, Minu; Das, Rashmi Ranjan; Panda, Shasanka Shekhar

    2013-01-01

    Background: Craniosynostosis is a congenital defect that causes one or more sutures on an infant's skull to close earlier than normal. Though both genetic and environmental factors play a role in its pathogenesis, there is no published Indian data to verify this. Materials and Methods: In this case-control study, we investigated the association of craniosynostosis with parental age in 50 children with craniosynostosis attending the surgical outpatient department of a tertiary care institution in North India. Results: There was a significant association of craniosynostosis with advanced parental [OR 2.17 (95% CI 1.08 to 4.36)] but not maternal age. Education status of parents also revealed that those having a higher education had an increased risk of having a child with craniosynostosis [maternal education, OR 2.32 (95% CI 1.2 to 4.76); paternal education, OR 2.51 (95% CI 1.21 to 5.0)]. Molecular analysis by sequencing confirmed following amino-acid substitution in different Exons of the FGFR2 gene. Besides these, we found other novel identical mutations in FGFR2 gene in both syndromic and non-syndromic craniosynostoses. Conclusion: This is the first epidemiological study in India that provides evidence that, advanced paternal age and higher parental education level might be associated with an increased risk of craniosynostosis. New mutations were identified in cases of both syndromic and non-syndromic craniosynostosis. PMID:24082921

  13. Multi-periodic nanostructures for photon control

    DEFF Research Database (Denmark)

    Kluge, Christian; Adam, Jost; Barié, Nicole

    2014-01-01

    We propose multi-periodic nanostructures yielded by superposition of multiple binary gratings for wide control over photon emission in thin-film devices. We present wavelength- and angle-resolved photoluminescence measurements of multi-periodically nanostructured organic light-emitting layers...

  14. Laryngeal sarcoidosis: a case-control study.

    Science.gov (United States)

    Duchemann, Boris; Lavolé, Armelle; Naccache, Jean-Marc; Nunes, Hilario; Benzakin, Sylvain; Lefevre, Marine; Kambouchner, Marianne; Périé, Sophie; Valeyre, Dominique; Cadranel, Jacques

    2014-10-20

    We undertook a study on a series of laryngeal sarcoidosis (LS), a very rare and often threatening localization to better specify laryngeal manifestations, sarcoidosis clinical expression and long-term follow-up. This was a retrospective case-control study. All LS patients from two French centers were included and compared to sarcoidosis patients without laryngeal localization with two controls for one patient. Twelve consecutive LS patients were recruited between 1993 and 2011. LS revealed sarcoidosis in eight cases (67%). The most common symptoms were hoarseness (77%), inspiratory dyspnea (38%) and dysphagia (38%). Epidemiological characterisics were not different. Extrapulmonary localizations were significantly more common in LS patients than in controls (92% vs. 54%, p=0.02), particularly lupus pernio (25% vs. 0%, p=0.03) and nasosinusal involvement (83% vs. 4%, p<0.01) while thoracic involvement was less frequent (58% vs 100%, p < 0.01). Treatment rates were higher in the LS group (92% vs. 58%, p=0.04), and treatment duration was longer (median: 81 vs. 13 months, p=0.04), with frequent long-term treatment (67%, N=8/12). Two patients underwent surgery. One patient needed temporary tracheostomy during the course of the disease; Remission rates were lower in LS patients (9% vs. 58% at 2 years p<0.01). Eventually, there was no death nor definitive tracheotomy. LS is a rare condition that is often associated to other loco-regional localizations. LS are often difficult to manage. Survival is good but may require a medico-surgical approach.

  15. Case-control study of gadodiamide-related nephrogenic systemic fibrosis

    DEFF Research Database (Denmark)

    Marckmann, Peter; Skov, Lone; Rossen, Kristian

    2007-01-01

    exposed to gadodiamide develop nephrogenic systemic fibrosis. METHODS: We conducted a case-control study of 19 histologically verified cases and 19 sex- and age-matched controls. All subjects had chronic renal failure when exposed to gadodiamide. Clinical, biochemical and pharmacological data were.......02). CONCLUSIONS: Increasing cumulative gadodiamide exposure, high-dose epoietin-beta treatment, and higher serum concentrations of ionized calcium and phosphate increase the risk of gadodiamide-related nephrogenic systemic fibrosis in renal failure patients. Severe cases seem to develop primarily among patients......BACKGROUND: Nephrogenic systemic fibrosis may be caused by gadolinium (Gd)-containing magnetic resonance imaging contrast agents. Most reported cases were associated with one particular agent, gadodiamide. Yet, unidentified cofactors might explain why only a minority of renal failure patients...

  16. Multiple-state based power control for multi-radio multi-channel wireless mesh networks

    CSIR Research Space (South Africa)

    Olwal, TO

    2009-01-01

    Full Text Available Multi-Radio Multi-Channel (MRMC) systems are key to power control problems in wireless mesh networks (WMNs). In this paper, we present asynchronous multiple-state based power control for MRMC WMNs. First, WMN is represented as a set of disjoint...

  17. Reducing selection bias in case-control studies from rare disease registries

    Directory of Open Access Journals (Sweden)

    Mistry Pramod K

    2011-09-01

    Full Text Available Abstract Background In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG Gaucher Registry were used as an example. Methods A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals were calculated for each variable before and after matching. Results The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN and controls (i.e., patients without AVN who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age, treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. Conclusions We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

  18. Distributed Control in Multi-Vehicle Systems

    Directory of Open Access Journals (Sweden)

    Paul A. Avery

    2013-12-01

    Full Text Available The Southwest Research Institute (SwRI Mobile Autonomous Robotics Technology Initiative (MARTI program has enabled the development of fully-autonomous passenger-sized commercial vehicles and military tactical vehicles, as well as the development of cooperative vehicle behaviors, such as cooperative sensor sharing and cooperative convoy operations. The program has also developed behaviors to interface intelligent vehicles with intelligent road-side devices. The development of intelligent vehicle behaviors cannot be approached as stand-alone phenomena; rather, they must be understood within a context of the broader traffic system dynamics. The study of other complex systems has shown that system-level behaviors emerge as a result of the spatio-temporal dynamics within a system's constituent parts. The design of such systems must therefore account for both the system-level emergent behavior, as well as behaviors of individuals within the system. It has also become clear over the past several years, for both of these domains, that human trust in the behavior of individual vehicles is paramount to broader technology adoption. This paper examines the interplay between individual vehicle capabilities, vehicle connectivity, and emergent system behaviors, and presents some considerations for a distributed control paradigm in a multi-vehicle system.

  19. 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

  20. 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.

  1. Suspected survivor bias in case-control studies: stratify on survival time and use a negative control.

    Science.gov (United States)

    van Rein, Nienke; Cannegieter, Suzanne C; Rosendaal, Frits R; Reitsma, Pieter H; Lijfering, Willem M

    2014-02-01

    Selection bias in case-control studies occurs when control selection is inappropriate. However, selection bias due to improper case sampling is less well recognized. We describe how to recognize survivor bias (i.e., selection on exposed cases) and illustrate this with an example study. A case-control study was used to analyze the effect of statins on major bleedings during treatment with vitamin K antagonists. A total of 110 patients who experienced such bleedings were included 18-1,018 days after the bleeding complication and matched to 220 controls. A protective association of major bleeding for exposure to statins (odds ratio [OR]: 0.56; 95% confidence interval: 0.29-1.08) was found, which did not become stronger after adjustment for confounding factors. These observations lead us to suspect survivor bias. To identify this bias, results were stratified on time between bleeding event and inclusion, and repeated for a negative control (an exposure not related to survival): blood group non-O. The ORs for exposure to statins increased gradually to 1.37 with shorter time between outcome and inclusion, whereas ORs for the negative control remained constant, confirming our hypothesis. We recommend the presented method to check for overoptimistic results, that is, survivor bias in case-control studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Adaptive fuzzy sliding-mode control for multi-input multi-output chaotic systems

    International Nuclear Information System (INIS)

    Poursamad, Amir; Markazi, Amir H.D.

    2009-01-01

    This paper describes an adaptive fuzzy sliding-mode control algorithm for controlling unknown or uncertain, multi-input multi-output (MIMO), possibly chaotic, dynamical systems. The control approach encompasses a fuzzy system and a robust controller. The fuzzy system is designed to mimic an ideal sliding-mode controller, and the robust controller compensates the difference between the fuzzy controller and the ideal one. The parameters of the fuzzy system, as well as the uncertainty bound of the robust controller, are tuned adaptively. The adaptive laws are derived in the Lyapunov sense to guarantee the asymptotic stability and tracking of the controlled system. The effectiveness of the proposed method is shown by applying it to some well-known chaotic systems.

  3. Analysis of Case-Control Association Studies: SNPs, Imputation and Haplotypes

    KAUST Repository

    Chatterjee, Nilanjan; Chen, Yi-Hau; Luo, Sheng; Carroll, Raymond J.

    2009-01-01

    Although prospective logistic regression is the standard method of analysis for case-control data, it has been recently noted that in genetic epidemiologic studies one can use the "retrospective" likelihood to gain major power by incorporating various population genetics model assumptions such as Hardy-Weinberg-Equilibrium (HWE), gene-gene and gene-environment independence. In this article we review these modern methods and contrast them with the more classical approaches through two types of applications (i) association tests for typed and untyped single nucleotide polymorphisms (SNPs) and (ii) estimation of haplotype effects and haplotype-environment interactions in the presence of haplotype-phase ambiguity. We provide novel insights to existing methods by construction of various score-tests and pseudo-likelihoods. In addition, we describe a novel two-stage method for analysis of untyped SNPs that can use any flexible external algorithm for genotype imputation followed by a powerful association test based on the retrospective likelihood. We illustrate applications of the methods using simulated and real data. © Institute of Mathematical Statistics, 2009.

  4. Analysis of Case-Control Association Studies: SNPs, Imputation and Haplotypes

    KAUST Repository

    Chatterjee, Nilanjan

    2009-11-01

    Although prospective logistic regression is the standard method of analysis for case-control data, it has been recently noted that in genetic epidemiologic studies one can use the "retrospective" likelihood to gain major power by incorporating various population genetics model assumptions such as Hardy-Weinberg-Equilibrium (HWE), gene-gene and gene-environment independence. In this article we review these modern methods and contrast them with the more classical approaches through two types of applications (i) association tests for typed and untyped single nucleotide polymorphisms (SNPs) and (ii) estimation of haplotype effects and haplotype-environment interactions in the presence of haplotype-phase ambiguity. We provide novel insights to existing methods by construction of various score-tests and pseudo-likelihoods. In addition, we describe a novel two-stage method for analysis of untyped SNPs that can use any flexible external algorithm for genotype imputation followed by a powerful association test based on the retrospective likelihood. We illustrate applications of the methods using simulated and real data. © Institute of Mathematical Statistics, 2009.

  5. A Multi-Usable Cloud Service Platform: A Case Study on Improved Development Pace and Efficiency

    Directory of Open Access Journals (Sweden)

    John Lindström

    2018-02-01

    Full Text Available The case study, spanning three contexts, concerns a multi-usable cloud service platform for big data collection and analytics and how the development pace and efficiency of it has been improved by 50–75% by using the Arrowhead framework and changing development processes/practices. Furthermore, additional results captured during the case study are related to technology, competencies and skills, organization, management, infrastructure, and service and support. A conclusion is that when offering a complex offer such as an Industrial Product-Service System, comprising sensors, hardware, communications, software, cloud service platform, etc., it is necessary that the technology, business model, business setup, and organization all go hand in hand during the development and later operation, as all ‘components’ are required for a successful result.

  6. 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.

  7. Risk factors associated with lipomyelomeningocele: a case-control study.

    Science.gov (United States)

    Esmaeili, Arash; Hanaei, Sara; Fadakar, Kaveh; Dadkhah, Sahar; Arjipour, Mahdi; Habibi, Zohreh; Nejat, Farideh; El Khashab, Mostafa

    2013-01-01

    In general, it seems that both genetic and environmental factors play important roles in the induction of neural tube defects. Lipomyelomeningocele (LipoMMC) is a rather common type of closed neural tube defect, but only limited studies have investigated the potential risk factors of this anomaly. Therefore, the purpose of this case-control study was to investigate the risk factors involved in LipoMMC formation. Various risk factors were evaluated in 35 children between 1 month and 10 years of age with LipoMMC in a hospital-based case-control study. The 2 control arms consisted of 35 children with myelomeningocele (MMC group) and 35 children with congenital anomalies other than central nervous system problems (control group). All groups were matched for age and visited the same hospital. A structured questionnaire was used for the collection of all data, including the mothers' weight and height during pregnancy, education, reproductive history, previous abortions, and socioeconomic status, as well as the parents' consanguinity and family history of the same anomalies. Univariate analysis of the children with LipoMMC compared to the control group showed that the use of periconceptional folic acid supplementation was significantly lower in the MMC and LipoMMC groups compared to the control group. In addition, comparison of the MMC and control groups revealed statistically significant differences regarding the use of folic acid and maternal obesity. In multivariate analysis, use of folic acid in the periconceptional period and during the first trimester was an independent risk factor for LipoMMC and MMC. Furthermore, maternal obesity was a significantly positive risk factor for MMC. The probable risk factors for LipoMMC were investigated in this case-control study. Consumption of folic acid in the periconceptional period and during the first trimester is an independent protective factor against LipoMMC. It seems that larger studies are needed to examine other possible

  8. 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.

  9. Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

    OpenAIRE

    Maha M. Al-Khaduri; Rania Mohammed Abudraz; Sayed G. Rizvi; Yahya M. Al-Farsi

    2014-01-01

    Objective: This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods: A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factor...

  10. 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…

  11. Linear and Non-linear Multi-Input Multi-Output Model Predictive Control of Continuous Stirred Tank Reactor

    Directory of Open Access Journals (Sweden)

    Muayad Al-Qaisy

    2015-02-01

    Full Text Available In this article, multi-input multi-output (MIMO linear model predictive controller (LMPC based on state space model and nonlinear model predictive controller based on neural network (NNMPC are applied on a continuous stirred tank reactor (CSTR. The idea is to have a good control system that will be able to give optimal performance, reject high load disturbance, and track set point change. In order to study the performance of the two model predictive controllers, MIMO Proportional-Integral-Derivative controller (PID strategy is used as benchmark. The LMPC, NNMPC, and PID strategies are used for controlling the residual concentration (CA and reactor temperature (T. NNMPC control shows a superior performance over the LMPC and PID controllers by presenting a smaller overshoot and shorter settling time.

  12. Case-control study of fetal microchimerism and breast cancer.

    Directory of Open Access Journals (Sweden)

    Vijayakrishna K Gadi

    2008-03-01

    Full Text Available Prior pregnancy is known to protect against development of breast cancer. Recent studies have demonstrated that pregnancy has the capacity to establish small numbers of immunologically active fetal-derived cells in the mother, a phenomenon known as fetal microchimerism (FMc. We asked whether presence of FMc, routinely acquired during pregnancy, is a protective factor for breast cancer.DNA extracts from peripheral blood specimens were obtained from a population-based case-control study of risk factors for breast cancer in women 21 to 45 years old. Specimens were tested with quantitative PCR for presence and concentrations of male DNA presumed to derive from prior pregnancies with a male fetus. Odds ratios (OR and 95% confidence intervals (CI were estimated with consideration of multiple established reproductive and environmental risk factors for breast cancer. FMc results were generated on 99 parous women, 54 with primary invasive breast cancer and 45 general population controls. FMc prevalence was 56% (25/45 and 26% (14/54 in controls and cases, respectively. Women harboring FMc were less likely to have had breast cancer (OR = 0.29, 95% CI 0.11-0.83; p = 0.02, adjusting for age, number of children, birth of a son, history of miscarriage, and total DNA tested. In addition, FMc concentrations were higher in controls versus cases (p = 0.01. Median concentrations were 2 (0-78 and 0 (0-374 fetal genomes/10(6 maternal genomes in controls and cases, respectively.Results suggest that the enigma of why some parous women are not afforded protection from breast cancer by pregnancy might in part be explained by differences in FMc. Mechanistic studies of FMc-derived protection against breast cancer are warranted.

  13. 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.

  14. Evaluating institutional capacity for research ethics in Africa: a case study from Botswana

    Science.gov (United States)

    2013-01-01

    Background The increase in the volume of research conducted in Low and Middle Income Countries (LMIC), has brought a renewed international focus on processes for ethical conduct of research. Several programs have been initiated to strengthen the capacity for research ethics in LMIC. However, most such programs focus on individual training or development of ethics review committees. The objective of this paper is to present an approach to institutional capacity assessment in research ethics and application of this approach in the form of a case study from an institution in Africa. Methods We adapted the Octagon model originally used by the Swedish International Development Cooperation Agency to assess an organization along eight domains in research ethics: basic values and identity; structure and organization; ability to carry out activities; relevance of activities to stated goals; capacity of staff and management; administrative, financing and accounting systems; its relations with target groups; and the national context. We used a mixed methods approach to collect empirical data at the University of Botswana from March to December 2010. Results The overall shape of the external evaluation Octagon suggests that strengths of the University of Botswana are in the areas of structure, relevance, production and identity; while the university still needs more work in the areas of systems of finance, target groups, and environment. The Octagons also show the similarities and discrepancies between the 'external' and 'internal' evaluations and provide an opportunity for exploration of these different assessments. For example, the discrepant score for 'identity' between internal and external evaluations allows for an exploration of what constitutes a strong identity for research ethics at the University of Botswana and how it can be strengthened. Conclusions There is a general lack of frameworks for evaluating research ethics capacity in LMICs. We presented an approach that

  15. Evaluating institutional capacity for research ethics in Africa: a case study from Botswana.

    Science.gov (United States)

    Hyder, Adnan A; Zafar, Waleed; Ali, Joseph; Ssekubugu, Robert; Ndebele, Paul; Kass, Nancy

    2013-07-30

    The increase in the volume of research conducted in Low and Middle Income Countries (LMIC), has brought a renewed international focus on processes for ethical conduct of research. Several programs have been initiated to strengthen the capacity for research ethics in LMIC. However, most such programs focus on individual training or development of ethics review committees. The objective of this paper is to present an approach to institutional capacity assessment in research ethics and application of this approach in the form of a case study from an institution in Africa. We adapted the Octagon model originally used by the Swedish International Development Cooperation Agency to assess an organization along eight domains in research ethics: basic values and identity; structure and organization; ability to carry out activities; relevance of activities to stated goals; capacity of staff and management; administrative, financing and accounting systems; its relations with target groups; and the national context. We used a mixed methods approach to collect empirical data at the University of Botswana from March to December 2010. The overall shape of the external evaluation Octagon suggests that strengths of the University of Botswana are in the areas of structure, relevance, production and identity; while the university still needs more work in the areas of systems of finance, target groups, and environment. The Octagons also show the similarities and discrepancies between the 'external' and 'internal' evaluations and provide an opportunity for exploration of these different assessments. For example, the discrepant score for 'identity' between internal and external evaluations allows for an exploration of what constitutes a strong identity for research ethics at the University of Botswana and how it can be strengthened. There is a general lack of frameworks for evaluating research ethics capacity in LMICs. We presented an approach that stresses evaluation from both internal

  16. Dengue infection and miscarriage: a prospective case control study.

    Directory of Open Access Journals (Sweden)

    Peng Chiong Tan

    Full Text Available BACKGROUND: Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known. METHOD: We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1 antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy plus 45 controls (39 lost to follow up and six subsequent late miscarriages were excluded from analysis. FINDINGS: Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection was positive in 6/115 (5·2% cases and 5/296 (1·7% controls RR 3·1 (95% CI 1·0-10 P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2-14 P = 0·023. INTERPRETATION: Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained.

  17. 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

  18. Real-Time Flood Control by Tree-Based Model Predictive Control Including Forecast Uncertainty: A Case Study Reservoir in Turkey

    Directory of Open Access Journals (Sweden)

    Gökçen Uysal

    2018-03-01

    Full Text Available Optimal control of reservoirs is a challenging task due to conflicting objectives, complex system structure, and uncertainties in the system. Real time control decisions suffer from streamflow forecast uncertainty. This study aims to use Probabilistic Streamflow Forecasts (PSFs having a lead-time up to 48 h as input for the recurrent reservoir operation problem. A related technique for decision making is multi-stage stochastic optimization using scenario trees, referred to as Tree-based Model Predictive Control (TB-MPC. Deterministic Streamflow Forecasts (DSFs are provided by applying random perturbations on perfect data. PSFs are synthetically generated from DSFs by a new approach which explicitly presents dynamic uncertainty evolution. We assessed different variables in the generation of stochasticity and compared the results using different scenarios. The developed real-time hourly flood control was applied to a test case which had limited reservoir storage and restricted downstream condition. According to hindcasting closed-loop experiment results, TB-MPC outperforms the deterministic counterpart in terms of decreased downstream flood risk according to different independent forecast scenarios. TB-MPC was also tested considering different number of tree branches, forecast horizons, and different inflow conditions. We conclude that using synthetic PSFs in TB-MPC can provide more robust solutions against forecast uncertainty by resolution of uncertainty in trees.

  19. Multi-institutional Comparison of Intensity Modulated Radiation Therapy (IMRT) Planning Strategies and Planning Results for Nasopharyngeal Cancer

    Science.gov (United States)

    Park, Sung Ho; Park, Suk Won; Oh, Do Hoon; Choi, Youngmin; Kim, Jeung Kee; Ahn, Yong Chan; Park, Won; Suh, Hyun Sook; Lee, Rena; Bae, Hoonsik

    2009-01-01

    The intensity-modulated radiation therapy (IMRT) planning strategies for nasopharyngeal cancer among Korean radiation oncology facilities were investigated. Five institutions with IMRT planning capacity using the same planning system were invited to participate in this study. The institutions were requested to produce the best plan possible for 2 cases that would deliver 70 Gy to the planning target volume of gross tumor (PTV1), 59.4 Gy to the PTV2, and 51.5 Gy to the PTV3 in which elective irradiation was required. The advised fractionation number was 33. The planning parameters, resultant dose distributions, and biological indices were compared. We found 2-3-fold variations in the volume of treatment targets. Similar degree of variation was found in the delineation of normal tissue. The physician-related factors in IMRT planning had more influence on the plan quality. The inhomogeneity index of PTV dose ranged from 4 to 49% in Case 1, and from 5 to 46% in Case 2. Variation in tumor control probabilities for the primary lesion and involved LNs was less marked. Normal tissue complication probabilities for parotid glands and skin showed marked variation. Results from this study suggest that greater efforts in providing training and continuing education in terms of IMRT planning parameters usually set by physician are necessary for the successful implementation of IMRT. PMID:19399266

  20. INL Sitewide Institutional Controls Annual Report FY2006

    Energy Technology Data Exchange (ETDEWEB)

    W. L. Jolley

    2006-08-01

    This document reports the results of the fiscal year 2006 institutional controls assessment at Comprehensive Environmental Response, Compensation, and Liability Act sites at the Idaho National Laboratory. These activities are described in the INEEL Sitewide Institutional Control Plan. Inspections were performed by Long-term Stewardship Program personnel with representatives of the various facilities. The assessments showed that the various institutional control measures in place across the Idaho National Laboratory Site are functioning as intended. Information in the Idaho National Engineering and Environmental Laboratory Comprehensive Facilities and Land Use Plan was reviewed as part of the annual assessment and was revised as needed to reflect the current status of the institutional control sites.

  1. 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

  2. Is work organisation associated with work status 3 months after injury? Results from a case-control study of New Zealand workers.

    Science.gov (United States)

    Lilley, Rebbecca; Derrett, Sarah; Davie, Gabrielle

    2015-01-01

    Little empirical examination of the relationship between work organisational factors and return to work following injury has been undertaken despite the growing recognition of examining broader multi-dimensional contexts for recovery following injury. To explore relationships between pre-injury work organisational factors and work status (working/work absent) 3-month after injury among people employed prior to injury. Cases (work absent) and controls (working), selected from a larger study of injury outcomes according to reported work status 3-month after injury, completed a postal questionnaire. Work organisational factors were compared between cases and controls using univariate and multivariable analyses. One hundred and twelve participants completed the questionnaire (44 cases; 68 controls). Of 11 work organisation factors examined, organisational size was the only explanatory variable significantly associated with work status in the multivariable model. Higher odds of work absence were found in small ( 500 employees) (OR 7.2) workplaces, compared with medium-sized (50-500 employees) organisations. Variations in post-injury work patterns among those working pre-injury may be partly explained by organisation size. Future research examining work status following injury should examine the influence of work organisational factors in larger studies.

  3. 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.)

  4. Institutional reforms and their impact on rural electrification: Case studies in South and Southeast Asia

    Energy Technology Data Exchange (ETDEWEB)

    Shrestha, R.M.; Kumar, S.; Toodoc, M.J.; Sharma, S.

    2004-04-01

    and relieving the financial burden of electricity institutions by sharing the costs of electricity supply with the private sector and the electricity consumers. The subregion, therefore, cover a wide continuum on the reform scale and present an interesting case study for analysing the issues of electricity (a sut-sector of energy) access to the poor and the impacts of reform. The objective of the study was to examine the reforms in the electricity sector that have crucial influence on electricity access. The study assessed whether the institutional restructuring and major reforms mentioned above had had impacts on the access to electricity among the poor. Three country case studies were chosen for assessment: Thailand, Bangladesh, and Vietnam. These countries in the subregion represented diverse economic standing as well as different approaches in increasing electricity access among the people. The selected reform measures in the three countries were assessed with respect to the following indicators: 1) Electrification levels. 2) Electrification rates. 3) Average or per capita kWh consumption. 4) Average electricity tariffs; and Electricity expenditures as percentage of total household expenditures. As various reform measures were undertaken in the past, the study had chosen few reform measures for Bach country case study for assessment. In the absence of electricity and affordability data by income classes (poor and non-poor), the study used electricity data of rural and urban population as a proxy of the poor and the nonpoor households, respectively. (BA)

  5. Study Design for a Case Control Investigation of Cellular Telephones and Other Risk Factors for Brain Tumors in Adults

    International Nuclear Information System (INIS)

    Inskip, P.D.; Hatch, E.E.; Stewart, P.A.; Heineman, E.F.; Ziegler, R.G.; Dosemeci, M.; Parry, D.; Rothman, N.; Boice, J.D. Jr.; Wilcosky, T.C.; Watson, D.J.; Shapiro, W.R.; Selker, R.G.; Fine, H.A.; Black, P. McL.; Loeffler, J.S.; Linet, M.S.

    1999-01-01

    The aetiology of brain tumours is poorly understood. Due, in part, to public concern about a postulated relationship between the use of cellular telephones or other increasingly prevalent environmental exposures and the incidence of brain cancer in adults, the National Cancer Institute is collaborating with three US hospitals in a comprehensive case control study of malignant and benign brain tumours. Factors under consideration include use of cellular phones and other wireless communication devices, workplace exposures to chemical agents and electromagnetic fields, dietary factors, family history of tumours, genetic determinants of susceptibility, home appliance use, reproductive history and hormonal exposures, viruses, medical and dental exposure to ionising radiation, and other aspects of medical history. Approximately 800 newly diagnosed brain tumour cases and 800 controls were enrolled at hospitals in Boston, Phoenix and Pittsburgh from 1994 to 1998. Cases include all adults (age ≥ 18 y) newly diagnosed with a histologically confirmed intracranial glioma, histologically confirmed intracranial meningioma or acoustic neuroma. Controls are patients admitted to the same hospitals as the cases, and treated for any of a variety of non-malignant conditions. Key features of the study include its large size, the emphasis on rapid ascertainment of incident cases and interview of study subjects rather than surrogate respondents, the use of detailed, job-specific questions developed by industrial hygienists to ascertain occupational exposures, and the storage of blood samples for future evaluation of inherited susceptibility, biomarkers of exposure and gene environment interactions. (author)

  6. A Multi-Case Study of University Students' Language-Learning Experience Mediated by Mobile Technologies: A Socio-Cultural Perspective

    Science.gov (United States)

    Ma, Qing

    2017-01-01

    Emerging mobile technologies can be considered a new form of social and cultural artefact that mediates people's language learning. This multi-case study investigates how mobile technologies mediate a group of Hong Kong university students' L2 learning, which serves as a lens with which to capture the personalised, unique, contextual and…

  7. Topology Control in Aerial Multi-Beam Directional Networks

    Science.gov (United States)

    2017-04-24

    Topology Control in Aerial Multi-Beam Directional Networks Brian Proulx, Nathaniel M. Jones, Jennifer Madiedo, Greg Kuperman {brian.proulx, njones...significant interference. Topology control (i.e., selecting a subset of neighbors to communicate with) is vital to reduce the interference. Good topology ...underlying challenges to topology control in multi-beam direction networks. Two topology control algorithms are developed: a centralized algorithm

  8. Analgesics use and ESRD in younger age: a case-control study

    Directory of Open Access Journals (Sweden)

    Moehner Sabine

    2007-12-01

    Full Text Available Abstract Background An ad hoc peer-review committee was jointly appointed by Drug Authorities and Industry in Germany, Austria and Switzerland in 1999/2000 to review the evidence for a causal relation between phenacetin-free analgesics and nephropathy. The committee found the evidence as inconclusive and requested a new case-control study of adequate design. Methods We performed a population-based case-control study with incident cases of end-stage renal disease (ESRD under the age of 50 years and four age and sex-matched neighborhood controls in 170 dialysis centers (153 in Germany, and 17 in Austria from January 1, 2001 to December 31, 2004. Data on lifetime medical history, risk factors, treatment, job exposure and intake of analgesics were obtained in a standardized face-to-face interview using memory aids to enhance accuracy. Study design, study performance, analysis plan, and study report were approved by an independent international advisory committee and by the Drug Authorities involved. Unconditional logistic regression analyses were performed. Results The analysis included 907 cases and 3,622 controls who had never used phenacetin-containing analgesics in their lifetime. The use of high cumulative lifetime dose (3rd tertile of analgesics in the period up to five years before dialysis was not associated with later ESRD. Adjusted odds ratios with 95% confidence intervals were 0.8 (0.7 – 1.0 and 1.0 (0.8 – 1.3 for ever- compared with no or low use and high use compared with low use, respectively. The same results were found for all analgesics and for mono-, and combination preparations with and without caffeine. No increased risk was shown in analyses stratifying for dose and duration. Dose-response analyses showed that analgesic use was not associated with an increased risk for ESRD up to 3.5 kg cumulative lifetime dose (98 % of the cases with ESRD. While the large subgroup of users with a lifetime dose up to 0.5 kg (278 cases and

  9. 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

  10. Obstacles to action in arthritis: a community case-control study.

    Science.gov (United States)

    Hutton, Ingrid; Gamble, Greg; McLean, Grant; Butcher, Hugh; Gow, Peter; Dalbeth, Nicola

    2009-07-01

    Despite the benefits of physical activity, people with arthritis are less active than the general population. The aim of this study was to determine the motivators and obstacles to physical activity for adults with arthritis. Participants were identified from the Obstacles to Action Study, a community based study of 8163 adults, which explored barriers and motivators to physical activity. A 1:1 case-control study was designed; cases were identified as those participants who reported arthritis (n = 1106). Each case was matched with an age, sex and ethnicity-matched non-arthritis control (n = 1106). Cases were less likely to achieve recommended physical activity targets (58.8% vs. 68.1% P = 0.00001). Furthermore, fewer people with arthritis believed that physical activity would help them lead healthy lives (86.7% vs. 91.3% P = 0.006) or viewed physical activity as a priority (53.8% vs. 59.8% P = 0.005). Cases were less confident in their abilities to try a new activity (37.1% vs. 43.7% P = 0.002) or maintain a healthy weight (65.0% vs. 74.3% P = 0.00001). Cases also reported greater negative impact scores for barriers to activity, particularly arthritis, accessibility, cost and discomfort while exercising. Motivators and environmental barriers to activity were similar for cases and controls. These findings persisted after adjusting for educational level, body mass index and comorbidities. People with arthritis are less active and demonstrate different attitudes toward physical activity. Although people with arthritis identify similar environmental barriers, they have different psychosocial barriers. In order to design effective physical activity programs for people with arthritis, these barriers must be specifically addressed.

  11. Pretreatment serum concentrations of 25-hydroxyvitamin D and breast cancer prognostic characteristics: a case-control and a case-series study.

    Directory of Open Access Journals (Sweden)

    Song Yao

    2011-02-01

    Full Text Available Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity.In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER, and molecular subtypes defined by ER, progesterone receptor (PR and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001. Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03. Levels were lowest among women with triple-negative cancer (17.5 ng/mL, significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002. In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08-0.53 than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22-0.56. The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses.In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant vitamin D supplementation for

  12. Pretreatment Serum Concentrations of 25-Hydroxyvitamin D and Breast Cancer Prognostic Characteristics: A Case-Control and a Case-Series Study

    Science.gov (United States)

    Yao, Song; Sucheston, Lara E.; Millen, Amy E.; Johnson, Candace S.; Trump, Donald L.; Nesline, Mary K.; Davis, Warren; Hong, Chi-Chen; McCann, Susan E.; Hwang, Helena; Kulkarni, Swati; Edge, Stephen B.; O'Connor, Tracey L.; Ambrosone, Christine B.

    2011-01-01

    Background Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity. Methods and Findings In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD) in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER), and molecular subtypes defined by ER, progesterone receptor (PR) and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08–0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22–0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses. Conclusion In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant

  13. 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.

  14. Periodontal disease and spontaneous preterm birth: a case control study

    Directory of Open Access Journals (Sweden)

    Eley Barry

    2006-07-01

    Full Text Available Abstract Background Several studies have suggested an association between periodontal disease and prematurity but this finding has not been consistently observed. Methods Case control study. Cases (n = 50 were women who had delivered after spontaneous preterm labor at Results There was no difference in the proportion of sites with significant attachment loss (≥3 mm: Cases-3.2%, Controls-2.2% p = 0.21. The gingival crevicular fluid concentrations of elastase and gingipain were elevated in cases vs. controls 238.8 uU/ul vs. 159.6 uU/ul p = .007 and 2.70 uU/ul vs. 1.56 uU/ul p = .001. On multivariate analysis, the mean log concentration of elastase, but not of gingipain, remained a significant predictor of preterm labor p = .0.015. Conclusion We found no evidence that clinical periodontal disease is associated with spontaneous preterm birth. Elevated gingival crevicular fluid levels of elastase were associated with preterm birth but further research is needed before this can be assumed to be a causal relationship.

  15. Does marriage protect against hospitalization with pneumonia? A population-based case-control study

    Directory of Open Access Journals (Sweden)

    Mor A

    2013-10-01

    Full Text Available Anil Mor, Sinna P Ulrichsen, Elisabeth Svensson, Klara Berencsi, Reimar W Thomsen Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark Background: To reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle. Patients and methods: In this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children. Results: The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7% or never married (13% versus 11%. Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively compared with married (3% and widowed (6% patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25-1.33 among divorced; 1.15 (95% CI: 1.12-1.17 among widowed; and 1.33 (95% CI: 1.29-1.37 among never-married individuals as compared with those who were married. Conclusion: Married individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients

  16. Multi Car Elevator Control by using Learning Automaton

    Science.gov (United States)

    Shiraishi, Kazuaki; Hamagami, Tomoki; Hirata, Hironori

    We study an adaptive control technique for multi car elevators (MCEs) by adopting learning automatons (LAs.) The MCE is a high performance and a near-future elevator system with multi shafts and multi cars. A strong point of the system is that realizing a large carrying capacity in small shaft area. However, since the operation is too complicated, realizing an efficient MCE control is difficult for top-down approaches. For example, “bunching up together" is one of the typical phenomenon in a simple traffic environment like the MCE. Furthermore, an adapting to varying environment in configuration requirement is a serious issue in a real elevator service. In order to resolve these issues, having an autonomous behavior is required to the control system of each car in MCE system, so that the learning automaton, as the solutions for this requirement, is supposed to be appropriate for the simple traffic control. First, we assign a stochastic automaton (SA) to each car control system. Then, each SA varies its stochastic behavior distributions for adapting to environment in which its policy is evaluated with each passenger waiting times. That is LA which learns the environment autonomously. Using the LA based control technique, the MCE operation efficiency is evaluated through simulation experiments. Results show the technique enables reducing waiting times efficiently, and we confirm the system can adapt to the dynamic environment.

  17. External radiotherapy prior to thyroid cancer: A case-control study

    International Nuclear Information System (INIS)

    Hallquist, A.; Loefroth, P.O.; Hardell, L.

    1993-01-01

    The aim of this investigation was to study previous radiotherapy of malignant diseases as a risk factor for thyroid cancer. By using the Swedish Cancer Registry all cases of thyroid cancer with another malignant disease at least one year previously and living within the catchment area of the hospital were traced. During 1959-1989 a total of 1056 cases of thyroid cancer were identified. Of these, 37 had had another previous malignant disease and they constituted the cases in this study. As controls four persons with at least two malignant diseases, thyroid cancer excluded, were selected for each case from the same cancer registry. Ten (27.0%) of the 37 patients with thyroid cancer as a second tumor had earlier been irradiated with the treatment dose including the thyroid gland as compared with 34 (24.5%) of the 139 control patients. Eight of the ten cases with previous irradiation of the thyroid gland had papillary cancer. The median latency was 13 years. The estimated radiation dose in the thyroid varied between 3 and 40 Gy. External radiotherapy gave a crude odds ratio of 1.1 with 95% confidence interval = 0.5-2.8 for thyroid cancer. The weighted odds ratio was calculated to 2.3 with confidence interval = 0.5-8.9. This case-control study gave a nonsignificantly increased odds ratio for thyroid cancer in patients with external radiotherapy including the thyroid gland. 26 refs., 4 tabs

  18. Analytical and numerical study of validation test-cases for multi-physic problems: application to magneto-hydro-dynamic

    Directory of Open Access Journals (Sweden)

    D Cébron

    2016-04-01

    Full Text Available The present paper is concerned with the numerical simulation of Magneto-Hydro-Dynamic (MHD problems with industrial tools. MHD has receivedattention some twenty to thirty years ago as a possible alternative inpropulsion applications; MHD propelled ships have even been designed forthat purpose. However, such propulsion systems have been proved of lowefficiency and fundamental researches in the area have progressivelyreceived much less attention over the past decades. Numerical simulationof MHD problem could however provide interesting solutions in the field ofturbulent flow control. The development of recent efficient numericaltechniques for multi-physic applications provide promising tool for theengineer for that purpose. In the present paper, some elementary testcases in laminar flow with magnetic forcing terms are analysed; equationsof the coupled problem are exposed, analytical solutions are derived ineach case and are compared to numerical solutions obtained with anumerical tool for multi-physic applications. The present work can be seenas a validation of numerical tools (based on the finite element method foracademic as well as industrial application purposes.

  19. BRCA2 Variants and cardiovascular disease in a multi-ethnic study

    Directory of Open Access Journals (Sweden)

    Zbuk Kevin

    2012-07-01

    Full Text Available Abstract Background Germline mutations of BRCA1/2 are associated with hereditary breast and ovarian cancer. Recent data suggests excess mortality in mutation carriers beyond that conferred by neoplasia, and recent in vivo and in vitro studies suggest a modulatory role for BRCA proteins in endothelial and cardiomyocyte function. We therefore tested the association of BRCA2 variants with clinical cardiovascular disease (CVD. Methods Using data from 1,170 individuals included in two multi-ethnic population-based studies (SHARE and SHARE-AP, the association between BRCA2 variants and CVD was evaluated. 15 SNPs in BRCA2 with minor allele frequencies (MAF > 0.01 had been previously genotyped using the cardiovascular gene-centric 50 k SNP array. 115 individuals (9.8% reported a CVD event, defined as myocardial infarction (MI, angina, silent MI, stroke, and angioplasty or coronary artery bypass surgery. Analyses were adjusted for age and sex. The SNPs rs11571836 and rs1799943 were subsequently genotyped using the MassARRAY platform in 1,045 cases of incident MI and 1,135 controls from the South Asian subset of an international case-control study of acute MI (INTERHEART, and rs11571836 was imputed in 4,686 cases and 4500 controls from the Pakistan Risk of Myocardial Infarction Study (PROMIS. Results Two BRCA2 SNPs, rs11571836 and rs1799943, both located in untranslated regions, were associated with lower risk of CVD (OR 0.47 p = 0.01 and OR 0.56 p = 0.03 respectively in the SHARE studies. Analysis by specific ethnicities demonstrated an association with CVD for both SNPs in Aboriginal People, and for rs11571836 only in South Asians. No association was observed in the European and Chinese subgroups. A non-significant trend towards an association between rs11571836 and lower risk of MI was observed in South Asians from INTERHEART [OR = 0.87 (95% CI: 0.75-1.01 p = 0.068], but was not evident in PROMIS [OR = 0.96 (95% CI: 0

  20. Characterizing and controlling industrial dust: a case study in small particle measurement.

    Science.gov (United States)

    Combes, Richard S; Warren, D Alan

    2005-07-01

    Instrumentation used to measure characteristics of fine particles entrained in gas or suspended in aerosols provides information needed to develop valid regulations for emission sources and to support the design of control technologies. This case study offers a brief history of "micromeritics," a term used by early researchers to describe the science of small particles, and the related invention of laboratory instruments for characterizing very fine particles. The historical view provides insights into the role that Progressive Era government agencies played in advancing esoteric science and applying this knowledge to the regulation of workplace air pollution. Micromeritics instrumentation developed in conjunction with federal research now has many commercial applications worldwide, with characterizing airborne pollutants only a minor one. However, the continuing advances in the micromeritics field provide important laboratory measurement capabilities to environmental research organizations, such as the National Institute for Occupational Safety and Health (NIOSH).

  1. Colistin use in critically ill neonates: A case–control study

    Directory of Open Access Journals (Sweden)

    Mehmet Sah Ä°pek

    2017-12-01

    Full Text Available Background: The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. Methods: This was a case–control study that included newborn infants with proven or suspected nosocomial infections between January 2012 and October 2015, at two centers in Diyarbakir, Turkey. The clinical and laboratory characteristics and outcomes of patients who received colistin therapy were reviewed and compared to patients who were treated with antimicrobial agents other than colistin during the same period. Results: Forty-seven cases who received intravenous colistin (colistin group and 59 control patients (control group were included. There were no significant differences between the groups regarding outcomes and nephrotoxicity, including acute renal failure. Colistin therapy was associated with significantly reduced serum magnesium (1.38 ± 0.39 mg/dL vs. 1.96 ± 0.39 mg/dL, p < 0.001 and hypokalemia (46.8% vs. 25.4%, p = 0.026. The patients who received colistin also had longer hospital stays (43 (32–70 days vs. 39 (28–55 days, p = 0.047, a higher rate of previous carbapenem exposure (40.4% vs. 11.9%, p = 0.001, and a higher age at the onset of infection (13 (10–21 days vs. 11 (9–15 days, p = 0.03. Conclusion: This study showed that colistin was both effective and safe for treating neonatal infections caused by multidrug-resistant gram-negative bacteria. However, intravenous colistin use was significantly associated with hypomagnesemia and hypokalemia. Key Words: colistin, neonate, nosocomial infection, multi-drug resistant, gram-negative bacteria

  2. CYP1A1 MspI Polymorphism and Cervical Carcinoma Risk in the Multi-Ethnic Population of Malaysia: a Case-Control Study.

    Science.gov (United States)

    Tan, Yee Hock; Sidik, Shiran Mohd; Syed Husain, Sharifah Noor Akmal; Lye, Munn Sann; Chong, Pei Pei

    2016-01-01

    Tobacco smoking is considered a risk factor for cervical cancer development due to the presence of tobacco based carcinogenic metabolites in cervical cells of female smokers. In this study, we investigated the role of the T3801C (MspI) polymorphism of CYP1A1, a gene encoding an enzyme necessary for the initiation of tobacco based carcinogen metabolism, on cervical cancer risk. The T to C substitution may alter CYP1A1 activities, potentially elevating cervical cancer risk. Since results of gene-disease association studies vary according to the study population, the multi-ethnic population of Malaysia provides an excellent representative cohort for identifying and comparing the cervical cancer risk among the 3 major ethnics in Southeast Asia in relation to CYP1A1 MspI polymorphism. A total of 195 Thin Prep Pap smear samples from HPV negative and cancer free females were randomly selected as controls while 106 formalin fixed paraffin embedded samples from females with invasive cervical cancer were randomly selected for the cases group. The polymorphisms were identified using restriction fragment length polymorphism (RFLP) PCR. We found no significant associations between CYP1A1 MspI polymorphism and cervical cancer in the general Malaysian female population. However, upon ethnic stratification, the variant C/C genotype was significantly associated with a 4.66-fold increase in cervical cancer risk in Malay females (95% CI= 1.21-17.9; p=0.03). No significant association was observed in the Chinese and Indian females. Additionally, there were no significant associations in the dominant model and allele frequency model analysis in both the general and ethnically stratified female population of Malaysia. Our findings suggest that the C/C genotype of CYP1A1 MspI polymorphism is associated with the development of cervical carcinoma in the Malay females of Malaysia.

  3. Nutritional risk assessment for Hip fracture, A Case control study

    OpenAIRE

    Torbergsen, Anne Cathrine

    2016-01-01

    The study was conducted at Oslo University Hospital, Norway. Patients were included from September 2009 until April 2011. In total 116 patients and 73 healthy non-fractured controls participated. The study has 3 parts. In the first part, we studied micronutrients and the risk of hip fracture in a case control study. In the second part, we conducted a randomized controlled nutrition intervention trial and finally, in the third part, we studied if micronutrients were associated with delirium in...

  4. 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.

  5. 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

  6. 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

  7. Theoretical and algorithmic advances in multi-parametric programming and control

    KAUST Repository

    Pistikopoulos, Efstratios N.; Dominguez, Luis; Panos, Christos; Kouramas, Konstantinos; Chinchuluun, Altannar

    2012-01-01

    This paper presents an overview of recent theoretical and algorithmic advances, and applications in the areas of multi-parametric programming and explicit/multi-parametric model predictive control (mp-MPC). In multi-parametric programming, advances include areas such as nonlinear multi-parametric programming (mp-NLP), bi-level programming, dynamic programming and global optimization for multi-parametric mixed-integer linear programming problems (mp-MILPs). In multi-parametric/explicit MPC (mp-MPC), advances include areas such as robust multi-parametric control, multi-parametric nonlinear MPC (mp-NMPC) and model reduction in mp-MPC. A comprehensive framework for multi-parametric programming and control is also presented. Recent applications include a hydrogen storage device, a fuel cell power generation system, an unmanned autonomous vehicle (UAV) and a hybrid pressure swing adsorption (PSA) system. © 2012 Springer-Verlag.

  8. Theoretical and algorithmic advances in multi-parametric programming and control

    KAUST Repository

    Pistikopoulos, Efstratios N.

    2012-04-21

    This paper presents an overview of recent theoretical and algorithmic advances, and applications in the areas of multi-parametric programming and explicit/multi-parametric model predictive control (mp-MPC). In multi-parametric programming, advances include areas such as nonlinear multi-parametric programming (mp-NLP), bi-level programming, dynamic programming and global optimization for multi-parametric mixed-integer linear programming problems (mp-MILPs). In multi-parametric/explicit MPC (mp-MPC), advances include areas such as robust multi-parametric control, multi-parametric nonlinear MPC (mp-NMPC) and model reduction in mp-MPC. A comprehensive framework for multi-parametric programming and control is also presented. Recent applications include a hydrogen storage device, a fuel cell power generation system, an unmanned autonomous vehicle (UAV) and a hybrid pressure swing adsorption (PSA) system. © 2012 Springer-Verlag.

  9. 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

  10. 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

  11. Risk Factors For Ectopic Pregnancy : A Case Control Study

    Directory of Open Access Journals (Sweden)

    Deshmukh J.S

    1999-01-01

    Full Text Available Research question: Which are the risk factors for ectopic pregnancy . Objective: To study the strength of association between hypothesised risk factors and ectopic pregnancy. Study design: Unmatched case- control study. Setting: Government Medical College, Hospital, Nagpur. Participants: 133 cases of ectopic pregnancy and equal number of controls (non pregnant women admitted to study hospital. Study variables : Pelvic inflammatory diseases, sexually transmitted diseases, IUD use at conception , past use of IUD, prior ectopic pregnancy, OC pills use at the time of conception, past use of OC pills, induced abortion, spontaneous abortion, infertility and pelvic and abdominal surgery. Statistical analysis: Odds ratios & their 95% CI, Pearson’s chi square test, unconditional logistic regression analysis and population attributable risk proportion. Results : Use of IUD at conception, prior ectopic pregnancy , pelvic inflammatory disease, sexually transmitted diseases, infertility, OC pills use at the time of conception, past use of IUD and induced abortion were found to be significantly associated with ectopic pregnancy. Conclusion: Identification of these risk factors for etopic pregnancy shall help in early detection and appropriate management in an individual case and it may help in devising a comprehensive preventive strategy for ectopic pregnancy

  12. Islam, Modernity, and the Liminal Space Between: A Vertical Case Study of the Institute of Traditional Islamic Art and Architecture in Amman, Jordan

    Science.gov (United States)

    Meehan, Mark W.

    2012-01-01

    This dissertation investigates the development and function of the Institute of Traditional Islamic Art and Architecture in Amman, Jordan. A vertical case study using grounded theory methodology, the research attempts to create a rich and holistic understanding of the Institute. Specific areas of study include the factors involved in the founding…

  13. 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

  14. Impact of case type, length of stay, institution type, and comorbidities on Medicare diagnosis-related group reimbursement for adult spinal deformity surgery.

    Science.gov (United States)

    Nunley, Pierce D; Mundis, Gregory M; Fessler, Richard G; Park, Paul; Zavatsky, Joseph M; Uribe, Juan S; Eastlack, Robert K; Chou, Dean; Wang, Michael Y; Anand, Neel; Frank, Kelly A; Stone, Marcus B; Kanter, Adam S; Shaffrey, Christopher I; Mummaneni, Praveen V

    2017-12-01

    OBJECTIVE The aim of this study was to educate medical professionals about potential financial impacts of improper diagnosis-related group (DRG) coding in adult spinal deformity (ASD) surgery. METHODS Medicare's Inpatient Prospective Payment System PC Pricer database was used to collect 2015 reimbursement data for ASD procedures from 12 hospitals. Case type, hospital type/location, number of operative levels, proper coding, length of stay, and complications/comorbidities (CCs) were analyzed for effects on reimbursement. DRGs were used to categorize cases into 3 types: 1) anterior or posterior only fusion, 2) anterior fusion with posterior percutaneous fixation with no dorsal fusion, and 3) combined anterior and posterior fixation and fusion. RESULTS Pooling institutions, cases were reimbursed the same for single-level and multilevel ASD surgery. Longer stay, from 3 to 8 days, resulted in an additional $1400 per stay. Posterior fusion was an additional $6588, while CCs increased reimbursement by approximately $13,000. Academic institutions received higher reimbursement than private institutions, i.e., approximately $14,000 (Case Types 1 and 2) and approximately $16,000 (Case Type 3). Urban institutions received higher reimbursement than suburban institutions, i.e., approximately $3000 (Case Types 1 and 2) and approximately $3500 (Case Type 3). Longer stay, from 3 to 8 days, increased reimbursement between $208 and $494 for private institutions and between $1397 and $1879 for academic institutions per stay. CONCLUSIONS Reimbursement is based on many factors not controlled by surgeons or hospitals, but proper DRG coding can significantly impact the financial health of hospitals and availability of quality patient care.

  15. 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

  16. Response rates in case-control studies of cancer by era of fieldwork and by characteristics of study design.

    Science.gov (United States)

    Xu, Mengting; Richardson, Lesley; Campbell, Sally; Pintos, Javier; Siemiatycki, Jack

    2018-04-09

    The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate. We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context. Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires. Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Delay-based virtual congestion control in multi-tenant datacenters

    Science.gov (United States)

    Liu, Yuxin; Zhu, Danhong; Zhang, Dong

    2018-03-01

    With the evolution of cloud computing and virtualization, the congestion control of virtual datacenters has become the basic issue for multi-tenant datacenters transmission. Regarding to the friendly conflict of heterogeneous congestion control among multi-tenant, this paper proposes a delay-based virtual congestion control, which translates the multi-tenant heterogeneous congestion control into delay-based feedback uniformly by setting the hypervisor translation layer, modifying three-way handshake of explicit feedback and packet loss feedback and throttling receive window. The simulation results show that the delay-based virtual congestion control can effectively solve the unfairness of heterogeneous feedback congestion control algorithms.

  18. Violence against Women and Gastroschisis: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Daniel Ruiz

    2013-10-01

    Full Text Available Background: Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the likely mechanism of pathogenesis. Given that chronic stress and violence against women are risk factors for cardiovascular disease we explored whether these may represent risk factors for gastroschisis, when they occur during pregnancy. A case-control study was conducted, with 15 incident cases of children born with gastroschisis in the Region of Murcia, Spain, from December 2007 to June 2013. Forty concurrent controls were recruited at gestation weeks 20–24 or post-partum. All mothers of cases and controls completed a comprehensive, in-person, ‘green sheet’ questionnaire on environmental exposures. Results: Mothers of children with gastroschisis were younger, smoked more cigarettes per week relative to controls, were exposed to higher amounts of illegal drugs, and suffered from domestic violence more frequently than the controls. Multivariable logistic regression analysis highlights periconceptional ‘gender-related violence’ (OR: 16.6, 95% CI 2.7 to 101.7 and younger maternal age (OR 1.1, 95% CI 1.0–1.3. Conclusions: Violence against pregnant women is associated with birth defects, and should be studied in more depth as a cause-effect teratogenic. Psychosocial risk factors, including gender-based violence, are important for insuring the health and safety of the pregnant mother and the fetus.

  19. Sample size calculations for case-control studies

    Science.gov (United States)

    This R package can be used to calculate the required samples size for unconditional multivariate analyses of unmatched case-control studies. The sample sizes are for a scalar exposure effect, such as binary, ordinal or continuous exposures. The sample sizes can also be computed for scalar interaction effects. The analyses account for the effects of potential confounder variables that are also included in the multivariate logistic model.

  20. Drug and alcohol crash risk : a case-control study.

    Science.gov (United States)

    2016-12-01

    This study used a case-control design to estimate the risk of crashes involving drivers using drugs, alcohol or both. Data was collected in Virginia Beach, Virginia, for 20 months. The study obtained biological measures on more than 3,000 crash...

  1. 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.

  2. Gabapentin in traumatic nerve injury pain: A randomized, double-blind, placebo-controlled, cross-over, multi-center study

    DEFF Research Database (Denmark)

    Gordh, Torsten E; Stubhaug, Audun; Jensen, Troels S

    2008-01-01

    A double-blind, randomized, placebo-controlled cross-over multi-center study was conducted to evaluate the efficacy and safety of gabapentin in the treatment of neuropathic pain caused by traumatic or postsurgical peripheral nerve injury, using doses up to 2400mg/day. The study comprised a run...

  3. Role of nutrition in pre-eclampsia and eclampsia cases, a case control study

    Directory of Open Access Journals (Sweden)

    Punyatoya Bej

    2014-12-01

    Full Text Available Background: Preeclampsia and eclampsia during pregnancy contribute to maternal and fetal morbidity as well as mortality. The identification of the role of maternal nutrition during pregnancy will help in reducing morbidity and mortality. Aims & Objective: The objective of this study is to find out the role of nutrition, in the form of total calorie, protein, fruits, iron, folic acid and calcium intake in the development of preeclampsia and eclampsia among pregnant women in a tertiary level hospital. Material Methods: After ethical approval and informed consent, 122 women who delivered beyond 22 weeks of gestation and diagnosed as preeclampsia or eclampsia were selected. Simultaneously, 122 controls with no diagnosis of preeclampsia or eclampsia were selected from the post natal ward. Cases and controls were administered the same pre-tested questionnaire containing questions related to food and micronutrient intake by cases and control. Results: Logistic regression was applied in the statistical analysis. The factors that were found to be significant predictors of risk for development of preeclampsia and eclampsia were higher calorie intake (adjusted Odds Ratio (OR 14.12 [6.41-43.23] P < 0.001, less protein intake (adjusted OR 3.87 [1.97-8.01] P < 0.001 during pregnancy. Fruits intake in both cases and controls were similar. 77.9% of cases and 84.4% of controls had taken iron tablets during their antenatal period. 75.4% of cases and 82.8% of controls had taken calcium tablets during their antenatal period. Iron and calcium intake is not significantly associated with development of preeclampsia and eclampsia. Conclusion: Higher calorie intake and less protein intake during pregnancy were associated with development of preeclampsia and eclampsia. Fruits intake, iron and calcium intake were not associated with development of preeclampsia and eclampsia

  4. Multi-Objective Nonlinear Model Predictive Control: Lexicographic Method

    OpenAIRE

    Zheng, Tao; Wu, Gang; Liu, Guang-Hong; Ling, Qing

    2010-01-01

    In this chapter, to avoid the disadvantages of weight coefficients in multi-objective dynamic optimization, lexicographic (completely stratified) and partially stratified frameworks of multi-objective controller are proposed. The lexicographic framework is absolutely prioritydriven and the partially stratified framework is a modification of it, they both can solve the multi-objective control problem with the concept of priority for objective’s relative importance, while the latter one is mo...

  5. Organization of Multi-controller Interaction in Software Defined Networks

    Directory of Open Access Journals (Sweden)

    Sergey V. Morzhov

    2018-01-01

    Full Text Available Software Defined Networking (SDN is a promising paradigm for network management. It is a centralized network intelligence on a dedicated server, which runs network operating system, and is called SDN controller. It was assumed that such an architecture should have an improved network performance and monitoring. However, the centralized control architecture of the SDNs brings novel challenges to reliability, scalability, fault tolerance and interoperability. These problems are especially acute for large data center networks and can be solved by combining SDN controllers into clusters, called multi-controllers. Multi-controller architecture became very important for SDN-enabled networks nowadays. This paper gives a comprehensive overview of SDN multi-controller architectures. The authors review several most popular distributed controllers in order to indicate their strengths and weaknesses. They also investigate and classify approaches used. This paper explains in details the difference among various types of multi-controller architectures, the distribution method and the communication system. Furthermore, it provides already implemented architectures and some examples of architectures under consideration by describing their design, communication process, and performance results. In this paper, the authors show their own classification of multi-controllers and claim that, despite the existence of undeniable advantages, all reviewed controllers have serious drawbacks, which must be eliminated. These drawbacks hamper the development of multi-controllers and their widespread adoption in corporate networks. In the end, the authors conclude that now it is impossible to find a solution capable to solve all the tasks assigned to it adequately and fully. The article is published in the authors’ wording.

  6. Risk factors for gallbladder cancer: a case-control study.

    Science.gov (United States)

    Jain, Kajal; Sreenivas, V; Velpandian, T; Kapil, Umesh; Garg, Pramod Kumar

    2013-04-01

    Risk factors for gallbladder cancer (GBC) except gallstones are not well known. The objective was to study the risk factors for GBC. In a case-control study, 200 patients with GBC, 200 healthy controls and 200 gallstones patients as diseased controls were included prospectively. The risk factors studied were related to socioeconomic profile, life style, reproduction, diet and bile acids. On comparing GBC patients (mean age 51.7 years; 130 females) with healthy controls, risk factors were chemical exposure [odd ratios (OR): 7.0 (2.7-18.2); p < 0.001)], family history of gallstones [OR: 5.3 (1.5-18.9); p < 0.01)], tobacco [OR: 4.1 (1.8-9.7); p < 0.001)], fried foods [OR: 3.1 (1.7-5.6); p < 0.001], joint family [OR: 3.2 (1.7-6.2); p < 0.001], long interval between meals [OR: 1.4 (1.2-1.6); p < 0.001] and residence in Gangetic belt [OR: 3.3 (1.8-6.2); p < 0.001]. On comparing GBC cases with gallstone controls, risk factors were female gender [OR: 2.4 (1.3-4.3); p = 0.004], residence in Gangetic belt [OR: 2.3 (1.2-4.4); p = 0.012], fried foods [OR: 2.5 (1.4-4.4); p < 0.001], diabetes [OR: 2.7 (1.2-6.4); p = 0.02)], tobacco [OR 3.8 (1.7-8.1); p < 0.001)] and joint family [OR: 2.1 (1.2-3.4); p = 0.004]. The ratio of secondary to primary bile acids was significantly higher in GBC cases than gallstone controls (20.8 vs. 0.44). Fried foods, tobacco, chemical exposure, family history of gallstones, residence in Gangetic belt and secondary bile acids were significant risk factors for GBC. Copyright © 2012 UICC.

  7. A case-control study of risk factors for male infertility in Southern ...

    African Journals Online (AJOL)

    Aim: The purpose of this study was to evaluate the association between selected potential socio-demographic and behavioural risk factors and infertility in Nigeria males. Methods: The study consisted of cases and controls. The cases were 150 males with proven male infertility, while the controls were 150 fertile males with ...

  8. Factors associated with home delivery in Bahirdar, Ethiopia: a case control study.

    Science.gov (United States)

    Abebe, Fantu; Berhane, Yemane; Girma, Belaineh

    2012-11-24

    In Ethiopia although pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. The individual or health system factors that affect women's preferences for delivery places are not well known. A case control study was conducted in July 2010 to assess factors associated with utilization of institutional delivery service. A total of 324 mothers who recently delivered and visited either postnatal care or sought immunization services were included. Cases (n = 108) were mothers who gave birth at home and controls (n = 216) were those who delivered at health facility. Pre-tested and standardized questionnaires were used to collect relevant data by trained data collectors. Logistic regression model was used to control for confounding. The likelihood of delivering at home was greater among mothers with inadequate knowledge of pregnancy related services (AOR = 62, 95% CI: 3, 128.4), those who started attending ANC after 24 weeks of gestation (AOR 8.7, 95% CI: 2.2, 33.3), mothers having no formal education (Adjusted OR 4.2, 95% CI 1.63, 11.27) and rural residents (AOR = 3.6, 95%CI: 1.4, 9.0). The predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC) follow up, having, Illiteracy and rural residence. Audience specific behavioral change communication should be designed to improve the demand for delivery services. Health professionals should take the opportunity to encourage mothers attend delivery services during ANC follow up. Improvements should be made in social conditions including literacy and major social mobilization endeavors.

  9. Factors associated with home delivery in Bahirdar, Ethiopia: A case control study

    Directory of Open Access Journals (Sweden)

    Abebe Fantu

    2012-11-01

    Full Text Available Abstract Background In Ethiopia although pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. The individual or health system factors that affect women’s preferences for delivery places are not well known. Method A case control study was conducted in July 2010 to assess factors associated with utilization of institutional delivery service. A total of 324 mothers who recently delivered and visited either postnatal care or sought immunization services were included. Cases (n = 108 were mothers who gave birth at home and controls (n = 216 were those who delivered at health facility. Pre-tested and standardized questionnaires were used to collect relevant data by trained data collectors. Logistic regression model was used to control for confounding. Result The likelihood of delivering at home was greater among mothers with inadequate knowledge of pregnancy related services (AOR = 62, 95% CI: 3, 128.4, those who started attending ANC after 24 weeks of gestation (AOR 8.7, 95% CI: 2.2, 33.3, mothers having no formal education (Adjusted OR 4.2, 95% CI 1.63, 11.27 and rural residents (AOR = 3.6, 95%CI: 1.4, 9.0. Conclusion The predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC follow up, having, Illiteracy and rural residence. Audience specific behavioral change communication should be designed to improve the demand for delivery services. Health professionals should take the opportunity to encourage mothers attend delivery services during ANC follow up. Improvements should be made in social conditions including literacy and major social mobilization endeavors.

  10. Robust multi-model predictive control of multi-zone thermal plate system

    Directory of Open Access Journals (Sweden)

    Poom Jatunitanon

    2018-02-01

    Full Text Available A modern controller was designed by using the mathematical model of a multi–zone thermal plate system. An important requirement for this type of controller is that it must be able to keep the temperature set-point of each thermal zone. The mathematical model used in the design was determined through a system identification process. The results showed that when the operating condition is changed, the performance of the controller may be reduced as a result of the system parameter uncertainties. This paper proposes a weighting technique of combining the robust model predictive controller for each operating condition into a single robust multi-model predictive control. Simulation and experimental results showed that the proposed method performed better than the conventional multi-model predictive control in rise time of transient response, when used in a system designed to work over a wide range of operating conditions.

  11. Case-Control Studies of Sporadic Enteric Infections: A Review and Discussion of Studies Conducted Internationally from 1990 to 2009

    Science.gov (United States)

    Fullerton, Kathleen E.; Scallan, Elaine; Kirk, Martyn D.; Mahon, Barbara E.; Angulo, Frederick J.; de Valk, Henriette; van Pelt, Wilfrid; Gauci, Charmaine; Hauri, Anja M.; Majowicz, Shannon; O’Brien, Sarah J.

    2015-01-01

    Epidemiologists have used case-control studies to investigate enteric disease outbreaks for many decades. Increasingly, case-control studies are also used to investigate risk factors for sporadic (not outbreak-associated) disease. While the same basic approach is used, there are important differences between outbreak and sporadic disease settings that need to be considered in the design and implementation of the case-control study for sporadic disease. Through the International Collaboration on Enteric Disease “Burden of Illness” Studies (the International Collaboration), we reviewed 79 case-control studies of sporadic enteric infections caused by nine pathogens that were conducted in 22 countries and published from 1990 through to 2009. We highlight important methodological and study design issues (including case definition, control selection, and exposure assessment) and discuss how approaches to the study of sporadic enteric disease have changed over the last 20 years (e.g., making use of more sensitive case definitions, databases of controls, and computer-assisted interviewing). As our understanding of sporadic enteric infections grows, methods and topics for case-control studies are expected to continue to evolve; for example, advances in understanding of the role of immunity can be used to improve control selection, the apparent protective effects of certain foods can be further explored, and case-control studies can be used to provide population-based measures of the burden of disease. PMID:22443481

  12. Expanding the Role of Institutional Research at Small Private Universities: A Case Study in Enrollment Management Using Data Mining

    Science.gov (United States)

    Antons, Christopher M.; Maltz, Elliot N.

    2006-01-01

    This case study documents a successful application of data-mining techniques in enrollment management through a partnership between the admissions office, a business administration master's-degree program, and the institutional research office at Willamette University (Salem, Oregon). (Contains 1 table and 3 figures.)

  13. Effect of vitamin C supplementation on stroke recovery: A case-control study

    Directory of Open Access Journals (Sweden)

    Meheroz H Rabadi

    2007-04-01

    Full Text Available Meheroz H Rabadi1, Bruce S Kristal2,31Burke Rehabilitation Hospital, an affiliate of Weill Medical College of Cornell Medical College, White Plains, NY, USA; 2Burke Medical Research Institute, an affiliate of Weill Medical College of Cornell Medical College, White Plains, NY, USA; 3Department of Neuroscience, Cornell University Medical College, White Plains, NY, USABackground and purpose: Epidemiological studies have associated increased dietary intake of antioxidants (vitamin C, E, and β-carotene in preventing and decreasing the extent of ischemic brain injury. The effect of vitamin C supplementation on functional recovery after stroke has not been studied. Method: In this retrospective, case-control study of 23 patients with ischemic stroke taking vitamin C were identified and matched for age, sex, onset to admission, and admission total functional independence measure (TFIM with 23 patients with ischemic stroke not taking Vitamin C supplementation. Vitamin C 1000 mg daily was prescribed on admission to our unit mainly to patients who were undernourished (defined as significant weight loss and/or 90% or less ideal body weight for age and sex and those with pressure sores. The outcome measures were: change in the TFIM, FIM-Cognition (FIM-Cog, and FIM-Motor sub-scores, discharge disposition, and length of stay (LOS.Results: The change in TFIM (20 ± 13 standard deviation [SD] vs. 26 ± 6, p = 0.20, FIM-Cog (3 ± 3 SD vs. 4 ± 5, p = 0.41, FIM-Motor (15 ± 11 SD vs. 20 ± 13, p = 0.21 sub-scores were less in the vitamin C treated group, but these differences did not reach statistical significance. Similarly, no significant differences were found in LOS (21 ± 9 SD vs. 23 ± 9, p = 0.59, and discharge disposition (home/institution (9/10 vs. 13/9, p = 0.60 between the vitamin C and the control groups.Conclusion: This study suggests vitamin C supplementation did not enhance functional recovery in undernourished ischemic stroke patients

  14. A GIS-based multi-source and multi-box modeling approach (GMSMB) for air pollution assessment--a North American case study.

    Science.gov (United States)

    Wang, Bao-Zhen; Chen, Zhi

    2013-01-01

    This article presents a GIS-based multi-source and multi-box modeling approach (GMSMB) to predict the spatial concentration distributions of airborne pollutant on local and regional scales. In this method, an extended multi-box model combined with a multi-source and multi-grid Gaussian model are developed within the GIS framework to examine the contributions from both point- and area-source emissions. By using GIS, a large amount of data including emission sources, air quality monitoring, meteorological data, and spatial location information required for air quality modeling are brought into an integrated modeling environment. It helps more details of spatial variation in source distribution and meteorological condition to be quantitatively analyzed. The developed modeling approach has been examined to predict the spatial concentration distribution of four air pollutants (CO, NO(2), SO(2) and PM(2.5)) for the State of California. The modeling results are compared with the monitoring data. Good agreement is acquired which demonstrated that the developed modeling approach could deliver an effective air pollution assessment on both regional and local scales to support air pollution control and management planning.

  15. Control method for multi-input multi-output non-Gaussian random vibration test with cross spectra consideration

    Directory of Open Access Journals (Sweden)

    Ronghui ZHENG

    2017-12-01

    Full Text Available A control method for Multi-Input Multi-Output (MIMO non-Gaussian random vibration test with cross spectra consideration is proposed in the paper. The aim of the proposed control method is to replicate the specified references composed of auto spectral densities, cross spectral densities and kurtoses on the test article in the laboratory. It is found that the cross spectral densities will bring intractable coupling problems and induce difficulty for the control of the multi-output kurtoses. Hence, a sequential phase modification method is put forward to solve the coupling problems in multi-input multi-output non-Gaussian random vibration test. To achieve the specified responses, an improved zero memory nonlinear transformation is utilized first to modify the Fourier phases of the signals with sequential phase modification method to obtain one frame reference response signals which satisfy the reference spectra and reference kurtoses. Then, an inverse system method is used in frequency domain to obtain the continuous stationary drive signals. At the same time, the matrix power control algorithm is utilized to control the spectra and kurtoses of the response signals further. At the end of the paper, a simulation example with a cantilever beam and a vibration shaker test are implemented and the results support the proposed method very well. Keywords: Cross spectra, Kurtosis control, Multi-input multi-output, Non-Gaussian, Random vibration test

  16. A multi-objective set covering problem: A case study of warehouse allocation in truck industry

    Directory of Open Access Journals (Sweden)

    Atefeh Malekinezhad

    2011-01-01

    Full Text Available Designing distribution centers is normally formulated in a form of set covering where is primary objective is to minimize the number of connected facilities. However, there are other issues affecting our decision on selecting suitable distribution centers such as weather conditions, temperature, infrastructure facilities, etc. In this paper, we propose a multi-objective set covering techniques where different objectives are considered in an integrated model. The proposed model of this paper is implemented for a real-world case study of truck-industry and the results are analyzed.

  17. Association of Barrett's esophagus with type II Diabetes Mellitus: results from a large population-based case-control study.

    Science.gov (United States)

    Iyer, Prasad G; Borah, Bijan J; Heien, Herbert C; Das, Ananya; Cooper, Gregory S; Chak, Amitabh

    2013-09-01

    Central obesity could increase the risk for Barrett's esophagus (BE) and esophageal adenocarcinoma by mechanical and/or metabolic mechanisms, such as hyperinsulinemia. We performed an epidemiologic study to determine whether prior type 2 diabetes mellitus (DM2) is associated with BE. We performed a population-based case-control study using the General Practice Research Database, a UK primary care database that contains information on more than 8 million subjects, to identify cases of BE (using previously validated codes; n = 14,245) and matched controls without BE (by age, sex, enrollment date, duration of follow-up evaluation, and practice region by incidence density sampling; n = 70,361). We assessed the association of a prior diagnosis of DM2 with BE using conditional univariate and multivariable regression analysis. Confounders assessed included smoking, obesity measured by body mass index (BMI), and gastroesophageal reflux disease. BE cases were more likely than controls to have smoked (52.4% vs 49.9%), have a higher mean BMI (27.2 vs 26.9), and a higher prevalence of DM2 than controls (5.8% vs 5.3%). On multivariable analysis, DM2 was associated with a 49% increase in the risk of BE, independent of other known risk factors (odds ratio, 1.49; 95% confidence interval, 1.16-1.91). This association was stronger in women than men. Results remained stable with sensitivity analyses. In a large population-based case-control study, DM2 was a risk factor for BE, independent of obesity (as measured by BMI) and other risk factors (smoking and gastroesophageal reflux disease). These data suggest that metabolic pathways related to DM2 should be explored in BE pathogenesis and esophageal carcinogenesis. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. Solvent exposure and malignant lymphoma: a population-based case-control study in Germany

    Directory of Open Access Journals (Sweden)

    Deeg Evelin

    2007-04-01

    Full Text Available Abstract Aims To analyze the relationship between exposure to chlorinated and aromatic organic solvents and malignant lymphoma in a multi-centre, population-based case-control study. Methods Male and female patients with malignant lymphoma (n = 710 between 18 and 80 years of age were prospectively recruited in six study regions in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/Gütersloh, and Munich. For each newly recruited lymphoma case, a gender, region and age-matched (± 1 year of birth population control was drawn from the population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least one year. On the basis of job task-specific supplementary questionnaires, a trained occupational physician assessed the exposure to chlorinated hydrocarbons (trichloroethylene, tetrachloroethylene, dichloromethane, carbon tetrachloride and aromatic hydrocarbons (benzene, toluene, xylene, styrene. Odds ratios (OR and 95% confidence intervals (CI were calculated using conditional logistic regression analysis, adjusted for smoking (in pack years and alcohol consumption. To increase the statistical power, patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression analysis. Results We observed a statistically significant association between high exposure to chlorinated hydrocarbons and malignant lymphoma (Odds ratio = 2.1; 95% confidence interval 1.1–4.3. In the analysis of lymphoma subentities, a pronounced risk elevation was found for follicular lymphoma and marginal zone lymphoma. When specific substances were considered, the association between trichloroethylene and malignant lymphoma was of borderline statistical significance. Aromatic hydrocarbons were not significantly associated with the lymphoma diagnosis

  19. Association of Serum Uric Acid with Preeclampsia: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Razia Sultana

    2013-07-01

    Full Text Available Background: Preeclampsia (PE is still one of the important causes of maternal and fetal mortality in Bangladesh. Many researches have been done to identify a unique screening test that would predict the risk of developing PE before the classic symptoms appear. One of the most accessible and easiest screening tests is serum uric acid measurement. Numerous studies have demonstrated a relation between elevated maternal serum uric acid levels and adverse maternal and fetal outcome. Among several pathophysiologic factors the most commonly accepted explanation for hyperuricemia in PE is increased reabsorption and decreased excretion of uric acid.Objective: The aim of the present study was to assess the association of serum uric acid with preeclampsia.Materials and method: A case control study was conducted in the department of Biochemistry, Dhaka Medical College, Dhaka from July 2010 to June 2011. A total number of 100 pregnant women in third trimester of pregnancy attending in Obstetrics and Gynaecology department of Dhaka Medical College Hospital were selected purposively as study subjects. Among them 50 pregnant women with preeclampsia were selected as cases and 50 normal healthy pregnant women as controls.Results: Most of the study subjects were within 21 – 30 years of age group and mean age in case and control was 24.06±3.71 and 24.66±3.22 years respectively, which was not statistically different. Mean gestational age in case and control was 33.50±2.55 weeks and 33.60±2.95 weeks respectively, which was also not statistically different. Among the study subjects majority was primi in both groups (case 76%, contol 58% showing no statistical significance. Majority of the subjects in both groups were irregular in their antenatal checkup (case 52%, contol 40%. Uric acid concentration was measured in all the study subjects. The mean serum uric acid concentration in cases and controls were 7.01±1.90 mg/dl and 4.55±1.63 mg/dl respectively. This

  20. Brain-relevant antibodies in first-episode psychosis: a matched case-control study.

    Science.gov (United States)

    Gaughran, Fiona; Lally, John; Beck, Katherine; McCormack, Ruaidhri; Gardner-Sood, Poonam; Coutinho, Ester; Jacobson, Leslie; Lang, Bethan; Sainz-Fuertes, Ricardo; Papanastasiou, Evangelos; Di Forti, Marta; Nicholson, Tim; Vincent, Angela; Murray, Robin M

    2018-06-01

    There has been much recent excitement about the possibility that some cases of psychosis may be wholly due to brain-reactive antibodies, with antibodies to N-methyl-D-aspartate receptor (NMDAR) and the voltage-gated potassium channel (VGKC)-complex reported in a few patients with first-episode psychosis (FEP). Participants were recruited from psychiatric services in South London, UK, from 2009 to 2011 as part of the Genetics and Psychosis study. We conducted a case-control study to examine NMDAR and VGKC-complex antibody levels and rates of antibody positivity in 96 patients presenting with FEP and 98 controls matched for age and sex. Leucine-rich glioma inactiviated-1 (LGI1) and contactin-associated protein (CASPR) antibodies were also measured. Notably, patients with suspicion of organic disease were excluded. VGKC-complex antibodies were found in both cases (n = 3) and controls (n = 2). NMDAR antibody positivity was seen in one case and one control. Either LGI1-Abs or CASPR2-Abs were found in three cases and three controls. Neuronal antibody staining, consistent with the above results or indicating potential novel antigens, was overall positive in four patients but also in six controls. Overall, antibody positivity was at low levels only and not higher in cases than in controls. This case-control study of the prevalence of antibodies in FEP does not provide evidence to support the hypothesis that FEP is associated with an immune-mediated process in a subgroup of patients. Nevertheless, as other bio-clinical factors may influence the effect of such antibodies in a given individual, and patients with organic neurological disease may be misdiagnosed as FEP, the field requires more research to put these findings in context.

  1. 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).

  2. Aetiology of handball injuries : a case-control study

    NARCIS (Netherlands)

    Dirx, M.; Bouter, L. M.; de Geus, G. H.

    This article presents the results of a case-control study regarding the background to handball injuries among players of 12 years and older. Data were collected by means of a written questionnaire on the nature, location and direct causes of the injuries as well as information on risk factors.

  3. Control of multi-machine using adaptive fuzzy

    Directory of Open Access Journals (Sweden)

    Bouchiba Bousmaha

    2011-01-01

    Full Text Available An indirect Adaptive fuzzy excitation control (IAFLC of power systems based on multi-input-multi-output linearization technique is developed in this paper. The power system considered in this paper consists of two generators and infinite bus connected through a network of transformers and transmission lines. The fuzzy controller is constructed from fuzzy feedback linearization controller whose parameters are adjusted indirectly from the estimates of plant parameters. The adaptation law adjusts the controller parameters on-line so that the plant output tracks the reference model output. Simulation results shown that the proposed controller IAFLC, compared with a controller based on tradition linearization technique can enhance the transient stability of the power system.

  4. A case - control study of risk factors for coronary artery disease in Pakistani females

    International Nuclear Information System (INIS)

    Nazeer, M.; Naveed, T.; Ullah, A.

    2010-01-01

    Objectives: To establish the strength of association of conventional risk factors for coronary artery disease in native Pakistani females. Methods: We conducted a case - control hospital based study on 198 females (age 30 - 80 years) scheduled for their first coronary angiography at Punjab Institute of Cardiology, Lahore. Patients were divided into pre-menopausal group (age: 45.1 +- 6.3) and post-menopausal group (62.1 +- 9.1). For each risk factor, patients with significant CAD (= 50% luminal diameter stenosis) were regarded as cases an those without significant CAD were taken as controls. Odds Ratios (OR) and their 95% confidence intervals (CI) were calculated by univariate analysis. Results: In total study cohort, Diabetes mellitus (OR 3.65 95% CI 2.0 - 6.5), Family history of premature coronary artery disease (OR 2.3, 95% CI 1.2 - 4.4), and increased waist circumference (OR 2.11, 95% CI 1.2 - 3.8) were strongly associated with significant CAD. In post menopausal age group, diabetes mellitus (OR 2.66 CI 1.3 - 5.1), hyperlipidaemia (OR 2.25 CI 1.2 - 2.3) and increased waist circumference (OR 2.16 CI 1.1 - 4.2) reached statistical significance. In pre-menopausal females only diabetes was strongly associated with significant coronary artery disease (OR 10 CI 2.6 - 37.4). Association of hypertension was not significant in any of subgroups studied. Very few cases of smoking (6 / 198) were found in our study to merit any further statistical analysis. Conclusions: Diabetes mellitus was the only risk factor in pre-menopausal females associated with coronary artery disease While diabetes, hyperlipidaemia and increased waist circumference were significantly associated with CAD in post menopausal females. (author)

  5. 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.

  6. 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.)

  7. Misclassification of Case-Control Studies in Neurosurgery and Proposed Solutions.

    Science.gov (United States)

    Esene, Ignatius Ngene; Mbuagbaw, Lawrence; Dechambenoit, Gilbert; Reda, Wael; Kalangu, Kazadi K

    2018-04-01

    Case-control studies (CCS) and cohort studies (CS) are common research designs in neurosurgery. But the term case-control study is frequently misused in the neurosurgical literature, with many articles reported as CCS, even although their methodology does not respect the basic components of a CCS. We sought to estimate the extent of these discrepancies in neurosurgical literature, explore factors contributing to mislabeling, and shed some light on study design reporting. We identified 31 top-ranking pure neurosurgical journals and searched them for articles reported as CCS, either in the title or in the abstract. The articles were read to determine if they really were CCS according to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Article assessment was conducted in duplicate (agreement [κ statistics] = 99.82%). Two hundred and twenty-four articles met our inclusion criteria, 133 of which (59.38%) correctly labeled the case-control design, whereas 91 (40.62%) misclassified this study design. Cohort studies (CS) were the most common design mislabeled as case-control studies in 76 articles (33.93%), 57 of which (25.45%) were retrospective CS. The mislabeling of CCS impairs the appropriate indexing, classification, and sorting of evidence. Mislabeling CS for CCS leads to a downgrading of evidence as CS represent the highest level of evidence for observational studies. Odds ratios instead of relative risk are reported for these studies, resulting in a distortion of the measurement of the effect size, compounded when these are summarized in systematic reviews and pooled in meta-analyses. Many studies reported as CCS are not true CCS. Reporting guidelines should include items that ensure that studies are labeled correctly. STROBE guidelines should be implemented in assessment of observational studies. Researchers in neurosurgery need better training in research methods and terminology. We also recommend accrued vigilance from

  8. The Aircraft Electric Taxi System: A Qualitative Multi Case Study

    Science.gov (United States)

    Johnson, Thomas Frank

    The problem this research addresses is the airline industry, and the seemingly unwillingness attitude towards adopting ways to taxi aircraft without utilizing thrust from the main engines. The purpose of the study was to get a better understanding of the decision-making process of airline executives, in respect to investing in cost saving technology. A qualitative research method is used from personal interviews with 24 airline executives from two major U.S. airlines, related industry journal articles, and aircraft performance data. The following three research questions are addressed. RQ1. Does the cost of jet fuel influence airline executives' decision of adopting the aircraft electric taxi system technology? RQ2 Does the measurable payback period for a return on investment influence airline executives' decision of adopting ETS technology? RQ3. Does the amount of government assistance influence airline executives' decision of adopting ETS technology? A multi case research study design is used with a triangulation technique. The participant perceptions indicate the need to reduce operating costs, they have concerns about investment risk, and they are in favor of future government sponsored performance improvement projects. Based on the framework, findings and implications of this study, a future research paper could focus on the positive environmental effects of the ETS application. A study could be conducted on current airport area air quality and the effects that aircraft main engine thrust taxiing has on the surrounding air quality.

  9. Review of Literature on Terminal Box Control, Occupancy Sensing Technology and Multi-zone Demand Control Ventilation (DCV)

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Guopeng; Dasu, Aravind R.; Zhang, Jian

    2012-03-01

    This report presents an overall review of the standard requirement, the terminal box control, occupancy sensing technology and DCV. There is system-specific guidance for single-zone systems, but DCV application guidance for multi-zone variable air volume (VAV) systems is not available. No real-world implementation case studies have been found using the CO2-based DCV. The review results also show that the constant minimum air flow set point causes excessive fan power consumption and potential simultaneous heating and cooling. Occupancy-based control (OBC) is needed for the terminal box in order to achieve deep energy savings. Key to OBC is a technology for sensing the actual occupancy of the zone served in real time. Several technologies show promise, but none currently fully meets the need with adequate accuracy and sufficiently low cost.

  10. An investigation into the organisation and structural design of multi-computer process-control systems

    International Nuclear Information System (INIS)

    Gertenbach, W.P.

    1981-12-01

    A multi-computer system for the collection of data and control of distributed processes has been developed. The structure and organisation of this system, a study of the general theory of systems and of modularity was used as a basis for an investigation into the organisation and structured design of multi-computer process-control systems. A multi-dimensional model of multi-computer process-control systems was developed. In this model a strict separation was made between organisational properties of multi-computer process-control systems and implementation dependant properties. The model was based on the principles of hierarchical analysis and modularity. Several notions of hierarchy were found necessary to describe fully the organisation of multi-computer systems. A new concept, that of interconnection abstraction was identified. This concept is an extrapolation of implementation techniques in the hardware implementation area to the software implementation area. A synthesis procedure which relies heavily on the above described analysis of multi-computer process-control systems is proposed. The above mentioned model, and a set of performance factors which depend on a set of identified design criteria, were used to constrain the set of possible solutions to the multi-computer process-control system synthesis-procedure

  11. Exposure to pistachio pesticides and stillbirth: a case-control study.

    Science.gov (United States)

    Razi, Saeid; Rezaeian, Mohsen; Dehkordi, Fatemeh Ghani; Manshoori, Azita; Goujani, Reza; Vazirinejad, Reza

    2016-01-01

    Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers. This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4) and 5.0 (95% CI, 1.2 to 28.6), respectively. No significant differences were found in stillbirth rates according to the distance between the mother's residence and a pistachio garden or involvement in agricultural activities. The results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.

  12. 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

  13. Risk factors for measles among adults in Tianjin, China: Who should be controls in a case-control study?

    Science.gov (United States)

    Wagner, Abram L; Boulton, Matthew L; Gillespie, Brenda W; Zhang, Ying; Ding, Yaxing; Carlson, Bradley F; Luo, Xiaoyan; Montgomery, JoLynn P; Wang, Xiexiu

    2017-01-01

    Control groups in previous case-control studies of vaccine-preventable diseases have included people immune to disease. This study examines risk factors for measles acquisition among adults 20 to 49 years of age in Tianjin, China, and compares findings using measles IgG antibody-negative controls to all controls, both IgG-negative and IgG-positive. Measles cases were sampled from a disease registry, and controls were enrolled from community registries in Tianjin, China, 2011-2015. Through a best subsets selection procedure, we compared which variables were selected at different model sizes when using IgG-negative controls or all controls. We entered risk factors for measles in two separate logistic regression models: one with measles IgG-negative controls and the other with all controls. The study included 384 measles cases and 1,596 community controls (194 IgG-negative). Visiting a hospital was an important risk factor. For specialty hospitals, the odds ratio (OR) was 4.53 (95% confidence interval (CI): 1.28, 16.03) using IgG-negative controls, and OR = 5.27 (95% CI: 2.73, 10.18) using all controls. Variables, such as age or length of time in Tianjin, were differentially selected depending on the control group. Individuals living in Tianjin ≤3 years had 2.87 (95% CI: 1.46, 5.66) times greater odds of measles case status compared to all controls, but this relationship was not apparent for IgG-negative controls. We recommend that case-control studies examining risk factors for infectious diseases, particularly in the context of transmission dynamics, consider antibody-negative controls as the gold standard.

  14. 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…

  15. [Application of nested case-control study on safe evaluation of post-marketing traditional Chinese medicine injection].

    Science.gov (United States)

    Xiao, Ying; Zhao, Yubin; Xie, Yanming

    2011-10-01

    The nested case-control study design (or the case-control in a cohort study) is described here as a new study design used in safe evaluation of post-marketing traditional Chinese medicine injection. In the nested case-control study, cases of a disease that occur in a defined cohort are identified and, for each, a specified number of matched controls is selected from among those in the cohort who have not developed the disease by the time of disease occurrence in the case. For many research questions, the nested case-control design potentially offers impressive reductions in costs and efforts of data collection and analysis compared with the full cohort approach, with relatively minor loss in statistical efficiency. The nested case-control design is particularly advantageous for studies in safe evaluation of post-marketing traditional Chinese medicine injection. Some examples of the application of nested case-control study were given.

  16. Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study.

    Science.gov (United States)

    Wong, Hui Jie; Moy, Foong Ming; Nair, Sulochana

    2014-08-03

    Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia. A case control study was conducted in the maternal and child health clinics in five districts of Terengganu, Malaysia from April to August 2012. Case was a child with moderate to severe malnutrition with z-scores economic characteristics, household food security status, child's dietary intake, caregivers' practices and resources were enquired. Univariate and multivariate logistic regression analyses were conducted. Crude odds ratio and adjusted odds ratio with 95% confidence interval were calculated. A total of 274 children with 137 cases and 137 controls were recruited. All respondents were Malays. Among the cases, a larger proportion of them was female and originated from low income families. After adjusting all confounders, childhood malnutrition was significantly associated with number of children (aOR: 5.86, 95% CI: 1.96, 17.55), child hunger (aOR: 16.38, 95% CI: 1.34,199.72), dietary energy intake (aOR: 0.99, 95% CI: 0.98, 0.99), protein intake (aOR: 1.06, 95% CI: 1.01, 1.12), vitamin A intake (aOR: 0.999, 95% CI: 0.997, 1.00), low birth weight (aOR: 6.83, 95% CI: 1.62, 28.89), frequent illness (aOR: 2.79, 95% CI: 1.06, 7.31), and history of worm infection (aOR: 3.48, 95% CI: 1.25, 9.70). Lower socio-economic status, household food insecurity, and poor child caring practices were associated with childhood malnutrition. Besides implementation of programmes focusing on poverty reduction, community based nutrition and hygiene education with extensive family planning and de-worming programmes should be intensified to improve both mother and

  17. 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

  18. INTERNAL CONTROLS IN ENSURING GOOD CORPORATE GOVERNANCE IN FINANCIAL INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    KOSMAS NJANIKE

    2011-01-01

    Full Text Available This paper assessed factors that influence the internal controls in ensuring good corporate governance in financial institutions in developing economies with special reference to Zimbabwe. The research paper assessed how lack of internal controls affected good corporate governance and aimed to bring out elements of good corporate governance. It emerged that failure to effectively implement internal controls contributed significantly to poor corporate governance. The study discovered that internal control system overrides and the issue of “fact cat” directors also contributed to poor corporate governance. The study recommended that there is need for the board of directors to guarantee an organizational structure that clearly defines management responsibilities, authority and reporting relationships. There is also need to ensure that delegated responsibilities are effectively carried out to ensure compliance with internal controls of the financial institution concerned.

  19. Leptospira Exposure and Gardeners: A Case-Control Seroprevalence Study

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

    2016-01-01

    Background Leptospira can be found in soil. However, it is unclear whether occupational exposure to soil may represent a risk for Leptospira infection in humans. Therefore, we sought to determine the association of Leptospira IgG seroprevalence with the occupation of gardener, and to determine the epidemiological characteristics of gardeners associated with Leptospira exposure. Methods We performed a case-control study in 168 gardeners and 168 age- and gender-matched control subjects without gardening occupation in Durango City, Mexico. The seroprevalence of anti-Leptospira IgG antibodies in cases and controls was determined using an enzyme immunoassay. Bivariate and multivariate analyses were used to assess the association of Leptospira exposure and the characteristics of the gardeners. Results Anti-Leptospira IgG antibodies were found in 10 (6%) of 168 gardeners and in 15 (8.9%) of 168 control subjects (odds ratio (OR): 0.64; 95% confidence interval (CI): 0.28 - 1.48; P = 0.40). Multivariate analysis showed that Leptospira seropositivity was positively associated with female gender (OR: 5.82; 95% CI: 1.11 - 30.46; P = 0.03), and negatively associated with eating while working (OR: 0.21; 95% CI: 0.05 - 0.87; P = 0.03). In addition, multivariate analysis showed that high anti-Leptospira levels were associated with consumption of boar meat (OR: 28.00; 95% CI: 1.20 - 648.80; P = 0.03). Conclusions This is the first case-control study of Leptospira exposure in gardeners. Results do not support an association of Leptospira exposure with the occupation of gardener. However, further studies to confirm the lack of this association are needed. The potential role of consumption of boar meat in Leptospira infection deserves further investigation. PMID:26668679

  20. Use of the i2b2 research query tool to conduct a matched case-control clinical research study: advantages, disadvantages and methodological considerations.

    Science.gov (United States)

    Johnson, Emilie K; Broder-Fingert, Sarabeth; Tanpowpong, Pornthep; Bickel, Jonathan; Lightdale, Jenifer R; Nelson, Caleb P

    2014-01-30

    A major aim of the i2b2 (informatics for integrating biology and the bedside) clinical data informatics framework aims to create an efficient structure within which patients can be identified for clinical and translational research projects.Our objective was to describe the respective roles of the i2b2 research query tool and the electronic medical record (EMR) in conducting a case-controlled clinical study at our institution. We analyzed the process of using i2b2 and the EMR together to generate a complete research database for a case-control study that sought to examine risk factors for kidney stones among gastrostomy tube (G-tube) fed children. Our final case cohort consisted of 41/177 (23%) of potential cases initially identified by i2b2, who were matched with 80/486 (17%) of potential controls. Cases were 10 times more likely to be excluded for inaccurate coding regarding stones vs. inaccurate coding regarding G-tubes. A majority (67%) of cases were excluded due to not meeting clinical inclusion criteria, whereas a majority of control exclusions (72%) occurred due to inadequate clinical data necessary for study completion. Full dataset assembly required complementary information from i2b2 and the EMR. i2b2 was critical as a query analysis tool for patient identification in our case-control study. Patient identification via procedural coding appeared more accurate compared with diagnosis coding. Completion of our investigation required iterative interplay of i2b2 and the EMR to assemble the study cohort.

  1. Spatial Multi-Criteria Decision Support System and Strategic Environmental Assessment: A Case Study

    Directory of Open Access Journals (Sweden)

    Francesca Torrieri

    2017-10-01

    Full Text Available This contribution focuses on the Strategic Environmental Assessment (SEA as an important tool to ensure sustainable development and reach a high level of environmental protection. More specifically, this paper provides an evaluation method based on the integration of Geographic Information System (GIS and Multi-criteria Analysis—named Integrated Spatial Multi-criteria Decision Support System (ISMDSS—to support the preparation of environmental assessment reports and the construction of scenarios for the adoption of urban plans, as an innovative tool that integrates objectives and multidimensional (economic, environmental, and social components, as well as different approaches and models for the construction of a long-term shared vision. In particular, considerations are made by presenting a thought-provoking case study on the SEA of the urban plan of the municipality of Marzano di Nola, located in the province of Avellino in the Campania region. The experiment carried out showed the potentiality of the ISMDSS to evaluate the impacts of different scenarios with the aim of developing a sustainable urban municipal plan. The spatial dimension is useful in understanding the dynamics that characterize each environmental topic in a specific area, by considering not only the components of the natural and developed environment, but also the interactions with social and economic components.

  2. Baldness and testicular cancer: the EPSAM case-control study.

    Science.gov (United States)

    Moirano, G; Zugna, D; Grasso, C; Lista, P; Ciuffreda, L; Segnan, N; Merletti, F; Richiardi, L

    2016-03-01

    The etiology of testicular cancer is largely unexplained. Research has mainly focused on prenatal exposures, especially to sex hormones, while less attention has been paid to exposures that may act also postnatally. As baldness has been previously associated with testicular cancer risk we focused on baldness and body hairiness, which are both associated with androgen activity. We used data of the Postnatal Exposures and Male Health (EPSAM) study, a case-control study on testicular cancer conducted in the Province of Turin, Italy, involving cases diagnosed between 1997 and 2008. Information was collected using mailed questionnaires. Analyses included 255 cases and 459 controls. We calculated ORs and 95% CIs to estimate testicular cancer risk among those who developed baldness and among those with body hairiness. We found an inverse association between testicular cancer and baldness (OR: 0.67, 95% CI: 0.46-0.98) and body hairiness (OR: 0.78, 95% CI: 0.53-1.16), although the latter had wider CIs. The inverse association between baldness and testicular cancer is consistent with the results from previous studies. These results suggest that androgens activity may influence testicular cancer risk. © 2016 American Society of Andrology and European Academy of Andrology.

  3. The lack of selection bias in a snowball sampled case-control study on drug abuse.

    Science.gov (United States)

    Lopes, C S; Rodrigues, L C; Sichieri, R

    1996-12-01

    Friend controls in matched case-control studies can be a potential source of bias based on the assumption that friends are more likely to share exposure factors. This study evaluates the role of selection bias in a case-control study that used the snowball sampling method based on friendship for the selection of cases and controls. The cases selected fro the study were drug abusers located in the community. Exposure was defined by the presence of at least one psychiatric diagnosis. Psychiatric and drug abuse/dependence diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. Cases and controls were matched on sex, age and friendship. The measurement of selection bias was made through the comparison of the proportion of exposed controls selected by exposed cases (p1) with the proportion of exposed controls selected by unexposed cases (p2). If p1 = p2 then, selection bias should not occur. The observed distribution of the 185 matched pairs having at least one psychiatric disorder showed a p1 value of 0.52 and a p2 value of 0.51, indicating no selection bias in this study. Our findings support the idea that the use of friend controls can produce a valid basis for a case-control study.

  4. Study of institutional Collaboration in the management Structure of the City Regions Case Study: Process of determining the city of Qazvin Growth boundaries.

    Directory of Open Access Journals (Sweden)

    Mohammad Sheikhi

    2015-12-01

    Full Text Available This article is about the institutional collaboration in the management structure of a city-region. To achieve this purpose, corporate limits of Qazvin are studied as the city is becoming a region. The possible institutional cooperative in the centralist governmental structure is planned based on the new regionalism theory and its governance pattern, new institutionalism theory and its emphasis on informal rules in institutions and rational dialogue as an indicator of institutional cooperative, in order to become closer to the governance structure. The methodology of this article is the instrumental case study. Also interviews, questionnaires and archival reports were used as applications of the data collection. An explanation building is the analysis method with the subsystem analysis such as survey and correlation test.There are three level of analysis in these studies, structural, organizational and individual level. The results show that the rational dialogue between urban institutional in both levels of analysis including organizational (formal rules and individual (informal rules analysis is not possible in the current situation and Because the governmental structure as a third level of analysis is not changeable, Therefore, the possible pattern of institutional cooperative in this city-region is about the organizational and individual level of analysis. The derived pattern to achieve the institutional cooperative is establishing the sphere for voluntary dialogue between city institutions in order to achieve agreement. Additionally, in the individual level, the experts and managers who are the main attendances in this sphere, have their own values and norms. Studies about the current values and norms show that values are appropriate to establish a rational dialogue but the norms are in the opposite direction. The value for these people should be internalized to achieve the rational dialogue in the organizational level.

  5. Institutional dynamics and barriers in wind energy development. A case study of Tamil Nadu and Andhra Pradesh, India

    Energy Technology Data Exchange (ETDEWEB)

    Jagadeesh, Anumakonda

    1999-09-01

    In India, there was a boom in 1995-96 when 282 MW windfarms were set up in Tamil Nadu and the capacity in Andhra Pradesh increased by 39 MW. Then there was a steady decline in the windfarm development in both states. The case study described in this report attempts to trace the reasons for the boom and the factors that have contributed to the slump in windfarm development in these two states. The role of institutions in determining the effectiveness of national and regional public sector initiatives to promote and disseminate wind energy in the two states is discussed. The study also examines the financial, technical, transaction and institutional barriers, which inhibit the diffusion of wind energy in the states. It is suggested that important measures must be taken if wind energy is to develop rapidly in the two states. The result of the case study may be used to improve public policy intervention in disseminating wind energy in India. It may also be relevant to multilateral and bilateral aid agencies in their projects and/or programmes to promote cost-effective wind energy technology dissemination in developing countries. 25 refs., 6 tabs.

  6. COMPARISON OF A FIXED-WING AND MULTI-ROTOR UAV FOR ENVIRONMENTAL MAPPING APPLICATIONS: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    M. A. Boon

    2017-08-01

    Full Text Available The advent and evolution of Unmanned Aerial Vehicles (UAVs and photogrammetric techniques has provided the possibility for on-demand high-resolution environmental mapping. Orthoimages and three dimensional products such as Digital Surface Models (DSMs are derived from the UAV imagery which is amongst the most important spatial information tools for environmental planning. The two main types of UAVs in the commercial market are fixed-wing and multi-rotor. Both have their advantages and disadvantages including their suitability for certain applications. Fixed-wing UAVs normally have longer flight endurance capabilities while multi-rotors can provide for stable image capturing and easy vertical take-off and landing. Therefore, the objective of this study is to assess the performance of a fixed-wing versus a multi-rotor UAV for environmental mapping applications by conducting a specific case study. The aerial mapping of the Cors-Air model aircraft field which includes a wetland ecosystem was undertaken on the same day with a Skywalker fixed-wing UAV and a Raven X8 multi-rotor UAV equipped with similar sensor specifications (digital RGB camera under the same weather conditions. We compared the derived datasets by applying the DTMs for basic environmental mapping purposes such as slope and contour mapping including utilising the orthoimages for identification of anthropogenic disturbances. The ground spatial resolution obtained was slightly higher for the multi-rotor probably due to a slower flight speed and more images. The results in terms of the overall precision of the data was noticeably less accurate for the fixed-wing. In contrast, orthoimages derived from the two systems showed small variations. The multi-rotor imagery provided better representation of vegetation although the fixed-wing data was sufficient for the identification of environmental factors such as anthropogenic disturbances. Differences were observed utilising the respective DTMs

  7. Comparison of a Fixed-Wing and Multi-Rotor Uav for Environmental Mapping Applications: a Case Study

    Science.gov (United States)

    Boon, M. A.; Drijfhout, A. P.; Tesfamichael, S.

    2017-08-01

    The advent and evolution of Unmanned Aerial Vehicles (UAVs) and photogrammetric techniques has provided the possibility for on-demand high-resolution environmental mapping. Orthoimages and three dimensional products such as Digital Surface Models (DSMs) are derived from the UAV imagery which is amongst the most important spatial information tools for environmental planning. The two main types of UAVs in the commercial market are fixed-wing and multi-rotor. Both have their advantages and disadvantages including their suitability for certain applications. Fixed-wing UAVs normally have longer flight endurance capabilities while multi-rotors can provide for stable image capturing and easy vertical take-off and landing. Therefore, the objective of this study is to assess the performance of a fixed-wing versus a multi-rotor UAV for environmental mapping applications by conducting a specific case study. The aerial mapping of the Cors-Air model aircraft field which includes a wetland ecosystem was undertaken on the same day with a Skywalker fixed-wing UAV and a Raven X8 multi-rotor UAV equipped with similar sensor specifications (digital RGB camera) under the same weather conditions. We compared the derived datasets by applying the DTMs for basic environmental mapping purposes such as slope and contour mapping including utilising the orthoimages for identification of anthropogenic disturbances. The ground spatial resolution obtained was slightly higher for the multi-rotor probably due to a slower flight speed and more images. The results in terms of the overall precision of the data was noticeably less accurate for the fixed-wing. In contrast, orthoimages derived from the two systems showed small variations. The multi-rotor imagery provided better representation of vegetation although the fixed-wing data was sufficient for the identification of environmental factors such as anthropogenic disturbances. Differences were observed utilising the respective DTMs for the mapping

  8. Multi-criteria decision making approaches for quality control of genome-wide association studies.

    Science.gov (United States)

    Malovini, Alberto; Rognoni, Carla; Puca, Annibale; Bellazzi, Riccardo

    2009-03-01

    Experimental errors in the genotyping phases of a Genome-Wide Association Study (GWAS) can lead to false positive findings and to spurious associations. An appropriate quality control phase could minimize the effects of this kind of errors. Several filtering criteria can be used to perform quality control. Currently, no formal methods have been proposed for taking into account at the same time these criteria and the experimenter's preferences. In this paper we propose two strategies for setting appropriate genotyping rate thresholds for GWAS quality control. These two approaches are based on the Multi-Criteria Decision Making theory. We have applied our method on a real dataset composed by 734 individuals affected by Arterial Hypertension (AH) and 486 nonagenarians without history of AH. The proposed strategies appear to deal with GWAS quality control in a sound way, as they lead to rationalize and make explicit the experimenter's choices thus providing more reproducible results.

  9. Risk factors for idiopathic orbital inflammation: a case-control study

    NARCIS (Netherlands)

    Bijlsma, Ward R.; van Gils, Carla H.; Paridaens, Dion; Mourits, Maarten P.; Kalmann, Rachel

    2011-01-01

    Objective To identify risk factors involved in the development of idiopathic orbital inflammation (IOI). Methods Case-control study of 69 adults who had had a first episode of IOI and 296 adult controls with rhegmatogenous retinal detachment (RD) selected from three orbital centres in The

  10. Characterization and optimized control by means of multi-parameter controllers

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Carsten; Hoeg, S.; Thoegersen, A. (Dan-Ejendomme, Hellerup (Denmark)) (and others)

    2009-07-01

    Poorly functioning HVAC systems (Heating, Ventilation and Air Conditioning), but also separate heating, ventilation and air conditioning systems are costing the Danish society billions of kroner every year: partly because of increased energy consumption and high operational and maintenance costs, but mainly due to reduced productivity and absence due to illness because of a poor indoor climate. Typically, the operation of buildings and installations takes place today with traditional build-ing automation, which is characterised by 1) being based on static considerations 2) the individual sensor being coupled with one actuator/valve, i.e. the sensor's signal is only used in one place in the system 3) subsystems often being controlled independently of each other 4) the dynamics in building constructions and systems which is very important to the system and comfort regulation is not being considered. This, coupled with the widespread tendency to use large glass areas in the facades without sufficient sun shading, means that it is difficult to optimise comfort and energy consumption. Therefore, the last 10-20 years have seen a steady increase in the complaints of the indoor climate in Danish buildings and, at the same time, new buildings often turn out to be considerably higher energy consuming than expected. The purpose of the present project is to investigate the type of multi parameter sensors which may be generated for buildings and further to carry out a preliminary evaluation on how such multi parameter controllers may be utilized for optimal control of buildings. The aim of the project isn't to develop multi parameter controllers - this requires much more effort than possible in the present project. The aim is to show the potential of using multi parameter sensors when controlling buildings. For this purpose a larger office building has been chosen - an office building with at high energy demand and complaints regarding the indoor climate. In order to

  11. A multi-channel humidity control system based on LabVIEW

    International Nuclear Information System (INIS)

    Zhang Aiwu; Xie Yuguang; Liu Hongbang; Liu Yingbiao; Cai Xiao; Yu Boxiang; Lu Junguang; Zhou Li

    2011-01-01

    A real time multi-channel humidity control system was designed based on LabVIEW, using the dry air branch of BESⅢ drying system. The hardware of this control system consist of mini humidity and temperature sensors, intelligent collection module, switch quantity controller and electromagnetic valves. The humidity can be controlled at arbitrary value from air humidity to 3% with accuracy better than 2%. Multi microenvironment with different humidity can be easily controlled and monitored in real time by this system. It can also be extended to hybrid control of multi channel humidity and temperature. (authors)

  12. Multi-hazard risk assessment using GIS in urban areas: a case study for the city of Turrialba, Costa Rica

    NARCIS (Netherlands)

    van Westen, Cees J.; Montoya, L.; Boerboom, Luc; Badilla Coto, Elena

    In the framework of the UNESCO sponsored project on “Capacity Building for Natural Disaster Reduction‿ a case study was carried out on multi-hazard risk assessment of the city of Turrialba, located in the central part of Costa Rica. The city with a population of 33,000 people is located in an area,

  13. A case-control study: occupational cooking and the risk of uveal melanoma

    Directory of Open Access Journals (Sweden)

    Marr Anja

    2010-10-01

    Full Text Available Abstract Background A European-wide population based case-control study (European rare cancer study undertaken in nine European countries examined risk factors for uveal melanoma. They found a positive association between cooks and the risk of uveal melanoma. In our study we examine whether cooks or people who worked in cook related jobs have an increased uveal melanoma risk. Methods We conducted a case-control study during 2002 and 2005. Overall, 1653 eligible subjects (age range: 20-74 years, living in Germany participated. Interviews were conducted with 459 incident uveal melanoma cases, 827 population controls, 180 ophthalmologist controls and 187 sibling controls. Data on occupational exposure were obtained from a self-administered postal questionnaire and a computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Results Overall, we did not observe an increased risk of uveal melanoma among people who worked as cooks or who worked in cook related jobs. When we restricted the source population of our study to the population of the Federal State of Northrhine-Westphalia, we observed an increased risk among subjects who were categorized as cooks in the cases-control analysis. Conclusion Our results are in conflict with former results of the European rare cancer study. Considering the rarity of the disease laboratory in vitro studies of human uveal melanoma cell lines should be done to analyze potential exposure risk factors like radiation from microwaves, strong light from incandescent ovens, or infrared radiation.

  14. Circulating folate levels and colorectal adenoma: a case-control study and a meta-analysis.

    Science.gov (United States)

    Park, Yeong Mi; Youn, Jiyoung; Cho, Chang Ho; Kim, Sung Hi; Lee, Jung Eun

    2017-10-01

    The relationship between folate and colorectal neoplasia remains controversial. We examined the association between serum folate concentrations and colorectal adenomas in a case-control study of Korean adults and conducted a meta-analysis. Our case-control study included 113 pairs of case and control who underwent colonoscopy and provided blood samples. We used multivariable conditional logistic regression models to obtain the odds ratios and 95% confidence interval (CIs). For meta-analysis, we identified the relevant studies by searching the PubMed database up to February 2017, included our case-control study and combined the study-specific relative risks (RRs) using a random-effects model. In this case-control study, we included 58 men and 55 women with colorectal adenomas and sex and fasting status matched the controls. We did not find any significant association between the serum folate levels and colorectal adenomas in either men or women. For meta-analysis, a total of eleven studies were included in our analysis and classified into two groups; polyp clearance group (PC) for the studies that included participants who underwent endoscopies and had their polyps removed at baseline; and no polyp clearance group (NPC) for the studies that included participants whose histories of endoscopies were unknown or who underwent their first endoscopies. Four PC (1,311 cases and 1,672 non-cases) and eight NPC studies (3,501 cases and 11,347 non-cases) were included. The combined RRs (95% CIs) comparing the bottom with the top categories of circulating folate levels were 1.07 (0.97-1.18) for the NPC group but 1.45 (1.16-1.74) for the PC group. Low circulating folate levels were associated with new adenoma formation.

  15. Association between smoking habits and acne vulgaris. A case-control study

    Directory of Open Access Journals (Sweden)

    Alice Mannocci

    2012-09-01

    Full Text Available

    Background: acne vulgaris, is one of the most common skin disorder. Previous studies about the role of smoke in the pathogenesis of acne reported contradictory results. The aim of this study was to conduct a case-control study investigating the relationship between tobacco smoking and acne.

    Methods: a case-control study was performed during the period September 2009 - February 2010. A questionnaire was administrated to each participant, to assess the association acne - smoke. Cases were outpatients of the Dermatologic Ambulatory of the “Fiorini” Hospital, Sapienza University of Rome (Italy. Controls were age and gender-matched to the cases. The ratio cases-controls was 1:2. A univariate and a multiple logistic regression analysis were conducted; Odds Ratio (OR and the relative 95% confidence interval (95%CI were assessed. The statistical significance was set at p < 0.05.

    Results: crude OR for the association acne - smoke was 7.26 (IC=2.27-23.18; adjusted OR for sex and age was 5.47 (IC=1.67-17.97. Of 93 cases, 6 had a severe grade of acne (6.5%, 19 had an intermediate grade of acne (20.4%, and 68 had a mild grade of acne (73.1%. No one of the smokers had a severe grade of acne, one had an intermediate grade of acne and 11 had mild acne; these differences are not statistically significant.

    Conclusions: the association between acne and smoke shows an increased risk (OR=7.26 with a statistically significant CI. Moreover, people ≥ 18 years of age have twice the risk compared to persons < 18 years of age (OR=2.31.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Efficacy of rasagiline and selegiline in Parkinson?s disease: a head-to-head 3-year retrospective case?control study

    OpenAIRE

    Cereda, Emanuele; Cilia, Roberto; Canesi, Margherita; Tesei, Silvana; Mariani, Claudio Bruno; Zecchinelli, Anna Lena; Pezzoli, Gianni

    2017-01-01

    Monoamine oxidase type B (MAO-B) inhibitors, such as selegiline and rasagiline, can be used as monotherapy or adjuvant therapy to levodopa in Parkinson?s disease (PD). Data on long-term efficacy of MAO-B inhibitors are limited with no head-to-head comparison available to date. The aim of this case?control retrospective study was to analyze data from patients with PD attending the Parkinson Institute (Milan, Italy) over a 6-year period (2009?2015) and compare the effects of selegiline and rasa...

  18. Exposure to pistachio pesticides and stillbirth: a case-control study

    Directory of Open Access Journals (Sweden)

    Saeid Razi

    2016-04-01

    Full Text Available OBJECTIVES Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers. METHODS This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs and 95% confidence intervals (CIs were calculated. RESULTS The ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4 and 5.0 (95% CI, 1.2 to 28.6, respectively. No significant differences were found in stillbirth rates according to the distance between the mother’s residence and a pistachio garden or involvement in agricultural activities. CONCLUSIONS The results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.

  19. Campylobacteriosis in New Zealand: results of a case-control study.

    OpenAIRE

    Eberhart-Phillips, J; Walker, N; Garrett, N; Bell, D; Sinclair, D; Rainger, W; Bates, M

    1997-01-01

    STUDY OBJECTIVE: To identify and assess the contributions of major risk factors for campylobacteriosis in New Zealand. DESIGN: Case-control study. Home interviews were conducted over nine months using a standardised questionnaire to assess recent food consumption and other exposures. SETTING: Four centres in New Zealand with high notification rates of campylobacter infections--Auckland, Hamilton, Wellington, and Christchurch. PARTICIPANTS: Case patients were 621 people notified between 1 June...

  20. Risk factors for neural tube defects in Riyadh City, Saudi Arabia: Case-control study.

    Science.gov (United States)

    Salih, Mustafa A M; Murshid, Waleed R; Mohamed, Ashry Gad; Ignacio, Lena C; de Jesus, Julie E; Baabbad, Rubana; El Bushra, Hassan M

    2014-01-01

    Both genetic and non-genetic environmental factors are involved in the etiology of neural tube defects (NTD) which affect 0.5-2/1000 pregnancies worldwide. This study aimed to explore the risk factors for the development of NTD in Saudi population, and highlight identifiable and preventable causes. Similar studies are scarce in similar populations ofthe Arabian Peninsula and North Africa. This is an unmatched concurrent case-control study including NTD cases born at King Khalid University Hospital, Riyadh during a 4-year period (2002-2006). The case-control study included 25 cases and 125 controls (case: control ratio of 1:5). Years of formal education, employment, household environment (including availability of air conditioning) and rate of parental consanguinity did not differ between mothers of cases and controls. Significantly higher proportion of mothers of cases had history of stillbirth compared to control mothers (16% vs 4.1%, P=0.02). Also family history of hydrocephalus and congenital anomalies were more prevalent in cases than controls (P values=0.0000 and 0.003, respectively). There was significant protective effect of periconceptional folic acid consumption both prior to conception (OR 0.02, 95% CI 0.00-0.07) and during the first 6 weeks of conception (OR 0.13, 95% CI 0.04-0.39). Further research, including a larger cohort, is required to enable ascertainment of gene-nutrient and gene environment interactions associated with NTD in Saudi Arabia.

  1. Potential risk factors for diabetic neuropathy: a case control study

    Directory of Open Access Journals (Sweden)

    Nooraei Mahdi

    2005-12-01

    Full Text Available Abstract Background Diabetes mellitus type II afflicts at least 2 million people in Iran. Neuropathy is one of the most common complications of diabetes and lowers the patient's quality of life. Since neuropathy often leads to ulceration and amputation, we have tried to elucidate the factors that can affect its progression. Methods In this case-control study, 110 diabetic patients were selected from the Shariati Hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS was used to differentiate cases from controls. The diagnosis of neuropathy was confirmed by nerve conduction studies (nerve conduction velocity and electromyography. The multiple factors compared between the two groups included consumption of angiotensin converting enzyme inhibitors (ACEI, blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality. Results Statistically significant relationships were found between neuropathy and age, gender, quality of diabetes control and duration of disease (P values in the order: 0.04, 0.04, Conclusion In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control reduces the incidence of neuropathy, slows its progression and improves the diabetic patient's quality of life. More attention must be paid to elderly male diabetic patients with poor diabetes control with regard to regular foot examinations and more practical education.

  2. Coprevalence of Anxiety and Depression With Spasmodic Dysphonia: A Case-Control Study

    Science.gov (United States)

    White, Laura J.; Hapner, Edie R.; Klein, Adam M.; Delgaudio, John M.; Hanfelt, John J.; Jinnah, H. A.; Johns, Michael M.

    2012-01-01

    Summary Introduction There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. Materials and Methods A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. Results One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR] = 0.985, 95% confidence interval [CI] = 0.59–1.63; and OR = 1.314; 95% CI 0.75–2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. Conclusion Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate. PMID:22209056

  3. Coprevalence of anxiety and depression with spasmodic dysphonia: a case-control study.

    Science.gov (United States)

    White, Laura J; Hapner, Edie R; Klein, Adam M; Delgaudio, John M; Hanfelt, John J; Jinnah, H A; Johns, Michael M

    2012-09-01

    There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR]=0.985, 95% confidence interval [CI]=0.59-1.63; and OR=1.314; 95% CI=0.75-2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  4. Comparative study of control selection in a national population-based case-control study: Estimating risk of smoking on cancer deaths in Chinese men.

    Science.gov (United States)

    Jiang, Jingmei; Liu, Boqi; Nasca, Philip C; Han, Wei; Zou, Xiaonong; Zeng, Xianjia; Tian, Xiaobing; Wu, Yanping; Zhao, Ping; Li, Junyao

    2009-10-28

    To assess the validation of a novel control selection design by comparing the consistency between the new design and a routine design in a large case-control study that was incorporated into a nationwide mortality survey in China. A nationwide mortality study was conducted during 1989-1991. Surviving spouses or other relatives of all adults who died during 1986-1988 provided detailed information about their own as well as the deceased person's smoking history. In this study, 130,079 males who died of various smoking-related cancers at age 35 or over were taken as cases, while 103,248 male surviving spouses (same age range with cases) of women who died during the same period and 49,331 males who died from causes other than those related to smoking were used as control group 1 and control group 2, respectively. Consistency in the results when comparing cases with each of the control groups was assessed. Consistency in the results was observed in the analyses using different control groups although cancer deaths varied with region and age. Equivalence could be ascertained using a 15% criterion in most cancer deaths which had high death rates in urban areas, but they were uncertain for most cancers in rural areas irrespective of whether the hypothesis testing showed significant differences or not. Sex-matched living spouse control design as an alternative control selection for a case-control study is valid and feasible, and the basic principles of the equivalence study are also supported by epidemiological survey data.

  5. Risk factors associated with deforming oral habits in children aged 5 to 11: a case-control study

    Directory of Open Access Journals (Sweden)

    Daniel Enrique Reyes Romagosa

    2014-03-01

    Full Text Available Introduction Dental and maxillofacial anomalies have multiple and complex causes. Most frequent among these are poor oral habits. A large number of children present with oral malocclusions, most of which are caused by deforming oral habits. It is important to learn about risk factors for this condition in order to institute preventive measures, early detection and treatment, and identification of low- and high-risk groups. Objectives To identify risk factors associated with deforming oral habits, which, if maintained over time, are responsible for occlusion defects, speech disorders, and can affect physical and emotional child development. Methods A case-control study of children presenting with deforming oral habits in the municipality of Manzanillo in Granma province was conducted between January and August 2013. 540 children aged 5 to 11 were included of which 180 had deforming oral habits and were asked to fill out a survey to identify specific type of habits leading to malocclusion. The case group was composed of children with deforming habits, and the remaining 360 children without poor oral habits were the control group. Each case was randomly matched to two control cases. The children’s mothers were also surveyed to gather supplemental information. Results Children with deforming oral habits were mostly female. At age 10, onychophagia was the predominant oral deforming habit. Risk factors detected for these habits were sociobiological maternal and child variables such as low and high birth weight, maternal breastfeeding inexperience, and discord in the family. Conclusions The study identified likely risk factors associated with deforming oral habits. These are discord in the family, birth weight, and lack of breastfeeding experience.

  6. Multi-agent based controller for islanding operation of active distribution networks with distributed generation

    DEFF Research Database (Denmark)

    Cha, Seung-Tae; Wu, Qiuwei; Østergaard, Jacob

    2011-01-01

    -bus system was used to investigate the dynamic and steady state performance of the active distribution system during islanding operation. Case studies have been carried out using the Real-Time Digital Simulator (RTDS) based simulation platform. Case study results show that the proposed multi......The increasing amount of distributed generation (DG) in today’s highly complex restructured power networks gives more options for distribution system operators (DSOs) under contingency conditions. A low voltage distribution network with a large amount of DG can be operated as an islanded system...... if the distribution system is disconnected from the main grid due to the contingency. In order to successfully operate distribution systems under islanding mode, the possibility of small power islands within the distribution system needs to be considered. The control and management of these small power islands...

  7. Microbial Characteristics of Peri-Implantitis : A Case-Control Study

    NARCIS (Netherlands)

    de Waal, Y C M; Eijsbouts, H V L C; Winkel, E G; van Winkelhoff, A J

    BACKGROUND: Aim of this case-control study was to compare oral microbiological characteristics of subjects with healthy peri-implant conditions and subjects with peri-implantitis and to explore the influence of various patient-related and implant-related factors on the microbiological

  8. Analysis of Risk Factors for Colonic Diverticular Bleeding: A Matched Case-Control Study.

    Science.gov (United States)

    Sugihara, Yuusaku; Kudo, Shin-ei; Miyachi, Hideyuki; Misawa, Masashi; Okoshi, Shogo; Okada, Hiroyuki; Yamamoto, Kazuhide

    2016-03-01

    Diverticular bleeding can occasionally cause massive bleeding that requires urgent colonoscopy (CS) and treatment. The aim of this study was to identify significant risk factors for colonic diverticular hemorrhage. Between January 2009 and December 2012, 26,602 patients underwent CS at our institution. One hundred twenty-three patients underwent an urgent CS due to acute lower gastrointestinal hemorrhage. Seventy-two patients were diagnosed with colonic diverticular hemorrhage. One hundred forty-nine age- and sex-matched controls were selected from the patients with nonbleeding diverticula who underwent CS during the same period. The relationship of risk factors to diverticular bleeding was compared between the cases and controls. Uni- and multivariate conditional logistic regression analyses demonstrated that the use of nonsteroidal anti-inflammatory drugs (odds ratio [OR], 14.70; 95% confidence interval [CI], 3.89 to 55.80; pdisease (OR, 8.66; 95% CI, 2.33 to 32.10; p=0.00126), and hyperuricemia (OR, 15.5; 95% CI, 1.74 to 138.00; p=0.014) remained statistically significant predictors of diverticular bleeding. Nonsteroidal anti-inflammatory drugs, cerebrovascular disease and hyperuricemia were significant risks for colonic diverticular hemorrhage. The knowledge obtained from this study may provide some insight into the diagnostic process for patients with lower gastrointestinal bleeding.

  9. 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)

  10. Social capital and adverse treatment outcomes of tuberculosis: a case-control study.

    Science.gov (United States)

    Deshmukh, P R; Mundra, A; Dawale, A

    2017-08-01

    'Social capital' refers to social norms, relationships, networks and values that affect the functioning and development of society. Social capital influences health positively, but its role in the treatment outcomes of tuberculosis (TB) is not known. To study the role of social capital in determining adverse TB treatment outcomes. Of 516 patients registered under the Revised National Tuberculosis Control Programme in 2014 in Wardha Tuberculosis Unit, Wardha, India, we included 88 patients with adverse treatment outcomes as cases and 187 controls from among those without adverse outcomes. Multiple logistic regression was used to compare standardised Z-scores. A greater proportion of controls than cases belonged to higher quartiles of social capital and its domains than cases, and the mean standardised Z-score was also consistently higher among controls than cases. Respectively 47% and 15% of cases and controls were in the poorest quartile of social capital, whereas respectively 10% and 33% of cases and controls were in the richest quartile. Each unit increase in Z-score of overall social capital reduced the odds of adverse treatment outcomes by 63.1%. Appropriate interventions for building social capital for TB patients and linking them with the programme would improve programme performance.

  11. A New Control Structure for Multi-Terminal dc Grids to Damp Inter-Area Oscillations

    DEFF Research Database (Denmark)

    Eriksson, Robert

    2014-01-01

    This article analyzes the control structure of the multi-terminal dc (MTDC) system to damp ac system interarea oscillations through active power modulation. A new control structure is presented that maximizes the relative controllability without the need for communication among the dc terminals....... In point-to-point high voltage dc (HVDC) transmission, the active power modulation of the two terminals occurs in opposite directions. In this case the control direction is given and only needs to be phase compensated to align for maximal damping. In the case of MTDC systems the control direction...... interrelates with the active power modulation share of the dc terminals and the relative controllability depends on this. The new control structure eliminates the need of communication between the dc terminals by performing dc voltage feedback loop shaping. This makes it possible to modulate the power in one...

  12. Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: a randomized clinical trial.

    Science.gov (United States)

    Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra L; Bone, Lee R; Wolff, Jennifer L; Lewis-Boyer, LaPricia; Levine, David M; Aboumatar, Hanan J; Cooper, Lisa A; Fitzpatrick, Stephanie J; Gudzune, Kimberly A; Albert, Michael C; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J; Fagan, Peter J; Ramamurthi, Hema C; Ameling, Jessica M; Charlston, Jeanne; Sam, Tanyka S; Carson, Kathryn A; Wang, Nae-Yuh; Crews, Deidra C; Greer, Raquel C; Sneed, Valerie; Flynn, Sarah J; DePasquale, Nicole; Boulware, L Ebony

    2014-07-01

    Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12months. Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Explaining the accreditation process from the institutional isomorphism perspective: a case study of Jordanian primary healthcare centers.

    Science.gov (United States)

    Alyahya, Mohammad; Hijazi, Heba; Harvey, Heather

    2018-01-01

    While the main focus of accreditation initiatives has been on hospitals, the implementation of these programs is a relatively new notion among other types of healthcare facilities. Correspondingly, this study aims to understand how accreditation is perceived among primary public healthcare centers using an isomorphic institutional theory. Semi-structured, in-depth interviews were conducted with 56 healthcare professionals and administrative staff from seven non-profit healthcare centers in Jordan using an explanatory case-study approach. The informants' narratives revealed that all three components of institutional theory: coercive, mimetic, and normative pressure, were drivers for institutional change in seeking accreditation. There was an overlapping and blending between the three various types of pressure. While participants perceived that healthcare centers faced formal and informal pressures to achieve accreditation, health centers were reluctant about the time, amount of effort, and their ability to achieve the accreditation. Ambiguity and fear of failure forced them to model successful ones. Moreover, the findings revealed that normative values of health professionals enhanced institutional isomorphism and influenced the accreditation process. Identifying these isomorphic changes may help key stakeholders to develop plans, policies, and procedures that could improve the quality of healthcare and enhance accreditation as an organizational strategic plan. Moreover, the study provided explanations of why and how organizations move to adopt new interventions and grow over time. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. FY1995 distributed control of man-machine cooperative multi agent systems; 1995 nendo ningen kyochogata multi agent kikai system no jiritsu seigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    In the near future, distributed autonomous systems will be practical in many situations, e.g., interactive production systems, hazardous environments, nursing homes, and individual houses. The agents which consist of the distributed system must not give damages to human being and should be working economically. In this project man-machine cooperative multi agent systems are studied in many kind of respects, and basic design technology, basic control technique are developed by establishing fundamental theories and by constructing experimental systems. In this project theoretical and experimental studies are conducted in the following sub-projects: (1) Distributed cooperative control in multi agent type actuation systems (2) Control of non-holonomic systems (3) Man-machine Cooperative systems (4) Robot systems learning human skills (5) Robust force control of constrained systems In each sub-project cooperative nature between machine agent systems and human being, interference between artificial multi agents and environment and new function emergence in coordination of the multi agents and the environment, robust force control against for the environments, control methods for non-holonomic systems, robot systems which can mimic and learn human skills were studied. In each sub-project, some problems were hi-lighted and solutions for the problems have been given based on construction of experimental systems. (NEDO)

  15. Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

    OpenAIRE

    Baltazar, J. C.; Tiglao, T. V.; Tempongko, S. B.

    1993-01-01

    The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoe...

  16. Cerebral gray matter volume losses in essential tremor: A case-control study using high resolution tissue probability maps.

    Science.gov (United States)

    Cameron, Eric; Dyke, Jonathan P; Hernandez, Nora; Louis, Elan D; Dydak, Ulrike

    2018-03-10

    Essential tremor (ET) is increasingly recognized as a multi-dimensional disorder with both motor and non-motor features. For this reason, imaging studies are more broadly examining regions outside the cerebellar motor loop. Reliable detection of cerebral gray matter (GM) atrophy requires optimized processing, adapted to high-resolution magnetic resonance imaging (MRI). We investigated cerebral GM volume loss in ET cases using automated segmentation of MRI T1-weighted images. MRI was acquired on 47 ET cases and 36 controls. Automated segmentation and voxel-wise comparisons of volume were performed using Statistical Parametric Mapping (SPM) software. To improve upon standard protocols, the high-resolution International Consortium for Brain Mapping (ICBM) 2009a atlas and tissue probability maps were used to process each subject image. Group comparisons were performed: all ET vs. Controls, ET with head tremor (ETH) vs. Controls, and severe ET vs. An analysis of variance (ANOVA) was performed between ET with and without head tremor and controls. Age, sex, and Montreal Cognitive Assessment (MoCA) score were regressed out from each comparison. We were able to consistently identify regions of cerebral GM volume loss in ET and in ET subgroups in the posterior insula, superior temporal gyri, cingulate cortex, inferior frontal gyri and other occipital and parietal regions. There were no significant increases in GM volume in ET in any comparisons with controls. This study, which uses improved methodologies, provides evidence that GM volume loss in ET is present beyond the cerebellum, and in fact, is widespread throughout the cerebrum as well. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Candidate gene analysis of spontaneous preterm delivery: New insights from re-analysis of a case-control study using case-parent triads and control-mother dyads

    Directory of Open Access Journals (Sweden)

    Myking Solveig

    2011-12-01

    Full Text Available Abstract Background Spontaneous preterm delivery (PTD has a multifactorial etiology with evidence of a genetic contribution to its pathogenesis. A number of candidate gene case-control studies have been performed on spontaneous PTD, but the results have been inconsistent, and do not fully assess the role of how two genotypes can impact outcome. To elucidate this latter point we re-analyzed data from a previously published case-control candidate gene study, using a case-parent triad design and a hybrid design combining case-parent triads and control-mother dyads. These methods offer a robust approach to genetic association studies for PTD compared to traditional case-control designs. Methods The study participants were obtained from the Norwegian Mother and Child Cohort Study (MoBa. A total of 196 case triads and 211 control dyads were selected for the analysis. A case-parent triad design as well as a hybrid design was used to analyze 1,326 SNPs from 159 candidate genes. We compared our results to those from a previous case-control study on the same samples. Haplotypes were analyzed using a sliding window of three SNPs and a pathway analysis was performed to gain biological insight into the pathophysiology of preterm delivery. Results The most consistent significant fetal gene across all analyses was COL5A2. The functionally similar COL5A1 was significant when combining fetal and maternal genotypes. PON1 was significant with analytical approaches for single locus association of fetal genes alone, but was possibly confounded by maternal effects. Focal adhesion (hsa04510, Cell Communication (hsa01430 and ECM receptor interaction (hsa04512 were the most constant significant pathways. Conclusion This study suggests a fetal association of COL5A2 and a combined fetal-maternal association of COL5A1 with spontaneous PTD. In addition, the pathway analysis implied interactions of genes affecting cell communication and extracellular matrix.

  18. Superfund and Toxic Release Inventory Sites - INSTITUTIONAL_CONTROLS_IDEM_IN.SHP: Institutional Control Sites in Indiana (Indiana Department of Environmental Management, Polygon Shapefile)

    Data.gov (United States)

    NSGIC State | GIS Inventory — INSTITUTIONAL_CONTROLS_IDEM_IN is a polygon shapefile that contains Institutional Control (IC) site locations in Indiana, provided by personnel of Indiana Department...

  19. Lumbar lordosis and pars interarticularis fractures: a case-control study

    International Nuclear Information System (INIS)

    Bugg, William G.; Lewis, Mark; Juette, Arne; Cahir, John G.; Toms, Andoni P.

    2012-01-01

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  20. Lumbar lordosis and pars interarticularis fractures: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Bugg, William G; Lewis, Mark; Juette, Arne; Cahir, John G; Toms, Andoni P [Cotman Centre, Norwich Radiology Academy, Norwich, Norfolk (United Kingdom)

    2012-07-15

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  1. Lumbar lordosis and pars interarticularis fractures: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Bugg, William G.; Lewis, Mark; Juette, Arne; Cahir, John G.; Toms, Andoni P. [Cotman Centre, Norwich Radiology Academy, Norwich, Norfolk (United Kingdom)

    2012-07-15

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  2. Lower Breast Cancer Risk among Women following the World Cancer Research Fund and American Institute for Cancer Research Lifestyle Recommendations: EpiGEICAM Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Adela Castelló

    Full Text Available According to the "World Cancer Research Fund" and the "American Institute of Cancer Research" (WCRF/AICR one in four cancer cases could be prevented through a healthy diet, weight control and physical activity.To explore the association between the WCRF/AICR recommendations and risk of breast cancer.During the period 2006 to 2011 we recruited 973 incident cases of breast cancer and 973 controls from 17 Spanish Regions. We constructed a score based on 9 of the WCRF/AICR recommendations for cancer prevention:: 1Maintain adequate body weight; 2Be physically active; 3Limit the intake of high density foods; 4Eat mostly plant foods; 5Limit the intake of animal foods; 6Limit alcohol intake; 7Limit salt and salt preserved food intake; 8Meet nutritional needs through diet; S1Breastfeed infants exclusively up to 6 months. We explored its association with BC by menopausal status and by intrinsic tumor subtypes (ER+/PR+ & HER2-; HER2+; ER&PR-&HER2- using conditional and multinomial logistic models respectively.Our results point to a linear association between the degree of noncompliance and breast cancer risk. Taking women who met 6 or more recommendations as reference, those meeting less than 3 showed a three-fold excess risk (OR=2.98(CI95%:1.59-5.59, especially for postmenopausal women (OR=3.60(CI95%:1.24;10.47 and ER+/PR+&HER2- (OR=3.60(CI95%:1.84;7.05 and HER2+ (OR=4.23(CI95%:1.66;10.78 tumors. Noncompliance of recommendations regarding the consumption of foods and drinks that promote weight gain in premenopausal women (OR=2.24(CI95%:1.18;4.28; p for interaction=0.014 and triple negative tumors (OR=2.93(CI95%:1.12-7.63; the intake of plant foods in postmenopausal women (OR=2.35(CI95%:1.24;4.44 and triple negative tumors (OR=3.48(CI95%:1.46-8.31; and the alcohol consumption in ER+/PR+&HER2- tumors (OR=1.52 (CI95%:1.06-2.19 showed the strongest associations.Breast cancer prevention might be possible by following the "World Cancer Research Fund" and the

  3. Multi-Stakeholder Case Prioritization in Digital Investigations

    Directory of Open Access Journals (Sweden)

    Joshua I. James

    2014-09-01

    Full Text Available This work examines the problem of case prioritization in digital investigations for better utilization of limited criminal investigation resources. Current methods of case prioritization, as well as observed prioritization methods used in digital forensic investigation laboratories are examined. After, a multi-stakeholder approach to case prioritization is given that may help reduce reputational risk to digital forensic laboratories while improving resource allocation. A survey is given that shows differing opinions of investigation priority between Law Enforcement and the public that is used in the development of a prioritization model. Finally, an example case is given to demonstrate the practicality of the proposed method.

  4. [Child abuse in Tlaxcala: a case-control study].

    Science.gov (United States)

    Herrada-Huidobro, A; Nazar-Beutelspacher, A; Cassaball-Núñez, M; Vega-Ramos, R; Nava-Cruz, C B

    1992-01-01

    A longitudinal, retrospective and descriptive study about child abuse was carried out in the Hospitals of the Tlaxcala Secretariat of Health, Mexico. The information was obtained from hospitalized children's charts between January first and November 30, 1991. The charts included were those belonging to zero to 14 year old children with injuries, poisoning, and II-III degrees of malnutrition. Four child-abuse criteria were established: physical, sexual, non organic malnutrition and mixed (physical and non organic malnutrition). Two control groups were defined. Different patterns were observed between accidental and non accidental injuries, malnutrition and poisoning among the case and the control groups. The study provides useful information for the integral diagnosis of child abuse in hospitalized children.

  5. Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

    Energy Technology Data Exchange (ETDEWEB)

    Spiliopoulos, Stavros, E-mail: stavspiliop@med.uoa.gr, E-mail: stavspiliop@upatras.gr; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com [Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, Department of Interventional Radiology (United Kingdom); Ali, Tariq, E-mail: tariq.ali@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom); Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com [Patras University Hospital, Department of Interventional Radiology (Greece); Cannavale, Alessandro, E-mail: alessandro.cannavale@hotmail.com; Krokidis, Miltiadis, E-mail: miltiadis.krokidis@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

    2016-12-15

    PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

  6. Field-based random sampling without a sampling frame: control selection for a case-control study in rural Africa.

    Science.gov (United States)

    Crampin, A C; Mwinuka, V; Malema, S S; Glynn, J R; Fine, P E

    2001-01-01

    Selection bias, particularly of controls, is common in case-control studies and may materially affect the results. Methods of control selection should be tailored both for the risk factors and disease under investigation and for the population being studied. We present here a control selection method devised for a case-control study of tuberculosis in rural Africa (Karonga, northern Malawi) that selects an age/sex frequency-matched random sample of the population, with a geographical distribution in proportion to the population density. We also present an audit of the selection process, and discuss the potential of this method in other settings.

  7. A Qualitative Multi-Case Study of the Influence of Personal and Professional Ethics on the Leadership of Public School Superintendents

    Science.gov (United States)

    McDermott, Brian J.

    2010-01-01

    The purpose of this study is to examine the influence of personal and professional ethics on the leadership of public school superintendents. A multi-case, qualitative research design was used to gather data from four practicing public school superintendents. Transformational leadership theory and the three pillars of ethics of leadership…

  8. 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…

  9. Dietary and lifestyle characteristics of colorectal cancer in Jordan: a case-control study.

    Science.gov (United States)

    Arafa, Mostafa A; Waly, Mostafa I; Jriesat, Sahar; Al Khafajei, Ahmed; Sallam, Sunny

    2011-01-01

    We evaluated dietary pattern and lifestyle characteristics of patients with colorectal cancer (CRC) in Jordan. The case-control study included 220 recently diagnosed CRC cases and 220 age and gender matched healthy subjects as a control group. The participating CRC cases had lower dietary intake of fibre, folate, vitamin B12, β-carotene, vitamin C and selenium as compared to controls (P<0.05). The frequency of consumption of fruits and vegetables was also lower among CRC cases, while the frequency of consumption of red meat and saturated fat was higher and positively associated with CRC risk. Furthermore, family history for CRC played a positive role and the majority of CRC cases and controls had a low physical activity level. A sedentary lifestyle and a diet low in fruits and vegetables, and high in animal red meat and saturated fat, appeared associated with CRC among the studied Jordanian subjects. This is consistent with the reported CRC studies in developed nations indicating global causal effects for this tumour type.

  10. Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study.

    Science.gov (United States)

    Pontes, Leonilda Giani; Menezes, Fernando Gatti de; Gonçalves, Priscila; Toniolo, Alexandra do Rosário; Silva, Claudia Vallone; Kawagoe, Julia Yaeko; Santos, Camila Marques Dos; Castagna, Helena Maria Fernandes; Martino, Marinês Dalla Valle; Corrêa, Luci

    2017-01-01

    To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011. A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004). Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis. Descrever as características microbiológicas e avaliar os fatores de risco para mortalidade na traqueobronquite associada à ventilação mecânica em um estudo caso-controle de pacientes de terapia intensiva. Estudo realizado ao longo de 6 anos em uma unidade de terapia intensiva médico-cirúrgica de 40 leitos, em um hospital privado e de nível terciário em São Paulo, Brasil. O Grupo Caso foi identificado usando o banco de dados da Comissão de

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

    Science.gov (United States)

    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

  12. Demand controlled ventilation for multi-family dwellings

    DEFF Research Database (Denmark)

    Mortensen, Dorthe Kragsig

    for centrally balanced DCV systems with heat recovery. A design expected to fulfill this requirement was investigated in detail with regard to its electricity consumption by evaluating a control strategy that resets the static pressure set point at part load. The results showed that this control strategy can......The present thesis “Demand controlled ventilation for multi-family dwellings” constitutes the summary of a three year project period during which demand specification and system design of demand controlled ventilation for residential buildings were studied. Most standards and buildings codes...... can be reduced compared to a system with constant air flow. A literature study on indoor pollutants in homes, their sources and their impact on humans formed the basis for the demand specification. Emission of pollutants in residential buildings roughly fall into constantly emitted background sources...

  13. Case-control study of mesothelioma in the shipyard industry

    International Nuclear Information System (INIS)

    Correa-Villasenor, A.

    1987-01-01

    A nested case-control study was undertaken to investigate the relationship between occupational exposures to asbestos and low-level gamma radiation and mesothelioma. One hundred nineteen cases and four hundred fifty-two latency-matched controls were selected. Analyses were conducted using the conditional maximum likelihood estimate of the odds ratio and conditional logistic regression for matched sets. The results from the analyses revealed a relationship between asbestos exposure and mesothelioma; the strength of this relationship increased with the intensity and duration of the asbestos exposure. Exposure to low-level gamma radiation was also associated with an increased risk of mesothelioma. There was no interaction between asbestos and radiation. Shipyard employment in non-asbestos jobs and male gender were also found to be associated with mesothelioma

  14. Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

    Science.gov (United States)

    Baltazar, J C; Tiglao, T V; Tempongko, S B

    1993-01-01

    The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.

  15. 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.

  16. 77 FR 11136 - Proposed Collection; Comment Request; a Multi-Center International Hospital-Based Case-Control...

    Science.gov (United States)

    2012-02-24

    ... proposed projects to be submitted to the Office of Management and Budget (OMB) for review and approval... conclusively established and the identification of the key, functional alleles in gene regions associated with... underlying genetic structure. A multidisciplinary case- control study of lymphoma in Asia, where lymphoma...

  17. Effect of severe anaemia on renal function: a case-control study

    International Nuclear Information System (INIS)

    Kumar, A.; Hentok, P.; Chandrashekar, N.; Thomas, E.J.; Tripathi, M.; Bal, C.S.; Ghosh, A.; Jailkhani, B.L.; Malhotra, O.P.

    2002-01-01

    Aim: Anaemia, if severe, causes multi systemic functional changes. We tried to find out the effect of severe anaemia on renal function. Materials and Methods: A total of 66 patients with severe anemia and 10 healthy controls were recruited in this study. The cases were divided into following groups: group A: patients with Hb≤3 gm/dl (n=33); group B: patients with Hb≤6 but > 3 gm/dl (n=33); group C: healthy controls with normal renal function and Hb>12gm/dl. Out of 66 anaemic patients, 36 had nutritional anaemia (mainly iron deficiency; group A=20, group B=16), 24 patients were suffering from aplastic anaemia (group A=11, group B=13) and rest 6 had megaloblastic anaemia (group A=2, group B=4). No subject had hypertension, diabetes, primary renal dysfunction or any other systemic illness, affecting kidney. Various renal function test parameters and diagnostic renal failure indices were obtained for all subjects. GFR with 2-sample method after injection of 99m-Tc DTPA and ERPF with single sample method after injection of 131-I OIH were also calculated. Results: Fourteen patients had mild to moderate pedal edema (10 in group A and 4 in group B). Out of these patients, 8 had palpable liver and signs of systemic congestion. Signs of raised systemic venous pressure (raised JVP) were found in 7 patients of group A. In about 55% of patients, chest x-ray showed mild to moderately enlarged heart with disturbed cardiophrenic angle. Urine output was >600 ml/day in all cases. Results are presented. All renal functional parameters and indices were significantly reduced in anaemic patients and were suggestive of pre-renal failure. The reduction was correlating well with the severity of anaemia.Conclusion: Severe anaemia leads to renal dysfunction with alteration of minor and major renal failure indices, which can be characterized by sub-clinical and pre-biochemical non-oliguric pre-renal failure

  18. Thyroid cancer in French Polynesia: a population based case control study

    International Nuclear Information System (INIS)

    Brindel, P.; Doyon, F.; Adjadj, E.; Vathaire, F. de; Drozdovitch, V.; Bouville, A.; Paoaafaite, J.; Teuri, J.

    2006-01-01

    Full text of publication follows: Because a previous study had shown that registered thyroid cancer incidence is higher among natives of French Polynesia (FP) than in other Maori populations from Hawaii and New-Zealand, a case-control study of thyroid cancer coordinated by Unit 605 of INSERM was conducted in FP. The main objective was to assess the potential role of atmospheric nuclear weapons tests performed by France between 1966 and 1974 on such a high incidence. The study included 600 subjects born and residing in FP: 229 cases of differentiated thyroid carcinoma diagnosed between 1979 and 2004, aged up to 30 years old at start of nuclear weapons testing and 371 control s matched on gender and birth date randomly selected from t he FP registry of births. Face to face interviews were conducted from 2002 to 2004 by specialized investigators native from FP who received a specific formation for this study. Addresses were collected from the territorial medical insurance, which covers all the inhabitants, whatever their professional status. Detailed information about nutrition at time of interview and at the end of adolescence was collected by means of a semi-quantitative method using pictures. Data concerning residence, hormonal and reproductive life, familial and personal background of thyroid pathologies and cancers, and professional and environmental exposure to carcinogens were also collected. For each study subject, radiation thyroid dose was estimated taking into account residential history and dietary habits of the subject and deposition densities of radionuclides reconstructed for each island where the subject resided during the testing period. The iodine intake will be estimated from the dietary questionnaire, as well as from mass-spectrometry measurements of stable iodine in nail clippings, which were collected during the interviews. Among the 229 cases, 89% were females, 54% declared themselves as of pure Maori origin, another 36% of Maori-Asian or Maori

  19. A Two-Stage Penalized Logistic Regression Approach to Case-Control Genome-Wide Association Studies

    Directory of Open Access Journals (Sweden)

    Jingyuan Zhao

    2012-01-01

    Full Text Available We propose a two-stage penalized logistic regression approach to case-control genome-wide association studies. This approach consists of a screening stage and a selection stage. In the screening stage, main-effect and interaction-effect features are screened by using L1-penalized logistic like-lihoods. In the selection stage, the retained features are ranked by the logistic likelihood with the smoothly clipped absolute deviation (SCAD penalty (Fan and Li, 2001 and Jeffrey’s Prior penalty (Firth, 1993, a sequence of nested candidate models are formed, and the models are assessed by a family of extended Bayesian information criteria (J. Chen and Z. Chen, 2008. The proposed approach is applied to the analysis of the prostate cancer data of the Cancer Genetic Markers of Susceptibility (CGEMS project in the National Cancer Institute, USA. Simulation studies are carried out to compare the approach with the pair-wise multiple testing approach (Marchini et al. 2005 and the LASSO-patternsearch algorithm (Shi et al. 2007.

  20. Effect of vitamin C supplementation on stroke recovery: a case-control study.

    Science.gov (United States)

    Rabadi, Meheroz H; Kristal, Bruce S

    2007-01-01

    Epidemiological studies have associated increased dietary intake of antioxidants (vitamin C, E, and beta-carotene) in preventing and decreasing the extent of ischemic brain injury. The effect of vitamin C supplementation on functional recovery after stroke has not been studied. In this retrospective, case-control study of 23 patients with ischemic stroke taking vitamin C were identified and matched for age, sex, onset to admission, and admission total functional independence measure (TFIM) with 23 patients with ischemic stroke not taking Vitamin C supplementation. Vitamin C 1000 mg daily was prescribed on admission to our unit mainly to patients who were undernourished (defined as significant weight loss and/or 90% or less ideal body weight for age and sex) and those with pressure sores. The outcome measures were: change in the TFIM, FIM-Cognition (FIM-Cog), and FIM-Motor sub-scores, discharge disposition, and length of stay (LOS). The change in TFIM (20 +/- 13 standard deviation [SD] vs. 26 +/- 6, p = 0.20), FIM-Cog (3 +/- 3 SD vs. 4 +/- 5, p = 0.41), FIM-Motor (15 +/- 11 SD vs. 20 +/- 13, p = 0.21) sub-scores were less in the vitamin C treated group, but these differences did not reach statistical significance. Similarly, no significant differences were found in LOS (21 +/- 9 SD vs. 23 +/- 9, p = 0.59), and discharge disposition (home/institution) (9/10 vs. 13/9, p = 0.60) between the vitamin C and the control groups. This study suggests vitamin C supplementation did not enhance functional recovery in undernourished ischemic stroke patients.

  1. Adaptive Droop Control for Microgrids Based on the Synergetic Control of Multi-Agent Systems

    Directory of Open Access Journals (Sweden)

    Zhiwen Yu

    2016-12-01

    Full Text Available In this paper, a distributed synergetic control based on multi-agent systems is proposed to solve the problems of frequency and voltage errors, system stability and power sharing accuracy in the traditional droop control of microgrids. Starting with power flow equations, we build the secondary-order dynamic model of DG, which consists of three parts: (1 active power allocation; (2 active power-frequency; and (3 reactive power-voltage droop control. Considering time-delays in communication networks, a leaderless synergetic control algorithm is proposed to allocate the active power in inverse proportion to the droop coefficient, and the synergetic control with a virtual leader is proposed to control the system frequency and voltage to keep at the expected value. Besides, the direct Lyapunov method is introduced to verify the globally asymptotical stability. Moreover, the impacts of communication disturbance are also discussed from the aspects of control precision and system stability. Finally, based on a test microgrid, numerous cases are designed as illustration, and the simulation results validate the proposed method.

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

    Science.gov (United States)

    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.

  3. Leading Change: A Case Study of Leadership Practices from the Development of the Niagara County Community College Culinary Institute

    Science.gov (United States)

    Caton, Jazmin; Mistriner, Mark

    2016-01-01

    The purpose of this case study was to evaluate the lessons learned from the development of a project that set out to revitalize an economically depressed area with an innovative approach to workforce development through partnerships. The focus was to utilize the development of the Niagara County Community College Culinary Institute as an example…

  4. Multi input-output fuzzy logic smart controller for a residential hybrid solar-wind-storage energy system

    International Nuclear Information System (INIS)

    Derrouazin, A.; Aillerie, M.; Mekkakia-Maaza, N.; Charles, J.-P.

    2017-01-01

    Highlights: • We present a fuzzy smart controller for hybrid renewable and conventional energy system. • The rules are based on human intelligence and implemented in the smart controller. • Efficient tracking capability of the proposed controller is proofed in this paper by an example. • Excess produced renewable energy is converted to hydrogen for household use . • Considerable electric grid energy saving is highlighted in the proposed controller system. - Abstract: This study concerns the conception and development of an efficient multi input-output fuzzy logic smart controller, to manage the energy flux of a sustainable hybrid power system, based on renewable power sources, integrating solar panels and a wind turbine associated with storage, applied to a typical residential habitat. In the suggested topology, the energy surplus is redirected to an electrolysis system to produce hydrogen suitable for household utilities. To assume a constant access to electricity in case of consumption peak, connection to the grid is also considered as an exceptional rescue resource. The objective of the presented controller is to exploit instantaneously the produced renewable electric energy and insure savings of electric grid energy. The proposed multi input-output fuzzy logic smart controller has been achieved and verified, outcome switches command signals are discussed and the renewable energy system integration ratio is highlighted.

  5. 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...

  6. AUDITING INTERNAL CONTROLS IN FINANCING PRESCHOOL PUBLIC INSTITUTION: EVIDENCE FROM SLOVENIA

    Directory of Open Access Journals (Sweden)

    Tatjana HORVAT

    2017-12-01

    Full Text Available Public preschool educational institutions in Slovenia are mostly financed by public money, it means bay state and municipalities. They are also financed by parents. So, it is important that preschool institutions are using public money transparent and responsible, for this reason public preschool institution should have internal controls in financing. The internal auditor as independent professional should verify if internal controls works. The purpose of this paper is to investigate how internal controls in financing public educational institution works it means which internal controls are important in financing the preschool institution - on the selected institution to show and check how internal controls work. For this reason we divide internal controls in the financing in two phases: (1 internal controls in the preparation of the annual financial plan and financial planning of financial resources for institution’s programs and activities, (2 internal controls in obtaining financial resources. We used methods of internal auditing and research approaches as sampling, unstructured interviews and analysis of documents. The results showed that selected preschool institution should work on rules of recovery and monitoring of claims. The findings provide useful academic insight to setting internal controls as well as practical guidance for preschool institutions.

  7. Ideas and institutions in global governance - the case of microcredit

    DEFF Research Database (Denmark)

    Aagaard, Peter

    There is a growing demand for effective strategic problem solving in relation to a wide array of global policy problems such as AIDS, poverty, global warming, etc. This makes the introduction of new policy ideas for institutional change increasingly important in global governance. But researchers...... need a new approach in order to better grasp the complexity in global problem solving. We need to know more about how ideas emerge, spread and transform in a complex, networked global environment. New literature on institutional dynamics can inform the literature on global governance networks......, especially when it comes to the meta-governance of global networks. Based on a case study of microcredit and its emergence as a policy idea in development policy, the paper will illustrate the use of institutional dynamic conceptualisation in global governance....

  8. A Study of the Chinese Shipyard Management Control System.

    Science.gov (United States)

    1987-09-01

    market, however, som significant. changes occured in that control system Why these changes occured can be explained with institutional theory . Taken...management control system developed in Chinese shipyards can be explained by either the resource dependency or the institutional theory . The focus is on...34 Institutional theory treats organizations as successful to the extent that they embody societal myths concerning rationality. A societal myth, in this case, is

  9. Degenerative disc disease as a cause of back pain in the thalassaemic population: a case-control study using MRI and plain radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Desigan, S.; Hall-Craggs, M.A.; Ho, C.-P. [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Eliahoo, J. [University College London Hospitals NHS Trust, Research and Development Directorate, London (United Kingdom); Porter, J.B. [University College Hospital, Department of Haematology, University College London Hospitals NHS Trust, London (United Kingdom)

    2006-02-15

    The aim of this study was to test our observation that back pain in thalassemic patients could be caused by premature and extensive lumbar degenerative disc disease, when compared to non-thalassemic patients with back pain. Sixteen thalassemic patients with their sex- and age-matched controls were recruited into the study, 12 with thalassemia major, and 4 with thalassemia intermedia. Both the thalassemia patients and control subjects suffered from back pain, which was subjective rather than measured/pain scored. All subjects underwent magnetic resonance (MR) imaging of the lumbar spine, and 11 of the cases and 8 controls had lumbar spine radiographs. Each lumbar disc was scored for radiographic appearances and MR features of disc degeneration and disc protrusion. Proportion values for these parameters and median scores were derived at each disc level, and were analyzed and compared. There was a statistically-significant difference between proportion values of cases and controls for the MR features (P value=0.01, n=16) and the radiographic features (P value=0.01, n=11 cases, n=8 controls) of disc degeneration. The median disc level scores for the thalassemic group were uniformly high across all lumbar discs, and at all levels except at L 4/5. The control group conversely demonstrated a predilection for disc degeneration at L4/5 level. The distribution of lumbar disc degeneration in thalassemic patients with back pain is more extensive, severe and multi-level in nature compared to matched controls, and disc degeneration should be considered as a significant cause of back pain in this population group. (orig.)

  10. Degenerative disc disease as a cause of back pain in the thalassaemic population: a case-control study using MRI and plain radiographs

    International Nuclear Information System (INIS)

    Desigan, S.; Hall-Craggs, M.A.; Ho, C.-P.; Eliahoo, J.; Porter, J.B.

    2006-01-01

    The aim of this study was to test our observation that back pain in thalassemic patients could be caused by premature and extensive lumbar degenerative disc disease, when compared to non-thalassemic patients with back pain. Sixteen thalassemic patients with their sex- and age-matched controls were recruited into the study, 12 with thalassemia major, and 4 with thalassemia intermedia. Both the thalassemia patients and control subjects suffered from back pain, which was subjective rather than measured/pain scored. All subjects underwent magnetic resonance (MR) imaging of the lumbar spine, and 11 of the cases and 8 controls had lumbar spine radiographs. Each lumbar disc was scored for radiographic appearances and MR features of disc degeneration and disc protrusion. Proportion values for these parameters and median scores were derived at each disc level, and were analyzed and compared. There was a statistically-significant difference between proportion values of cases and controls for the MR features (P value=0.01, n=16) and the radiographic features (P value=0.01, n=11 cases, n=8 controls) of disc degeneration. The median disc level scores for the thalassemic group were uniformly high across all lumbar discs, and at all levels except at L 4/5. The control group conversely demonstrated a predilection for disc degeneration at L4/5 level. The distribution of lumbar disc degeneration in thalassemic patients with back pain is more extensive, severe and multi-level in nature compared to matched controls, and disc degeneration should be considered as a significant cause of back pain in this population group. (orig.)

  11. Person-centred web-based support--development through a Swedish multi-case study.

    Science.gov (United States)

    Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela

    2013-10-19

    Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

  12. On the Analysis of Case-Control Studies in Cluster-correlated Data Settings.

    Science.gov (United States)

    Haneuse, Sebastien; Rivera-Rodriguez, Claudia

    2018-01-01

    In resource-limited settings, long-term evaluation of national antiretroviral treatment (ART) programs often relies on aggregated data, the analysis of which may be subject to ecological bias. As researchers and policy makers consider evaluating individual-level outcomes such as treatment adherence or mortality, the well-known case-control design is appealing in that it provides efficiency gains over random sampling. In the context that motivates this article, valid estimation and inference requires acknowledging any clustering, although, to our knowledge, no statistical methods have been published for the analysis of case-control data for which the underlying population exhibits clustering. Furthermore, in the specific context of an ongoing collaboration in Malawi, rather than performing case-control sampling across all clinics, case-control sampling within clinics has been suggested as a more practical strategy. To our knowledge, although similar outcome-dependent sampling schemes have been described in the literature, a case-control design specific to correlated data settings is new. In this article, we describe this design, discuss balanced versus unbalanced sampling techniques, and provide a general approach to analyzing case-control studies in cluster-correlated settings based on inverse probability-weighted generalized estimating equations. Inference is based on a robust sandwich estimator with correlation parameters estimated to ensure appropriate accounting of the outcome-dependent sampling scheme. We conduct comprehensive simulations, based in part on real data on a sample of N = 78,155 program registrants in Malawi between 2005 and 2007, to evaluate small-sample operating characteristics and potential trade-offs associated with standard case-control sampling or when case-control sampling is performed within clusters.

  13. Multi-terminal direct-current grids modeling, analysis, and control

    CERN Document Server

    Chaudhuri, Nilanjan; Majumder, Rajat; Yazdani, Amirnaser

    2014-01-01

    A comprehensive modeling, analysis, and control design framework for multi-terminal direct current (MTDC) grids is presented together with their interaction with the surrounding AC networks and the impact on overall stability. The first book of its kind on the topic of multi-terminal DC (MTDC) grids  Presents a comprehensive modeling framework for MTDC grids which is compatible with the standard AC system modeling for stability studies Includes modal analysis and study of the interactions between the MTDC grid and the surrounding AC systems Addresses the problems of autonomous power sharing an

  14. Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

    Science.gov (United States)

    Al-Khaduri, Maha M.; Abudraz, Rania Mohammed; Al-Farsi, Yahya M.

    2014-01-01

    Objective This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. Results Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51%) was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb’s Palsy was the most prevalent (79%). Conclusion Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further p rospective studies are required to confirm the obtained results. PMID:25337307

  15. Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Maha M. Al-Khaduri

    2014-09-01

    Full Text Available Objective: This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods: A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. Results: Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51% was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb’s Palsy was the most prevalent (79%. Conclusion: Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further prospective studies are required to confirm the obtained results.

  16. Analysis of single nucleotide polymorphisms in case-control studies.

    Science.gov (United States)

    Li, Yonghong; Shiffman, Dov; Oberbauer, Rainer

    2011-01-01

    Single nucleotide polymorphisms (SNPs) are the most common type of genetic variants in the human genome. SNPs are known to modify susceptibility to complex diseases. We describe and discuss methods used to identify SNPs associated with disease in case-control studies. An outline on study population selection, sample collection and genotyping platforms is presented, complemented by SNP selection, data preprocessing and analysis.

  17. Multi-robot control interface

    Science.gov (United States)

    Bruemmer, David J [Idaho Falls, ID; Walton, Miles C [Idaho Falls, ID

    2011-12-06

    Methods and systems for controlling a plurality of robots through a single user interface include at least one robot display window for each of the plurality of robots with the at least one robot display window illustrating one or more conditions of a respective one of the plurality of robots. The user interface further includes at least one robot control window for each of the plurality of robots with the at least one robot control window configured to receive one or more commands for sending to the respective one of the plurality of robots. The user interface further includes a multi-robot common window comprised of information received from each of the plurality of robots.

  18. The use of the bootstrap in the analysis of case-control studies with missing data

    DEFF Research Database (Denmark)

    Siersma, Volkert Dirk; Johansen, Christoffer

    2004-01-01

    nonparametric bootstrap, bootstrap confidence intervals, missing values, multiple imputation, matched case-control study......nonparametric bootstrap, bootstrap confidence intervals, missing values, multiple imputation, matched case-control study...

  19. Multi-model Simulation for Optimal Control of Aeroacoustics.

    Energy Technology Data Exchange (ETDEWEB)

    Collis, Samuel Scott; Chen, Guoquan

    2005-05-01

    Flow-generated noise, especially rotorcraft noise has been a serious concern for bothcommercial and military applications. A particular important noise source for rotor-craft is Blade-Vortex-Interaction (BVI)noise, a high amplitude, impulsive sound thatoften dominates other rotorcraft noise sources. Usually BVI noise is caused by theunsteady flow changes around various rotor blades due to interactions with vorticespreviously shed by the blades. A promising approach for reducing the BVI noise isto use on-blade controls, such as suction/blowing, micro-flaps/jets, and smart struc-tures. Because the design and implementation of such experiments to evaluate suchsystems are very expensive, efficient computational tools coupled with optimal con-trol systems are required to explore the relevant physics and evaluate the feasibilityof using various micro-fluidic devices before committing to hardware.In this thesis the research is to formulate and implement efficient computationaltools for the development and study of optimal control and design strategies for com-plex flow and acoustic systems with emphasis on rotorcraft applications, especiallyBVI noise control problem. The main purpose of aeroacoustic computations is todetermine the sound intensity and directivity far away from the noise source. How-ever, the computational cost of using a high-fidelity flow-physics model across thefull domain is usually prohibitive and itmight also be less accurate because of thenumerical diffusion and other problems. Taking advantage of the multi-physics andmulti-scale structure of this aeroacoustic problem, we develop a multi-model, multi-domain (near-field/far-field) method based on a discontinuous Galerkin discretiza-tion. In this approach the coupling of multi-domains and multi-models is achievedby weakly enforcing continuity of normal fluxes across a coupling surface. For ourinterested aeroacoustics control problem, the adjoint equations that determine thesensitivity of the cost

  20. Radon and Lung Cancer Case-Control Study in Middle Ural

    International Nuclear Information System (INIS)

    Kirdin, I.A.; Lezhnin, V.L.; Yarmoshenko, I.V.; Ekidin, A.

    2001-01-01

    Full text: The pilot phase of radon and lung cancer case-control study has been performed in Karpinsk and Pervouralsk towns of Middle Ural region of Russia. The case group consists of 341 persons with lung cancer and living in that towns at least five previous years. The lung cancer diagnoses were carefully verified by instrumental techniques and 70% of its were morphologically validated. The persons for the control group (448) were chosen from the population living in that towns at least five years taking into account the age and sex. The special epidemiological questionnaire was developed which includes the items by the groups of factors as follow: clinical data, social factors, chronic lung diseases, life habit, tobacco smoking, alcohol drinking, diet preference etc. The epidemiological questionnaires were fulfilled for each member of case and control groups. Radon gas concentration and thoron equilibrium equivalent concentration measurements had been performed using nuclear track detectors and grab sampling accordingly in the dwellings of case and control groups members. By preliminary estimation the odds ratios are 1, 0.91, 1.2, 1.1 in the ranges of radon and thoron equilibrium equivalent concentration 0-6, 3-13, 13-36 and 36-370 Bq/m 3 respectively. The deeper and more rigorous analysis as well as different independent approaches will be discussed in the paper.(author)

  1. High risk human papillomavirus in the periodontium : A case control study.

    Science.gov (United States)

    Shipilova, Anna; Dayakar, Manjunath Mundoor; Gupta, Dinesh

    2017-01-01

    Human papilloma viruses (HPVs) are small DNA viruses that have been identified in periodontal pocket as well as gingival sulcus. High risk HPVs are also associated with a subset of head and neck carcinomas. It is thought that the periodontium could be a reservoir for HPV. 1. Detection of Human Papilloma virus (HPV) in periodontal pocket as well as gingival of patients having localized chronic periodontitis and gingival sulcus of periodontally healthy subjects. 2. Quantitative estimation of E6 and E7 mRNA in subjects showing presence of HPV3. To assess whether periodontal pocket is a reservoir for HPV. This case-control study included 30 subjects with localized chronic Periodontitis (cases) and 30 periodontally healthy subjects (controls). Two samples were taken from cases, one from periodontal pocket and one from gingival sulcus and one sample was taken from controls. Samples were collected in the form of pocket scrapings and gingival sulcus scrapings from cases and controls respectively. These samples were sent in storage media for identification and estimation of E6/E7 mRNA of HPV using in situ hybridization and flow cytometry. Statistical analysis was done by using, mean, percentage and Chi Square test. A statistical package SPSS version 13.0 was used to analyze the data. P value oral cancer, periodontitis and HPV. However prospective studies are required to further explore this link.

  2. Characteristics and prognosis of pneumococcal endocarditis: a case-control study.

    Science.gov (United States)

    Daudin, M; Tattevin, P; Lelong, B; Flecher, E; Lavoué, S; Piau, C; Ingels, A; Chapron, A; Daubert, J-C; Revest, M

    2016-06-01

    Case series have suggested that pneumococcal endocarditis is a rare disease, mostly reported in patients with co-morbidities but no underlying valve disease, with a rapid progression to heart failure, and high mortality. We performed a case-control study of 28 patients with pneumococcal endocarditis (cases), and 56 patients with non-pneumococcal endocarditis (controls), not matched for sex and age, during the years 1991-2013, in one referral centre. Alcoholism (39.3% versus 10.7%; p endocarditis. Cardiac surgery was required in 64.3% of patients with pneumococcal endocarditis, much earlier than in patients with non-pneumococcal endocarditis (mean time from symptom onset, 14.1 ± 18.2 versus 69.0 ± 61.1 days). In-hospital mortality rates were similar (7.1% versus 12.5%). Streptococcus pneumoniae causes rapidly progressive endocarditis requiring life-saving early cardiac surgery in most cases. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  3. Controlling the dynamics of multi-state neural networks

    International Nuclear Information System (INIS)

    Jin, Tao; Zhao, Hong

    2008-01-01

    In this paper, we first analyze the distribution of local fields (DLF) which is induced by the memory patterns in the Q-Ising model. It is found that the structure of the DLF is closely correlated with the network dynamics and the system performance. However, the design rule adopted in the Q-Ising model, like the other rules adopted for multi-state neural networks with associative memories, cannot be applied to directly control the DLF for a given set of memory patterns, and thus cannot be applied to further study the relationships between the structure of the DLF and the dynamics of the network. We then extend a design rule, which was presented recently for designing binary-state neural networks, to make it suitable for designing general multi-state neural networks. This rule is able to control the structure of the DLF as expected. We show that controlling the DLF not only can affect the dynamic behaviors of the multi-state neural networks for a given set of memory patterns, but also can improve the storage capacity. With the change of the DLF, the network shows very rich dynamic behaviors, such as the 'chaos phase', the 'memory phase', and the 'mixture phase'. These dynamic behaviors are also observed in the binary-state neural networks; therefore, our results imply that they may be the universal behaviors of feedback neural networks

  4. Multi-leg Seat Inventory Control Based on EMSU and Virtual Bucket

    Directory of Open Access Journals (Sweden)

    Wei Fan

    2014-01-01

    Full Text Available Expected marginal seat revenue (EMSR is a well-known method for airline seat inventory control airlines. However, this method employs a static model to study the dynamic reservation process, and does not take into account the risk tolerance of policy makers. Expected marginal seat utility (EMSU replaces revenue by utility, which addresses the real situation of seat inventory control. However, there is still a lack of multi-leg seat control algorithms based on EMSU. Therefore, using EMSU and bucket algorithms, this paper applies the Markov decision-making process to simulate the flight reservation process and builds a dynamic multi-leg seat inventory control model. Experimental results validate the effectiveness of the proposed method.

  5. Spatial processes decouple management from objectives in a heterogeneous landscape: predator control as a case study.

    Science.gov (United States)

    Mahoney, Peter J; Young, Julie K; Hersey, Kent R; Larsen, Randy T; McMillan, Brock R; Stoner, David C

    2018-04-01

    Predator control is often implemented with the intent of disrupting top-down regulation in sensitive prey populations. However, ambiguity surrounding the efficacy of predator management, as well as the strength of top-down effects of predators in general, is often exacerbated by the spatially implicit analytical approaches used in assessing data with explicit spatial structure. Here, we highlight the importance of considering spatial context in the case of a predator control study in south-central Utah. We assessed the spatial match between aerial removal risk in coyotes (Canis latrans) and mule deer (Odocoileus hemionus) resource selection during parturition using a spatially explicit, multi-level Bayesian model. With our model, we were able to evaluate spatial congruence between management action (i.e., coyote removal) and objective (i.e., parturient deer site selection) at two distinct scales: the level of the management unit and the individual coyote removal. In the case of the former, our results indicated substantial spatial heterogeneity in expected congruence between removal risk and parturient deer site selection across large areas, and is a reflection of logistical constraints acting on the management strategy and differences in space use between the two species. At the level of the individual removal, we demonstrated that the potential management benefits of a removed coyote were highly variable across all individuals removed and in many cases, spatially distinct from parturient deer resource selection. Our methods and results provide a means of evaluating where we might anticipate an impact of predator control, while emphasizing the need to weight individual removals based on spatial proximity to management objectives in any assessment of large-scale predator control. Although we highlight the importance of spatial context in assessments of predator control strategy, we believe our methods are readily generalizable in any management or large

  6. Putative periodontopathic bacteria and herpesviruses in pregnant women: a case-control study

    OpenAIRE

    Lu, Haixia; Zhu, Ce; Li, Fei; Xu, Wei; Tao, Danying; Feng, Xiping

    2016-01-01

    Little is known about herpesvirus and putative periodontopathic bacteria in maternal chronic periodontitis. The present case-control study aimed to explore the potential relationship between putative periodontopathic bacteria and herpesviruses in maternal chronic periodontitis.Saliva samples were collected from 36 pregnant women with chronic periodontitis (cases) and 36 pregnant women with healthy periodontal status (controls). Six putative periodontopathic bacteria (Porphyromonas gingivalis ...

  7. Case based reasoning applied to medical diagnosis using multi-class classifier: A preliminary study

    Directory of Open Access Journals (Sweden)

    D. Viveros-Melo

    2017-02-01

    Full Text Available Case-based reasoning (CBR is a process used for computer processing that tries to mimic the behavior of a human expert in making decisions regarding a subject and learn from the experience of past cases. CBR has demonstrated to be appropriate for working with unstructured domains data or difficult knowledge acquisition situations, such as medical diagnosis, where it is possible to identify diseases such as: cancer diagnosis, epilepsy prediction and appendicitis diagnosis. Some of the trends that may be developed for CBR in the health science are oriented to reduce the number of features in highly dimensional data. An important contribution may be the estimation of probabilities of belonging to each class for new cases. In this paper, in order to adequately represent the database and to avoid the inconveniences caused by the high dimensionality, noise and redundancy, a number of algorithms are used in the preprocessing stage for performing both variable selection and dimension reduction procedures. Also, a comparison of the performance of some representative multi-class classifiers is carried out to identify the most effective one to include within a CBR scheme. Particularly, four classification techniques and two reduction techniques are employed to make a comparative study of multiclass classifiers on CBR

  8. Deterministic methods for multi-control fuel loading optimization

    Science.gov (United States)

    Rahman, Fariz B. Abdul

    We have developed a multi-control fuel loading optimization code for pressurized water reactors based on deterministic methods. The objective is to flatten the fuel burnup profile, which maximizes overall energy production. The optimal control problem is formulated using the method of Lagrange multipliers and the direct adjoining approach for treatment of the inequality power peaking constraint. The optimality conditions are derived for a multi-dimensional multi-group optimal control problem via calculus of variations. Due to the Hamiltonian having a linear control, our optimal control problem is solved using the gradient method to minimize the Hamiltonian and a Newton step formulation to obtain the optimal control. We are able to satisfy the power peaking constraint during depletion with the control at beginning of cycle (BOC) by building the proper burnup path forward in time and utilizing the adjoint burnup to propagate the information back to the BOC. Our test results show that we are able to achieve our objective and satisfy the power peaking constraint during depletion using either the fissile enrichment or burnable poison as the control. Our fuel loading designs show an increase of 7.8 equivalent full power days (EFPDs) in cycle length compared with 517.4 EFPDs for the AP600 first cycle.

  9. Waterparks are high risk for cryptosporidiosis: A case-control study in Victoria, 2015.

    Science.gov (United States)

    de Gooyer, Tanyth E; Gregory, Joy; Easton, Marion; Stephens, Nicola; Fearnley, Emily; Kirk, Martyn

    2017-06-30

    An increase in notifications of cryptosporidiosis was observed in Victoria between March and April 2015. Cases mostly resided in one metropolitan region and hypothesis-generating interviews identified common exposures to aquatic facilities. We conducted a case-control study to determine exposure source(s) and facilitate control measures. Laboratory-confirmed cases of cryptosporidiosis from the region of interest notified between 1 March and 23 April 2015 were included. Controls residing in the same region were recruited from participants in a population health survey and frequency matched (2 per case) by age group. Details of exposure to potential risk factors were collected using a standardised telephone questionnaire for the 14-days prior to illness for cases, and an analogous exposure period for controls. Univariable and multivariable logistic regression were used to determine risk factors associated with illness using STATA SE 13.1. Thirty cases and 66 controls were included in the study. Half the cases were less than 12 years of age and 62% were female. Illness was most strongly associated with recreational water exposure at any waterpark (adjusted odds ratio (aOR)=73.5; 95% confidence interval (CI):6.74-802), and specifically at Victorian waterparks (aOR=45.6; 95% CI:5.20-399). Cases were linked with attendance at either a waterpark in the region or an adjacent region. As a result of this investigation, hyperchlorination was completed at identified facilities and swim hygiene information distributed. This study reinforces the potential for recreational water facilities, particularly waterparks, to act as a transmission source of Cryptosporidium infections. Continued communication to patrons is required to ensure healthy swimming practice in Victorian aquatic facilities.

  10. Innate immunity and non-Hodgkin's lymphoma (NHL related genes in a nested case-control study for gastric cancer risk.

    Directory of Open Access Journals (Sweden)

    Sue K Park

    Full Text Available OBJECTIVE: Genetic variants regulating the host immune system may contribute to the susceptibility for the development of gastric cancer. Little is known about the role of the innate immunity- and non-Hodgkin's lymphoma (NHL-related genes for gastric cancer risk. This nested case-control study was conducted to identify candidate genes for gastric cancer risk for future studies. METHODS: In the Discovery phase, 3,072 SNPs in 203 innate immunity- and 264 NHL-related genes using the Illumine GoldenGateTM OPA Panel were analyzed in 42 matched case-control sets selected from the Korean Multi-center Cancer Cohort (KMCC. Six significant SNPs in four innate immunity (DEFA6, DEFB1, JAK3, and ACAA1 and 11 SNPs in nine NHL-related genes (INSL3, CHMP7, BCL2L11, TNFRSF8, RAD50, CASP7, CHUK, CD79B, and CLDN9 with a permutated p-value <0.01 were re-genotyped in the Replication phase among 386 cases and 348 controls. Odds ratios (ORs for gastric cancer risk were estimated adjusting for age, smoking status, and H. pylori and CagA sero-positivity. Summarized ORs in the total study population (428 cases and 390 controls are presented using pooled- and meta-analyses. RESULTS: Four SNPS had no heterogeneity across the phases: in the meta-analysis, DEFA6 rs13275170 and DEFB1 rs2738169 had both a 1.3-fold increased odds ratio (OR for gastric cancer (95% CIs = 1.1-1.6; and 1.1-1.5, respectively. INSL3 rs10421916 and rs11088680 had both a 0.8-fold decreased OR for gastric cancer (95% CIs = 0.7-0.97; and 0.7-0.9, respectively. CONCLUSIONS: Our findings suggest that certain variants in the innate immunity and NHL-related genes affect the gastric cancer risk, perhaps by modulating infection-inflammation-immunity mechanisms that remain to be defined.

  11. 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...

  12. Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study.

    Science.gov (United States)

    Hirshberg, A; Levine, L D; Srinivas, S K

    2016-05-01

    To evaluate the association between mode of delivery and length of labor on readmission for postpartum hypertension in women with pregnancy-related hypertension. Nested case control study within a cohort of 99 women with pregnancy-related hypertension who delivered at our institution between 2005 and 2009. Data were abstracted for clinical and labor information. Mode of delivery and length of labor were compared between women with previously diagnosed pregnancy-related hypertension readmitted within 4 weeks post partum (25 cases) and those not readmitted (74 controls). Categorical and continuous variables were compared using χ(2) and T-tests, respectively. Multivariable logistic regression controlled for confounders. Hypertension readmission was not associated with mode of delivery (cases: 10(40%) spontaneous vaginal delivery, 15(60%) cesarean delivery; controls: 38(51%) spontaneous vaginal delivery, 36(49%) cesarean delivery, P=0.33). Length of labor appeared longer in cases, with a trend toward significance (median: 15.5 [7,28] h vs 10.75 [5.8,15.9] h, P=0.12) and was significantly associated with readmission after controlling for delivery mode, induction and parity (adjusted odds ratio=1.06 [1 to 1.12], P=0.048). Readmitted patients were less likely to have initially been started on antihypertensive medications after controlling for age, race and chronic hypertension (adjusted odds ratio=0.23 [0.06 to 0.88], P=0.03). Postpartum readmission for hypertension in women with known pregnancy-related hypertension is not associated with mode of delivery, appears increased in those with longer length of labor and decreased in those initially started on antihypertensive medications. This provides targets for future research to continue to improve transitions of care and reduce preventable readmissions.

  13. Internal control as part of prevention irregularities in accounting of budgetary institution

    Directory of Open Access Journals (Sweden)

    O.М. Bunda

    2016-07-01

    Full Text Available The article researches the principles of internal control, the importance, the rationale for the essence of the system of internal control and the legislative building in budgetary institution. It describes the main challenges and problems of practical application of internal control in the normal course of business in modern enterprises. It reveals the following elements of the internal control of a budget institution as: control environment, risk assessment process of a budget institution, information systems, control procedures and control monitoring. The dependence between the effectiveness of accounting and internal control of a budget institution is determined. The paper highlights the methods of evaluation of internal control of a budget institution. This method is recommended for use in the preliminary assessment of control risk budget institution. The concept of «decision» as on the whole and also in particular in internal control is covered. The essential grouping indications of internal control decisions are defined and every type of decisions is characterized. The main directions of improvement of internal control to prevent violations in accounting of a budgetary institution is examined.

  14. Institutional Control Program: Long Term Care and Control of Decommissioned Mine/Mill Sites Located on Crown Land

    International Nuclear Information System (INIS)

    Cunningham, K.

    2014-01-01

    Institutional Control Program: • Establishes an endpoint for mining company activities on sites located on Crown land; • Establishes funding for the long-term care and control of the closed sites; • Company responsibilities for sites under the Environmental Management and Protection Act remain; • Establishes an Institutional Control Registry; • Establishes an Institutional Control Monitoring and Maintenance Fund and an Institutional Control Unforeseen Events Fund

  15. Adaptation of Chain Event Graphs for use with Case-Control Studies in Epidemiology.

    Science.gov (United States)

    Keeble, Claire; Thwaites, Peter Adam; Barber, Stuart; Law, Graham Richard; Baxter, Paul David

    2017-09-26

    Case-control studies are used in epidemiology to try to uncover the causes of diseases, but are a retrospective study design known to suffer from non-participation and recall bias, which may explain their decreased popularity in recent years. Traditional analyses report usually only the odds ratio for given exposures and the binary disease status. Chain event graphs are a graphical representation of a statistical model derived from event trees which have been developed in artificial intelligence and statistics, and only recently introduced to the epidemiology literature. They are a modern Bayesian technique which enable prior knowledge to be incorporated into the data analysis using the agglomerative hierarchical clustering algorithm, used to form a suitable chain event graph. Additionally, they can account for missing data and be used to explore missingness mechanisms. Here we adapt the chain event graph framework to suit scenarios often encountered in case-control studies, to strengthen this study design which is time and financially efficient. We demonstrate eight adaptations to the graphs, which consist of two suitable for full case-control study analysis, four which can be used in interim analyses to explore biases, and two which aim to improve the ease and accuracy of analyses. The adaptations are illustrated with complete, reproducible, fully-interpreted examples, including the event tree and chain event graph. Chain event graphs are used here for the first time to summarise non-participation, data collection techniques, data reliability, and disease severity in case-control studies. We demonstrate how these features of a case-control study can be incorporated into the analysis to provide further insight, which can help to identify potential biases and lead to more accurate study results.

  16. Conflicting Multi-Objective Compatible Optimization Control

    OpenAIRE

    Xu, Lihong; Hu, Qingsong; Hu, Haigen; Goodman, Erik

    2010-01-01

    Based on ideas developed in addressing practical greenhouse environmental control, we propose a new multi-objective compatible control method. Several detailed algorithms are proposed to meet the requirements of different kinds of problem: 1) A two-layer MOCC framework is presented for problems with a precise model; 2) To deal with situations

  17. The Science Case for Multi-Object Spectroscopy on the European ELT

    NARCIS (Netherlands)

    Evans, Chris; Puech, Mathieu; Afonso, Jose; Almaini, Omar; Amram, Philippe; Aussel, Hervé; Barbuy, Beatriz; Basden, Alistair; Bastian, Nate; Battaglia, Giuseppina; Biller, Beth; Bonifacio, Piercarlo; Bouché, Nicholas; Bunker, Andy; Caffau, Elisabetta; Charlot, Stephane; Cirasuolo, Michele; Clenet, Yann; Combes, Francoise; Conselice, Chris; Contini, Thierry; Cuby, Jean-Gabriel; Dalton, Gavin; Davies, Ben; de Koter, Alex; Disseau, Karen; Dunlop, Jim; Epinat, Benoît; Fiore, Fabrizio; Feltzing, Sofia; Ferguson, Annette; Flores, Hector; Fontana, Adriano; Fusco, Thierry; Gadotti, Dimitri; Gallazzi, Anna; Gallego, Jesus; Giallongo, Emanuele; Gonçalves, Thiago; Gratadour, Damien; Guenther, Eike; Hammer, Francois; Hill, Vanessa; Huertas-Company, Marc; Ibata, Roridgo; Kaper, Lex; Korn, Andreas; Larsen, Søren; Le Fèvre, Olivier; Lemasle, Bertrand; Maraston, Claudia; Mei, Simona; Mellier, Yannick; Morris, Simon; Östlin, Göran; Paumard, Thibaut; Pello, Roser; Pentericci, Laura; Peroux, Celine; Petitjean, Patrick; Rodrigues, Myriam; Rodríguez-Muñoz, Lucía; Rouan, Daniel; Sana, Hugues; Schaerer, Daniel; Telles, Eduardo; Trager, Scott; Tresse, Laurence; Welikala, Niraj; Zibetti, Stefano; Ziegler, Bodo

    2015-01-01

    This White Paper presents the scientific motivations for a multi-object spectrograph (MOS) on the European Extremely Large Telescope (E-ELT). The MOS case draws on all fields of contemporary astronomy, from extra-solar planets, to the study of the halo of the Milky Way and its satellites, and from

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

    Science.gov (United States)

    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.

  19. Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study.

    Science.gov (United States)

    Buddingh, K Tim; Herngreen, Thomas; Haringsma, Jelle; van der Zwet, Wil C; Vleggaar, Frank P; Breumelhof, Ronald; Ter Borg, Frank

    2011-06-01

    Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor. The objective of this study was to determine whether polyp location is an independent risk factor for delayed post-polypectomy hemorrhage. A retrospective case-control study was conducted in two university hospitals and two community hospitals. Thirty-nine cases and 117 controls were identified. In multivariate analysis, size and location were found to be independent polyp-related risk factors for delayed type hemorrhage. The risk increased by 13% for every 1 mm increase in polyp diameter (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.05-1.20, Plocated in the right hemi-colon had an OR of 4.67 (1.88-11.61, P=0.001) for delayed hemorrhage. Polyps in the cecum seemed to be especially at high risk in univariate analysis (OR 13.82, 95% CI 2.66-71.73), but this could not be assessed in multivariate analysis as the number of cases was too small. Polyp type (sessile or pedunculated) was not a risk factor. Polyp location in the right hemi-colon seems to be an independent and substantial risk factor for delayed post-polypectomy hemorrhage. A low threshold for preventive hemostatic measures is advised when removing polyps from this region.

  20. Multi-faceted case management: reducing compensation costs of musculoskeletal work injuries in Australia.

    Science.gov (United States)

    Iles, Ross Anthony; Wyatt, M; Pransky, G

    2012-12-01

    This study aimed to determine whether a multi-faceted model of management of work related musculoskeletal disorders reduced compensation claim costs and days of compensation for injured workers. An intervention including early reporting, employee centred case management and removal of barriers to return to work was instituted in 16 selected companies with a combined remuneration over $337 million. Outcomes were evaluated by an administrative dataset from the Victorian WorkCover Authority database. A 'quasi experimental' pre-post design was employed with 492 matched companies without the intervention used as a control group and an average of 21 months of post-intervention follow-up. Primary outcomes were average number of days of compensation and average cost of claims. Secondary outcomes were total medical costs and weekly benefits paid. Information on 3,312 claims was analysed. In companies where the intervention was introduced the average cost of claims was reduced from $6,019 to $3,913 (estimated difference $2,329, 95 % CI $1,318-$3,340) and the number of days of compensation decreased from 33.5 to 14.1 (HR 0.77, 95 % CI 0.67-0.88). Medical costs and weekly benefits costs were also lower after the intervention (p costs were noted across industry types, injury location and most employer sizes. The model of claims management investigated was effective in reducing the number of days of compensation, total claim costs, total medical costs and the amount paid in weekly benefits. Further research should investigate whether the intervention improves non-financial outcomes in the return to work process.

  1. Risk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: a matched case-control study.

    Science.gov (United States)

    Ahn, Jin Young; Song, Je Eun; Kim, Min Hyung; Choi, Heun; Kim, Jae Kyung; Ann, Hea Won; Kim, Jung Ho; Jeon, Yongduk; Jeong, Su Jin; Kim, Sun Bean; Ku, Nam Su; Han, Sang Hoon; Song, Young Goo; Yong, Dongeun; Lee, Kyungwon; Kim, June Myung; Choi, Jun Yong

    2014-06-01

    Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE). We conducted a matched case-control study comprising 57 cases of acquisition of CRE and 114 controls (1:2 matched) selected from patients with a culture of carbapenem-susceptible E coli between January 2006 and December 2010 at a 2000-bed tertiary care center in South Korea. On univariate analysis, previous use of carbapenem (P carbapenem (odds ratio [OR], 4.56; 95% confidence interval [CI] 1.44-14.46; P = .01) and previous use of fluoroquinolone (OR, 2.81; 95% CI, 1.14-6.99; P = .03) were independent risk factors. At this institute, the antibiotic selective pressure of carbapenems and fluoroquinolones was shown to be an important risk factor for the acquisition of CRE. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Mental illness, poverty and stigma in India: a case-control study.

    Science.gov (United States)

    Trani, Jean-Francois; Bakhshi, Parul; Kuhlberg, Jill; Narayanan, Sreelatha S; Venkataraman, Hemalatha; Mishra, Nagendra N; Groce, Nora E; Jadhav, Sushrut; Deshpande, Smita

    2015-02-23

    To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. Matching case (hospital)-control (population) study. University Hospital (cases) and National Capital Region (controls), India. A case-control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Higher risk of poverty due to stigma among PSMI. 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from 'lower castes' were more likely to be poor due to stigma than male controls (ppoverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Decentralized control of multi-agent aerial transportation system

    KAUST Repository

    Toumi, Noureddine

    2017-04-01

    Autonomous aerial transportation has multiple potential applications including emergency cases and rescue missions where ground intervention may be difficult. In this context, the following work will address the control of multi-agent Vertical Take-off and Landing aircraft (VTOL) transportation system. We develop a decentralized method. The advantage of such a solution is that it can provide better maneuverability and lifting capabilities compared to existing systems. First, we consider a cooperative group of VTOLs transporting one payload. The main idea is that each agent perceive the interaction with other agents as a disturbance while assuming a negotiated motion model and imposing certain magnitude bounds on each agent. The theoretical model will be then validated using a numerical simulation illustrating the interesting features of the presented control method. Results show that under specified disturbances, the algorithm is able to guarantee the tracking with a minimal error. We describe a toolbox that has been developed for this purpose. Then, a system of multiple VTOLs lifting payloads will be studied. The algorithm assures that the VTOLs are coordinated with minimal communication. Additionally, a novel gripper design for ferrous objects is presented that enables the transportation of ferrous objects without a cable. Finally, we discuss potential connections to human in the loop transportation systems.

  4. Importance of Internal Audit and Internal Control in an organization - Case Study

    OpenAIRE

    Bubilek, Olga

    2017-01-01

    This research is a descriptive case study of a company. It presents concepts of the internal audit and internal control based on an example of a Finnish company. The research examines the role and importance that internal audit and internal controls have in an organization. The main research question is “What is the role and importance of internal audit and internal control in an organization” Additional sub-questions relating to the case company that will allow for better understanding of...

  5. Nutritional variables and work-related accidents: a case-control study.

    Science.gov (United States)

    de Medeiros, M A T; Zangirolani, Lia Thieme Oikawa; Cordeiro, Ricardo Carlos; da Costa, Proença Rossana Pacheco; Diez-Garcia, Rosa Wanda

    2014-01-01

    Nutritional aspects are important for the prevention of diseases and disorders, and few studies have focused on the relationship between risk of work injury and nutritional variables. This study aimed to verify whether nutritional variables constitute risk factors for work-related accidents. 1,422 industrial workers (600 cases plus 822 controls). A case-control study was carried out in an industrial city in south-east Brazil. A multiple logistic regression model was adjusted using work-related accidents as the response variable and nutritional variables as predictors. The associations were assessed by Odds Ratio (OR), with a p-value work-related accidents were (a) attending formal education for an above average number of years (OR=0.91, pwork-related accidents. This indicates the need, during the formulation of policies for these kinds of government benefits, to include nutrition aspects in order to minimize work-related accidents risks.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Comparison of two control groups for estimation of oral cholera vaccine effectiveness using a case-control study design.

    Science.gov (United States)

    Franke, Molly F; Jerome, J Gregory; Matias, Wilfredo R; Ternier, Ralph; Hilaire, Isabelle J; Harris, Jason B; Ivers, Louise C

    2017-10-13

    Case-control studies to quantify oral cholera vaccine effectiveness (VE) often rely on neighbors without diarrhea as community controls. Test-negative controls can be easily recruited and may minimize bias due to differential health-seeking behavior and recall. We compared VE estimates derived from community and test-negative controls and conducted bias-indicator analyses to assess potential bias with community controls. From October 2012 through November 2016, patients with acute watery diarrhea were recruited from cholera treatment centers in rural Haiti. Cholera cases had a positive stool culture. Non-cholera diarrhea cases (test-negative controls and non-cholera diarrhea cases for bias-indicator analyses) had a negative culture and rapid test. Up to four community controls were matched to diarrhea cases by age group, time, and neighborhood. Primary analyses included 181 cholera cases, 157 non-cholera diarrhea cases, 716 VE community controls and 625 bias-indicator community controls. VE for self-reported vaccination with two doses was consistent across the two control groups, with statistically significant VE estimates ranging from 72 to 74%. Sensitivity analyses revealed similar, though somewhat attenuated estimates for self-reported two dose VE. Bias-indicator estimates were consistently less than one, with VE estimates ranging from 19 to 43%, some of which were statistically significant. OCV estimates from case-control analyses using community and test-negative controls were similar. While bias-indicator analyses suggested possible over-estimation of VE estimates using community controls, test-negative analyses suggested this bias, if present, was minimal. Test-negative controls can be a valid low-cost and time-efficient alternative to community controls for OCV effectiveness estimation and may be especially relevant in emergency situations. Copyright © 2017. Published by Elsevier Ltd.

  8. A multi-disciplinary approach to study coastal complex landslides: the case of Torino di Sangro (Central Italy)

    Science.gov (United States)

    Sciarra, Marco; Carabba, Luigi; Urbano, Tullio; Calista, Monia

    2016-04-01

    This work illustrates the studies carried out on a complex landslide phenomenon between the Sangro and Osento River's mouths, near Torino di Sangro village in Southern Abruzzo Region (Italy). Historical activity of this landslide is well-documented since 1916; the activation/reactivation of the movements caused several interruptions of a national railway and the damage of few houses. The Torino di Sangro case study can be regarded as representative of many large landslides distributed along the central Adriatic coast (e.g., Ancona, Ortona, Vasto and Petacciato Landslides) that affect densely populated urban areas with a large amount of man-made infrastructure. The main controlling factors of these large and deep-seated landslides are still debated. From the geological and geomorphological viewpoint, the central Adriatic coast is characterized by a low-relief landscape (mesa) carved on clay-sandstone-conglomerate bedrock belonging to the Upper Pliocene - Lower Pleistocene marine deposits and locally to the Middle Pleistocene marine to continental transitional deposits. This high coast is widely affected by slope instability (rock falls, rotational, complex and shallow landslides) on both active and inactive sea cliffs, the first being mainly affected by wave-cut erosion and the latter influenced by heavy rainfall and changes of pore pressure. The main landslide has the typical characteristics of a deep-seated gravitation deformation. The landslide study was based on a multidisciplinary approach including: 1) definition and GIS mapping of geology and geomorphology factors (slope, aspect, topographic curvature, bedrock lithology, near-surface deposits, deposit thickness and land use), by means of DTM processing, multi-temporal analysis, and large-scale geomorphological field survey; 2) monitoring system in the landslide; 3) application of empiric models for the analysis of unstable sandstone-conglomerate escarpments; 4) slope stability analysis performed using a

  9. High risk human papillomavirus in the periodontium : A case control study

    Directory of Open Access Journals (Sweden)

    Anna Shipilova

    2017-01-01

    Full Text Available Background: Human papilloma viruses (HPVs are small DNA viruses that have been identified in periodontal pocket as well as gingival sulcus. High risk HPVs are also associated with a subset of head and neck carcinomas. It is thought that the periodontium could be a reservoir for HPV. Aims: 1. Detection of Human Papilloma virus (HPV in periodontal pocket as well as gingival of patients having localized chronic periodontitis and gingival sulcus of periodontally healthy subjects. 2. Quantitative estimation of E6 and E7 mRNA in subjects showing presence of HPV3. To assess whether periodontal pocket is a reservoir for HPV. Settings and Design: This case-control study included 30 subjects with localized chronic Periodontitis (cases and 30 periodontally healthy subjects (controls. Two samples were taken from cases, one from periodontal pocket and one from gingival sulcus and one sample was taken from controls. Methods and Materials: Samples were collected in the form of pocket scrapings and gingival sulcus scrapings from cases and controls respectively. These samples were sent in storage media for identification and estimation of E6/E7 mRNA of HPV using in situ hybridization and flow cytometry. Statistical analysis: Statistical analysis was done by using, mean, percentage and Chi Square test. A statistical package SPSS version 13.0 was used to analyze the data. P value < 0.05 was considered as statistically significant. Results: pocket samples as well as sulcus samples for both cases and controls were found to contain HPV E6/E7 mRNAInterpretation and Conclusion: Presence of HPV E6/E7 mRNA in periodontium supports the hypothesis that periodontal tissues serve as a reservoir for latent HPV and there may be a synergy between oral cancer, periodontitis and HPV. However prospective studies are required to further explore this link.

  10. Modalities of Generalization Through Single Case Studies.

    Science.gov (United States)

    Zittoun, Tania

    2017-06-01

    The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

  11. 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.

  12. Psychiatric morbidity in psoriasis: A case-control study

    Directory of Open Access Journals (Sweden)

    Sunil Goyal

    2017-01-01

    Full Text Available Objective: Psoriasis is a chronic, relapsing and disfiguring dermatological disorder with a significant effect on occupational, social, and other areas of functioning. Psychological stress has been known to have a significant role in the onset and exacerbation of this illness. To study the prevalence of psychiatric morbidity in psoriasis and the influence of specified demographic, psychological, social and illness-related variables. Methods: The study was carried out at a tertiary care hospital in a large urban setup. In this case–control study, 100 cases of psoriasis were studied in comparison with healthy controls who were matched for sociodemographic profile. The participants were given a sociodemographic questionnaire, clinical profile sheet, and psoriasis area and severity index (PASI. General Health Questionnaire-12 (GHQ-12 was used to screen for psychological distress, and subsequently, Hospital Anxiety and Depression Scale for screening for depression and anxiety and World Health Organization Quality of Life-BREF scale for assessing the quality of life (QOL were administered. The results obtained were analyzed for evaluating the psychiatric morbidity and its various correlates. Appropriate statistical analysis was done using SPSS 21. Results: Using GHQ-12 cutoff score (≥3 for psychological distress, the overall prevalence of psychological distress was significantly more in cases of in comparison to healthy controls with an odds ratio of 8.54 (95% confidence interval 3.16–23.07, P < 0.0001. Statistical analysis showed a statistically significant correlation of educational status with QOL and severity of skin lesions (PASI with anxiety level. Severe skin lesions, more so on visible body parts were associated more commonly with psychological distress. Conclusions: All patients of psoriasis should be educated about the nature of the illness and screened for psychological distress. Dermatologists and family members should be educated to

  13. Selection of controls in case-control studies on maternal medication use and risk of birth defects

    NARCIS (Netherlands)

    Bakker, M.K.; de Walle, H.E.; Dequito, A.; van den Berg, P.B.; de Jong-van den Berg, L.T.

    BACKGROUND:: In case-control studies on teratogenic risks of maternal drug use during pregnancy, the use of normal or malformed controls may lead to recall-bias or selection bias. This can be avoided by using controls with a genetic disorder. However, researchers are hesitant to use these as

  14. Risk factors for cataract: A case control study

    Directory of Open Access Journals (Sweden)

    Ughade Suresh

    1998-01-01

    Full Text Available The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES, illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI, use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.

  15. Multi-Model Adaptive Fuzzy Controller for a CSTR Process

    Directory of Open Access Journals (Sweden)

    Shubham Gogoria

    2015-09-01

    Full Text Available Continuous Stirred Tank Reactors are intensively used to control exothermic reactions in chemical industries. It is a very complex multi-variable system with non-linear characteristics. This paper deals with linearization of the mathematical model of a CSTR Process. Multi model adaptive fuzzy controller has been designed to control the reactor concentration and temperature of CSTR process. This method combines the output of multiple Fuzzy controllers, which are operated at various operating points. The proposed solution is a straightforward implementation of Fuzzy controller with gain scheduler to control the linearly inseparable parameters of a highly non-linear process.

  16. The Influence of Game Design on the Collaborative Problem Solving Process: A Cross-Case Study of Multi-Player Collaborative Gameplay Analysis

    Science.gov (United States)

    Yildirim, Nilay

    2013-01-01

    This cross-case study examines the relationships between game design attributes and collaborative problem solving process in the context of multi-player video games. The following game design attributes: sensory stimuli elements, level of challenge, and presentation of game goals and rules were examined to determine their influence on game…

  17. A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

    Science.gov (United States)

    Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

    2017-09-01

    An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.

  18. Layered Multi-mode Optimal Control Strategy for Multi-MW Wind Turbine

    Institute of Scientific and Technical Information of China (English)

    KONG Yi-gang; WANG Zhi-xin

    2008-01-01

    The control strategy is one of the most important renewable technology, and an increasing number of multi-MW wind turbines are being developed with a variable speed-variable pitch (VS-VP) technology. The main objective of adopting a VS-VP technology is to improve the fast response speed and capture maximum energy. But the power generated by wind turbine changes rapidly because of the centinuous fluctuation of wind speed and direction. At the same time, wind energy conversion systems are of high order, time delays and strong nonlinear characteristics because of many uncertain factors. Based on analyzing the all dynamic processes of wind turbine, a kind of layered multi-mode optimal control strategy is presented which is that three control strategies: bang-bang, fuzzy and adaptive proportienai integral derivative (PID) are adopted according to different stages and expected performance of wind turbine to capture optimum wind power, compensate the nonlinearity and improve the wind turbine performance at low, rated and high wind speed.

  19. Multi-angle Indicators System of Non-point Pollution Source Assessment in Rural Areas: A Case Study Near Taihu Lake

    Science.gov (United States)

    Huang, Lei; Ban, Jie; Han, Yu Ting; Yang, Jie; Bi, Jun

    2013-04-01

    This study aims to identify key environmental risk sources contributing to water eutrophication and to suggest certain risk management strategies for rural areas. The multi-angle indicators included in the risk source assessment system were non-point source pollution, deficient waste treatment, and public awareness of environmental risk, which combined psychometric paradigm methods, the contingent valuation method, and personal interviews to describe the environmental sensitivity of local residents. Total risk values of different villages near Taihu Lake were calculated in the case study, which resulted in a geographic risk map showing which village was the critical risk source of Taihu eutrophication. The increased application of phosphorus (P) and nitrogen (N), loss vulnerability of pollutant, and a lack of environmental risk awareness led to more serious non-point pollution, especially in rural China. Interesting results revealed by the quotient between the scores of objective risk sources and subjective risk sources showed what should be improved for each study village. More environmental investments, control of agricultural activities, and promotion of environmental education are critical considerations for rural environmental management. These findings are helpful for developing targeted and effective risk management strategies in rural areas.

  20. Knowledge-driven institutional change: an empirical study on combating desertification in northern China from 1949 to 2004.

    Science.gov (United States)

    Yang, Lihua; Wu, Jianguo

    2012-11-15

    Understanding institutional changes is crucial for environmental management. Here we investigated how institutional changes influenced the process and result of desertification control in northern China between 1949 and 2004. Our analysis was based on a case study of 21 field sites and a meta-analysis of additional 29 sites reported in the literature. Our results show that imposed knowledge-driven institutional change was often perceived as a more progressive, scientific, and rational type of institutional change by entrepreneurs, scholars, experts, and technicians, while voluntary, knowledge-driven institutional change based on indigenous knowledge and experiences of local populations was discouraged. Our findings also demonstrate that eight working rules of imposed knowledge-driven institutional change can be applied to control desertification effectively. These rules address the issues of perception of potential gains, entrepreneurs' appeals and support, coordination of multiple goals, collaboration among multiple organizations, interest distribution and conflict resolution, incremental institutional change, external intervention, and coordination among the myriad institutions involved. Imposed knowledge-driven institutional change tended to be more successful when these rules were thoroughly implemented. These findings provide an outline for implementing future institutional changes and policy making to combat desertification and other types of ecological and environmental management. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. 10 CFR 61.63 - Financial assurances for institutional controls.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Financial assurances for institutional controls. 61.63... RADIOACTIVE WASTE Financial Assurances § 61.63 Financial assurances for institutional controls. (a) Prior to... the Commission to ensure that changes in inflation, technology and disposal facility operations are...

  2. 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

  3. 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....

  4. Greenidge Multi-Pollutant Control Project

    Energy Technology Data Exchange (ETDEWEB)

    Connell, Daniel

    2008-10-18

    The Greenidge Multi-Pollutant Control Project was conducted as part of the U.S. Department of Energy's Power Plant Improvement Initiative to demonstrate an innovative combination of air pollution control technologies that can cost-effectively reduce emissions of SO{sub 2}, NO{sub x}, Hg, acid gases (SO{sub 3}, HCl, and HF), and particulate matter from smaller coal-fired electric generating units (EGUs). There are about 400 units in the United States with capacities of 50-300 MW that currently are not equipped with selective catalytic reduction (SCR), flue gas desulfurization (FGD), or mercury control systems. Many of these units, which collectively represent more than 55 GW of installed capacity, are difficult to retrofit for deep emission reductions because of space constraints and unfavorable economies of scale, making them increasingly vulnerable to retirement or fuel switching in the face of progressively more stringent environmental regulations. The Greenidge Project sought to confirm the commercial readiness of an emissions control system that is specifically designed to meet the environmental compliance requirements of these smaller coal-fired EGUs by offering a combination of deep emission reductions, low capital costs, small space requirements, applicability to high-sulfur coals, mechanical simplicity, and operational flexibility. The multi-pollutant control system includes a NO{sub x}OUT CASCADE{reg_sign} hybrid selective non-catalytic reduction (SNCR)/in-duct SCR system for NO{sub x} control and a Turbosorp{reg_sign} circulating fluidized bed dry scrubbing system (with a new baghouse) for SO{sub 2}, SO{sub 3}, HCl, HF, and particulate matter control. Mercury removal is provided as a co-benefit of the in-duct SCR, dry scrubber, and baghouse, and by injection of activated carbon upstream of the scrubber, if required. The multi-pollutant control system was installed and tested on the 107-MW{sub e}, 1953-vintage AES Greenidge Unit 4 by a team including

  5. Can iridology detect susceptibility to cancer? A prospective case-controlled study.

    Science.gov (United States)

    Münstedt, Karsten; El-Safadi, Samer; Brück, Friedel; Zygmunt, Marek; Hackethal, Andreas; Tinneberg, Hans-Rudolf

    2005-06-01

    This prospective case-control study aimed to investigate the value of iridology as a diagnostic tool in detecting some common cancers. One hundred ten (110) subjects were enrolled in the study: 68 subjects had histologically proven cancers of the breast, ovary, uterus, prostate, or colorectum, and 42 were control subjects. All subjects were examined by an experienced practitioner of iridology, who was unaware of their gender or medical details. He was allowed to suggest up to five diagnoses for each subject and his results were then compared with each subject's medical diagnosis to determine the accuracy of iridology in detecting malignancy. Iridology identified the correct diagnosis in only 3 cases (sensitivity, 0.04). Iridology was of no value in diagnosing the cancers investigated in this study.

  6. A population-based case-control study of occupation and renal cell carcinoma risk in Iowa.

    Science.gov (United States)

    Zhang, Yawei; Cantor, Kenneth P; Lynch, Charles F; Zheng, Tongzhang

    2004-03-01

    A case-control study involving 406 incident cases and 2,434 controls was conducted in Iowa to examine the association between occupational exposures and renal cell carcinoma risk. After adjusting for major confounders, an increased risk was observed for men among mechanics and repairers (odds ratio [OR] 1.9, 95% confidence interval [CI] = 1.2-2.9); assemblers (OR 2.5, 95% CI = 0.8-7.6); automotive dealership and service station employees (OR 1.9, 95% CI = 0.9-3.9); wholesale traders of durable goods (OR 1.5, 95% CI = 0.7-3.2); farm product vendors (OR 4.4, 95% CI = 1.3-15.5); service organization managers (OR 2.2, 95% CI = 1.0-5.1); financial specialists (OR 2.7, 95% CI = 1.0-7.6); sales occupation supervisors (OR 1.8, 95% CI = 1.0-3.3); guards (OR 5.4, 95% CI = 1.4-20.7); and general farm workers (OR 1.9, 95% CI = 1.0-3.7). Among women, an increased risk was found for employees in depository institutions (OR 3.6, 95% CI = 1.1-11.3); colleges and universities (OR 7.6-95% CI = 2.3-25.6); and retail, including those in grocery stores (OR 2.2, 95% CI = 1.0-4.7). Our results indicate that occupational exposures may increase the risk of renal cell carcinoma.

  7. Modified metabolic syndrome and second cancers in women: A case control study.

    Science.gov (United States)

    Ortiz-Mendoza, Carlos-Manuel; Pérez-Chávez, Ernesto; Fuente-Vera, Tania-Angélica De-la

    2016-01-01

    According to some studies, the metabolic syndrome causes diverse primary cancers; however, there is no evidence about metabolic syndrome impact on second cancers development in women. To find out the implication of the modified metabolic syndrome in women with second cancers. This was a case-control study, at a general hospital in Mexico City, in women with second cancers (cases) and age-matched women with only one neoplasm (controls). The analysis comprised: Tumor (s), anthropometric features, and body mass index (BMI); moreover, presence of diabetes mellitus, hypertension, and fasting serum levels of total cholesterol, triglycerides and glucose. The sample was of nine cases and 27 controls. In cases, the metabolic syndrome (diabetes mellitus or glucose > 99 mg/dL + hypertension or blood pressure ≥ 135/85 mm Hg + triglycerides > 149 mg/dL or BMI ≥ 30 kg/m 2 ) was more frequent (odds ratio 20.8, 95% confidence interval: 1.9-227.1). Our results suggest that in women, the modified metabolic syndrome may be a risk factor for second cancers.

  8. Modified metabolic syndrome and second cancers in women: A case control study

    Directory of Open Access Journals (Sweden)

    Carlos-Manuel Ortiz-Mendoza

    2016-01-01

    Full Text Available Background: According to some studies, the metabolic syndrome causes diverse primary cancers; however, there is no evidence about metabolic syndrome impact on second cancers development in women. Aim: To find out the implication of the modified metabolic syndrome in women with second cancers. Materials and Methods: This was a case-control study, at a general hospital in Mexico City, in women with second cancers (cases and age-matched women with only one neoplasm (controls. The analysis comprised: Tumor (s, anthropometric features, and body mass index (BMI; moreover, presence of diabetes mellitus, hypertension, and fasting serum levels of total cholesterol, triglycerides and glucose. Results: The sample was of nine cases and 27 controls. In cases, the metabolic syndrome (diabetes mellitus or glucose > 99 mg/dL + hypertension or blood pressure ≥ 135/85 mm Hg + triglycerides > 149 mg/dL or BMI ≥ 30 kg/m 2 was more frequent (odds ratio 20.8, 95% confidence interval: 1.9-227.1. Conclusion: Our results suggest that in women, the modified metabolic syndrome may be a risk factor for second cancers.

  9. Adipokines as Possible New Predictors of Cardiovascular Diseases: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Laura Pala

    2012-01-01

    Full Text Available Background and Aims. The secretion of several adipocytokines, such as adiponectin, retinol-binding protein 4 (RBP4, adipocyte fatty acid binding protein (aFABP, and visfatin, is altered in subjects with abdominal adiposity; these endocrine alterations could contribute to increased cardiovascular risk. The aim of the study was to assess the relationship among adiponectin, RBP4, aFABP, and visfatin, and incident cardiovascular disease. Methods and Results. A case-control study, nested within a prospective cohort, on 2945 subjects enrolled for a diabetes screening program was performed. We studied 18 patients with incident fatal or nonfatal IHD (Ischemic Heart Disease or CVD (Cerebrovascular Disease, compared with 18 matched control subjects. Circulating adiponectin levels were significantly lower in cases of IHD with respect to controls. Circulating RBP4 levels were significantly increased in CVD and decreased in IHD with respect to controls. Circulating aFABP4 levels were significantly increased in CVD, while no difference was associated with IHD. Circulating visfatin levels were significantly lower in cases of both CVD and IHD with respect to controls, while no difference was associated with CVD. Conclusions. The present study confirms that low adiponectin is associated with increased incidents of IHD, but not CVD, and suggests, for the first time, a major effect of visfatin, aFABP, and RBP4 in the development of cardiovascular disease.

  10. An Epidemiological Study of Accidents in a Construction Industry: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Malakouti J.

    2013-01-01

    Full Text Available Background and Objectives: Despite science and technology development and their application in various industries, accidents continue to occur in many workplaces. This study was designed and carried out with the aim of epidemiological survey of accident among workers of a tunneling industry.Methods: This study was conducted on 144 out of a total of 440 employees of a tunneling project who were at risk of occupational accidents. 48 workers with a history of occupational accident over the past two years were selected as case group and 96 workers of the same project were selected as control group. The data were collected through a designed checklist and analyzed using logistic regression, chi-square and independent t tests.Results: A significant association was observed between accident rate and different age groups (p<0.05. There was a significant relationship (p=0.016 in the case of sport activities between case and control groups, and significant relationships were observed between two groups regarding education (p=0.057 and smoking (p=0.06, but there was no significant relationships between accident occurrence with marital status, residence in workplace, job related education, job experience, chronic diseases and obesity.Conclusion: The results of this study clarify the necessity of the use of epidemiological data in preventive and control measures in workplaces. Therefore, Developing programs for determination of physical and mental capacity of workers are essential to employ them in jobs commensurate with their abilities, especially in older workers.

  11. A case-control study of Yersinia enterocolitica infections in Auckland.

    Science.gov (United States)

    Satterthwaite, P; Pritchard, K; Floyd, D; Law, B

    1999-10-01

    To identify major risk factors for Yersinia enterocolitica (YE) and identify measures to reduce YE infections. A prospective case control study, group age matched, using 186 cases of YE identified by community pathology laboratories and 379 randomly selected controls. Conducted between April 1995 and June 1996 in Auckland, New Zealand. Face-to-face interviews used a standardised questionnaire examining exposures to factors potentially associated with YE infections including untreated water, unreticulated sewerage, consumption of selected foods, selected food handling practices and socio-demographic factors. Multivariate logistic regression was used to calculate adjusted odds ratios for the potential risk factors. Population attributable risk (PAR) was calculated for significant exposures. Having more than two people living in the home was more common among cases than controls (OR = 2.2). Town supply water (OR = 0.2), reticulated sewerage (OR = 0.34) and looking after a young child (OR = 0.51) were significantly less common. Of the meats, only pork (OR = 1.34) had a higher consumption rate, while bacon (OR = 0.75) and smallgoods (OR = 0.73) were consumed less frequently by cases than controls. Eating food from a sandwich bar was more frequent among cases (OR = 1.18). Fruit and vegetable consumption was marginally less (OR = 0.98). The population attributable risk of these factors was 0.89, implying that 89% of YE would be eliminated if adverse exposures were removed. The risk of YE illness is increased by contact with untreated water, unreticulated sewerage and consumption of pork. Investigation of non-town water supply, informal sewerage systems and methods of preparation and consumption of pork are recommended to determine how YE enters the human food chain.

  12. Externalizing behavior and impulsivity in the children of alcoholics: A case-control study

    Directory of Open Access Journals (Sweden)

    Ayyanar Sugaparaneetharan

    2016-01-01

    Full Text Available Context: Reduced behavioural inhibition, characterized by impulsivity and disruptive behaviour disorders, has been identified as a developmental precursor of alcoholism with a considerable genetic component. Aims: The present study aimed to assess whether children of fathers with alcohol dependence have high impulsivity and externalizing behaviours. Setting and Design: Observational case-control study, done in a tertiary care teaching hospital of Southern India. Materials and Methods: The present case-control study recruited 50 children aged 7 to 14 years of fathers with alcohol dependence and 50 age- and gender-matched children of fathers without alcohol dependence. The two groups were compared using the DSM-IV-TR criteria for ADHD, the Barratt Impulsivity Scale (BIS and the Child Behaviour Checklist (CBCL. Statistical Analysis Used: Descriptive statistics used to summarise the study findings. Cases and controls were compared on BIS and CBCL scores using a general linear model (GLM. All analyses were two tailed and test P value <0.05 was considered significant. Results: The children of fathers with alcohol dependence were more likely to meet criteria for ADHD (30% versus 10%, χ2 = 6.250, P = 0.012. After controlling for age and gender, impulsivity scores on the BIS tended to be higher in the cases (F = 2.410, P = 0.055 than controls, mainly in the non-planning domains (F = 3.650, P = 0.008. Similarly, externalizing behaviours on CBCL were more common in the cases than controls (F = 2.817, P = 0.029. Conclusions: Children of fathers with alcohol dependence had greater impulsivity and externalizing behaviours. This may represent a behavioural phenotype as well as a potential target for early intervention.

  13. Family control, institutional environment and cash dividend policy: Evidence from China

    Directory of Open Access Journals (Sweden)

    Zhihua Wei

    2011-06-01

    Full Text Available Using a sample of 1486 Chinese A-share listed companies for the period 2004–2008, this study empirically tests the impact of family control, institutional environment and their interaction on the cash dividend policy of listed companies. Our results indicate that (1 family firms have a lower cash dividend payout ratio and propensity to pay dividends than non-family firms; (2 a favorable regional institutional environment has a significant positive impact on the cash dividend payout ratio and propensity to pay dividends of listed companies; and (3 the impact of the regional institutional environment on cash dividends is stronger in family firms than in non-family firms. Somewhat surprisingly, we find that controlling family shareholders in China may intensify Agency Problem I (the owner–manager conflict rather than Agency Problem II (the controlling shareholder–minority shareholder conflict, and thus have a significant negative impact on cash dividend policy. In contrast, a favorable regional institutional environment plays a positive corporate governance role in mitigating Agency Problem I and encouraging family firms to pay cash dividends.

  14. A case-control study of airways obstruction among construction workers.

    Science.gov (United States)

    Dement, John; Welch, Laura; Ringen, Knut; Quinn, Patricia; Chen, Anna; Haas, Scott

    2015-10-01

    While smoking is the major cause of chronic obstructive pulmonary disease (COPD), occupational exposures to vapors, gases, dusts, and fumes (VGDF) increase COPD risk. This case-control study estimated the risk of COPD attributable to occupational exposures among construction workers. The study population included 834 cases and 1243 controls participating in a national medical screening program for older construction workers between 1997 and 2013. Qualitative exposure indices were developed based on lifetime work and exposure histories. Approximately 18% (95% CI = 2-24%) of COPD risk can be attributed to construction-related exposures, which are additive to the risk contributed by smoking. A measure of all VGDF exposures combined was a strong predictor of COPD risk. Construction workers are at increased risk of COPD as a result of broad and complex effects of many exposures acting independently or interactively. Control methods should be implemented to prevent worker exposures, and smoking cessation should be promoted. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

  15. Clinical implications of antiretroviral drug interactions with warfarin: a case-control study.

    Science.gov (United States)

    Esterly, John S; Darin, Kristin M; Gerzenshtein, Lana; Othman, Fidah; Postelnick, Michael J; Scarsi, Kimberly K

    2013-06-01

    Warfarin, a frequently prescribed anticoagulant with a narrow therapeutic index, is susceptible to drug-drug interactions with antiretroviral therapy (ART). This study compared the warfarin maintenance dose (WMD) between patients receiving and not receiving ART and evaluated predictors of warfarin dosage among those on ART. This was a case-control (1:2) study. Cases were HIV-infected patients receiving warfarin and protease inhibitor (PI)- and/or non-nucleoside reverse transcriptase inhibitor (NNRTI)-based ART. Controls were randomly selected HIV-uninfected patients receiving warfarin. The WMD was compared between cases and controls and between cases on varying ART regimens. Bivariate comparisons were performed and a linear regression model was developed to identify predictors of WMD. We identified 18 case and 36 control patients eligible for inclusion. Cases were younger than controls (mean age: 45.8 versus 63.1 years, P African American (50.0% versus 22.2%, P=0.04). ART was classified as PI-based (n=9), NNRTI-based (n=7) and PI + NNRTI-based (n=2). The WMD (mean ± SD) differed between cases and controls (8.6  ±  3.4 mg versus 5.1 ± 1.5 mg, P ART regimens (PI: 8.8  ±  4.5 mg; NNRTI: 8.6   ± 1.8 mg; PI + NNRTI: 7.3  ±  3.3 mg; P = 0.86). Race and ritonavir dose were independent predictors of WMD, predicting an increase of 3.9 mg (95% CI: 0.88-6.98, P = 0.02) if a patient was African American or 3.7 mg (95% CI: 0.53-6.89, P = 0.03) if the total daily ritonavir dose was 200 mg. The required WMD was significantly higher in patients receiving ART. Prompt dose titration to achieve a higher WMD with vigilant monitoring may be required due to these drug-drug interactions.

  16. On estimation of time-dependent attributable fraction from population-based case-control studies.

    Science.gov (United States)

    Zhao, Wei; Chen, Ying Qing; Hsu, Li

    2017-09-01

    Population attributable fraction (PAF) is widely used to quantify the disease burden associated with a modifiable exposure in a population. It has been extended to a time-varying measure that provides additional information on when and how the exposure's impact varies over time for cohort studies. However, there is no estimation procedure for PAF using data that are collected from population-based case-control studies, which, because of time and cost efficiency, are commonly used for studying genetic and environmental risk factors of disease incidences. In this article, we show that time-varying PAF is identifiable from a case-control study and develop a novel estimator of PAF. Our estimator combines odds ratio estimates from logistic regression models and density estimates of the risk factor distribution conditional on failure times in cases from a kernel smoother. The proposed estimator is shown to be consistent and asymptotically normal with asymptotic variance that can be estimated empirically from the data. Simulation studies demonstrate that the proposed estimator performs well in finite sample sizes. Finally, the method is illustrated by a population-based case-control study of colorectal cancer. © 2017, The International Biometric Society.

  17. The outcome of a multi-centre feasibility study of online adaptive radiotherapy for muscle-invasive bladder cancer TROG 10.01 BOLART

    International Nuclear Information System (INIS)

    Foroudi, Farshad; Pham, Daniel; Rolfo, Aldo; Bressel, Mathias; Tang, Colin I.; Tan, Alex; Turner, Sandra; Hruby, George; Williams, Stephen; Hayne, Dickon; Lehman, Margot; Skala, Marketa; Jose, Chakiath C.; Gogna, Kumar; Kron, Tomas

    2014-01-01

    Purpose: To assess whether online adaptive radiotherapy for bladder cancer is feasible across multiple Radiation Oncology departments using different imaging, delivery and recording technology. Materials and methods: A multi-centre feasibility study of online adaptive radiotherapy, using a choice of three “plan of the day”, was conducted at 12 departments. Patients with muscle-invasive bladder cancer were included. Departments were activated if part of the pilot study or after a site-credentialing visit. There was real time review of the first two cases from each department. Results: 54 patients were recruited, with 50 proceeding to radiotherapy. There were 43 males and 7 females with a mean age of 78 years. The tumour stages treated included T1 (1 patient), T2 (35), T3 (10) and T4 (4). One patient died of an unrelated cause during radiotherapy. The three adaptive plans were created before the 10th fraction in all cases. In 8 (16%) of the patients, a conventional plan using a ‘standard’ CTV to PTV margin of 1.5 cm was used for one or more fractions where the pre-treatment bladder CTV was larger than any of the three adaptive plans. The bladder CTV extended beyond the PTV on post treatment imaging in 9 (18%) of the 49 patients. Conclusions: From a technical perspective an online adaptive radiotherapy technique can be instituted in a multi-centre setting. However, without further bladder filling control or imaging, a CTV to PTV margin of 7 mm is insufficient

  18. Formalization, implementation, and modeling of institutional controllers for distributed robotic systems.

    Science.gov (United States)

    Pereira, José N; Silva, Porfírio; Lima, Pedro U; Martinoli, Alcherio

    2014-01-01

    The work described is part of a long term program of introducing institutional robotics, a novel framework for the coordination of robot teams that stems from institutional economics concepts. Under the framework, institutions are cumulative sets of persistent artificial modifications made to the environment or to the internal mechanisms of a subset of agents, thought to be functional for the collective order. In this article we introduce a formal model of institutional controllers based on Petri nets. We define executable Petri nets-an extension of Petri nets that takes into account robot actions and sensing-to design, program, and execute institutional controllers. We use a generalized stochastic Petri net view of the robot team controlled by the institutional controllers to model and analyze the stochastic performance of the resulting distributed robotic system. The ability of our formalism to replicate results obtained using other approaches is assessed through realistic simulations of up to 40 e-puck robots. In particular, we model a robot swarm and its institutional controller with the goal of maintaining wireless connectivity, and successfully compare our model predictions and simulation results with previously reported results, obtained by using finite state automaton models and controllers.

  19. Improving digital breast tomosynthesis reading time: A pilot multi-reader, multi-case study using concurrent Computer-Aided Detection (CAD).

    Science.gov (United States)

    Balleyguier, Corinne; Arfi-Rouche, Julia; Levy, Laurent; Toubiana, Patrick R; Cohen-Scali, Franck; Toledano, Alicia Y; Boyer, Bruno

    2017-12-01

    Evaluate concurrent Computer-Aided Detection (CAD) with Digital Breast Tomosynthesis (DBT) to determine impact on radiologist performance and reading time. The CAD system detects and extracts suspicious masses, architectural distortions and asymmetries from DBT planes that are blended into corresponding synthetic images to form CAD-enhanced synthetic images. Review of CAD-enhanced images and navigation to corresponding planes to confirm or dismiss potential lesions allows radiologists to more quickly review DBT planes. A retrospective, crossover study with and without CAD was conducted with six radiologists who read an enriched sample of 80 DBT cases including 23 malignant lesions in 21 women. Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) compared the readings with and without CAD to determine the effect of CAD on overall interpretation performance. Sensitivity, specificity, recall rate and reading time were also assessed. Multi-reader, multi-case (MRMC) methods accounting for correlation and requiring correct lesion localization were used to analyze all endpoints. AUCs were based on a 0-100% probability of malignancy (POM) score. Sensitivity and specificity were based on BI-RADS scores, where 3 or higher was positive. Average AUC across readers without CAD was 0.854 (range: 0.785-0.891, 95% confidence interval (CI): 0.769,0.939) and 0.850 (range: 0.746-0.905, 95% CI: 0.751,0.949) with CAD (95% CI for difference: -0.046,0.039), demonstrating non-inferiority of AUC. Average reduction in reading time with CAD was 23.5% (95% CI: 7.0-37.0% improvement), from an average 48.2 (95% CI: 39.1,59.6) seconds without CAD to 39.1 (95% CI: 26.2,54.5) seconds with CAD. Per-patient sensitivity was the same with and without CAD (0.865; 95% CI for difference: -0.070,0.070), and there was a small 0.022 improvement (95% CI for difference: -0.046,0.089) in per-lesion sensitivity from 0.790 without CAD to 0.812 with CAD. A slight reduction in specificity with a -0

  20. Sexual Dysfunction in Breast Cancer: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Mandana Ebrahimi

    2015-02-01

    Full Text Available Background: Sexual dysfunction in breast cancer patients is considered as a common and distressing problem. Considering the increasing number of breast cancer survivors living for longer periods of time with the disease and the importance of their quality of life, we conducted the present study to compare the sexual functioning in breast cancer patients with their healthy counterparts.Methods: In this case-control study, breast cancer patients who completed their treatment protocol and were followed up for at least six months were included. The controls were healthy women with normal clinical breast examinations. All subjects filled-in the Persian version of Female Sexual Function Index questionnaire.Results: A total of 165 subjects including 71 breast cancer patients and 94 healthy women were studied. The frequency of sexual dysfunction in cases and controls was 52.6% and 47.4%, respectively (P = 0.09. There were no significant differences between the two groups regarding domain scores, except for vaginal lubrication (P = 0.045. Logistic regression analysis indicated that significant determinants of sexual dysfunction in breast cancer group was patients' age (OR = 4.0, 95%CI: 1.3 – 11.5, P = 0.01 and age of the spouse (OR= 9.8, 95% CI: 1.8-51.9, P= 0.007, while in controls, only emotional relationship with the husband was the significant predictive factor (OR = 6.3, 95%CI: 1.9 – 20.5, P = 0.002.Conclusions: Our findings indicated that sexual dysfunction is prevalent in Iranian women regardless of their physical health status. The frequency of vaginal dryness in breast cancer patients was significantly higher than controls. Age of the patient and the spouse (>40 were the only significant predictors of sexual dysfunction among women with breast cancer. Preventive strategies, sexual education and access to effective treatment should be planned in supportive care of breast cancer patients.

  1. Multi-objective PID Optimization for Speed Control of an Isolated Steam Turbine using Gentic Algorithm

    OpenAIRE

    Sanjay Kr. Singh; D. Boolchandani; S.G. Modani; Nitish Katal

    2014-01-01

    This study focuses on multi-objective optimization of the PID controllers for optimal speed control for an isolated steam turbine. In complex operations, optimal tuning plays an imperative role in maintaining the product quality and process safety. This study focuses on the comparison of the optimal PID tuning using Multi-objective Genetic Algorithm (NSGA-II) against normal genetic algorithm and Ziegler Nichols methods for the speed control of an isolated steam turbine. Isolated steam turbine...

  2. Optical network control plane for multi-domain networking

    DEFF Research Database (Denmark)

    Manolova, Anna Vasileva

    This thesis focuses on multi-domain routing for traffice engineering and survivability support in optical transport networks under the Generalized Multi-Protocol Label Switching (GMPLS) control framework. First, different extensions to the Border Gateway Protocol for multi-domain Traffic...... process are not enough for efficient TE in mesh multi-domain networks. Enhancing the protocol with multi-path dissemination capability, combined with the employment of an end-to-end TE metric proves to be a highly efficient solution. Simulation results show good performance characteristics of the proposed...... is not as essential for improved network performance as the length of the provided paths. Second, the issue of multi-domain survivability support is analyzed. An AS-disjoint paths is beneficial not only for resilience support, but also for facilitating adequate network reactions to changes in the network, which...

  3. Distributed model based control of multi unit evaporation systems

    International Nuclear Information System (INIS)

    Yudi Samyudia

    2006-01-01

    In this paper, we present a new approach to the analysis and design of distributed control systems for multi-unit plants. The approach is established after treating the effect of recycled dynamics as a gap metric uncertainty from which a distributed controller can be designed sequentially for each unit to tackle the uncertainty. We then use a single effect multi-unit evaporation system to illustrate how the proposed method is used to analyze different control strategies and to systematically achieve a better closed-loop performance using a distributed model-based controller

  4. Brain white matter changes associated with urological chronic pelvic pain syndrome: Multi-site neuroimaging from a MAPP case-control study

    Science.gov (United States)

    Huang, Lejian; Kutch, Jason J.; Ellingson, Benjamin M.; Martucci, Katherine T.; Harris, Richard E.; Clauw, Daniel J.; Mackey, Sean; Mayer, Emeran A.; Schaeffer, Anthony J.; Apkarian, A. Vania; Farmer, Melissa A.

    2016-01-01

    Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPS) in men and women has focused on end-organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multi-site investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared to positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data was collected from participants with UCPPS (n=52), IBS (n=39), and healthy, sex- and age-matched controls (n=61). White matter microstructure, measured as fractional anisotropy (FA), was examined with diffusion tensor imaging (DTI). Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished IBS from UCPPS patients and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development. PMID:27842046

  5. The regeneration of a multi-ethnic mixed-use area: The case of Robin Hood Chase

    Directory of Open Access Journals (Sweden)

    Ian Bentley

    1997-01-01

    Full Text Available Urban designers show increasing interest in promoting community participation in urban regeneration and especially housing regeneration. However, effective participation has proved difficult in multi-ethnic mixed-use areas, with their wide range of different (and often conflicting interest groups. This paper, presented in case-study form, analyses a project in one such area: the Robin Hood Chase local centre in St. Ann’s area of Nottingham. It pays particular attention to the identification of different interest groups and their associated institutions, the use of local media and social events to involve these groups in the urban design process, the use of rearrangeable models in a process of “enquiry by design”, and the production of a widely acceptable urban design strategy for the area. Analysis of feedback from participants indicates a high level of satisfaction both with the final physical design proposal and with the process itself; and also identifies directions for further development in the approach and techniques employed.

  6. Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study.

    Science.gov (United States)

    Frykman, Mandus; Hasson, Henna; Athlin, Åsa Muntlin; von Thiele Schwarz, Ulrica

    2014-05-15

    While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork. A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis. The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback. The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior change interventions influence staff

  7. Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study

    Science.gov (United States)

    2014-01-01

    Background While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork. Methods A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis. Results The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback. Conclusions The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior

  8. Effect of alpha amylase on early childhood caries: a matched case-control study

    OpenAIRE

    Mojarad, Farzad; Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan; Fazlollahifar, Samira; Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan; Poorolajal, Jalal; Research Center for Health Sciences, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan; Hajilooi, Mehrdad; Department of Pathology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan

    2013-01-01

    Objectives: There are a few studies addressing the relationship between salivary alpha-amylase and dental caries. This study was implemented in order to investigate the effect of salivary alpha-amylase level on early childhood caries (ECC).Materials and Methods: In this matched case-control study, which was carried out from November 2011 to March 2012 in Hamadan City, the west of Iran, mean levels of salivary alpha-amylase of 84 ECC-active cases were compared to that of 84 ECC-free controls u...

  9. Adjuvant radiotherapy after extrapleural pneumonectomy for mesothelioma. Prospective analysis of a multi-institutional series

    International Nuclear Information System (INIS)

    Tonoli, Sandro; Vitali, Paola; Scotti, Vieri; Bertoni, Filippo; Spiazzi, Luigi; Ghedi, Barbara; Buonamici, Fabrizio Banci; Marrazzo, Livia; Guidi, Gabriele; Meattini, Icro; Bastiani, Paolo; Amichetti, Maurizio; Schwarz, Marco; Magrini, Stefano Maria

    2011-01-01

    Background and purpose: To evaluate survival, locoregional control and toxicity in a series of 56 mesothelioma patients treated from May 2005 to May 2010 with post-operative radiotherapy after extrapleural pneumonectomy (EPP) in three Italian Institutions (Brescia, Florence, and Modena). Material and methods: Fifty-six patients treated with adjuvant radiotherapy (RT) after EPP were analyzed. Four patients were treated with 3DCRT, 50 with IMRT and two with helical tomotherapy. Forty-five to 50 Gy in 25 fractions were given to the affected hemithorax and to ipsilateral mediastinum, with a simultaneous integrated boost to the sites of microscopically involved margins up to 60 Gy in 20/56 cases. Results: Three year locoregional control (LRC), distant metastasis free (DMF), disease free (DF), disease specific (DSS) and overall survival (OS) rates are 90%, 66%, 57%, 62%, and 60%, respectively. Conclusion: Postoperative RT with modern techniques is an effective method to obtain excellent local control and cure rates in mesothelioma patients submitted to EPP.

  10. 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.

  11. Environmental and occupational risk factors for progressive supranuclear palsy: Case-control study.

    Science.gov (United States)

    Litvan, Irene; Lees, Peter S J; Cunningham, Christopher R; Rai, Shesh N; Cambon, Alexander C; Standaert, David G; Marras, Connie; Juncos, Jorge; Riley, David; Reich, Stephen; Hall, Deborah; Kluger, Benzi; Bordelon, Yvette; Shprecher, David R

    2016-05-01

    The cause of progressive supranuclear palsy (PSP) is largely unknown. Based on evidence for impaired mitochondrial activity in PSP, we hypothesized that the disease may be related to exposure to environmental toxins, some of which are mitochondrial inhibitors. This multicenter case-control study included 284 incident PSP cases of 350 cases and 284 age-, sex-, and race-matched controls primarily from the same geographical areas. All subjects were administered standardized interviews to obtain data on demographics, residential history, and lifetime occupational history. An industrial hygienist and a toxicologist unaware of case status assessed occupational histories to estimate past exposure to metals, pesticides, organic solvents, and other chemicals. Cases and controls were similar on demographic factors. In unadjusted analyses, PSP was associated with lower education, lower income, more smoking pack-years, more years of drinking well water, more years living on a farm, more years living 1 mile from an agricultural region, more transportation jobs, and more jobs with exposure to metals in general. However, in adjusted models, only more years of drinking well water was significantly associated with PSP. There was an inverse association with having a college degree. We did not find evidence for a specific causative chemical exposure; higher number of years of drinking well water is a risk factor for PSP. This result remained significant after adjusting for income, smoking, education and occupational exposures. This is the first case-control study to demonstrate PSP is associated with environmental factors. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Augmented-reality-based skills training for robot-assisted urethrovesical anastomosis: a multi-institutional randomised controlled trial.

    Science.gov (United States)

    Chowriappa, Ashirwad; Raza, Syed Johar; Fazili, Anees; Field, Erinn; Malito, Chelsea; Samarasekera, Dinesh; Shi, Yi; Ahmed, Kamran; Wilding, Gregory; Kaouk, Jihad; Eun, Daniel D; Ghazi, Ahmed; Peabody, James O; Kesavadas, Thenkurussi; Mohler, James L; Guru, Khurshid A

    2015-02-01

    To validate robot-assisted surgery skills acquisition using an augmented reality (AR)-based module for urethrovesical anastomosis (UVA). Participants at three institutions were randomised to a Hands-on Surgical Training (HoST) technology group or a control group. The HoST group was given procedure-based training for UVA within the haptic-enabled AR-based HoST environment. The control group did not receive any training. After completing the task, the control group was offered to cross over to the HoST group (cross-over group). A questionnaire administered after HoST determined the feasibility and acceptability of the technology. Performance of UVA using an inanimate model on the daVinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) was assessed using a UVA evaluation score and a Global Evaluative Assessment of Robotic Skills (GEARS) score. Participants completed the National Aeronautics and Space Administration Task Load Index (NASA TLX) questionnaire for cognitive assessment, as outcome measures. A Wilcoxon rank-sum test was used to compare outcomes among the groups (HoST group vs control group and control group vs cross-over group). A total of 52 individuals participated in the study. UVA evaluation scores showed significant differences in needle driving (3.0 vs 2.3; P = 0.042), needle positioning (3.0 vs 2.4; P = 0.033) and suture placement (3.4 vs 2.6; P = 0.014) in the HoST vs the control group. The HoST group obtained significantly higher scores (14.4 vs 11.9; P 0.012) on the GEARS. The NASA TLX indicated lower temporal demand and effort in the HoST group (5.9 vs 9.3; P = 0.001 and 5.8 vs 11.9; P = 0.035, respectively). In all, 70% of participants found that HoST was similar to the real surgical procedure, and 75% believed that HoST could improve confidence for carrying out the real intervention. Training in UVA in an AR environment improves technical skill acquisition with minimal cognitive demand. © 2014 The Authors. BJU International

  14. Adherence to nutrition-based cancer prevention guidelines and breast, prostate and colorectal cancer risk in the MCC-Spain case-control study.

    Science.gov (United States)

    Romaguera, Dora; Gracia-Lavedan, Esther; Molinuevo, Amaia; de Batlle, Jordi; Mendez, Michelle; Moreno, Victor; Vidal, Carmen; Castelló, Adela; Pérez-Gómez, Beatriz; Martín, Vicente; Molina, Antonio J; Dávila-Batista, Verónica; Dierssen-Sotos, Trinidad; Gómez-Acebo, Inés; Llorca, Javier; Guevara, Marcela; Castilla, Jesús; Urtiaga, Carmen; Llorens-Ivorra, Cristóbal; Fernández-Tardón, Guillermo; Tardón, Adonina; Lorca, José Andrés; Marcos-Gragera, Rafael; Huerta, José María; Olmedo-Requena, Rocío; Jimenez-Moleon, José Juan; Altzibar, Jone; de Sanjosé, Silvia; Pollán, Marina; Aragonés, Núria; Castaño-Vinyals, Gemma; Kogevinas, Manolis; Amiano, Pilar

    2017-07-01

    Prostate, breast and colorectal cancer are the most common tumours in Spain. The aim of the present study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and prostate, breast and colorectal cancer, in the MCC-Spain case-control study. A total of 1,718 colorectal, 1,343 breast and 864 prostate cancer cases and 3,431 population-based controls recruited between 2007 and 2012, were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on six recommendations for cancer prevention (on body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods and alcoholic drinks; score range 0-6) was constructed. We used unconditional logistic regression analysis adjusting for potential confounders. One-point increment in the WCRF/AICR score was associated with 25% (95% CI 19-30%) lower risk of colorectal, and 15% (95% CI 7-22%) lower risk of breast cancer; no association with prostate cancer was detected, except for cases with a Gleason score ≥7 (poorly differentiated/undifferentiated tumours) (OR 0.87, 95% CI 0.76-0.99). These results add to the wealth of evidence indicating that a great proportion of common cancer cases could be avoided by adopting healthy lifestyle habits. © 2017 UICC.

  15. Hybrid Multi-Layer Network Control for Emerging Cyber-Infrastructures

    Energy Technology Data Exchange (ETDEWEB)

    Summerhill, Richard [Internet2, Washington, DC (United States); Lehman, Tom [Univ. of Southern California, Los Angeles, CA (United States). Information Sciences Inst. (ISI); Ghani, Nasir [Univ. of New Mexico, Albuquerque, NM (United States). Dept. of Electrical & Computer Engineering; Boyd, Eric [Univ. Corporation for Advanced Internet Development (UCAID), Washington, DC (United States)

    2009-08-14

    There were four basic task areas identified for the Hybrid-MLN project. They are: Multi-Layer, Multi-Domain, Control Plane Architecture and Implementation; Heterogeneous DataPlane Testing; Simulation; Project Publications, Reports, and Presentations.

  16. GP leadership in clinical commissioning groups: a qualitative multi-case study approach across England.

    Science.gov (United States)

    Marshall, Martin; Holti, Richard; Hartley, Jean; Matharu, Tatum; Storey, John

    2018-06-01

    Clinical commissioning groups (CCGs) were established in England in 2013 to encourage GPs to exert greater influence over the processes of service improvement and redesign in the NHS. Little is known about the extent and the ways in which GPs have assumed these leadership roles. To explore the nature of clinical leadership of GPs in CCGs, and to examine the enablers and barriers to implementing a policy of clinical leadership in the NHS. A qualitative multi-case study approach in six localities across England. The case studies were purposefully sampled to represent different geographical localities and population demographics, and for their commitment to redesigning specified clinical or service areas. Data were collected from the case study CCGs and their partner organisations using a review of relevant documents, semi-structured individual or group interviews, and observations of key meetings. The data were analysed thematically and informed by relevant theories. GPs prefer a collaborative style of leadership that may be unlikely to produce rapid or radical change. Leadership activities are required at all levels in the system from strategy to frontline delivery, and the leadership behaviours of GPs who are not titular leaders are as important as formal leadership roles. A new alliance is emerging between clinicians and managers that draws on their different skillsets and creates new common interests. The uncertain policy environment in the English NHS is impacting on the willingness and the focus of GP leaders. GPs are making an important contribution as leaders of health service improvement and redesign but there are significant professional and political barriers to them optimising a leadership role. © British Journal of General Practice 2018.

  17. Individual Correlates of Podoconiosis in Areas of Varying Endemicity: A Case-Control Study

    Science.gov (United States)

    Molla, Yordanos B.; Le Blond, Jennifer S.; Wardrop, Nicola; Baxter, Peter; Atkinson, Peter M.; Newport, Melanie J.; Davey, Gail

    2013-01-01

    Background Podoconiosis is a non-filarial form of elephantiasis resulting in lymphedema of the lower legs. Previous studies have suggested that podoconiosis arises from the interplay of individual and environmental factors. Here, our aim was to understand the individual-level correlates of podoconiosis by comparing 460 podoconiosis-affected individuals and 707 unaffected controls. Methods/principal findings This was a case-control study carried out in six kebeles (the lowest governmental administrative unit) in northern Ethiopia. Each kebele was classified into one of three endemicity levels: ‘low’ (prevalence 5%). A total of 142 (30.7%) households had two or more cases of podoconiosis. Compared to controls, the majority of the cases, especially women, were less educated (OR = 1.7, 95% CI = 1.3 to 2.2), were unmarried (OR = 3.4, 95% CI = 2.6–4.6) and had lower income (t = −4.4, p<0.0001). On average, cases started wearing shoes ten years later than controls. Among cases, age of first wearing shoes was positively correlated with age of onset of podoconiosis (r = 0.6, t = 12.5, p<0.0001). Among all study participants average duration of shoe wearing was less than 30 years. Between both cases and controls, people in ‘high’ and ‘medium’ endemicity kebeles were less likely than people in ‘low’ endemicity areas to ‘ever’ have owned shoes (OR = 0.5, 95% CI = 0.4–0.7). Conclusions Late use of shoes, usually after the onset of podoconiosis, and inequalities in education, income and marriage were found among cases, particularly among females. There were clustering of cases within households, thus interventions against podoconiosis will benefit from household-targeted case tracing. Most importantly, we identified a secular increase in shoe-wearing over recent years, which may give opportunities to promote shoe-wearing without increasing stigma among those at high risk of podoconiosis. PMID:24340109

  18. Individual correlates of podoconiosis in areas of varying endemicity: a case-control study.

    Directory of Open Access Journals (Sweden)

    Yordanos B Molla

    Full Text Available Podoconiosis is a non-filarial form of elephantiasis resulting in lymphedema of the lower legs. Previous studies have suggested that podoconiosis arises from the interplay of individual and environmental factors. Here, our aim was to understand the individual-level correlates of podoconiosis by comparing 460 podoconiosis-affected individuals and 707 unaffected controls.This was a case-control study carried out in six kebeles (the lowest governmental administrative unit in northern Ethiopia. Each kebele was classified into one of three endemicity levels: 'low' (prevalence 5%. A total of 142 (30.7% households had two or more cases of podoconiosis. Compared to controls, the majority of the cases, especially women, were less educated (OR = 1.7, 95% CI = 1.3 to 2.2, were unmarried (OR = 3.4, 95% CI = 2.6-4.6 and had lower income (t = -4.4, p<0.0001. On average, cases started wearing shoes ten years later than controls. Among cases, age of first wearing shoes was positively correlated with age of onset of podoconiosis (r = 0.6, t = 12.5, p<0.0001. Among all study participants average duration of shoe wearing was less than 30 years. Between both cases and controls, people in 'high' and 'medium' endemicity kebeles were less likely than people in 'low' endemicity areas to 'ever' have owned shoes (OR = 0.5, 95% CI = 0.4-0.7.Late use of shoes, usually after the onset of podoconiosis, and inequalities in education, income and marriage were found among cases, particularly among females. There were clustering of cases within households, thus interventions against podoconiosis will benefit from household-targeted case tracing. Most importantly, we identified a secular increase in shoe-wearing over recent years, which may give opportunities to promote shoe-wearing without increasing stigma among those at high risk of podoconiosis.

  19. Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

    Science.gov (United States)

    Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

    2018-05-05

    Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. [Research on competency building standards of institutions of schistosomiasis prevention and control in Hubei Province I Investigation of institution management].

    Science.gov (United States)

    Liu, Han-cheng; Zhong, Chen-hui; Liao, Si-qi; He, Hui

    2014-08-01

    To investigate the current situation of management of institutions of schistosomiasis prevention and control in Hubei Province, so as to explore the probable competency building standards for these institutions at the county and township levels. By using a combination of quantitative and qualitative methods, the institutions of schistosomiasis prevention and control at county and township levels were investigated for the institutional setup, staffing and fulfillment functions since the reform of 2004. Among 63 schistosomiasis endemic counties (cities, districts) of Hubei Province, there were 26 independent schistosomiasis control institutions (41.27%), there were 24 institutions which were incorporated into CDC (38.10%), and there were no institutions in 13 counties (20.63%). Among 518 endemic towns, there were 299 institutions (57.72%). The total staffing size were 1 932, but there were 1 586 (82.09%) people actually working in the post, and therefore there were 346 (17.91%) empty positions. The average rates of carrying out the six functions were 91.48%-71.19%, but only 19.23% of the institutions participated in the comprehensive schistosomiasis control management project and its effect assessment. According to the management model for schistosomiasis control institutions under the current institutional mechanisms, we need a rigorous industry standard to constrain, guide and standardize the management and capacity-building of the institutions in different historical periods.