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Sample records for multicenter-studie mit iomeprol

  1. Multicenter study of radiosynoviorthesis. Clinical outcome in osteoarthritis and other disorders with concomitant synovitis in comparison with rheumatoid arthritis; Multizenterstudie zur Radiosynoviorthese: Klinische Ergebnisse bei aktivierten Arthrosen und anderen Gelenkerkrankungen mit chronischer Synovialitis im Vergleich zur rheumatoiden Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Rau, H.; Lohmann, K.; Spitz, J. [Praxis fuer Nuklearmedizin, am Staedtischen Klinikum Wiesbaden (Germany); Franke, C. [Praxis fuer Nuklearmedizin, Hamburg (Germany); Goretzki, G. [Praxis fuer Nuklearmedizin, Bielefeld (Germany); Lemb, M.A. [Praxis fuer Nuklearmedizin, Bremen (Germany); Mueller, J. [Klinik fuer Nuklearmedizin, Kantonspital St. Gallen (Switzerland); Panholzer, P.J. [Abt. fuer Nuklearmedizin und Endokrinologie, PET-Zentrum, Krankenhaus der Barmherzigen Schwestern, Linz (Austria); Stelling, E. [Praxis fuer diagnostische und therapeutische Nuklearmedizin, Berlin (Germany)

    2004-04-01

    Aim: evaluation of the effectiveness of radiosynoviorthesis (RSO) in osteoarthritis and other disorders with concomitant synovitis versus rheumatoid arthritis by means of a standardized questionnaire. Patients, methods: 803 RSO treatments were monitored in 691 patients by standardized questionnaires of 7 centers in 3 countries. Patients were assigned to 3 groups according to their age (20-40, 41-60, 61-80 years). Additionally, the data were analyzed separately for patients with rheumatoid arthritis (group A) and those with osteoarthritis, psoriasis arthritis, pigmental villonodular synovitis or persistent effusions after joint replacement (group B). Results: ameliorations of joint pain, swelling/effusion or flexibility were found in 80% of group A and 56% of group B (p <0.01). Quality of life improved in 78% of group A and 59% of group B (p <0.01). The response rate was similar for small- and large-sized joints in group A, but significantly higher for large-sized joints in group B (p <0.01). The positive effects on joint pain, swelling/effusion or flexibility lasted longer in group A (p <0.01). Repeated RSOs were as effective as initial ones. The clinical outcome was neither influenced by age, nor gender, nor transient immobilisation for 48 hours after RSO. Conclusion: although slightly more efficient in rheumatoid arthritis, RSO represents an effective treatment option also in osteoarthritis and other disorders with concomitant synovitis. (orig.) [German] Ziel: Effektivitaetsvergleich der Radiosynoviorthese (RSO) bei aktivierter Arthrose und anderen Gelenkerkrankungen mit chronischer Synovialitis versus rheumatoider Arthritis. Ueberpruefung der Eignung eines standardisierten Fragebogens fuer Multizenterstudien. Patienten, Methoden: Bei 691 Patienten wurden 803 RSO-Behandlungsverlaeufe von 7 Zentren in 3 Laendern mit Hilfe eines standardisierten Fragebogens erfasst. Die Patienten wurden 3 Alterskategorien (20-40, 41-60 und 61-80 Jahre) zugeordnet. Ausserdem wurden

  2. Iomeprol: results of clinical trials in children with a new nonionic contrast medium

    International Nuclear Information System (INIS)

    Gessel, R. van; Moeller, A.; Schmiedel, E.

    1994-01-01

    A total of 438 patients (1 day - 17 years) were enrolled in open-label phase III studies with Iomeprol in the most important radiologic, urologic, and cardiologic indications. Iomeprol was tested in five concentrations ranging from isotonic solutions of 150 mg iodine/ml up to 400 mg iodine/ml. Half of the patients were younger than 3 years. Apart from the mostly slight sensations of heat, pain, and taste, the following adverse events were observed independently of a causal relationship to the test compound: vomiting (1.8%), rise in blood pressure (1.8%), and restlessness (1.1%). The respective incidence of all other adverse events was below 1%. Iomeprol is a suitable and well-tolerated nonionic contrast medium for use in pediatric examinations. (orig./MG) [de

  3. Original Paper Multicenter study on antibiotic susceptibility ...

    African Journals Online (AJOL)

    Multicenter study on antibiotic susceptibility/resistance trends in the western region of Cameroon ... antibiotic era, IDs used to be serious threats because of lack or insufficient ...... antimicrobial use in livestock; AMR. Control., 116-122. Vandini ...

  4. Biodegradation of phenol, salicylic acid, benzenesulfonic acid, and iomeprol by Pseudomonas fluorescens in the capillary fringe.

    Science.gov (United States)

    Hack, Norman; Reinwand, Christian; Abbt-Braun, Gudrun; Horn, Harald; Frimmel, Fritz H

    2015-12-01

    Mass transfer and biological transformation phenomena in the capillary fringe were studied using phenol, salicylic acid, benzenesulfonic acid, and the iodinated X-ray contrast agent iomeprol as model organic compounds and the microorganism strain Pseudomonas fluorescens. Three experimental approaches were used: Batch experiments (uniform water saturation and transport by diffusion), in static columns (with a gradient of water saturation and advective transport in the capillaries) and in a flow-through cell (with a gradient of water saturation and transport by horizontal and vertical flow: 2-dimension flow-through microcosm). The reactors employed for the experiments were filled with quartz sand of defined particle size distribution (dp=200...600 μm, porosity ε=0.42). Batch experiments showed that phenol and salicylic acid have a high, whereas benzenesulfonic acid and iomeprol have a quite low potential for biodegradation under aerobic conditions and in a matrix nearly close to water saturation. Batch experiments under anoxic conditions with nitrate as electron acceptor revealed that the biodegradation of the model compounds was lower than under aerobic conditions. Nevertheless, the experiments showed that the moisture content was also responsible for an optimized transport in the liquid phase of a porous medium. Biodegradation in the capillary fringe was found to be influenced by both the moisture content and availability of the dissolved substrate, as seen in static column experiments. The gas-liquid mass transfer of oxygen also played an important role for the biological activity. In static column experiments under aerobic conditions, the highest biodegradation was found in the capillary fringe (e.g. βt/β0 (phenol)=0 after t=6 d) relative to the zone below the water table and unsaturated zone. The highest biodegradation occurred in the flow-through cell experiment where the height of the capillary fringe was largest. Copyright © 2015 Elsevier B.V. All rights

  5. A multicenter study on Leigh syndrome

    DEFF Research Database (Denmark)

    Sofou, Kalliopi; De Coo, Irenaeus F M; Isohanni, Pirjo

    2014-01-01

    BACKGROUND: Leigh syndrome is a progressive neurodegenerative disorder, associated with primary or secondary dysfunction of the mitochondrial oxidative phosphorylation. Despite the fact that Leigh syndrome is the most common phenotype of mitochondrial disorders in children, longitudinal natural...... history data is missing. This study was undertaken to assess the phenotypic and genotypic spectrum of patients with Leigh syndrome, characterise the clinical course and identify predictors of survival in a large cohort of patients. METHODS: This is a retrospective study of patients with Leigh syndrome...... to thrive, brainstem lesions on neuroimaging and intensive care treatment were significantly associated with poorer survival. CONCLUSIONS: This is a multicenter study performed in a large cohort of patients with Leigh syndrome. Our data help define the natural history of Leigh syndrome and identify novel...

  6. Coordination of international multicenter studies: governance and administrative structure

    Directory of Open Access Journals (Sweden)

    Bangdiwala Shrikant I.

    2003-01-01

    Full Text Available A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. The organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. The elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. The experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (WorldSAFE, illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators.

  7. Mit kokkeri

    DEFF Research Database (Denmark)

    Ejlersen, Søren; Lorang, Louisa

    MIT kokkeri er resultatet af et samarbejde mellem Komiteen for Sundhedsoplysning, Institut for Uddannelse og Pædagogik/Aarhus Universitet og Haver til Maver. Projektet støttes af Nordea-fonden. Bag kogebogens mange opskrifter står en række erfarne madeksperter bestående af Søren Ejlersen, Louisa...

  8. Acute necrotizing pancreatitis: a multicenter study.

    Science.gov (United States)

    Fernández-Cruz, L; Navarro, S; Valderrama, R; Sáenz, A; Guarner, L; Aparisi, L; Espi, A; Jaurietta, E; Marruecos, L; Gener, J

    1994-04-01

    A multicenter study of acute necrotizing pancreatitis (ANP) classified in accordance with the Balthazar criteria (grades D and E), has been performed in 12 teaching hospitals. A total of 233 patients were reviewed, and the mortality rate was 26.6%. The most common etiology was biliary pancreatitis (45.5%). Among the complications, shock, renal insufficiency, pulmonary insufficiency and hemorrhagic gastritis were associated with a mortality rate of 51-66%. Diffuse fluid collections were associated with a higher mortality rate (26.8%) than localized fluid collections (14.5%). In 106 patients with gallstone pancreatitis, early surgery was performed in 17, and 5 patients (29.4%) died. No mortality was observed in 32 patients with delayed surgery. Sphincterotomy was performed in 13 patients, and 4 (30.7%) died. Early surgery (necrosectomy and closed peritoneal lavage) was undertaken in 75 patients, with a mortality rate of 39%. In conclusion, the morbidity and mortality rates of ANP can be improved with proper monitoring, adequate supportive care and the judicious use of surgery based on clinical and morphological findings.

  9. Statistics of the Iomazenil-multicenter study

    International Nuclear Information System (INIS)

    Hasler, P.H.; Beer-Wohlfahrt, H.; Schubiger, P.A.

    1990-01-01

    The 123 I-Ro 16-0154 (= Iomazenil) has been shown as a very potent benzodiazepine antagonist by Beer et al. (1990). In this study the in vitro and in vivo characteristics have been described. The preliminary clinical results revealed clearly images of the benzodiazepine receptor density in the brain. Also storage defects due to pathological CBF and changed receptor density were detected. The Iomazenil showed potential usefulness and therefore extended clinical tests in a multicenter study have been performed. The goals were twofold, first to define the normal benzodiazepine receptor distribution in a healthy human brain and second to investigate the possible diagnostic usefulness of Iomazenil in the case of partial epilepsy. Furthermore, on a few normal volunteers the pharmacokinetics should be determined and some patients with other dieseases (e.g. Alzheimer) would be screened. Some preliminary clinical results have already been published. Hoell et al. (1989) compared the biodistribution of Iomazenil in normal humans with the animal data published (Beer et al., 1990). They concluded that the distribution was similar. The radioactivity concentration in the plasma was virtually cleared after 15 min., cerebral uptake reached a maximum of 10-15 min p.i. and remained stable for about 20 min. Bangerl et al. (1990) found a reduction of benzodiazepine receptors in patients with Lennox-Gaustaut-syndrome. Bartenstein et al. (1989) compared early (30 min.) and late (2h) SPECT-images. They found that early images showed flow-phenomena and receptor binding, whereas late one corresponded clearly to receptor binding. Their findings confirm the results published by Beer et al. (1990). In this work the patient data of all participating clinical centers are evaluated and discussed. (author) 3 figs., 7 tabs., 5 refs

  10. Kinetic study of photocatalytic degradation of carbamazepine, clofibric acid, iomeprol and iopromide assisted by different TiO2 materials--determination of intermediates and reaction pathways.

    Science.gov (United States)

    Doll, Tusnelda E; Frimmel, Fritz H

    2004-02-01

    The light-induced degradation of clofibric acid, carbamazepine, iomeprol and iopromide under simulated solar irradiation has been investigated in aqueous solutions suspended with different TiO2 materials (P25 and Hombikat UV100). Kinetic studies showed that P25 had a better photocatalytic activity for clofibric acid and carbamazepine than Hombikat UV100. For photocatalytic degradation of iomeprol Hombikat UV100 was more suitable than P25. The results can be explained by the higher adsorption capacity of Hombikat UV100 for iomeprol. The study also focuses on the identification and quantification of possible degradation products. The degradation process was monitored by determination of sum parameters and inorganic ions. In case of clofibric acid various aromatic and aliphatic degradation products have been identified and quantified. A possible multi-step degradation scheme for clofibric acid is proposed. This study proves the high potential of the photocatalytic oxidation process to transform and mineralize environmentally relevant pharmaceuticals and contrast media in water.

  11. Photocatalytic degradation of clofibric acid, carbamazepine and iomeprol using conglomerated TiO2 and activated carbon in aqueous suspension.

    Science.gov (United States)

    Ziegmann, Markus; Frimmel, Fritz H

    2010-01-01

    The combination of powdered activated carbon (PAC) and TiO(2) has been tested for synergistic/antagonistic effects in the photocatalytic degradation of carbamazepine, clofibric acid and iomeprol. Synergistic effects are thought to be caused by rapid adsorption on the PAC surface followed by diffusion to the TiO(2) surface and photocatalytic degradation. The Freundlich constant K(F) was used for comparing the sorption properties of the three substances and it was found that K(F) for clofibric acid was 3 times lower than for carbamazepine and iomeprol, regardless of the kind of PAC used. A PAC with a distinct tendency to form conglomerates was selected so that a high percentage of the PAC surface was in direct proximity to the TiO(2) surface. The photocatalytic degradation of the pharmaceutically active compounds studied followed pseudo-first order kinetics. Synergistic effects only occurred for clofibric acid (factor 1.5) and an inverse relationship between adsorption affinity and synergistic effects was found. High affinity of the target substances to the PAC surface seemed to be counterproductive for the photocatalytic degradation.

  12. Are the tolerabilities of nonionic contrast media identical? Outcome of a double-blind, randomized multicentre study with Iomeprol and lopromide

    International Nuclear Information System (INIS)

    Schmiedel, E.

    1997-01-01

    Since a larger number of nonionic contrast media is available for the radiologist, the question arises as to whether they differ in their clinical tolerability. A double-blind, randomized, two-group comparison of phase IV with Iomeprol and Iopromide was carried out at 6 hospitals involving a total of 1.200 patients with the indication for computed tomography. The contrast media doses and the flow in computed tomography of the skull, thorax, and abdomen were, depending on the centre, between 50 and 200 ml and 0.5 to 3.0 ml/s, respectively. The biostatistical evaluation of adverse events which were probably contrast medium-related produced a highly significant difference between the two contrast media in favor of Iomeprol (p=0.0005). The difference in the reactions of heat, nausea, and vomiting is of clinical relevance as such adverse events may negatively affect the examination procedure and the opacification in spiral computed tomography. (orig.) [de

  13. Intraoperative Death During Cervical Spinal Surgery: A Retrospective Multicenter Study.

    Science.gov (United States)

    Wang, Jeffrey C; Buser, Zorica; Fish, David E; Lord, Elizabeth L; Roe, Allison K; Chatterjee, Dhananjay; Gee, Erica L; Mayer, Erik N; Yanez, Marisa Y; McBride, Owen J; Cha, Peter I; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    A retrospective multicenter study. Routine cervical spine surgeries are typically associated with low complication rates, but serious complications can occur. Intraoperative death is a very rare complication and there is no literature on its incidence. The purpose of this study was to determine the intraoperative mortality rates and associated risk factors in patients undergoing cervical spine surgery. Twenty-one surgical centers from the AOSpine North America Clinical Research Network participated in the study. Medical records of patients who received cervical spine surgery from January 1, 2005, to December 31, 2011, were reviewed to identify occurrence of intraoperative death. A total of 258 patients across 21 centers met the inclusion criteria. Most of the surgeries were done using the anterior approach (53.9%), followed by posterior (39.1%) and circumferential (7%). Average patient age was 57.1 ± 13.2 years, and there were more male patients (54.7% male and 45.3% female). There was no case of intraoperative death. Death during cervical spine surgery is a very rare complication. In our multicenter study, there was a 0% mortality rate. Using an adequate surgical approach for patient diagnosis and comorbidities may be the reason how the occurrence of this catastrophic adverse event was prevented in our patient population.

  14. Chest radiographic data acquisition and quality assurance in multicenter studies

    International Nuclear Information System (INIS)

    Cleveland, R.H.; Schluchter, M.; Easley, K.A.; Wood, B.P.; Berdon, W.E.; Boechat, M.I.; Meziane, M.; Mellins, R.B.; Norton, K.I.; Singleton, E.; Trautwein, L.

    1997-01-01

    Background. Multicenter studies rely on data derived from different institutions. Forms can be designed to standardize the reporting process allowing reliable comparison of data. Objective. The purpose of the report is to provide a standardized method, developed as a part of a multicenter study of vertically transmitted HIV, for assessing chest radiographic results. Materials and methods. Eight hundred and five infants and children were studied at five centers; 3057 chest radiographs were scored. Data were entered using a forced-choice, graded response for 12 findings. Quality assurance measures and inter-rater agreement statistics are reported. Results. The form used for reporting chest radiographic results is presented. Inter-rater agreement was moderate to high for most findings, with the best correlation reported for the presence of bronchovascular markings and/or reticular densities addressed as a composite question (kappa = 0.71). The presence of nodular densities (kappa 0.56) and parenchymal consolidation (kappa = 0.57) had moderate agreement. Agreement for lung volume was low. Conclusion. The current tool, developed for use in the pediatric population, is applicable to any study involving the assessment of pediatric chest radiographs for a large population, whether at one or many centers. (orig.)

  15. A prospective, randomized multicenter study comparing APD and CAPD treatment

    DEFF Research Database (Denmark)

    Bro, S; Bjorner, J B; Tofte-Jensen, P

    2000-01-01

    , dialysis-related complications, dialysis-related expenses. RESULTS: The quality-of-life studies showed that significantly more time for work, family, and social activities was available to patients on APD compared to those on CAPD (p ...) treatment with respect to quality of life and clinical outcomes in relation to therapy costs. DESIGN: A prospective, randomized multicenter study. SETTING: Three Danish CAPD units. PATIENTS: Thirty-four adequately dialyzed patients with high or high-average peritoneal transport characteristics were included...... were assessed at baseline and after 6 months by the self-administered short-form SF-36 generic health survey questionnaire supplemented with disease- and treatment-specific questions. Therapy costs were compared by evaluating dialysis-related expenses. MAIN OUTCOME MEASURES: Quality-of-life parameters...

  16. Stakeholders' views on data sharing in multicenter studies.

    Science.gov (United States)

    Mazor, Kathleen M; Richards, Allison; Gallagher, Mia; Arterburn, David E; Raebel, Marsha A; Nowell, W Benjamin; Curtis, Jeffrey R; Paolino, Andrea R; Toh, Sengwee

    2017-09-01

    To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. Semistructured interviews with five US stakeholder groups. We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks.

  17. Marketing mit Youtube

    OpenAIRE

    Nufer, Gerd; Kaps, Anne

    2017-01-01

    Die Video-Plattform Youtube ist eine der meistbesuchten Webseiten weltweit. Youtube-Stars erreichen mit ihren Videos große Zuschauergruppen und können als Multiplikatoren für Werbebotschaften dienen. Sie sind oftmals Meinungsführer, denen hohes Vertrauen entgegengebracht wird, weshalb sie sich sehr gut für Influencer-Marketing eignen. Marketing mit Youtube ermöglicht eine offene, mehrwegige, schnelle und kostengünstige Kommunikation mit Kunden, insbesondere jüngeren. Unternehmen können sich d...

  18. MITS machine operations

    International Nuclear Information System (INIS)

    Flinchem, J.

    1980-01-01

    This document contains procedures which apply to operations performed on individual P-1c machines in the Machine Interface Test System (MITS) at AiResearch Manufacturing Company's Torrance, California Facility

  19. Kommunikation mit Mitarbeitern

    Science.gov (United States)

    Spychala, Anne; Fleischmann, Jürgen

    Kommunikation ist der Austausch von Nachrichten und Informationen zwischen Mitarbeitern eines Unternehmens (O'Hair et al. 1997). Dieser Austausch kann persönlich, aber z.B. auch per Telefon, E-Mail oder durch Computersysteme erfolgen. In diesem Kapitel betrachten wir die persönliche Kommunikation zwischen Vorgesetzten und Mitarbeitern. Zur persönlichen Kommunikation mit Mitarbeitern zählen sowohl formelle Gespräche mit Mitarbeitern als auch eher informelle Gespräche zwischen Tür und Angel. Die Gespräche können dabei mit einzelnen Mitarbeitern (z.B. jährliches Mitarbeitergespräch) oder mit Gruppen von Mitarbeitern (z.B. regelmäßige Projekt- oder Teambesprechungen) stattfinden.

  20. A prospective randomised controlled trial to determine the early and late reactions after the use of iopamidol 340 (NiopamTM) and iomeprol 350 (Iomeron[reg]) in cardiac catheterisation

    International Nuclear Information System (INIS)

    Vijayalakshmi, Kunadian; Kunadian, Babu; Wright, Robert A.; Hall, James A.; Stewart, Michael J.; Davies, Adrian; Sutton, Andrew; Belder, Mark A. de

    2007-01-01

    A new generation of intravascular contrast agents, the non-ionic monomers have safety profiles that are superior to those of older ionic compounds. There are, however, significant differences between these agents. Aim: The aim of this study was to determine the incidence of early ( 24 h to 7 days) reactions to two non-ionic contrast agents currently used during cardiac catheterisation: iopamidol 340 (Niopam TM Bracco UK Ltd.) and iomeprol 350 (Iomeron[reg] Bracco UK Ltd.). Methods: This was a prospective, randomised, double blinded trial. One thousand nine hundred and eighty-five patients undergoing cardiac catheterisation received one of the following contrast agents on a weekly basis: iopamidol 340 (Niopam TM ) and iomeprol 350 (Iomeron[reg]). Reactions that were possibly related to the contrast agents were recorded on predefined data collection forms during the first 24 h of the procedure (early reaction) and after 24 h to 7 days (late reaction) by means of a questionnaire. Results: The baseline characteristics were matched in both the groups. There was no significant difference in the incidence of heat sensation experienced between the two groups (p = 0.1). Early non-heat reactions occurred in 2.7% of patients receiving iopamidol 340 (Niopam TM ) and 4% of those receiving iomeprol 350 (Iomeron[reg]) (p = 0.1). Significant electrocardiographic changes were recorded in 1.7% of patients who received iopamidol 340 (Niopam TM ), and 1% of those who received iomeprol 350 (Iomeron[reg]) (p = 0.2). Bradycardia occurred more frequently in the iopamidol 350 group (0.8%) compared to the iomeprol 350 group (0.1%) p = 0.02. Late reactions occurred in 16.2% of those receiving iopamidol 340 (Niopam TM ) and 21.7% of those receiving iomeprol 350 (Iomeron[reg] (p = 0.02). A total of 23 (3.7%) patients in the iopamidol group and 39 (6.2%) patients in the iomeprol group reported nausea, p = 0.01. Conclusions: The incidence of early adverse reactions was similar with the two non

  1. [Motivations for a consultation before adoption: A multicenter study].

    Science.gov (United States)

    Thieblemont, M; Francois, P; Poirier, V; Bosdure, E; Munck, M-R; Borsa-Dorion, A; Hazart, I; Moukagni-Pelzer, M; Brunel, D; Peyron, F; de Monleon, J-V

    2016-01-01

    While the number of international adoptions in France is decreasing, adopted children are older and in poorer health than they used to be. This phenomenon has resulted in an increase in the demand for preadoption consultations over the past several years. This study analyses the reasons for these consultations. Prospective multicenter study conducted from 1 January to 31 December 2013. Ten centers contributed to the study, i.e., 196 preadoption consultations. Seeking medical advice was the reason for 88% of the consultations, whether the advice was based on the study of an identified child's medical file (32%) or a country's healthcare characteristics, whether the country was identified (34%) or not (23%). In 6% of cases, the motive for preadoption consultations was social and familial, and in the last 5% it was to obtain general information about adoption and its procedures. In more than 40% of the cases, whether the child or the country identified, Russia is the subject of the consultation because of the complexity of the files and because of the dreaded but rarely mentioned fetal alcohol syndrome. The deterioration of adopted children's health is an additional worry for future adoption applicants. To provide them with the best information possible without making choices for them, specialists should have substantial experience in adoption before going into these preadoption consultations. Copyright © 2015. Published by Elsevier SAS.

  2. Bronchiectasis diagnosed after renal transplantation: a retrospective multicenter study.

    Science.gov (United States)

    Dury, Sandra; Colosio, Charlotte; Etienne, Isabelle; Anglicheau, Dany; Merieau, Elodie; Caillard, Sophie; Rivalan, Joseph; Thervet, Eric; Essig, Marie; Babinet, François; Subra, Jean-François; Toubas, Olivier; Rieu, Philippe; Launois, Claire; Perotin-Collard, Jeanne-Marie; Lebargy, François; Deslée, Gaëtan

    2015-11-07

    Bronchiectasis is characterized by abnormal, permanent and irreversible dilatation of the bronchi, usually responsible for daily symptoms and frequent respiratory complications. Many causes have been identified, but only limited data are available concerning the association between bronchiectasis and renal transplantation. We conducted a retrospective multicenter study of cases of bronchiectasis diagnosed after renal transplantation in 14 renal transplantation departments (French SPIESSER group). Demographic, clinical, laboratory and CT scan data were collected. Forty-six patients were included (mean age 58.2 years, 52.2 % men). Autosomal dominant polycystic kidney disease (32.6 %) was the main underlying renal disease. Chronic cough and sputum (50.0 %) were the major symptoms leading to chest CT scan. Mean duration of symptoms before diagnosis was 1.5 years [0-12.1 years]. Microorganisms were identified in 22 patients, predominantly Haemophilus influenzae. Hypogammaglobulinemia was observed in 46.9 % patients. Bronchiectasis was usually extensive (84.8 %). The total bronchiectasis score was 7.4 ± 5.5 with a significant gradient from apex to bases. Many patients remained symptomatic (43.5 %) and/or presented recurrent respiratory tract infections (37.0 %) during follow-up. Six deaths (13 %) occurred during follow-up, but none were attributable to bronchiectasis. These results highlight that the diagnosis of bronchiectasis should be considered in patients with de novo respiratory symptoms after renal transplantation. Further studies are needed to more clearly understand the mechanisms underlying bronchiectasis in this setting.

  3. Decision making in liver transplant selection committees: a multicenter study.

    Science.gov (United States)

    Volk, Michael L; Biggins, Scott W; Huang, Mary Ann; Argo, Curtis K; Fontana, Robert J; Anspach, Renee R

    2011-10-18

    To receive a liver transplant, patients must first be placed on a waiting list-a decision made at most transplant centers by a multidisciplinary committee. The function of these committees has never been studied. To describe decision making in liver transplant committees and identify opportunities for process improvement. Observational multicenter study. 4 liver transplant centers in the United States. 68 members of liver transplant committees across the 4 centers. 63 meetings were observed, and 50 committee members were interviewed. Recorded transcripts and field notes were analyzed by using standard qualitative sociologic methods. Although the structure of the meetings varied by center, the process was uniform and primarily involved inductive reasoning to review possible reasons for patient exclusion. Patients were excluded if they were too well, too sick (in the setting of advanced liver disease), or too old or had nonhepatic comorbid conditions, substance abuse problems, or other psychosocial barriers. Dominant themes in the discussions included member angst over deciding who lived or died, a high correlation between psychosocial barriers to transplantation and the patient's socioeconomic status, and the influence of external forces on decision making. Unwritten center policies and confusion regarding advocacy versus stewardship roles were consistently identified as barriers to effective group decision making. The use of qualitative methods provides broad understanding but limits specific inferences. The 4 centers may not reflect the practices of every transplant center nationwide. The difficult decisions made by liver transplant committees are reasonably consistent and well-intentioned, but the process might be improved by having more explicit written policies and clarifying roles. This may inform resource allocation in other areas of medicine. The Greenwall Foundation and the National Institutes of Health.

  4. Determination of serum albumin, analytical challenges: a French multicenter study.

    Science.gov (United States)

    Rossary, Adrien; Blondé-Cynober, Françoise; Bastard, Jean-Philippe; Beauvieux, Marie-Christine; Beyne, Pascale; Drai, Jocelyne; Lombard, Christine; Anglard, Ingrid; Aussel, Christian; Claeyssens, Sophie; Vasson, Marie-Paule

    2017-06-01

    Among the biological markers of morbidity and mortality, albumin holds a key place in the range of criteria used by the High Authority for Health (HAS) for the assessment of malnutrition and the coding of information system medicalization program (PMSI). If the principle of quantification methods have not changed in recent years, the dispersion of external evaluations of the quality (EEQ) data shows that the standardization using the certified reference material (CRM) 470 is not optimal. The aim of this multicenter study involving 7 sites, conducted by a working group of the French Society of Clinical Biology (SFBC), was to assess whether the albuminemia values depend on the analytical system used. The albumin from plasma (n=30) and serum (n=8) pools was quantified by 5 different methods [bromocresol green (VBC) and bromocresol purple (PBC) colorimetry, immunoturbidimetry (IT), immunonephelometry (IN) and capillary electrophoresis (CE)] using 12 analyzers. Bland and Altman's test evaluated the difference between the results obtained by the different methods. For example, a difference as high as 13 g/L was observed for the same sample between the methods (p albumin across the range of values tested compared to PBC (p albumin values inducing a difference of performance between the immunoprecipitation methods (IT vs IN, p albumin results are related to the technical/analyzer tandem used. This variability is usually not taken into account by the clinician. Thus, clinicians and biologists have to be aware and have to check, depending on the method used, the albumin thresholds identified as risk factors for complications related to malnutrition and PMSI coding.

  5. Mit anderen Augen

    DEFF Research Database (Denmark)

    Ydesen, Christian; Høberg, Per

    2010-01-01

    The article 'Mit anderen Augen' focuses on the debate about the state-church relationship in the German Democratic Republic (GDR). Starting from the immediate assumption that a protestant church and a socialist, Marxist-Leninist state were irreconcilable in the construction of a new society...

  6. The filtering, clear-cornea diathermal keratostomy: a minor Danish multicenter study

    DEFF Research Database (Denmark)

    Kessing, S.V.; Nissen, O.I.; Thygesen, J.

    2008-01-01

    PURPOSE: Is the new micropenetrating, clear-cornea procedure, intrastromal diathermal keratostomy (IDK), an alternative to the intricate "modern trabeculectomy"? METHODS: Prospective multicenter study. Four surgeons from 4 Danish eye departments attended an IDK course and subsequently decided whe...

  7. [Enterococcal endocarditis: a multicenter study of 76 cases].

    Science.gov (United States)

    Martínez-Marcos, Francisco Javier; Lomas-Cabezas, José Manuel; Hidalgo-Tenorio, Carmen; de la Torre-Lima, Javier; Plata-Ciézar, Antonio; Reguera-Iglesias, José María; Ruiz-Morales, Josefa; Márquez-Solero, Manuel; Gálvez-Acebal, Juan; de Alarcón-González, Arístides

    2009-12-01

    Although enterococci occupy the third position among microorganisms producing infectious endocarditis (IE) following streptococci and Staphylococcus aureus, few multicenter studies have provided an in-depth analysis of enterococcal IE. Description of the characteristics of 76 cases of enterococcal left-sided infectious endocarditis (LSIE) (native: 59, prosthetic: 17) retrieved from the database of the Cardiovascular Infections Study Group of the Andalusian Society of Infectious Diseases, with emphasis on the comparison with non-enterococcal LSIE. Enterococci were the causal agent in 76 of the 696 episodes of LSIE (11%). Compared with non-enterococcal LSIE, enterococcal LSIE was more commonly seen in patients older than 65 (47.4% vs. 27.6%, P<0.0005), and those with chronic diseases (75% vs. 54.6%, P<0.001), calcified valves (18.6% vs. 10%, P<0.05), and previous urinary (30.3% vs. 2.1%, P<0.00001) or abdominal (10.5% vs. 3.1%, P<0.01) infections, and produced a higher rate of relapses (6.6% vs. 2.3%, P<0.05). Enterococcal LSIE was associated with fewer peripheral vascular or skin manifestations (14.5% vs. 27.1%, P<0.05) and fewer immunological phenomena (10.5% vs. 24%, P<0.01). Among the total of patients with enterococcal LSIE, 36.8% underwent valve surgery during hospitalization. In-hospital mortality was 32.9% for enterococcal LSIE, 9.3% for viridans group streptococci (VGS) LSIE and 48.6% for S. aureus LSIE (enterococci vs VGS: P<0.0001; enterococci vs S. aureus: P=0.02). Enterococcal LSIE patients treated with the combination of a penicillin or vancomycin plus an aminoglycoside (n=60) and those treated with ampicillin plus ceftriaxone (n=6) showed similar in-hospital mortality (26.7% vs 33.3%, P=0.66). High-level resistance to gentamicin was detected in 5 of 38 episodes of enterococcal LSIE (13.1%). Enterococcal LSIE appears in patients with well-defined clinical characteristics, and causes few peripheral vascular or skin manifestations and few immunological

  8. Surgical site infections in Italian Hospitals: a prospective multicenter study

    Directory of Open Access Journals (Sweden)

    Ippolito Giuseppe

    2008-03-01

    Full Text Available Abstract Background Surgical site infections (SSI remain a major clinical problem in terms of morbidity, mortality, and hospital costs. Nearly 60% of SSI diagnosis occur in the postdischarge period. However, literature provides little information on risk factors associated to in-hospital and postdischarge SSI occurrence. A national prospective multicenter study was conducted with the aim of assessing the incidence of both in-hospital and postdisharge SSI, and the associated risk factors. Methods In 2002, a one-month, prospective national multicenter surveillance study was conducted in General and Gynecological units of 48 Italian hospitals. Case ascertainment of SSI was carried out using standardized surveillance methodology. To assess potential risk factors for SSI we used a conditional logistic regression model. We also reported the odds ratios of in-hospital and postdischarge SSI. Results SSI occurred in 241 (5.2% of 4,665 patients, of which 148 (61.4% during in-hospital, and 93 (38.6% during postdischarge period. Of 93 postdischarge SSI, sixty-two (66.7% and 31 (33.3% were detected through telephone interview and questionnaire survey, respectively. Higher SSI incidence rates were observed in colon surgery (18.9%, gastric surgery (13.6%, and appendectomy (8.6%. If considering risk factors for SSI, at multivariate analysis we found that emergency interventions, NNIS risk score, pre-operative hospital stay, and use of drains were significantly associated with SSI occurrence. Moreover, risk factors for total SSI were also associated to in-hospital SSI. Additionally, only NNIS, pre-operative hospital stay, use of drains, and antibiotic prophylaxis were associated with postdischarge SSI. Conclusion Our study provided information on risk factors for SSI in a large population in general surgery setting in Italy. Standardized postdischarge surveillance detected 38.6% of all SSI. We also compared risk factors for in-hospital and postdischarge SSI

  9. Economic Impact of Dengue: Multicenter Study across Four Brazilian Regions

    Science.gov (United States)

    Martelli, Celina Maria Turchi; Siqueira, Joao Bosco; Parente, Mirian Perpetua Palha Dias; Zara, Ana Laura de Sene Amancio; Oliveira, Consuelo Silva; Braga, Cynthia; Pimenta, Fabiano Geraldo; Cortes, Fanny; Lopez, Juan Guillermo; Bahia, Luciana Ribeiro; Mendes, Marcia Costa Ooteman; da Rosa, Michelle Quarti Machado; de Siqueira Filha, Noemia Teixeira; Constenla, Dagna; de Souza, Wayner Vieira

    2015-01-01

    Background Dengue is an increasing public health concern in Brazil. There is a need for an updated evaluation of the economic impact of dengue within the country. We undertook this multicenter study to evaluate the economic burden of dengue in Brazil. Methods We estimated the economic burden of dengue in Brazil for the years 2009 to 2013 and for the epidemic season of August 2012- September 2013. We conducted a multicenter cohort study across four endemic regions: Midwest, Goiania; Southeast, Belo Horizonte and Rio de Janeiro; Northeast: Teresina and Recife; and the North, Belem. Ambulatory or hospitalized cases with suspected or laboratory-confirmed dengue treated in both the private and public sectors were recruited. Interviews were scheduled for the convalescent period to ascertain characteristics of the dengue episode, date of first symptoms/signs and recovery, use of medical services, work/school absence, household spending (out-of-pocket expense) and income lost using a questionnaire developed for a previous cost study. We also extracted data from the patients’ medical records for hospitalized cases. Overall costs per case and cumulative costs were calculated from the public payer and societal perspectives. National cost estimations took into account cases reported in the official notification system (SINAN) with adjustment for underreporting of cases. We applied a probabilistic sensitivity analysis using Monte Carlo simulations with 90% certainty levels (CL). Results We screened 2,223 cases, of which 2,035 (91.5%) symptomatic dengue cases were included in our study. The estimated cost for dengue for the epidemic season (2012–2013) in the societal perspective was US$ 468 million (90% CL: 349–590) or US$ 1,212 million (90% CL: 904–1,526) after adjusting for under-reporting. Considering the time series of dengue (2009–2013) the estimated cost of dengue varied from US$ 371 million (2009) to US$ 1,228 million (2013). Conclusions The economic burden

  10. Report of a Brazilian multicenter study on nephropathic cystinosis.

    Science.gov (United States)

    Vaisbich, Maria Helena; Koch, Vera H

    2010-01-01

    The Brazilian Multicenter Nephropathic Study Group, founded in 1999, is currently composed of 16 pediatric nephrology units, which are coordinated by the Pediatric Nephrology Unit of Instituto da Criança--HCFMUSP. This Study Group intends to better know our patients, their special characteristics and facilitates the treatment. To present an update on the demographics of the ongoing study participants with interest on renal function status, response to therapy, and extra-renal complications. Patient recruitment to the study is based on informed consent and has been supported by the Brazilian Society of Nephrology, by the creation of an electronic homepage and by the participation in medical meetings and publications in medical periodicals. Our study protocol involves the initial and follow-up questionnaire, the measurement of intraleukocyte cystine content, initiation and follow-up therapy with cysteamine, and clinical patient follow-up based on a protocol of subsidiary exams. We identified 102 patients (42 females) with nephropathic cystinosis in Brazil since 1999. Forty-six children are followed at the Instituto da Criança/SP, 15 at the Hospital Pequeno Príncipe/PR, 12 at the UNICAMP/SP, 10 at the Unidade de Transplante Renal - HCFMUSP/SP and 3 at the Santa Casa/SP; the remaining patients are followed at the Instituto da Criança and at their respective doctors' offices in different nephrology services in Brazil. Of these patients, 23/102 (22.5%) have normal renal function, 19/102 (18.6%) are in chronic renal failure with conservative treatment, 26/102 are on dialysis (18 on peritoneal dialysis and 8 on hemodialysis), and 34/102 received a renal transplant. The extra-renal involvement diagnosed was: hypothyroidism in 63 patients, diabetes mellitus in 8 patients, muscular involvement in 7 patients, a compromised central nervous system in 5 patients, hepatic complications in 5 patients, and deglutition dysfunction in 2 patients. During this period, 10/102 patients died. Cysteamine has been used by 81/102 patients (20 children started the therapy under 2 years of age). Growth parameters were improved by cysteamine, mainly in the youngest patients. We used recombinant growth hormone in 15 patients with persistent low growth velocity and stature z score under 2.5%. We could also observe a delay in appearance of extra-renal complications in patients receiving cysteamine. Our study demonstrates the importance of a multi-center study for recruitment, diagnosis and management of rare diseases. This study promotes access to the adequate treatment with profound impact on the quality of life. Copyright 2009 S. Karger AG, Basel.

  11. Photocatalytic degradation of carbamazepine, clofibric acid and iomeprol with P25 and Hombikat UV100 in the presence of natural organic matter (NOM) and other organic water constituents.

    Science.gov (United States)

    Doll, Tusnelda E; Frimmel, Fritz H

    2005-01-01

    The photocatalytic degradation of natural organic matter (NOM) and organic substance mixtures under simulated solar UV light has been investigated with suspended TiO(2). It could be shown by size-exclusion chromatography that photocatalysis of NOM led to a reduction of the average hydrodynamic radii and presumably of the nominal molecular weight, too. The decrease of the UV/Vis absorption of NOM was faster than the NOM mineralization. This study also focuses on the different abilities of photocatalytic materials (P25 and Hombikat UV100) to decrease persistent substances influenced by the presence of NOM and mixtures of pharmaceuticals or diagnostic agents. In general, the presence of NOM and other organic substances retarded the photocatalysis of a specific persistent substance by the combination of radiation attenuation, competition for active sites and surface deactivation of the catalyst by adsorption. The results of this work prove that photocatalysis is a promising technology to reduce persistent substances like NOM, carbamazepine, clofibric acid, iomeprol and iopromide even if they are present in a complex matrix.

  12. Influence of radiographic contrast media (Iodixanol and Iomeprol) on the endothelin-1 release from human arterial and venous endothelial cells cultured on an extracellular matrix.

    Science.gov (United States)

    Franke, R P; Fuhrmann, R; Hiebl, B; Jung, F

    2012-01-01

    Various radiographic contrast media (RCM) are available for visualization of blood vessels in interventional cardiology which can vary widely in their physicochemical properties thereby influencing different functions of blood cells. In the in vitro study described here the influence of two RCMs on arterial as well as on venous endothelial cells was compared to control cultures and examined under statical culture conditions, thus eliminating the influence of RCM viscosity almost completely. The supplementation of the culture medium with RCM (30% v/v) resulted in clearly different reactions of the endothelial cells exposed. Exposition to Iodixanol supplemented culture medium was followed by endothelin-1 release from venous endothelial cells which was equivalent to the endothelin-1 release from venous control cultures. Compared to control cultures, venous endothelial cells exposed to culture medium supplemented with Iomeprol displayed a completely different reaction, the increase in endothelin-1 secretion was missing completely after a 12 hours exposure. Following a 12 hours exposure to both RCMs there were no longer endothelial cells adherent, neither in venous nor in arterial endothelial cell cultures. The study showed that not the wall shear stress was responsible for the differing effects visible after 1.5 min, 5 min, and 12 hours exposure to culture media supplemented with RCM but differences in chemotoxicity of the RCM applied.

  13. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study

    NARCIS (Netherlands)

    von Renteln, Daniel; Fuchs, Karl-Hermann; Fockens, Paul; Bauerfeind, Peter; Vassiliou, Melina C.; Werner, Yuki B.; Fried, Gerald; Breithaupt, Wolfram; Heinrich, Henriette; Bredenoord, Albert J.; Kersten, Jan F.; Verlaan, Tessa; Trevisonno, Michael; Rösch, Thomas

    2013-01-01

    Pilot studies have indicated that peroral endoscopic myotomy (POEM) might be a safe and effective treatment for achalasia. We performed a prospective, international, multicenter study to determine the outcomes of 70 patients who underwent POEM at 5 centers in Europe and North America. Three months

  14. Sucralfate versus cimetidine in reflux esophagitis. A single-blind multicenter study

    NARCIS (Netherlands)

    Hameeteman, W.; v d Boomgaard, D. M.; Dekker, W.; Schrijver, M.; Wesdorp, I. C.; Tytgat, G. N.

    1987-01-01

    A single-blind randomized multicenter study was performed in 42 patients with endoscopically documented reflux esophagitis. Patients were randomly given 400 mg cimetidine q.i.d. or a suspension of 1 g sucralfate q.i.d. for a period of 8 weeks. Forty patients were evaluated after 8 weeks. Symptomatic

  15. Simplified Therapeutic Intervention Scoring System : The TISS-28 items - Results from a multicenter study

    NARCIS (Netherlands)

    Miranda, DR; deRijk, A; Schaufeli, W

    Objectives: To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. Design: Prospective, multicenter study. Setting: Twenty-two adult medical, surgical,

  16. Die Last mit der Lust

    Directory of Open Access Journals (Sweden)

    Lutz Sauerteig

    2004-03-01

    Full Text Available Robert Jütte legt mit Lust ohne Last eine umfassende, allgemeinverständliche und spannend zu lesende Geschichte der Empfängnisverhütung von der Antike bis in die unmittelbare Gegenwart vor.

  17. Spillerum og mit eget rum

    DEFF Research Database (Denmark)

    2014-01-01

    Undervisningsmaterialet Spillerum udviklet som APP til Ipad med interaktive muligheder. Spillerum som APP - et interaktivt undervisningsmateriale, hvor man ud over at bruge det originale materiale Spillerum elektronisk kan skabe sit eget billedbaserede rum "Mit eget rum" som udgangspunkt for dialog....

  18. Kleben von Kunststoff mit Metall

    CERN Document Server

    Brockmann, W; Käufer, H

    1989-01-01

    Das Buch behandelt das Kleben von Kunststoffen mit Metallen in einer fur den Praktiker verstandlichen und umsetzbaren Form. Es leitet zu Klebeverfahren an, die optimale Ergebnisse hinsichtlich Qualitat, Dauerhaftigkeit und Wirtschaftlichkeit liefern.

  19. MIT-CSR XIS Project

    Science.gov (United States)

    1998-01-01

    This report outlines the proposers' progress toward MIT's contribution to the X-Ray Imaging Spectrometer (XIS) experiment on the Japanese ASTRO-E mission. The report discusses electrical system design, mechanical system design, and ground support equipment.

  20. Segmentation of age-related white matter changes in a clinical multi-center study

    DEFF Research Database (Denmark)

    Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.

    2008-01-01

    Age-related white matter changes (WMC) are thought to be a marker of vascular pathology, and have been associated with motor and cognitive deficits. In the present study, an optimized artificial neural network was used as an automatic segmentation method to produce probabilistic maps of WMC...... in a clinical multi-center study. The neural network uses information from T1- and T2-weighted and fluid attenuation inversion recovery (FLAIR) magnetic resonance (MR) scans, neighboring voxels and spatial location. Generalizability of the neural network was optimized by including the Optimal Brain Damage (OBD......) pruning method in the training stage. Six optimized neural networks were produced to investigate the impact of different input information on WMC segmentation. The automatic segmentation method was applied to MR scans of 362 non-demented elderly subjects from 11 centers in the European multi-center study...

  1. Detection of multidrug-resistant tuberculosis from stored DNA Samples: A multicenter study

    OpenAIRE

    Marie Sylvianne Rabodoarivelo; A Brandao; M C Cergole Novella; A G C. Bombonatte; B Imperiale; N Rakotosamimanana; N Morcillo; V Rasolofo; J C Palomino; A Martin

    2018-01-01

    Background: In low-income countries, rapid detection of tuberculosis (TB) drug resistance is often restricted by the difficulties of transporting and storing sputum samples from remote health centers to the reference laboratories where molecular tests are available. The aim of this study was to evaluate the performance of four transport and storage systems for molecular detection of rifampicin (RIF) and isoniazid (INH) resistance. Methods: This was a multicenter study. Molecular detection of ...

  2. Comparative assessment of image quality for coronary CT angiography with iobitridol and two contrast agents with higher iodine concentrations: iopromide and iomeprol. A multicentre randomized double-blind trial

    Energy Technology Data Exchange (ETDEWEB)

    Achenbach, Stephan [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Cardiology, Erlangen (Germany); Paul, Jean-Francois [Centre Chirurgical Marie Lannelongue, Department of Radiology, Le Plessis Robinson (France); Laurent, Francois [University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux (France); CHU de Bordeaux, Service d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Becker, Hans-Christoph [University Hospital Grosshadern, Department of Clinical Radiology, Munich (Germany); Rengo, Marco [Sapienza - University of Rome, ICOT Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Caudron, Jerome [University Hospital of Rouen, Department of Radiology, Rouen (France); Leschka, Sebastian [Saint Gallen Hospital, Department of Radiology, Saint Gallen (Switzerland); Vignaux, Olivier [Cochin Hospital, Department of Radiology, Paris (France); Knobloch, Gesine [La Charite, Department of Radiology, Berlin (Germany); Benea, Giorgio [Ospedale del Delta, Ferrara (Italy); Schlosser, Thomas [Elisabeth-Krankenhaus Hospital, Essen (Germany); Andreu, Jordi [Hospital Vall d' Hebron, Barcelona (Spain); Cabeza, Beatriz [Hospital Clinico San Carlos, Madrid (Spain); Jacquier, Alexis [La Timone Adult Hospital, Department of Radiology, Marseille (France); Souto, Miguel [Complejo Hospitalario Universitario, Santiago de Compostela (Spain); Revel, Didier [Louis Pradel Hospital, Department of Radiology, Lyon (France); Qanadli, Salah Dine [University of Lausanne, Department of Radiology, Lausanne (Switzerland); Cademartiri, Filippo [Giovanni XXIII Hospital, Department of Radiology, Monastier di Treviso (Italy); Collaboration: X-ACT Study Group

    2017-02-15

    To demonstrate non-inferiority of iobitridol 350 for coronary CT angiography (CTA) compared to higher iodine content contrast media regarding rate of patients evaluable for the presence of coronary artery stenoses. In this multicentre trial, 452 patients were randomized to receive iobitridol 350, iopromide 370 or iomeprol 400 and underwent coronary CTA using CT systems with 64-detector rows or more. Two core lab readers assessed 18 coronary segments per patient regarding image quality (score 0 = non diagnostic to 4 = excellent quality), vascular attenuation, signal and contrast to noise ratio (SNR, CNR). Patients were considered evaluable if no segment had a score of 0. Per-patient, the rate of fully evaluable CT scans was 92.1, 95.4 and 94.6 % for iobitridol, iopromide and iomeprol, respectively. Non-inferiority of iobitridol over the best comparator was demonstrated with a 95 % CI of the difference of [-8.8 to 2.1], with a pre-specified non-inferiority margin of -10 %. Although average attenuation increased with higher iodine concentrations, average SNR and CNR did not differ between groups. With current CT technology, iobitridol 350 mg iodine/ml is not inferior to contrast media with higher iodine concentrations in terms of image quality for coronary stenosis assessment. (orig.)

  3. An open multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and mixed urinary incontinence

    DEFF Research Database (Denmark)

    Lose, Gunnar; Sørensen, Helle Christina; Axelsen, Susanne Maigaard

    2010-01-01

    Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence.......Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence....

  4. Mass Spectrometry Imaging of Biological Tissue: An Approach for Multicenter Studies

    Energy Technology Data Exchange (ETDEWEB)

    Rompp, Andreas; Both, Jean-Pierre; Brunelle, Alain; Heeren, Ronald M.; Laprevote, Olivier; Prideaux, Brendan; Seyer, Alexandre; Spengler, Bernhard; Stoeckli, Markus; Smith, Donald F.

    2015-03-01

    Mass spectrometry imaging has become a popular tool for probing the chemical complexity of biological surfaces. This led to the development of a wide range of instrumentation and preparation protocols. It is thus desirable to evaluate and compare the data output from different methodologies and mass spectrometers. Here, we present an approach for the comparison of mass spectrometry imaging data from different laboratories (often referred to as multicenter studies). This is exemplified by the analysis of mouse brain sections in five laboratories in Europe and the USA. The instrumentation includes matrix-assisted laser desorption/ionization (MALDI)-time-of-flight (TOF), MALDI-QTOF, MALDIFourier transform ion cyclotron resonance (FTICR), atmospheric-pressure (AP)-MALDI-Orbitrap, and cluster TOF-secondary ion mass spectrometry (SIMS). Experimental parameters such as measurement speed, imaging bin width, and mass spectrometric parameters are discussed. All datasets were converted to the standard data format imzML and displayed in a common open-source software with identical parameters for visualization, which facilitates direct comparison of MS images. The imzML conversion also allowed exchange of fully functional MS imaging datasets between the different laboratories. The experiments ranged from overview measurements of the full mouse brain to detailed analysis of smaller features (depending on spatial resolution settings), but common histological features such as the corpus callosum were visible in all measurements. High spatial resolution measurements of AP-MALDI-Orbitrap and TOF-SIMS showed comparable structures in the low-micrometer range. We discuss general considerations for planning and performing multicenter studies in mass spectrometry imaging. This includes details on the selection, distribution, and preparation of tissue samples as well as on data handling. Such multicenter studies in combination with ongoing activities for reporting guidelines, a common

  5. Diagnostic imaging and interventional radiology of hepatocellular carcinoma: A multicenter study on 290 cases

    International Nuclear Information System (INIS)

    Dalla Palma, Ludovico; Puzzi Mucelli, Roberto; Sponza, Massimo; De Santis, Mario; Gandini, Giovanni; Matricardi, Luigi; Rossi, Cristina

    1997-01-01

    The authors report of a multicenter study on the diagnosis and interventional therapy of hepatocellular carcinoma (HCC).The first aim -diagnostic - was to evaluate the sensitivity of 4 imaging techniques, namely ultrasonography (US), Computed Tomography (CT), digital arteriography (DSA) and Lipiodol CT (LCT), in hepatocellular carcinoma detection. The accuracy of these techniques was also investigated in tumor staging, which is important for treatment planning.The second aim - treatment - consisted in assessing the therapeutic efficacy of intraarterial chemoembolization (CEAT) versus percutaneous ethanol injection (PEI) in non advanced hepatocellular carcinoma and of intraarterial chemoembolization versus no treatment (NT) in advanced hepatocellular carcinoma. Treatment efficacy was evaluated with the following randomized protocols

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

    Directory of Open Access Journals (Sweden)

    Samir eDas

    2012-01-01

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

  7. MITS instrumentation error analysis report

    International Nuclear Information System (INIS)

    Nelson, D.W.; Hillon, D.D.

    1980-01-01

    The MITS (Machine Interface Test System) installation consists of three types of process monitoring and control instrumentation: flow, pressure, and temperature. An effort has been made to assess the various instruments used and assign a value to the accuracy that can be expected. Efforts were also made to analyze the calibration and installation procedures to be used and determine how these might effect the system accuracy

  8. MIT miniaturized disk bend test

    International Nuclear Information System (INIS)

    Harling, O.K.; Lee, M.; Sohn, D.S.; Kohse, G.; Lau, C.W.

    1983-01-01

    A miniaturized disk bend test (MDBT) using transmission electron microscopy specimens for the determination of various mechanical properties is being developed at MIT. Recent progress in obtaining strengths and ductilities of highly irradiated metal alloys is reviewed. Other mechanical properties can also be obtained using the MDBT approach. Progress in fatigue testing and in determination of the ductile-to-brittle transition temperature is reviewed briefly. 11 figures

  9. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study

    DEFF Research Database (Denmark)

    Giovannini, Marc; Thomas, Botelberge; Erwan, Bories

    2009-01-01

    AIM: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS: A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph...... node (n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUS-FNA) and/or by surgical pathology. An interobserver...... study was performed. RESULTS: The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS...

  10. [Information management in multicenter studies: the Brazilian longitudinal study for adult health].

    Science.gov (United States)

    Duncan, Bruce Bartholow; Vigo, Álvaro; Hernandez, Émerson; Luft, Vivian Cristine; Ahlert, Hubert; Bergmann, Kaiser; Mota, Eduardo

    2013-06-01

    Information management in large multicenter studies requires a specialized approach. The Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil - Brazilian Longitudinal Study for Adult Health) has created a Datacenter to enter and manage its data system. The aim of this paper is to describe the steps involved, including the information entry, transmission and management methods. A web system was developed in order to allow, in a safe and confidential way, online data entry, checking and editing, as well as the incorporation of data collected on paper. Additionally, a Picture Archiving and Communication System was implemented and customized for echocardiography and retinography. It stores the images received from the Investigation Centers and makes them available at the Reading Centers. Finally, data extraction and cleaning processes were developed to create databases in formats that enable analyses in multiple statistical packages.

  11. [Role of multicenter study groups for clinical research in hematology and oncology].

    Science.gov (United States)

    Gökbuget, N; Hoelzer, D

    2009-04-01

    During the past 25 years a highly effective infrastructure for clinical trials was developed in hematology. Following initial funding by the BMFT (Ministry for Research and Technology) a number of large multicenter study groups for leukemia and lymphoma were developed. Treatment results from these studies often represent the"gold standard". However, since no standard therapy is defined for these diseases, the study groups aim to treat all patients within treatment optimization trials (TOT) to combine research and care. They contribute considerably to quality control in therapy and diagnostics, e.g., by establishing central reference laboratories. The regulatory requirements for clinical trials were extended considerably after the activation of the 12th drug law and TOTs now have to fulfill requirements similar to registration trials in the pharmaceutical industry. Due to the considerable bureaucratic effort and increased costs, only few large multicenter trials could thereafter be initiated and a substantial disadvantage for independent academic research becomes clearly evident.

  12. Multicenter Study of the Clinical Presentation of Staphylococcus lugdunensis Bacteremia in Japan.

    Science.gov (United States)

    Ainoda, Yusuke; Takeshita, Nozomi; Hase, Ryota; Mikawa, Takahiro; Hosokawa, Naoto; Kawamura, Ichiro; Kurai, Hanako; Abe, Masahiro; Kimura, Muneyoshi; Araoka, Hideki; Fujita, Takahiro; Totsuka, Kyoichi; Mezaki, Kazuhisa; Sekiya, Noritaka; Ohmagari, Norio

    2017-07-24

    Staphylococcus lugdunensis (SL) is a bacterium with a highly pathogenicity than most other coagulase-negative Staphylococcus spp. (CoNS). In Japan, data on this pathogen are sparse, and the current prevalence of SL bacteremia is unknown. Therefore, we investigated the prevalence of SL in blood culture specimens in a prospective multicenter study across 5 facilities. A total of 3,284 patients had positive blood cultures, and 2,478 patients had bacteremia. Among the patients with bacteremia, 7 patients (0.28%) had SL bacteremia. A total of 281 patients had CoNS bacteremia, with SL accounting for 2.49% of these cases. Of the 7 patients with SL bacteremia, 1 patient (14.3%) had infective endocarditis, and 1 patient (14.3%) died within 30 days. In this study, SL resulted in the development of bacteremia in select patients. Clinicians in Japan should be aware of the prevalence of SL and the complications of SL bacteremia.

  13. Prevalence of genital Chlamydia trachomatis infections in Russia: systematic literature review and multicenter study.

    Science.gov (United States)

    Smelov, Vitaly; Thomas, Pierre; Ouburg, Sander; Morré, Servaas A

    2017-09-29

    A reliable overview of data on the prevalence of Chlamydia trachomatis (CT) in Russia is lacking and needed. All the available data on CT prevalence were analyzed in a systematic literature review on CT prevalence in Russia, strengthened with data from the multicenter study among 1263 people in the second-largest Russian megalopolis, St. Petersburg, testing for CT DNA in urethral, anal, cervical and prostate samples. A total of 10 articles met the inclusion criteria. The overall average prevalence of genital CT infections in Russian populations ranged from 2.9% to 33%. Risk factors included being symptomatic (P = 0.004; in men P Russia should be considered. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

    Science.gov (United States)

    O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

    2017-04-01

    Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

  15. CT perfusion-guided patient selection for endovascular recanalization in acute ischemic stroke: a multicenter study.

    Science.gov (United States)

    Turk, Aquilla S; Magarick, Jordan Asher; Frei, Don; Fargen, Kyle Michael; Chaudry, Imran; Holmstedt, Christine A; Nicholas, Joyce; Mocco, J; Turner, Raymond D; Huddle, Daniel; Loy, David; Bellon, Richard; Dooley, Gwendolyn; Adams, Robert; Whaley, Michelle; Fanale, Chris; Jauch, Edward

    2013-11-01

    The treatment of acute ischemic stroke is traditionally centered on time criteria, although recent evidence suggests that physiologic neuroimaging may be useful. In a multicenter study we evaluated the use of CT perfusion, regardless of time from symptom onset, in patients selected for intra-arterial treatment of ischemic stroke. Three medical centers retrospectively assessed stroke patients with a National Institute of Health Stroke Scale of ≥ 8, regardless of time from symptom onset. CT perfusion maps were qualitatively assessed. Patients with defined salvageable penumbra underwent intra-arterial revascularization of their occlusion. Functional outcome using the modified Rankin Score (mRS) was recorded. Two hundred and forty-seven patients were selected to undergo intra-arterial treatment based on CT perfusion imaging. The median time from symptom onset to procedure was 6 h. Patients were divided into two groups for analysis: ≤ 8 h and >8 h from symptom onset to endovascular procedure. We found no difference in functional outcome between the two groups (42.8% and 41.9% achieved 90-day mRS ≤ 2, respectively (p=1.0), and 54.9% vs 55.4% (p=1.0) achieved 90-day mRS ≤ 3, respectively). Overall, 48 patients (19.4%) had hemorrhages, of which 20 (8.0%) were symptomatic, with no difference between the groups (p=1.0). In a multicenter study, we demonstrated similar rates of good functional outcome and intracranial hemorrhage in patients with ischemic stroke when endovascular treatment was performed based on CT perfusion selection rather than time-guided selection. Our findings suggest that physiologic imaging-guided patient selection rather than time for endovascular reperfusion in ischemic stroke may be effective and safe.

  16. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects

    NARCIS (Netherlands)

    Tack, C.J.; Pohlmeier, H.; Behnke, T.; Schmid, V.; Grenningloh, M.; Forst, T.; Pfutzner, A.

    2012-01-01

    BACKGROUND: This multicenter study was conducted to evaluate the performance of five recently introduced blood glucose (BG) monitoring (BGM) devices under daily routine conditions in comparison with the YSI (Yellow Springs, OH) 2300 Stat Plus glucose analyzer. METHODS: Five hundred one diabetes

  17. MIT pebble bed reactor project

    Energy Technology Data Exchange (ETDEWEB)

    Kadak, Andrew C. [Massachusetts Institute of Technology, Cambridge (United States)

    2007-03-15

    The conceptual design of the MIT modular pebble bed reactor is described. This reactor plant is a 250 Mwth, 120 Mwe indirect cycle plant that is designed to be deployed in the near term using demonstrated helium system components. The primary system is a conventional pebble bed reactor with a dynamic central column with an outlet temperature of 900 C providing helium to an intermediate helium to helium heat exchanger (IHX). The outlet of the IHX is input to a three shaft horizontal Brayton Cycle power conversion system. The design constraint used in sizing the plant is based on a factory modularity principle which allows the plant to be assembled 'Lego' style instead of constructed piece by piece. This principle employs space frames which contain the power conversion system that permits the Lego-like modules to be shipped by truck or train to sites. This paper also describes the research that has been conducted at MIT since 1998 on fuel modeling, silver leakage from coated fuel particles, dynamic simulation, MCNP reactor physics modeling and air ingress analysis.

  18. MIT pebble bed reactor project

    International Nuclear Information System (INIS)

    Kadak, Andrew C.

    2007-01-01

    The conceptual design of the MIT modular pebble bed reactor is described. This reactor plant is a 250 Mwth, 120 Mwe indirect cycle plant that is designed to be deployed in the near term using demonstrated helium system components. The primary system is a conventional pebble bed reactor with a dynamic central column with an outlet temperature of 900 C providing helium to an intermediate helium to helium heat exchanger (IHX). The outlet of the IHX is input to a three shaft horizontal Brayton Cycle power conversion system. The design constraint used in sizing the plant is based on a factory modularity principle which allows the plant to be assembled 'Lego' style instead of constructed piece by piece. This principle employs space frames which contain the power conversion system that permits the Lego-like modules to be shipped by truck or train to sites. This paper also describes the research that has been conducted at MIT since 1998 on fuel modeling, silver leakage from coated fuel particles, dynamic simulation, MCNP reactor physics modeling and air ingress analysis

  19. Biotechnology Process Engineering Center at MIT Home

    Science.gov (United States)

    has provided a focal point for biotechnology research and education at MIT. Prominent examples include the NIH Training Program in Biotechnology and the NIH Training Program in Genomics; both of these are -genomic biology. Another example is the new DuPont-MIT Alliance (DMA), focused on materials biotechnology

  20. Fibromyalgia as a cause of uncontrolled asthma: a case-control multicenter study.

    Science.gov (United States)

    Martinez-Moragon, Eva; Plaza, Vicente; Torres, Isabel; Rosado, Ana; Urrutia, Isabel; Casas, Xavier; Hinojosa, Belen; Blanco-Aparicio, Marina; Delgado, Julio; Quirce, Santiago; Sabadell, Carles; Cebollero, Pilar; Muñoz-Fernández, Ana

    2017-12-01

    Fibromyalgia can affect the control of asthma when both diseases are present in a single patient. To characterize asthma in patients with concomitant fibromyalgia to assess whether fibromyalgia is an independent factor of asthma severity that influences poor asthma control. We also evaluated how dyspnea is perceived by patients in order to demonstrate that alterations in the perception of airway obstruction may be responsible for poor asthma control. This was a cross-sectional case-control multicenter study, in which 56 patients in the asthma and fibromyalgia group were matched to 36 asthmatics by sex, approximate age, and asthma severity level. All patients were women. Study variables included the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), the Nijmegen hyperventilation syndrome questionnaire, the Hospital Anxiety and Depression Scale, and perception of dyspnea after acute bronchoconstriction. Although patients in both study groups showed similar asthma severity and use of anti-asthmatic drugs, patients in the asthma and fibromyalgia group showed lower scores on the ACT and MiniAQLQ questionnaires, and higher scores of anxiety and depression as well as hyperventilation compared to asthma patients without fibromyalgia. All these differences were statistically significant. Fibromyalgia in patients with asthma influences poor control of the respiratory disease and is associated with altered perception of dyspnea, hyperventilation syndrome, high prevalence of depression and anxiety, and impaired quality of life. Fibromyalgia may be considered a risk factor for uncontrolled asthma in patients suffering from asthma and fibromyalgia concomitantly.

  1. Recurrent peptic ulcers in patients following successful Helicobacter pylori eradication: a multicenter study of 4940 patients.

    Science.gov (United States)

    Miwa, Hiroto; Sakaki, Nobuhiro; Sugano, Kentaro; Sekine, Hitoshi; Higuchi, Kazuhide; Uemura, Naomi; Kato, Mototsugu; Murakami, Kazunari; Kato, Chieko; Shiotani, Akiko; Ohkusa, Toshifumi; Takagi, Atsushi; Aoyama, Nobuo; Haruma, Ken; Okazaki, Kazuichi; Kusugami, Kazuo; Suzuki, Masayuki; Joh, Takashi; Azuma, Takeshi; Yanaka, Akinori; Suzuki, Hidekazu; Hashimoto, Hiroshi; Kawai, Takashi; Sugiyama, Toshiro

    2004-02-01

    Although curative treatment of Helicobacter pylori infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection. This was a multicenter study involving 4940 peptic ulcer patients who were H. pylori negative after successful eradication treatment and were followed for up to 48 months. The annual incidence of ulcer relapse in H. pylori-cured patients, background of patients with relapsed ulcers, time to relapse, ulcer size, and site of relapsed ulcers were investigated. Crude peptic ulcer recurrence rate was 3.02% (149/4940). The annual recurrence rates of gastric, duodenal and gastroduodenal ulcer were 2.3%, 1.6%, and 1.6%, respectively. Exclusion of patients who took NSAIDs led annual recurrence rates to 1.9%, 1.5% and 1.3%, respectively. The recurrence rate was significantly higher in gastric ulcer. Recurrence rates of patients who smoked, consumed alcohol, and used NSAIDs were significantly higher in those with gastric ulcer recurrence compared to duodenal ulcer recurrence (e.g. 125 of 149 [83.9%] relapsed ulcers recurred at the same or adjacent sites as the previous ulcers). Curative treatment of H. pylori infection is useful in preventing ulcer recurrence. Gastric ulcer is more likely to relapse than duodenal ulcer. Recurrent ulcer tended to recur at the site of the original ulcers.

  2. Normative data for Aδ contact heat evoked potentials in adult population: a multicenter study.

    Science.gov (United States)

    Granovsky, Yelena; Anand, Praveen; Nakae, Aya; Nascimento, Osvaldo; Smith, Benn; Sprecher, Elliot; Valls-Solé, Josep

    2016-05-01

    There has been a significant increase over recent years in the use of contact heat evoked potentials (CHEPs) for the evaluation of small nerve fiber function. Measuring CHEP amplitude and latency has clinical utility for the diagnosis and assessment of conditions with neuropathic pain. This international multicenter study aimed to provide reference values for CHEPs to stimuli at 5 commonly examined body sites. Contact heat evoked potentials were recorded from 226 subjects (114 females), distributed per age decade between 20 and 79 years. Temperature stimuli were delivered by a thermode (32°C-51°C at a rate of 70°C/s). In phase I of the study, we investigated side-to-side differences and reported the maximum normal side-to-side difference in Aδ CHEP peak latency and amplitude for leg, forearm, and face. In phase II, we obtained normative data for 3 CHEP parameters (N2P2 amplitude, N2 latency, and P2 latency), stratified for gender and age decades from face, upper and lower limbs, and overlying cervical and lumbar spine. In general, larger CHEP amplitudes were associated with higher evoked pain scores. Females had CHEPs of larger amplitude and shorter latency than males. This substantive data set of normative values will facilitate the clinical use of CHEPs as a rapid, noninvasive, and objective technique for the assessment of patients presenting with neuropathic pain.

  3. Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

    Science.gov (United States)

    Burks, Collin E; Jones, Christopher W; Braz, Valerie A; Swor, Robert A; Richmond, Natalie L; Hwang, Kay S; Hollowell, Allison G; Weaver, Mark A; Platts-Mills, Timothy F

    2017-08-01

    Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury. To identify modifiable risk factors associated with malnutrition in older patients. Prospective cross-sectional multicenter study. 3 EDs in the South, Northeast, and Midwest. Non-critically ill, English-speaking adults aged ≥65 years. Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor. In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%). Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  4. Multicenter study of antimicrobial susceptibility of anaerobic bacteria in Korea in 2012.

    Science.gov (United States)

    Lee, Yangsoon; Park, Yeon Joon; Kim, Mi Na; Uh, Young; Kim, Myung Sook; Lee, Kyungwon

    2015-09-01

    Periodic monitoring of regional or institutional resistance trends of clinically important anaerobic bacteria is recommended, because the resistance of anaerobic pathogens to antimicrobial drugs and inappropriate therapy are associated with poor clinical outcomes. There has been no multicenter study of clinical anaerobic isolates in Korea. We aimed to determine the antimicrobial resistance patterns of clinically important anaerobes at multiple centers in Korea. A total of 268 non-duplicated clinical isolates of anaerobic bacteria were collected from four large medical centers in Korea in 2012. Antimicrobial susceptibility was tested by the agar dilution method according to the CLSI guidelines. The following antimicrobials were tested: piperacillin, piperacillin-tazobactam, cefoxitin, cefotetan, imipenem, meropenem, clindamycin, moxifloxacin, chloramphenicol, metronidazole, and tigecycline. Organisms of the Bacteroides fragilis group were highly susceptible to piperacillin-tazobactam, imipenem, and meropenem, as their resistance rates to these three antimicrobials were lower than 6%. For B. fragilis group isolates and anaerobic gram-positive cocci, the resistance rates to moxifloxacin were 12-25% and 11-13%, respectively. Among B. fragilis group organisms, the resistance rates to tigecycline were 16-17%. Two isolates of Finegoldia magna were non-susceptible to chloramphenicol (minimum inhibitory concentrations of 16-32 mg/L). Resistance patterns were different among the different hospitals. Piperacillin-tazobactam, cefoxitin, and carbapemems are highly active beta-lactam agents against most of the anaerobes. The resistance rates to moxifloxacin and tigecycline are slightly higher than those in the previous study.

  5. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

    Institute of Scientific and Technical Information of China (English)

    Massimiliano Rizzi; Silvia Mazzuoli; Nunzia Regano; Rosa Inguaggiato; Margherita Bianco; Gioacchino Leandro; Elisabetta Bugianesi; Donatella Noè; Nicoletta Orzes; Paolo Pallini; Maria Letizia Petroni; Gianni Testino; Francesco William Guglielmi

    2016-01-01

    AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.

  6. Factors associated with nursing students' academic success or failure: a retrospective Italian multicenter study.

    Science.gov (United States)

    Dante, A; Valoppi, G; Saiani, L; Palese, A

    2011-01-01

    With the increasing standardization of nursing education in Europe under the Bologna Process Declaration (1999), there is a growing interest in defining a common concept of academic success and/or failure, measuring associated factors and comparing differences and similarities between different countries. While there is literature available on these issues from other countries, the phenomenon has not been studied in Italy. The aim of this study was to define the factors associated with academic success or failure in an Italian cohort of nursing students on a bachelor's degree course. A retrospective multicenter study design was adopted. All students enrolling in the academic year 2004-05 on two different bachelor's courses in the north of Italy were interviewed. Only 81 of the 117 students considered (69.2%) concluded their course in three years. Multivariate analysis identified two factors determining academic success/failure: good results in the entry examination for the bachelor's degree in nursing sciences were associated with academic success (OR 4.217, IC(95%) 1.501-11.84), while family commitments, e.g. caring for children or elderly people were associated with academic failure (OR 0.120, IC(95%) 0.03-0.471). Academic failure has a strong impact on students, their families, the teaching faculties and the community, and its prevention is a challenge in the countries with a shortage of nurses. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    International Nuclear Information System (INIS)

    Pellerin, O.; Barral, F. G.; Lions, C.; Novelli, L.; Beregi, J. P.; Sapoval, M.

    2008-01-01

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 ± 15 days (range, 6-722 days) through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.

  8. Detection of multidrug-resistant tuberculosis from stored DNA Samples: A multicenter study

    Directory of Open Access Journals (Sweden)

    Marie Sylvianne Rabodoarivelo

    2018-01-01

    Full Text Available Background: In low-income countries, rapid detection of tuberculosis (TB drug resistance is often restricted by the difficulties of transporting and storing sputum samples from remote health centers to the reference laboratories where molecular tests are available. The aim of this study was to evaluate the performance of four transport and storage systems for molecular detection of rifampicin (RIF and isoniazid (INH resistance. Methods: This was a multicenter study. Molecular detection of RIF and INH resistance was performed directly from smear-positive TB sputa spotted on a slide, FTA card, GenoCard, and ethanol using the Genotype MTBDRplus assay. The performance of the DNA extraction method from each storage support to detect drug resistance was assessed by calculating their sensitivity and specificity compared to the phenotypic method. Results: From all sites, the overall sensitivity and specificity for RIF-resistance detection was 88% and 85%, respectively, for slides, 86% and 92%, respectively, for GenoCard, 87% and 89%, respectively, for FTA card, and 88% and 92%, respectively, for ethanol. For INH-resistance detection, the overall sensitivity and specificity was 82% and 90%, respectively, for slides, 85% and 96%, respectively, for GenoCard, 86% and 92%, respectively, for FTA card, and 86% and 94%, respectively, for ethanol. Conclusion: Smear slides and filter cards showed to be very useful tools to facilitate DNA extraction from sputum samples with the potential to accelerate the detection of drug resistance in remote areas.

  9. Detection of multidrug-resistant tuberculosis from stored DNA Samples: A multicenter study.

    Science.gov (United States)

    Rabodoarivelo, Marie Sylvianne; Brandao, A; Cergole Novella, M C; C Bombonatte, A G; Imperiale, B; Rakotosamimanana, N; Morcillo, N; Rasolofo, V; Palomino, J C; Martin, A

    2018-01-01

    In low-income countries, rapid detection of tuberculosis (TB) drug resistance is often restricted by the difficulties of transporting and storing sputum samples from remote health centers to the reference laboratories where molecular tests are available. The aim of this study was to evaluate the performance of four transport and storage systems for molecular detection of rifampicin (RIF) and isoniazid (INH) resistance. This was a multicenter study. Molecular detection of RIF and INH resistance was performed directly from smear-positive TB sputa spotted on a slide, FTA card, GenoCard, and ethanol using the Genotype MTBDRplus assay. The performance of the DNA extraction method from each storage support to detect drug resistance was assessed by calculating their sensitivity and specificity compared to the phenotypic method. From all sites, the overall sensitivity and specificity for RIF-resistance detection was 88% and 85%, respectively, for slides, 86% and 92%, respectively, for GenoCard, 87% and 89%, respectively, for FTA card, and 88% and 92%, respectively, for ethanol. For INH-resistance detection, the overall sensitivity and specificity was 82% and 90%, respectively, for slides, 85% and 96%, respectively, for GenoCard, 86% and 92%, respectively, for FTA card, and 86% and 94%, respectively, for ethanol. Smear slides and filter cards showed to be very useful tools to facilitate DNA extraction from sputum samples with the potential to accelerate the detection of drug resistance in remote areas.

  10. [Immunodiagnosis of endemic mycoses and bronchopulmonary aspergillosis: a multicenter study in Argentina].

    Science.gov (United States)

    Canteros, C E; Rivas, M C; Soria, M; Lee, W; Perrotta, D; Rodero, L; Davel, G

    2004-01-01

    In order to contribute to the knowledge of the relative frequency of chronic fungal diseases and assess the performance of diagnostic laboratories in Argentina, a multicenter study was performed with the participation of 25 medical centers located in 12 different provinces and Buenos Aires City. Between 04-01-2000 and 03-30-2001, 965 serum specimens from patients clinically suspected of having histoplasmosis (HP), paracoccidioidomycosis (PCM), coccidioidomycosis (CM) or aspergilosis were analyzed. Agar immunodiffusion tests (IDD) were done locally. All positive and 35% of negative sera were retested in the reference center. Results of laboratories of origin showed 98.8% concordance with those of reference center. Antibodies against any of the etiological agents were detected in 120 specimens from 98 patients. Endemic mycoses (HP, PCM and CM) were diagnosed in 70 patients (71.4%) and aspergilosis in 28 (28.6%). The frequencies of the different mycoses in decreasing order were PCM 47 patients (47.9%), aspergilosis 28 patients (28.6%), HP 13 patients (13.3%) and CM 10 patients (10.2%). The study was carried out on a voluntary basis and some areas of the country were not represented. However, the frequencies were in range with the expected rates in the population under study.

  11. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

    OpenAIRE

    Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

    2015-01-01

    Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to...

  12. One-year results of a prospective randomized, evaluator-blinded, multicenter study comparing TVT and TVT Secur.

    OpenAIRE

    Andrada Hamer, Maria; Larsson, Per-Göran; Teleman, Pia; Bergqvist, Christina Eten; Persson, Jan

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this prospective randomized multicenter study was to compare retropubic tension-free vaginal tape (TVT) with TVT Secur in terms of efficacy and safety. METHODS: We set out to enrol 280 stress urinary incontinent (SUI) women with a half-time interim analysis of short-term cure and adverse events. The short-term results have previously been published. Of the133 randomized women, 125 underwent surgery, and 121 (TVT n = 61, TVT Secur n = 60)...

  13. A global multicenter study on reference values: 2. Exploration of sources of variation across the countries.

    Science.gov (United States)

    Ichihara, Kiyoshi; Ozarda, Yesim; Barth, Julian H; Klee, George; Shimizu, Yoshihisa; Xia, Liangyu; Hoffmann, Mariza; Shah, Swarup; Matsha, Tandi; Wassung, Janette; Smit, Francois; Ruzhanskaya, Anna; Straseski, Joely; Bustos, Daniel N; Kimura, Shogo; Takahashi, Aki

    2017-04-01

    The intent of this study, based on a global multicenter study of reference values (RVs) for serum analytes was to explore biological sources of variation (SVs) of the RVs among 12 countries around the world. As described in the first part of this paper, RVs of 50 major serum analytes from 13,396 healthy individuals living in 12 countries were obtained. Analyzed in this study were 23 clinical chemistry analytes and 8 analytes measured by immunoturbidimetry. Multiple regression analysis was performed for each gender, country by country, analyte by analyte, by setting four major SVs (age, BMI, and levels of drinking and smoking) as a fixed set of explanatory variables. For analytes with skewed distributions, log-transformation was applied. The association of each source of variation with RVs was expressed as the partial correlation coefficient (r p ). Obvious gender and age-related changes in the RVs were observed in many analytes, almost consistently between countries. Compilation of age-related variations of RVs after adjusting for between-country differences revealed peculiar patterns specific to each analyte. Judged fromthe r p , BMI related changes were observed for many nutritional and inflammatory markers in almost all countries. However, the slope of linear regression of BMI vs. RV differed greatly among countries for some analytes. Alcohol and smoking-related changes were observed less conspicuously in a limited number of analytes. The features of sex, age, alcohol, and smoking-related changes in RVs of the analytes were largely comparable worldwide. The finding of differences in BMI-related changes among countries in some analytes is quite relevant to understanding ethnic differences in susceptibility to nutritionally related diseases. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Incidence of transfusion reactions: a multi-center study utilizing systematic active surveillance and expert adjudication

    Science.gov (United States)

    Hendrickson, Jeanne E.; Roubinian, Nareg H.; Chowdhury, Dhuly; Brambilla, Don; Murphy, Edward L.; Wu, Yanyun; Ness, Paul M.; Gehrie, Eric A.; Snyder, Edward L.; Hauser, R. George; Gottschall, Jerome L.; Kleinman, Steve; Kakaiya, Ram; Strauss, Ronald G.

    2017-01-01

    Background Prevalence estimates of serious hazards of transfusion vary widely. We hypothesized that the current reporting infrastructure in the United States fails to capture many transfusion reactions, and undertook a multi-center study utilizing active surveillance, data review, and adjudication to test this hypothesis. Study Design and Methods A retrospective record review was completed for a random sample of 17% of all inpatient transfusion episodes over 6 months at 4 academic tertiary care hospitals, with an episode defined as all blood products released to a patient in 6 hours. Data were recorded by trained clinical research nurses, and serious reactions were adjudicated by a panel of transfusion medicine experts. Results Of 4857 transfusion episodes investigated, 1.1% were associated with a serious reaction. Transfusion associated circulatory overload (TACO) was the most frequent serious reaction noted, being identified in 1% of transfusion episodes. Despite clinical notes describing a potential transfusion association in 59% of these cases, only 5.1% were reported to the transfusion service. Suspected transfusion related acute lung injury (TRALI/possible TRALI), anaphylactic, and hypotensive reactions were noted in 0.08%, 0.02%, and 0.02% of transfusion episodes. Minor reactions, including febrile non-hemolytic and allergic, were noted in 0.62% and 0.29% of transfusion episodes, with 30–50% reported to the transfusion service. Conclusion Underreporting of cardiopulmonary transfusion reactions is striking among academic, tertiary care hospitals. Complete and accurate reporting is essential to identify, define, establish pathogenesis, and mitigate/treat transfusion reactions. A better understanding of the failure to report may improve the accuracy of passive reporting systems. PMID:27460200

  15. Multicenter study of environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in 48 Canadian hospitals.

    Science.gov (United States)

    Poupeau, Céline; Tanguay, Cynthia; Caron, Nicolas J; Bussières, Jean-François

    2018-01-01

    Context Oncology workers are occupationally exposed to antineoplastic drugs. This exposure can induce adverse health effects. In order to reduce their exposure, contamination on surfaces should be kept as low as possible. Objectives To monitor environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in oncology pharmacy and patient care areas in Canadian hospitals. To describe the impact of some factors that may limit contamination. Methods This is a descriptive study. Twelve standardized sites were sampled in each participating center (six in the pharmacy and six in patient care areas). Samples were analyzed for the presence of cyclophosphamide, ifosfamide, and methotrexate by ultra-performance liquid chromatography tandem mass spectrometry technology. Descriptive statistical analyses were done and results were compared with a Kolmogorov-Smirnov test for independent samples. Results In 2015, 48 hospitals participated in this study (48/202, 24%). Overall, 34% (181/525) of the samples were positive for cyclophosphamide, 8% (41/525) for ifosfamide, and 6% (31/525) for methotrexate. The 75th percentile value of cyclophosphamide surface concentration was 6.9 pg/cm 2 . For ifosfamide and methotrexate, they were lower than the limit of detection. Centers who prepared more antineoplastic drugs per year and centers who used more cyclophosphamide per year showed significantly higher surface contamination ( p contamination. Conclusion In comparison with other multicenter studies that were conducted in Canada, the concentration of antineoplastic drugs measured on surfaces is decreasing. Regular environmental monitoring is a good practice in order to maintain contamination as low as reasonably achievable.

  16. Validation of the Spanish version of the Hip Outcome Score: a multicenter study.

    Science.gov (United States)

    Seijas, Roberto; Sallent, Andrea; Ruiz-Ibán, Miguel Angel; Ares, Oscar; Marín-Peña, Oliver; Cuéllar, Ricardo; Muriel, Alfonso

    2014-05-13

    The Hip Outcome Score (HOS) is a self-reported questionnaire evaluating the outcomes of treatment interventions for hip pathologies, divided in 19 items of activities of daily life (ADL) and 9 sports' items. The aim of the present study is to translate and validate HOS into Spanish. A prospective and multicenter study with 100 patients undergoing hip arthroscopy was performed between June 2012 and January 2013. Crosscultural adaptation was used to translate HOS into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Mean age was 45.05 years old. 36 women and 64 men were included. Feasibility: 13% had at least one missing item within the ADL subscale and 17% within the sport subscale. Reliability: the translated version of HOS was highly reproducible with intraclass correlation coefficient of 0.95 for ADL and 0.94 for the sports subscale. Internal consistency was confirmed with Cronbach's alpha >0.90 in both subscales. Construct validity showed statistically significant correlation with WOMAC. Ceiling effect was observed in 6% and 12% for ADL and sports subscale, respectively. Floor effect was found in 3% and 37% ADL and sports subscale, respectively. Large sensitivity to change was shown in both subscales. The translated version of HOS into Spanish has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of HOS allows for comparisons between studies involving either Spanish- or English-speaking patients. Prognostic study, Level I.

  17. A multicenter study of using carbon nanoparticles to show sentinel lymph nodes in early gastric cancer.

    Science.gov (United States)

    Yan, Jun; Zheng, Xiaoling; Liu, Zhangyuanzhu; Yu, Jiang; Deng, Zhenwei; Xue, Fangqing; Zheng, Yu; Chen, Feng; Shi, Hong; Chen, Gang; Lu, Jianping; Cai, Lisheng; Cai, Mingzhi; Xiang, Gao; Hong, Yunfeng; Chen, Wenbo; Li, Guoxin

    2016-04-01

    Lymph node metastasis occurs in approximately 10% of early gastric cancer. Preoperative or intra-operative identification of lymph node metastasis in early gastric cancer is crucial for surgical planning. The purpose of this study was to evaluate the feasibility of using carbon nanoparticles to show sentinel lymph nodes (SLNs) in early gastric cancer. A multicenter study was performed between July 2012 and November 2014. Ninety-one patients with early gastric cancer identified by preoperative endoscopic ultrasonography were recruited. One milliliter carbon nanoparticles suspension, which is approved by Chinese Food and Drug Administration, was endoscopically injected into the submucosal layer at four points around the site of the primary tumor 6-12 h before surgery. Laparoscopic radical resection with D2 lymphadenectomy was performed. SLNs were defined as nodes that were black-dyed by carbon nanoparticles in greater omentum and lesser omentum near gastric cancer. Lymph node status and SLNs accuracy were confirmed by pathological analysis. All patients had black-dyed SLNs lying in greater omentum and/or lesser omentum. SLNs were easily found under laparoscopy. The mean number of SLNs was 4 (range 1-9). Carbon nanoparticles were around cancer in specimen. After pathological analysis, 10 patients (10.99%) had lymph node metastasis in 91 patients with early gastric cancer. SLNs were positive in 9 cases and negative in 82 cases. In pathology, carbon nanoparticles were seen in lymphatic vessels, lymphoid sinus, and macrophages in SLNs. When SLNs were positive, cancer cells were seen in lymph nodes. The sensitivity, specificity, and accuracy of black-dyed SLNs in early gastric cancers were 90, 100, and 98.9 %, respectively. No patient had any side effects of carbon nanoparticles in this study. It is feasible to use carbon nanoparticles to show SLNs in early gastric cancer. Carbon nanoparticles suspension is safe for submucosal injection.

  18. The impact of skin diseases on quality of life: A multicenter study.

    Science.gov (United States)

    Sanclemente, G; Burgos, C; Nova, J; Hernández, F; González, C; Reyes, M I; Córdoba, N; Arévalo, Á; Meléndez, E; Colmenares, J; Ariza, S; Hernández, G

    2017-04-01

    To date, no formal study has been published regarding how Colombian patients with skin disorders could be affected according to their perception of disease. To determine the impact in quality of life of skin diseases in a Colombian population. This multicenter study included patients with skin disease from almost the whole country. Individuals >18 years old; of any gender; with any skin disease and who signed informed consent, were included. We applied the Colombian validated version of the Skindex-29 instrument. A total of 1896 questionnaires had sufficient information for the analyses. No significant differences in sociodemographic characteristics of patients who returned the questionnaire incomplete vs. complete, were found. Participants mean age was 41.5 years. There were no statistical differences in men vs. women regarding the global (p=0.37), symptoms (p=0.71) and emotions (p=0.32) domains, whereas statistical differences were found in the function domain (p=0.04; Mann-Whitney U test). Psoriasis, contact dermatitis, atopic dermatitis, urticaria, hair disorders, Hansen's disease, scars, hyperhidrosis and genital human papillomavirus disease scored the highest. Skindex-29 score variability as a result of differences in the location of the skin lesions, their inflammatory or non-inflammatory nature, and the start of therapy. Even the most localized or asymptomatic skin lesion in our population leads to a disruption at some level of patient's wellness. This study adds well supported scientific data of the burden of skin diseases worldwide. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study.

    Science.gov (United States)

    Giovannini, Marc; Thomas, Botelberge; Erwan, Bories; Christian, Pesenti; Fabrice, Caillol; Benjamin, Esterni; Geneviève, Monges; Paolo, Arcidiacono; Pierre, Deprez; Robert, Yeung; Walter, Schimdt; Hanz, Schrader; Carl, Szymanski; Christoph, Dietrich; Pierre, Eisendrath; Jean-Luc, Van Laethem; Jacques, Devière; Peter, Vilmann; Andrian, Saftoiu

    2009-04-07

    To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph node (n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUS-FNA) and/or by surgical pathology. An interobserver study was performed. The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%, respectively, compared to 78.6% and 50.0%, respectively, for the B-mode images. The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes. EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity, specificity and accuracy. It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.

  20. Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil

    Directory of Open Access Journals (Sweden)

    Gomes Marilia B

    2009-10-01

    Full Text Available Abstract According to Brazilian National Data Survey diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country. Aims to stratify the estimated cardiovascular risk (eCVR in a population of type 2 diabetics (T2DM according to the Framingham prediction equations as well as to determine the association between eCVR with metabolic and clinical control of the disease. Methods From 2000 to 2001 a cross-sectional multicenter study was conducted in 13 public out-patients diabetes/endocrinology clinics from 8 Brazilian cities. The 10-year risk of developing coronary heart disease (CHD was estimated by the prediction equations described by Wilson et al (Circulation 1998. LDL equations were preferably used; when patients missed LDL data we used total cholesterol equations instead. Results Data from 1382 patients (59.0% female were analyzed. Median and inter-quartile range (IQ of age and duration of diabetes were 57.4 (51-65 and 8.8 (3-13 years, respectively without differences according to the gender. Forty-two percent of these patients were overweight and 35.4% were obese (the prevalence of higher BMI and obesity in this T2DM group was significantly higher in women than in men; p 20% in 738 (53.4%, intermediate in 202 (14.6% and low in 442 (32% patients. Men [25.1(15.4-37.3] showed a higher eCVR than women [18.8 (12.4-27.9 p

  1. Statistical considerations for harmonization of the global multicenter study on reference values.

    Science.gov (United States)

    Ichihara, Kiyoshi

    2014-05-15

    The global multicenter study on reference values coordinated by the Committee on Reference Intervals and Decision Limits (C-RIDL) of the IFCC was launched in December 2011, targeting 45 commonly tested analytes with the following objectives: 1) to derive reference intervals (RIs) country by country using a common protocol, and 2) to explore regionality/ethnicity of reference values by aligning test results among the countries. To achieve these objectives, it is crucial to harmonize 1) the protocol for recruitment and sampling, 2) statistical procedures for deriving the RI, and 3) test results through measurement of a panel of sera in common. For harmonized recruitment, very lenient inclusion/exclusion criteria were adopted in view of differences in interpretation of what constitutes healthiness by different cultures and investigators. This policy may require secondary exclusion of individuals according to the standard of each country at the time of deriving RIs. An iterative optimization procedure, called the latent abnormal values exclusion (LAVE) method, can be applied to automate the process of refining the choice of reference individuals. For global comparison of reference values, test results must be harmonized, based on the among-country, pair-wise linear relationships of test values for the panel. Traceability of reference values can be ensured based on values assigned indirectly to the panel through collaborative measurement of certified reference materials. The validity of the adopted strategies is discussed in this article, based on interim results obtained to date from five countries. Special considerations are made for dissociation of RIs by parametric and nonparametric methods and between-country difference in the effect of body mass index on reference values. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Multicenter study evaluating the Vitek MS system for identification of medically important yeasts.

    Science.gov (United States)

    Westblade, Lars F; Jennemann, Rebecca; Branda, John A; Bythrow, Maureen; Ferraro, Mary Jane; Garner, Omai B; Ginocchio, Christine C; Lewinski, Michael A; Manji, Ryhana; Mochon, A Brian; Procop, Gary W; Richter, Sandra S; Rychert, Jenna A; Sercia, Linda; Burnham, Carey-Ann D

    2013-07-01

    The optimal management of fungal infections is correlated with timely organism identification. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is revolutionizing the identification of yeasts isolated from clinical specimens. We present a multicenter study assessing the performance of the Vitek MS system (bioMérieux) in identifying medically important yeasts. A collection of 852 isolates was tested, including 20 Candida species (626 isolates, including 58 C. albicans, 62 C. glabrata, and 53 C. krusei isolates), 35 Cryptococcus neoformans isolates, and 191 other clinically relevant yeast isolates; in total, 31 different species were evaluated. Isolates were directly applied to a target plate, followed by a formic acid overlay. Mass spectra were acquired using the Vitek MS system and were analyzed using the Vitek MS v2.0 database. The gold standard for identification was sequence analysis of the D2 region of the 26S rRNA gene. In total, 823 isolates (96.6%) were identified to the genus level and 819 isolates (96.1%) were identified to the species level. Twenty-four isolates (2.8%) were not identified, and five isolates (0.6%) were misidentified. Misidentified isolates included one isolate of C. albicans (n = 58) identified as Candida dubliniensis, one isolate of Candida parapsilosis (n = 73) identified as Candida pelliculosa, and three isolates of Geotrichum klebahnii (n = 6) identified as Geotrichum candidum. The identification of clinically relevant yeasts using MS is superior to the phenotypic identification systems currently employed in clinical microbiology laboratories.

  3. Factors contributing to disability in rheumatoid arthritis patients: An Egyptian multicenter study.

    Science.gov (United States)

    Hammad, Marwa; Eissa, Mervat; Dawa, Ghada A

    2018-04-30

    Minimizing disability and enhancing physical function to its optimal levels is still a challenge in management of rheumatoid arthritis (RA). The aim is to identify factors leading to disability in RA. This is a cross-sectional Egyptian multicenter study carried out on 215 RA patients attending to our inpatient and outpatient rheumatology clinics during 4 months starting from April to July 2017 who agreed to participate in the study; 170 patients were from Cairo University hospitals and 45 from Zagazig University hospitals. We recorded a number of possible risk factors including demographic, clinical, serological and therapeutic factors. The assessment of patients' disability was done using Modified HAQ (MHAQ). A significant positive correlation was found between MHAQ and different markers of activity in addition to age and depression score (P<0.001). Illiteracy accounted for higher MHAQ scores (P=0.001). A higher MHAQ was found in patients with ischemic heart disease (P<0.05). Patients with erosions on X-rays had significantly higher MHAQ scores. Subluxations also accounted for higher MHAQ scores (P=0.000). Aging, illiteracy, disease activity, erosions, subluxations, depression and ischemic heart disease were all related to higher disability. Good control of disease activity which in turn reduces erosions and subluxations is mandatory. Screening for depression and proper use of anti-depressants is of great value. Proper screening and prophylaxis is recommended against ischemic heart disease by controlling modifiable risk factors like obesity, dyslipidaemia, hypertension, smoking and sedentary lifestyle. Copyright © 2018 Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Factors associated to depression and anxiety in medical students: a multicenter study

    Directory of Open Access Journals (Sweden)

    Fernanda Brenneisen Mayer

    2016-10-01

    Full Text Available Abstract Background To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools. Methods The authors performed a multicenter study (August 2011 to August 2012, examining personal factors (age, sex, housing, tuition scholarship and institutional factors (year of the medical training, school legal status, location and support service in association with scores of Beck Depression Inventory (BDI and State Trait Anxiety Inventory (STAI. Results Of 1,650 randomly selected students, 1,350 (81.8 % completed the study. The depressive symptoms prevalence was 41 % (BDI > 9, state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33. There was a positive relationship between levels of state (r = 0,591, p < 0.001 and trait (r = 0,718, p < 0.001 anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements “I have adequate access to psychological support” and “There is a good support system for students who get stressed”. Conclusions The factors associated with the increase of medical students’ depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms.

  5. Clinical Features Associated with Delirium Motor Subtypes in Older Inpatients: Results of a Multicenter Study.

    Science.gov (United States)

    Morandi, Alessandro; Di Santo, Simona G; Cherubini, Antonio; Mossello, Enrico; Meagher, David; Mazzone, Andrea; Bianchetti, Angelo; Ferrara, Nicola; Ferrari, Alberto; Musicco, Massimo; Trabucchi, Marco; Bellelli, Giuseppe

    2017-10-01

    To date motor subtypes of delirium have been evaluated in single-center studies with a limited examination of the relationship between predisposing factors and motor profile of delirium. We sought to report the prevalence and clinical profile of subtypes of delirium in a multicenter study. This is a point prevalence study nested in the "Delirium Day 2015", which included 108 acute and 12 rehabilitation wards in Italy. Delirium was detected using the 4-AT and motor subtypes were measured with the Delirium Motor Subtype Scale (DMSS). A multinomial logistic regression was used to determine the factors associated with delirium subtypes. Of 429 patients with delirium, the DMSS was completed in 275 (64%), classifying 21.5% of the patients with hyperactive delirium, 38.5% with hypoactive, 27.3% with mixed and 12.7% with the non-motor subtype. The 4-AT score was higher in the hyperactive subtype, similar in the hypoactive, mixed subtypes, while it was lowest in the non-motor subtype. Dementia was associated with all three delirium motor subtypes (hyperactive, OR 3.3, 95% CI: 1.2-8.7; hypoactive, OR 2.8, 95% CI: 1.2-6.5; mixed OR 2.6, 95% CI: 1.1-6.2). Atypical antipsychotics were associated with hypoactive delirium (OR 0.23, 95% CI: 0.1-0.7), while intravenous lines were associated with mixed delirium (OR 2.9, 95% CI: 1.2-6.9). The study shows that hypoactive delirium is the most common subtype among hospitalized older patients. Specific clinical features were associated with different delirium subtypes. The use of standardized instruments can help to characterize the phenomenology of different motor subtypes of delirium. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Assessment of thromboprophylaxis in medical patients hospitalized in Andalusia. A multicenter study.

    Science.gov (United States)

    Navarro Puerto, M A; Medrano Ortega, F J; Izquierdo Guerrero, R; Calderón Sandubete, E; Buzón-Barrera, M L; Marín-León, I

    2015-04-01

    Hospitalized patients are a population at risk for venous thromboembolism (VTE). The PRETEMED-2007 clinical practice guidelines help identify high-risk medical patients who are suited to thromboprophylaxis. These guidelines therefore provide a standard for prophylaxis in such patients. We evaluated the risk of VTE and the adjustment of thromboprophylaxis to the standards of the PRETEMED-2007 guidelines in patients hospitalized in internal medicine departments. An observational, cross-sectional multicenter study was performed in 2010 in 16 hospitals in Andalusia and included 20 consecutive patients per center. The study variables were age, sex, risk factors for VTE and hemorrhage, the risk-adjusted PRETEMED of VTE, adjustment of thromboembolic prophylaxis at admission and at discharge and hospital mortality. The study included 293 patients (57.8% men) with a mean age of 69 (±15) years. The most common triggers for VTE were acute severe infection (27.3%) and neoplasia (16.4%). Some 43.4% of the patients presented a risk of hemorrhage. The risk of VTE at admission and discharge was high in 47.8% and 31% and moderate in 8.2% and 10.6%, respectively. A total of 91.7% and 17.3% of the patients underwent prophylaxis with low-molecular-weight heparin on admission and at discharge, respectively. The prescription was appropriate for 59.9% of the patients at admission (overutilization 38.4%, underutilization 1.7%) and for 74.7% at discharge (overutilization 5.4%, underutilization 19.9%). The adjustment was greater in patients older than 60 years and with greater hemorrhagic risk. For 60% of the patients admitted to the departments of internal medicine in Andalusia, the thromboprophylaxis was appropriate. The inadequacy of thromboprophylaxis (40%) is mostly due to overutilization. These results suggest significant space for improvement. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  7. Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy

    International Nuclear Information System (INIS)

    Biermann, M.; Pixberg, M.K.; Schober, O.; Schuck, A.; Willich, N.; Heinecke, A.; Koepke, W.; Schmid, K.W.; Dralle, H.

    2003-01-01

    Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pNO/1/xMO/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msds-studie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial's inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx). Advised by the trial's independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p 2 -test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity. (orig.) [de

  8. Shigella isolates from the global enteric multicenter study inform vaccine development.

    Science.gov (United States)

    Livio, Sofie; Strockbine, Nancy A; Panchalingam, Sandra; Tennant, Sharon M; Barry, Eileen M; Marohn, Mark E; Antonio, Martin; Hossain, Anowar; Mandomando, Inacio; Ochieng, John B; Oundo, Joseph O; Qureshi, Shahida; Ramamurthy, Thandavarayan; Tamboura, Boubou; Adegbola, Richard A; Hossain, Mohammed Jahangir; Saha, Debasish; Sen, Sunil; Faruque, Abu Syed Golam; Alonso, Pedro L; Breiman, Robert F; Zaidi, Anita K M; Sur, Dipika; Sow, Samba O; Berkeley, Lynette Y; O'Reilly, Ciara E; Mintz, Eric D; Biswas, Kousick; Cohen, Dani; Farag, Tamer H; Nasrin, Dilruba; Wu, Yukun; Blackwelder, William C; Kotloff, Karen L; Nataro, James P; Levine, Myron M

    2014-10-01

    Shigella, a major diarrheal disease pathogen worldwide, is the target of vaccine development. The Global Enteric Multicenter Study (GEMS) investigated burden and etiology of moderate-to-severe diarrheal disease in children aged Shigella was 1 of the 4 most common pathogens across sites and age strata. GEMS Shigella serotypes are reviewed to guide vaccine development. Subjects' stool specimens/rectal swabs were transported to site laboratories in transport media and plated onto xylose lysine desoxycholate and MacConkey agar. Suspect Shigella colonies were identified by biochemical tests and agglutination with antisera. Shigella isolates were shipped to the GEMS Reference Laboratory (Baltimore, MD) for confirmation and serotyping of S. flexneri; one-third of isolates were sent to the Centers for Disease Control and Prevention for quality control. Shigella dysenteriae and S. boydii accounted for 5.0% and 5.4%, respectively, of 1130 Shigella case isolates; S. flexneri comprised 65.9% and S. sonnei 23.7%. Five serotypes/subserotypes comprised 89.4% of S. flexneri, including S. flexneri 2a, S. flexneri 6, S. flexneri 3a, S. flexneri 2b, and S. flexneri 1b. A broad-spectrum Shigella vaccine must protect against S. sonnei and 15 S. flexneri serotypes/subserotypes. A quadrivalent vaccine with O antigens from S. sonnei, S. flexneri 2a, S. flexneri 3a, and S. flexneri 6 can provide broad direct coverage against these most common serotypes and indirect coverage against all but 1 (rare) remaining subserotype through shared S. flexneri group antigens. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  9. Peripheral nerve field stimulation (PNFS) in chronic low back pain: a prospective multicenter study.

    Science.gov (United States)

    Kloimstein, Herwig; Likar, Rudolf; Kern, Michael; Neuhold, Josef; Cada, Miroslav; Loinig, Nadja; Ilias, Wilfried; Freundl, Brigitta; Binder, Heinrich; Wolf, Andreas; Dorn, Christian; Mozes-Balla, Eva Maria; Stein, Rolf; Lappe, Ivo; Sator-Katzenschlager, Sabine

    2014-02-01

    The goal of this study was to evaluate the long-term efficacy and safety of peripheral nerve field stimulation (PNFS) for chronic low back pain (cLBP). In this prospective, multicenter observational study, 118 patients were admitted to 11 centers throughout Austria and Switzerland. After a screening visit, all patients underwent a trial stimulation period of at least seven days before implantation of the permanent system. Leads were placed in the subcutaneous tissues of the lower back directly in the region of greatest pain. One hundred five patients were implanted with a permanent stimulating system. Patients' evaluation of pain and functional levels were completed before implantation and one, three, and six months after implantation. Adverse events, medication usage, and coverage of the painful area and predictive value of transcutaneous electrical nerve stimulation (TENS) were monitored. All pain and quality-of-life measures showed statistically significant improvement during the treatment period. These included the average pain visual analog scale, the Oswestry Disability Questionnaire, the Becks Depression Inventory, and the Short Form-12 item Health survey. Additionally, medication usage with opioids, nonsteroidal anti-inflammatory drugs, and anti-convulsants showed a highly significant reduction. Complications requiring surgical intervention were reported in 9.6% of the patients. The degree of coverage of painful areas seems to be an important criterion for efficacy of PNFS, whereas TENS is presumably no predictor. This prospective, multicenter study confirms that PNFS is an effective therapy for the management of cLBP. Significant improvements in many aspects of the pain condition were measured, and complications were minimal. © 2013 International Neuromodulation Society.

  10. Medical students and controversial ethical issues: results from the multicenter study SBRAME.

    Science.gov (United States)

    Lucchetti, Giancarlo; de Oliveira, Leandro Romani; Leite, José Roberto; Lucchetti, Alessandra Lamas Granero

    2014-12-15

    Medical students(MS) will face ethical issues throughout their lives as doctors. The present study aims to investigate medical students' opinions on controversial ethical issues and factors associated with these opinions. SBRAME (Spirituality and Brazilian Medical Education) is a multicenter study involving 12 Brazilian medical schools with 5950 MS. Participants completed a questionnaire that collected information on socio-demographic data, medical schools characteristics, religious beliefs and opinions on controversial ethical issues. Of all MS, 3630 participated in the survey (61.0%). The sample was 53.8% women and the mean age was 22.5 years. In general, most MS have no objections to prescription of birth control (90.8%), adult stem cell use (87.5%), embryonic stem cell use (82.0%) and abortion for genetic reasons (51.2%). Approximately half of students have no objections to human cloning (47.3%), 45.7% to withdrawal of artificial life support, 41.4% to euthanasia and 23.3% to abortion for failed contraception. Socio-demographic data such as age, gender and income had little influence on MS opinions. On the other hand, medical schools characteristics (number of medical students in the university, year of medical school foundation, location of the university and type of university) and religious aspects (religious affiliation, religious attendance, non-organizational religiousness and intrinsic religiousness) were highly correlated with their opinions. In general, MS with more supportive opinions on controversial ethical issues were less religious and from non-traditional (newer), urban, public and bigger universities. The current study reveals MS have different opinions regarding controversial ethical issues. Noteworthy, these opinions seem to be shaped more by university characteristics and religious beliefs than socio-demographic data.

  11. Gemcitabine-Based Chemotherapy in Adrenocortical Carcinoma: A Multicenter Study of Efficacy and Predictive Factors.

    Science.gov (United States)

    Henning, Judith E K; Deutschbein, Timo; Altieri, Barbara; Steinhauer, Sonja; Kircher, Stefan; Sbiera, Silviu; Wild, Vanessa; Schlötelburg, Wiebke; Kroiss, Matthias; Perotti, Paola; Rosenwald, Andreas; Berruti, Alfredo; Fassnacht, Martin; Ronchi, Cristina L

    2017-11-01

    Adrenocortical carcinoma (ACC) is rare and confers an unfavorable prognosis in advanced stages. Other than combination chemotherapy with cisplatin, etoposide, doxorubicin, and mitotane, the second- and third-line regimens are not well-established. Gemcitabine (GEM)-based chemotherapy was suggested in a phase 2 clinical trial with 28 patients. In other solid tumors, human equilibrative nucleoside transporter type 1 (hENT1) and/or ribonucleotide reductase catalytic subunit M1 (RRM1) expression have been associated with resistance to GEM. To assess the efficacy of GEM-based chemotherapy in ACC in a real-world setting and the predictive role of molecular parameters. Retrospective multicenter study. Referral centers of university hospitals. A total of 145 patients with advanced ACC were treated with GEM-based chemotherapy (132 with concomitant capecitabine). Formalin-fixed paraffin-embedded tumor material was available for 70 patients for immunohistochemistry. The main outcome measures were progression-free survival (PFS) and an objective response to GEM-based chemotherapy. The secondary objective was the predictive role of hENT1 and RRM1. The median PFS for the patient population was 12 weeks (range, 1 to 94). A partial response or stable disease was achieved in 4.9% and 25.0% of cases, with a median duration of 26.8 weeks. Treatment was generally well tolerated, with adverse events of grade 3 or 4 occurring in 11.0% of cases. No substantial effect of hENT1 and/or RRM1 expression was observed in response to GEM-based chemotherapy. GEM-based chemotherapy is a well-tolerated, but modestly active, regimen against advanced ACC. No reliable molecular predictive factors could be identified. Owing to the scarce alternative therapeutic options, GEM-based chemotherapy remains an important option for salvage treatment for advanced ACC. Copyright © 2017 Endocrine Society

  12. Efficacy of Mesoglycan in Pain Control after Excisional Hemorrhoidectomy: A Pilot Comparative Prospective Multicenter Study

    Directory of Open Access Journals (Sweden)

    Gaetano Gallo

    2018-01-01

    Full Text Available Introduction. Various pain management strategies for patients undergoing open excisional hemorrhoidectomy have been proposed, yet postoperative pain remains a frequent complaint. Objective. To determine whether mesoglycan (30 mg two vials i.m. once/day for the first 5 days postoperative, followed by 50 mg 1 oral tablet twice/day for 30 days would reduce the edema of the mucocutaneous bridges and thus improve postoperative pain symptoms. Patients and Methods. For this prospective observational multicenter study, 101 patients undergoing excisional diathermy hemorrhoidectomy for III-IV degree hemorrhoidal disease were enrolled at 5 colorectal referral centers. Patients were assigned to receive either mesoglycan (study group SG or a recommended oral dose of ketorolac tromethamine of 10 mg every 4–6 hours, not exceeding 40 mg per day and not exceeding 5 postoperative days according to the indications for short-term management of moderate/severe acute postoperative pain, plus stool softeners (control group CG. Results. Postoperative thrombosis (SG 1/48 versus CG 5/45 (p<0.001 and pain after rectal examination (p<0.001 were significantly reduced at 7–10 days after surgery in the mesoglycan-treated group, permitting a faster return to work (p<0.001; however, in the same group, the incidence of postoperative bleeding, considered relevant when needing a readmission or an unexpected outpatient visit, was higher, possibly owing to the drug’s antithrombotic properties. Conclusions. The administration of mesoglycan after an open diathermy excisional hemorrhoidectomy can reduce postoperative thrombosis and pain at 7–10 days after surgery, permitting a faster return to normal activities.

  13. Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience

    International Nuclear Information System (INIS)

    Neuerburg, Joerg M.; Guenther, Rolf W.; Vorwerk, Dierk; Dondelinger, Robert F.; Jaeger, Horst; Lackner, Klaus J.; Schild, Hans H.; Plant, Graham R.; Joffre, Francis G.; Schneider, Pierre A.; Janssen, Johan H. A.

    1997-01-01

    Purpose. To evaluate clinically a new, retrievable vena caval filter in a multicenter study. Methods. The Tulip filter is a stainless steel half-basket that is suitable for antegrade or retrograde insertion via an 8.5 Fr introducer sheath. The filter can be retrieved via the jugular approach using an 11 Fr coaxial retrieval system. Forty-eight filters were implanted via the femoral approach and 38 via the jugular approach in 83 patients. Follow-up examinations (plain films, colorcoded duplex sonography) were performed up to 3 years after filter insertion (mean 136 days) in 75 patients. Twenty-seven patients were screened by colorcoded duplex sonography for insertion site thrombosis. Results. An appropriate filter position was achieved in all cases. Insertion problems occurred in 3 cases; these were not due to the filter design but to an imperfect prototype insertion mechanism that has now been modified (n=2) or a manipulation error (n=1). In 2 of these cases the filters were replaced percutaneously; 1 patient required venotomy for filter removal. No further complications due to filter insertion occurred. Two filters were used as temporary devices and were successfully removed after 6 and 11 days, respectively. There was 1 fatal recurrent pulmonary embolism (PE) and 2 non-fatal PE, 5 complete and 3 partial caval occlusions, and 3 caudal migrations of the filter. Insertion site venous thrombosis was not seen in the 27 patients monitored for this complication. Conclusion. Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion

  14. Overview of MIT, ADIP irradiation experiments

    International Nuclear Information System (INIS)

    Kohse, G.; Harling, O.K.; Grant, N.J.

    1985-06-01

    Various rapidly solidified austenitic, ferritic and copper alloys have been produced at MIT for inclusion in ADIP neutron irradiation experiments. A brief summary of the alloys and their preparation and the achieved or projected irradiation parameters is provided

  15. Biotechnology Process Engineering Center at MIT - Overview

    Science.gov (United States)

    | Facsimile (617) 253-2400 | e-mail: bpec-www@mit.edu THERAPEUTIC GENE BIOTECHNOLOGY INDUSTRIAL CONSORTIUM Board (ICAB) in Therapeutic Gene Biotechnology. ICAB Member Representatives review our research progress

  16. MITS Data Acquisition Subsystem Acceptance Test procedure

    International Nuclear Information System (INIS)

    Allison, R.

    1980-01-01

    This is an acceptance procedure for the Data Acquisition Subsystem of the Machine Interface Test System (MITS). Prerequisites, requirements, and detailed step-by-step instruction are presented for inspecting and performance testing the subsystem

  17. MIT research reactor. Power uprate and utilization

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Lin-Wen [Nuclear Reactor Laboratory, Massachusetts Inst. of Technology, Cambridge, MA (United States)

    2012-03-15

    The MIT Research Reactor (MITR) is a university research reactor located on MIT campus. and has a long history in supporting research and education. Recent accomplishments include a 20% power rate to 6 MW and expanding advanced materials fuel testing program. Another important ongoing initiative is the conversion to high density low enrichment uranium (LEU) monolithic U-Mo fuel, which will consist of a new fuel element design and power increase to 7 MW. (author)

  18. Hamlet er manden i mit liv

    DEFF Research Database (Denmark)

    Rösing, Lilian Munk

    2009-01-01

    Hamlet er manden i mit liv. Min elskede. Jeg har en drøm om at frelse ham. At redde ham ud af sin mors soveværelse og ind i mit. Væk fra det ødipale Helvede han befinder sig i, fastlåst mellem et svin af en faderskikkelse (Claudius) og en alt for idealiseret far (gamle Hamlet), vågende over sin m...

  19. Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence

    DEFF Research Database (Denmark)

    Toozs-Hobson, Philip; Al-Singary, Waleed; Fynes, Michelle

    2012-01-01

    Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This article presents the 2-year follow-up results of a multicenter study of PAHG injections for treating stress and stress-predominant mixed urinary incontinence....

  20. A Prospective, Multicentered Study to Assess Social Adjustment in Patients With an Intestinal Stoma in Turkey.

    Science.gov (United States)

    Karadağ, Ayişe; Karabulut, Hatice; Baykara, Zehra G; Harputlu, Deniz; Toyluk, Eylem; Ulusoy, Birgül; Karadağ, Sercan; Kahraman, Aysel; Hin, Aysel Ören; Altinsoy, Meral; Akıl, Yasemin; Leventoğlu, Sezai

    2015-10-01

    with planned stoma operations and persons with permanent stomas increased significantly (P less than 0.05) between assessments. Significant increases in OAI-23 scores also were noted among persons who did not receive information before the operation, patients whose stoma site was not marked, and patients who had experienced a complication (P less than 0.05). Postoperatively, it is important to consider sociodemographic and stoma characteristics as well as preoperative variables that may influence adaptation to stoma. Additional larger, multicentered studies with extended patient follow-up are warranted.

  1. Clinical manifestations of colorectal cancer patients from a large multicenter study in Colombia.

    Science.gov (United States)

    Bohorquez, Mabel; Sahasrabudhe, Ruta; Criollo, Angel; Sanabria-Salas, María Carolina; Vélez, Alejandro; Castro, Jorge Mario; Marquez, Juan Ricardo; Mateus, Gilbert; Bolaños, Fernando; Panqueva, Cesar; Restrepo, Jose Ignacio; Puerta, Juan Dario; Murillo, Raul; Bravo, María Mercedes; Hernández, Gustavo; Rios, Angela; Prieto, Rodrigo; Tomlinson, Ian; Echeverry, Magdalena; Carvajal-Carmona, Luis G

    2016-10-01

    Colorectal cancer (CRC) is a major public health problem, and its incidence is rising in developing countries. However, studies characterizing CRC clinicopathological features in cases from developing countries are still lacking. The goal of this study was to evaluate clinicopathological and demographic features in one of the largest CRC studies in Latin America.The study involved over 1525 CRC cases recruited in a multicenter study in Colombia between 2005 and 2014 as part of ongoing genetic and epidemiological studies. We gathered clinicopathological data such as age at diagnosis, sex, body mass index, tobacco and alcohol consumption, family history of cancer, and tumor features including location, histological type, and stage. Statistical analyses were performed to test the association between age of onset, sex, and clinical manifestations.The average age at CRC diagnosis was 57.4 years, with 26.5% of cases having early-onset CRC (diagnosed by age 50 years). Most cases were women (53.2%; P = 0.009), 49.2% were overweight or obese, 49.1% were regular alcohol drinkers, 52% were smokers/former smokers, and 12.2% reported relatives with cancer. Most tumors in the study were located in the rectum (42.7%), were adenocarcinomas (91.5%), and had advanced stage (T3-T4, 79.8%). Comparisons by sex found that male cases were more likely to be obese (36.5% vs 31.1%; P = 0.001), less likely to have a family history of cancer (9.7% vs 15.3%; P = 0.016), and more likely to have advanced-stage tumors (83.9% vs 76.1%; P = 0.036). Comparisons by age of onset found that early-onset cases were more likely to be women (59.3% vs 51.0%; P = 0.005) and report a family history of cancer (17.4% vs 10.2%; P = 0.001).To our knowledge, our study is the largest report of clinicopathological characterization of Hispanic CRC cases, and we suggest that further studies are needed to understand CRC etiology in diverse Hispanic populations.

  2. Profile of Nigerians with diabetes mellitus - Diabcare Nigeria study group (2008: Results of a multicenter study

    Directory of Open Access Journals (Sweden)

    Sunday Chinenye

    2012-01-01

    Full Text Available Background: Diabetes Mellitus is the commonest endocrine-metabolic disorder in Nigeria similar to the experience in other parts of the world. The aim was to assess the clinical and laboratory profile, and evaluate the quality of care of Nigerian diabetics with a view to planning improved diabetes care. Materials and Methods: In a multicenter study across seven tertiary health centers in Nigeria, the clinical and laboratory parameters of diabetic out-patients were evaluated. Clinical parameters studied include type of diabetes, anthropometry, and blood pressure (BP status, chronic complications of diabetes, and treatment types. Laboratory data assessed included fasting plasma glucose (FPG, 2-h post-prandial (2-HrPP glucose, glycated hemoglobin (HbA1c, urinalysis, serum lipids, electrolytes, urea, and creatinine. Results: A total of 531 patients, 209 (39.4% males and 322 (60.6% females enrolled. The mean age of the patients was 57.1 ± 12.3 years with the mean duration of diabetes of 8.8 ± 6.6 years. Majority (95.4% had type 2 diabetes mellitus (DM compared to type 1 DM (4.6%, with P < 0.001. The mean FPG, 2-HrPP glucose, and HbA1c were 8.1 ± 3.9 mmol/L, 10.6 ± 4.6 mmol/L, and 8.3 ± 2.2%, respectively. Only 170 (32.4% and 100 (20.4% patients achieved the ADA and IDF glycemic targets, respectively. Most patients (72.8% did not practice self-monitoring of blood glucose. Hypertension was found in 322 (60.9%, with mean systolic BP 142.0 ± 23.7 mmHg, and mean diastolic BP 80.7 ± 12.7 mmHg. Diabetic complications found were peripheral neuropathy (59.2%, retinopathy (35.5%, cataracts (25.2%, cerebrovascular disease (4.7%, diabetic foot ulcers (16.0%, and nephropathy (3.2%. Conclusion: Most Nigerian diabetics have suboptimal glycemic control, are hypertensives, and have chronic complications of DM. Improved quality of care and treatment to target is recommended to reduce diabetes-related morbidity and mortality.

  3. Untersuchungen an Eisen- und Lanthanoidhaltigen Koordinationsclustern mit Triazolat- sowie Semiquinonato-Liganden

    OpenAIRE

    Kriese, Thomas

    2016-01-01

    Magnetische Untersuchungen an Lanthanoiddimeren mit Semiquinonato-Liganden. Gemischtvalente Eisen-Koordinationsclustern. Lanthanoid-Koordinationscluster mit zwölf Lanthanoiden aber mit verschiedenen Clusterladungen.

  4. Minimally invasive thyroidectomy (MIT): indications and results.

    Science.gov (United States)

    Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

    2013-01-01

    To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

  5. RESULTS OF MULTICENTER STUDY OF PIDOTIMOD FOR THE PROPHYLAXIS OF ACUTE RESPIRATORY INFECTIONS IN FREQUENTLY AILING CHILDREN

    Directory of Open Access Journals (Sweden)

    L.S. Namazova-Baranova

    2010-01-01

    Full Text Available The article describes actual pediatric problem — frequent development of respiratory infections in children. Authors present the results of Russian multicenter study of effectiveness and safety of pidotimod (Imunorix in frequently ailing children. It was shown that treatment with pidotimod during 30 days resulted in decreased rate of acute respiratory infections and their complications including ones with necessity of antibacterial therapy compared to children from control group. The dynamics of immunological rates in blood serum was studied.Key words: frequently ailing children, acute respiratory infections, prophylaxis, pidotimod.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(2:40-44

  6. Magnetosphere - Ionosphere - Thermosphere (MIT) Coupling at Jupiter

    Science.gov (United States)

    Yates, J. N.; Ray, L. C.; Achilleos, N.

    2017-12-01

    Jupiter's upper atmospheric temperature is considerably higher than that predicted by Solar Extreme Ultraviolet (EUV) heating alone. Simulations incorporating magnetosphere-ionosphere coupling effects into general circulation models have, to date, struggled to reproduce the observed atmospheric temperatures under simplifying assumptions such as azimuthal symmetry and a spin-aligned dipole magnetic field. Here we present the development of a full three-dimensional thermosphere model coupled in both hemispheres to an axisymmetric magnetosphere model. This new coupled model is based on the two-dimensional MIT model presented in Yates et al., 2014. This coupled model is a critical step towards to the development of a fully coupled 3D MIT model. We discuss and compare the resulting thermospheric flows, energy balance and MI coupling currents to those presented in previous 2D MIT models.

  7. Kompressionstherapie bei Patienten mit Ulcus cruris venosum.

    Science.gov (United States)

    Dissemond, Joachim; Assenheimer, Bernd; Bültemann, Anke; Gerber, Veronika; Gretener, Silvia; Kohler-von Siebenthal, Elisabeth; Koller, Sonja; Kröger, Knut; Kurz, Peter; Läuchli, Severin; Münter, Christian; Panfil, Eva-Maria; Probst, Sebastian; Protz, Kerstin; Riepe, Gunnar; Strohal, Robert; Traber, Jürg; Partsch, Hugo

    2016-11-01

    Wund-D.A.CH. ist der Dachverband deutschsprachiger Fachgesellschaften, die sich mit den Thematiken der Wundbehandlung beschäftigen. Experten verschiedener Fachgesellschaften aus Deutschland, Österreich und der Schweiz haben nun einen aktuellen Konsens der Kompressionstherapie für Patienten mit Ulcus cruris venosum erstellt. In Europa ist das Ulcus cruris venosum eine der häufigsten Ursachen für chronische Wunden. Neben der konservativen und interventionellen Wund- und Venentherapie, ist die Kompressionstherapie die Basis der Behandlungsstrategien. Die Kompressionstherapie kann heute mit sehr unterschiedlichen Materialien und Systemen durchgeführt werden. Während in der Entstauungsphase insbesondere Verbände mit Kurzzugbinden oder Mehrkomponentensysteme zur Anwendung kommen, sind es anschließend überwiegend Ulkus-Strumpfsysteme. Eine weitere, bislang wenig verbreitete Alternative sind adaptive Kompressionsbandagen. Insbesondere für die Rezidivprophylaxe werden medizinische Kompressionsstrümpfe empfohlen. Durch die Vielzahl der heute zur Verfügung stehenden Behandlungsoptionen, kann für nahezu alle Patienten ein Konzept entwickelt werden, dass sich an den individuellen Bedürfnissen und Fähigkeiten orientiert und daher auch akzeptiert und durchgeführt wird. Die Kompressionstherapie ist für die Behandlung von Patienten mit Ulcus cruris venosum essentiell. In den letzten Jahren sind viele verschiedene Therapieoptionen verfügbar, die in den deutschsprachigen Ländern unterschiedlich angewendet oder durchgeführt werden. Daher soll dieser Expertenkonsens dazu beitragen, konkrete Empfehlungen für die praktische Durchführung der Kompressionstherapie von Patienten mit Ulcus cruris venosum darzustellen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  8. Grosse Axiallager mit Hybridschmierung - Theoretische und experimentelle Betrachtungen

    DEFF Research Database (Denmark)

    Santos, Ilmar; Fuerst, Axel

    2003-01-01

    Der vorliegende Artikel praesentiert die Simulation eines grossen axialen Kippsegmentlagers unter Beruecksichtigung der hybriden Schmierung, d.h. gleichzeitige hydrodynamische und hydrostatische Schmierung. Ein Vergleich mit Messungen zeigt, dass fuer das betrachtete Lager mit 2,2 m Durchmesser die...

  9. Effectiveness and predictors of success of noninvasive ventilation during H1N1 pandemics: a multicenter study.

    Science.gov (United States)

    Nicolini, A; Tonveronachi, E; Navalesi, P; Antonelli, M; Valentini, I; Melotti, R M; Pigna, A; Carrassi, A; Righini, P; Ferrari Bravo, M; Pelosi, P; Nicoli, F; Cosentini, R; Vaschetto, R; Faenza, S; Nava, S

    2012-12-01

    The use of non-invasive ventilation (NIV) in acute hypoxemic respiratory failure (AHRF) due to H1N1 virus infection is controversial. In this multicenter study we aimed to assess the efficacy of NIV in avoiding endotracheal intubation (ETI) and to identify predictors of success or failure. In this prospective multicenter study, 98 patients with new pulmonary infiltrate(s) sustained by H1N1 virus and a PaO(2)/FiO229 and a PaO(2)/FIO(2)≤127 at admission and PaO2/FIO(2)≤149 after 1 hr of NIV were independently associated with the need for ETI. The early application of NIV, with the aim to avoid invasive ventilation, during the H1N1 pandemics was associated with an overall success rate of 47/98 (48%). Patients presenting at admission with an high SAPS II score and a low PaO(2)/FiO(2) ratio and/or unable to promptly correct gas exchange are at high risk of intubation and mortality.

  10. Comparative Study for Efficacy and Safety of Adenoidectomy according to the Surgical Method: A Prospective Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Jeong-Whun Kim

    Full Text Available There have been several operative techniques for adenoidectomy and their efficacy and morbidity are different according to the technique. This prospective multicenter study was aimed to compare the efficacy and morbidity of coblation adenoidectomy (CA with those of power-assisted adenoidectomy.Prospective multi-institutional study.Children who underwent CA, power-assisted adenoidectomy with cauterization (PAA+C or without cauterization (PAA-C due to adenoid hypertrophy were enrolled from 13 hospitals between July 2013 and June 2014. Mean operation time, degree of intraoperative bleeding and postoperative bleeding rate were evaluated.A total of 388 children (mean age ± standard deviation = 6.6 ± 2.5 years; 245 males and 143 females were included. According to the adenoidectomy technique, the children were classified into 3 groups: (1 CA (n = 116; (2 PAA+C (n = 153; and (3 PAA-C (n = 119. Significant differences were not found in age and sex among three groups. In the CA group, mean operation time was significantly shorter (P < 0.001 and degree of intraoperative bleeding was significantly less (P < 0.001 compared to PAA+C or PAA-C group. Delayed postoperative bleeding rate of PAA-C group was significantly higher than that of CA or PAA+C group (P = 0.016.This prospective multicenter study showed that CA was superior to PAA in terms of mean operation time and degree of intraoperative bleeding.

  11. Wrestling with Pedagogical Change: The TEAL Initiative at MIT

    Science.gov (United States)

    Breslow, Lori

    2010-01-01

    In the late 1990s, the physics department at the Massachusetts Institute of Technology (MIT) had a problem. The department was responsible for teaching the two required physics courses that are part of the General Institute Requirements (GIRs), MIT's core curriculum--Physics I (mechanics, or in MIT parlance, 8.01) and Physics II (electricity and…

  12. MIT professor wins major international math prize

    CERN Multimedia

    Allen, S

    2004-01-01

    Mathematicians Isadore Singer of MIT and Sir Michael Francis Atiyah of the University of Edinburgh will share an $875,000 award as winners of the second Abel Prize, which some hope will come to be seen as a Nobel Prize for math.

  13. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This document details procedures for the operation of the MITS (Machine Interface Test System) Feed and Withdrawal Subsystem (F and W). Included are fill with UF 6 , establishment of recycle and thruput flows, shutdown, UF 6 makeup, dump to supply container, Cascade dump to F and W, and lights cold trap dump, all normal procedures, plus an alternate procedure for trapping light gases

  14. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This procedure details the steps involved in filling two of the four MITS (Machine Interface Test System) Feed and Withdrawal subsystem main traps and the Sample/Inventory Make-up Pipette with uranium hexafluoride from the ''AS RECEIVED'' UF 6 supply

  15. Nuclear matter as an MIT bag crystal

    International Nuclear Information System (INIS)

    Zhang, Q.; Derreth, C.; Schaefer, A.; Greiner, W.

    1986-01-01

    An MIT bag crystal model of nuclear matter is formulated. The energy bands of the quarks are calculated as a function of the overlap between adjacent bags. A clear indication of substantial overlap is found. Accordingly, infinite nuclear matter is more similar to a quark gas than to a nucleonic structure. (author)

  16. Editorial 3/2015: Handeln mit Symbolen

    Directory of Open Access Journals (Sweden)

    Alessandro Barberi

    2015-09-01

    Full Text Available Die paradigmatische Unterscheidung zwischen Sozial- und Kulturwissenschaften, die spätestens seit den 1980er Jahren eingehend diskutiert wurde, lässt sich anhand des Bereichs des Symbolischen auf den Punkt bringen: Ist das Symbolische nur ein Effekt von sozialen, ökonomischen oder medialen Strukturen einer gegebenen Gesellschaft oder reproduzieren sich Strukturen nur durch die symbolischen Handlungen der AkteurInnen innerhalb einer gegebenen Kultur? So hatte etwa der klassische "harte" Strukturalismus bei Claude Lévi-Strauss, Jacques Lacan und dem frühen Michel Foucault symbolische Ordnungen (und d. i. hier die Sprache als eine unbewusst determinierende Voraussetzung von menschlicher Interaktion begriffen, woraufhin mit dem Post- bzw. Neostrukturalismus die Rückkehr der individuellen Äußerung, der parole, des speech acts (und d. i. hier das Sprechen, also der symbolischen Handlung in den Mittelpunkt rückte. Medienpädagogisch ist diese Unterscheidung gerade dann von Interesse, wenn es darum geht, wie Lehrende und Lernende sich zueinander verhalten, interagieren und dabei eben mit Symbolen handeln. Insofern ist es bemerkenswert, dass – fast parallel zu Foucaults Unterscheidung von diskursiven und nicht-diskursiven Praktiken – auch Dieter Baacke 1973 von diskursiven und nicht-diskursiven Symbolen gesprochen hat. Denn – wie auch im Rahmen des "Symbolischen Interaktionismus" von George Herbert Mead argumentiert wurde – können Symbole nur im Rahmen einer gegebenen Diskursökonomie von AkteurInnen diskursiv ausgetauscht werden und konstituieren dabei Erfahrungen bzw. Wahrnehmungen und somit auch die soziale bzw. kulturelle Wirklichkeit. Insofern ist die Frage nach dem Symbolischen immer auch eine Frage nach den Möglichkeiten der Handlungstheorie (im Sinne Jürgen Habermas’ bzw. der Praxeologie (im Sinne Pierre Bourdieus. Die Redaktion der MEDIENIMPULSE geht in diesem Zusammenhang theoretisch und praktisch von Entscheidungsimpulse

  17. Redoxspeziation von endlagerrelevanten Elementen mit Hilfe von Trennmethoden gekoppelt an ein Massenspektrometer mit induktiv gekoppeltem Plasma

    OpenAIRE

    Graser, Carl-Heinrich

    2015-01-01

    Im Rahmen dieser Arbeit wurden Redoxspeziationsanalysen von Eisen, Neptunium und Plutonium per CE-SF-ICP-MS durchgeführt. Durch Optimierung der Trennparameter konnten Trennungen der Pu Oxidationsstufen III bis VI und Trennungen der Np Oxidationsstufen IV bis VI binnen 15 Minuten mit einer Nachweisgrenze von 10-12 M durchgeführt werden. Die Trennung der Fe Oxidationsstufen II und III gelang in weniger als 5 Minuten mit einer Nachweisgrenze von 5-10-8 M.

  18. Behandlung von Herzrhythmusstörungen mit Magnesium bei Patienten mit Herzinsuffizienz

    Directory of Open Access Journals (Sweden)

    Wink K

    2002-01-01

    Full Text Available Die medikamentöse Behandlung von Herzrhythmusstörungen ist unbefriedigend, da bei guter Wirksamkeit durch die Proarrhythmie eine Verbesserung der Prognose gefährdet und nicht gesichert ist. Man kann davon ausgehen, daß Magnesiumsalze keine arrhythmogene Effekte aufweisen. Bei Patienten mit einer Herzinsuffizienz besteht häufig ein Mg-Mangel, der durch gastrointestinale Störungen, neurohormonale Regulationen, aber auch durch die Therapie (Diuretika,Digitalisbedingt ist. An Patienten mit einer Herzinsuffizienz müßte sich demnach zeigen lassen, ob die Mg-Substitution einen antiarrhythmischen Effekt aufweist. In fünf placebokontrollierten Studien konnte gezeigt werden, daß sich teil weise signifikant und mit ausreichen der Aussagekraft (PowerArrhythmien bei Patienten mit Herzinsuffizienz durch orale und parenterale Gabe von Mg-Salzen reduzieren lassen. Trotz Einschränkungen wie z.B. inadäquates Design, fehlende Vermeidung von Bias, ungenügende Vergleichbarkeit der Behandlungsgruppen, inadäquate Auswertung und ungenügende Berücksichtigung der Spontanvariation läßt sich aufgrund der Ergebnisse der Studien die Hypothese aufstellen, daß Magnesiumsalze bei Patienten mit Herzinsuffizienz Herzrhythmusstörungen günstig beeinflussen können. Prospektive, randomisierte,verblindete und kontrollierte konfirmatorische Studien mit ausreichenden Fallzahlen sind jedoch notwendig, um diese Hypothese zu bestätigen.

  19. The reliability of echocardiographic left ventricular wall motion index to identify high-risk patients for multicenter studies

    DEFF Research Database (Denmark)

    Gislason, Gunnar H; Gadsbøll, Niels; Quinones, Miguel A

    2006-01-01

    that were screened for inclusion into the DIAMOND-CHF and DIAMOND-MI trials were reevaluated by an external expert echocardiographer. WMI was calculated using the 16-segment LV model. RESULTS: The external echocardiographer systematically found lower values of WMI than the core laboratory. The average...... difference in WMI was 0.18 (SD: 0.33) in the DIAMOND-CHF trial and 0.09 (SD: 0.33) in the DIAMOND-MI trial. The difference in WMI exceeded 0.33 in 34% of the patients in both trials. The cutoff value for inclusion into the DIAMOND trials was WMI ... overall agreement for identifying patients with severe impairment of LV function. This not only underscores the value of LV-WMI as a useful tool for selecting high-risk patients to be included in multicenter studies but also serves to warn against the use of rigid cutoff values for WMI in the treatment...

  20. Nutritional Deficiencies in Children of the First 3 Years of Life, According to a Multicenter Study in Ukraine

    Directory of Open Access Journals (Sweden)

    S.L. Nyankovsky

    2015-04-01

    Full Text Available Taking into account the fact that in Ukraine today there is not enough researches that summarize the data on the nutritional status of young children, the prevalence of eating disorders and lack of basic macro- and micronutrients in children, the multicenter study on nutrition of children from 9 months to 3 years of life has been carried out. It was found that the present dietary intake of infants is unbalanced, contains excess energy and proteins, lack of zinc, iron, calcium, and vitamins A, D, E, B6, B12, B1. Due to unbalanced diet, the use of special infant formula instead of unmodified bovine milk in feeding young child can increase consumption of important nutrients (calcium, iron, iodine, vitamin E, D and folates.

  1. Nutritional Deficiencies in Children of the First 3 Years of Life, According to a Multicenter Study in Ukraine

    Directory of Open Access Journals (Sweden)

    S.L. Nyankovsky

    2013-08-01

    Full Text Available Taking into account the fact that in Ukraine today there is not enough researches that summarize the data on the nutritional status of young children, the prevalence of eating disorders and lack of basic macro- and micronutrients in children, the multicenter study on nutrition of children from 9 months to 3 years of life has been carried out. It was found that the present dietary intake of infants is unbalanced, contains excess energy and proteins, lack of zinc, iron, calcium, and vitamins A, D, E, B6, B12, B1. Due to unbalanced diet, the use of special infant formula instead of unmodified bovine milk in feeding young child can increase consumption of important nutrients (calcium, iron, iodine, vitamin E, D and folates.

  2. In vivo field dependence of proton relaxation times in human brain, liver and skeletal muscle: a multicenter study

    DEFF Research Database (Denmark)

    Henriksen, O; de Certaines, J D; Spisni, A

    1993-01-01

    and MRS, the in vivo field dispersion of T1 and T2 has been measured in order to evaluate whether ex vivo data are representative for the in vivo situation. Brain, skeletal muscle, and liver of healthy human volunteers were studied. Fifteen MR units with a field strength ranging from 0.08 T to 1.5 T took......T1 and T2 relaxation times are fundamental parameters for signal contrast behaviour in MRI. A number of ex vivo relaxometry studies have dealt with the magnetic field dispersion of T1. By means of multicenter study within the frame of the COMAC BME Concerted Action on Tissue Characterization by MRI......, whereas no significant variations were seen for T2. Our in vivo data were generally in reasonable agreement with proposed models based on ex vivo measurements....

  3. MOG-IgG in NMO and related disorders: A multicenter study of 50 patients. Part 2

    DEFF Research Database (Denmark)

    Jarius, Sven; Ruprecht, Klemens; Kleiter, Ingo

    2016-01-01

    ), and electrophysiological features of a large cohort of MOG-IgG-positive patients with optic neuritis (ON) and/or myelitis (n=50) as well as attack and long-term treatment outcomes. Methods: Retrospective multicenter study. Results: The sex ratio was 1:2.8 (m:f). Median age at onset was 31years (range 6-70). The disease......; end-of-dose relapses occurred 9-12 months after the first infusion. Coexisting autoimmunity was rare (9%). Wingerchuk's 2006 and 2015 criteria for NMO(SD) and Barkhof and McDonald criteria for multiple sclerosis (MS) were met by 28%, 32%, 15%, 33%, respectively; MS had been suspected in 36%. Disease...... severe disease course and the short median time to second attack support the use of prophylactic long-term treatments in patients with MOG-IgG-positive ON and/or myelitis. © 2016 The Author(s)....

  4. Accuracy of cotinine serum test to detect the smoking habit and its association with periodontal disease in a multicenter study.

    Science.gov (United States)

    Duque, A; Martínez, P-J; Giraldo, A; Gualtero, D-F; Ardila, C-M; Contreras, A; Duarte, S; Lafaurie, G-I

    2017-07-01

    The validity of the surveys on self-reported smoking status is often questioned because smokers underestimate cigarette use and deny the habit. It has been suggested that self-report should be accompanied by cotinine test. This report evaluates the usefulness of serum cotinine test to assess the association between smoking and periodontal status in a study with a large sample population to be used in studies with other serum markers in epidemiologic and periodontal medicine researches. 578 patients who were part of a multicenter study on blood biomarkers were evaluated about smoking and its relation to periodontal disease. Severity of periodontal disease was determinate using clinical attachment loss (CAL). Smoking was assessed by a questionnaire and a blood sample drawn for serum cotinine determination. The optimal cut-off point for serum cotinine was 10 ng/ml. Serum cotinine showed greater association with severity of CAL than self-report for mild-moderate CAL [OR 2.03 (CI95% 1.16-3.53) vs. OR 1.08 (CI95% 0.62-1.87) ] advanced periodontitis [OR 2.36 (CI95% 1.30- 4.31) vs. OR 2.06 (CI95% 0.97-4.38) ] and extension of CAL > 3 mm [ OR 1.78 (CI95% 1.16-1.71) vs. 1.37 (CI95% 0.89-2.11)]. When the two tests were evaluated together were not shown to be better than serum cotinine test. Self-reported smoking and serum cotinine test ≥ 10ng/ml are accurate ,complementary and more reliable methods to assess the patient's smoking status and could be used in studies evaluating serum samples in large population and multicenter studies. The serum cotinine level is more reliable to make associations with the patient's periodontal status than self-report questionnaire and could be used in multicenter and periodontal medicine studies.

  5. Grundlegende Steuerungsverfahren im heterogenen Logistiknetz mit Kanban

    Science.gov (United States)

    Dickmann, Eva; Dickmann, Philipp; Lödding, Hermann; Möller, Niklas; Rücker, Thomas; Schneider, Herfried M.; Zäh, Michael F.

    In vielen Unternehmen werden heterogene (verschiedene) Steuerungen in einem abgestimmten Konzept kombiniert. Je nach Anwendungsfall und Rahmenbedingungen werden Kombinationen allgemein bekannter Steuerungen oder Steuerungsvarianten gemischt eingesetzt, um eine optimale Steuerung für unterschiedliche Fälle zu erreichen. Hierbei stehen neben den bekannten und weit verbreiteten Methoden, wie Material Requirements Planning (MRP) oder Kanban, auch weniger bekannte oder neue Methoden zur Auswahl, wie die Produktionssteuerung mit dezentraler, bestandsorientierter Fertigungsregelung (DBF). Kanban ist ein simples und effizientes Steuerungskonzept, das in der klassischen Form für spezifische einfache Anwendungsfälle umsetzbar ist. Hochentwickelte Steuerungsalgorithmen können helfen, komplexe Abläufe optimal abzubilden. Mit einer grundlegenden Vereinfachung der Abläufe kann allerdings in vielen Fällen ein wesentlich stärkerer und umfassender Verbesserungseffekt erzielt werden. Die wesentliche Fragestellung sollte folglich lauten: Warum ist der Ablauf nicht mit einer einfachen Steuerung wie Kanban abzubilden? Um die Vorteile des Konzepts auch in untypischen Bereichen anwenden zu können, sind jedoch verschiedene Varianten oder Kanban-ähnliche Steuerungsmethoden entstanden. Darüber hinaus sind in der Praxis hybride Steuerungen im Einsatz, welche so kombiniert werden, dass die Zusammensetzung anspruchsvolle Eigenschaftsbilder noch exakt abbildet. In der Praxis basieren die Steuerungsentscheidungen nur zu einem kleinen Teil auf den eigentlichen Steuerungsalgorithmen, wie sie uns das MRP-System zur Verfügung stellt. Moderne Steuerungswelten" schließen alle relevanten Informationsquellen in eine heterogene Entscheidungsmatrix mit ein. Letztlich zählt nicht, ob die Entscheidung auf den Informationen aus dem MRP-System oder auf Softfacts basierend getroffen wurde, sondern nur, ob die Entscheidung erfolgreich war.

  6. Untersuchungen zum Potential eines Verbrennungsmotors mit Druckwellenlader

    OpenAIRE

    Binder, Emanuel

    2015-01-01

    Mithilfe der Abgasturboaufladung lässt sich der Kraftstoffverbrauch im Fahrzeugbetrieb durch das Anheben der spezifischen Motorleistung senken. Im Gegensatz zur mechanischen Aufladung verschlechtert sich jedoch mit der Abgasturbolaufladung das Ansprechverhalten. Eine Möglichkeit den Zielkonflikt von Kraftstoffverbrauch und Ansprechverhalten zu lösen ist es, den Abgasturbolader durch einen Druckwellenladers zu ersetzen. Dieser überträgt die Abgasenergie direkt auf die Frischluft in Form von Dr...

  7. The MIT miniaturized disk bend test

    International Nuclear Information System (INIS)

    Harling, O.K.; Lee, M.; Sohn, D.S.; Kohse, G.; Lau, C.W.

    1983-01-01

    A miniaturized disk bend test (MDBT) using transmission electron microscopy specimens for the determination of various mechanical properties is being developed at MIT. Recent progress in obtaining strengths and ductilities of highly irradiated metal alloys is reviewed. Possibilities exist for applying the MDBT approach to the determination of other mechanical properties. Progress in fatigue testing and in determination of the ductile-to-brittle transition temperature is reviewed briefly

  8. Virtuelle Auskunft mit Mehrwert : Chatbots in Bibliotheken

    OpenAIRE

    Christensen, Anne

    2008-01-01

    Die virtuelle Auskunft mit Hilfe elektronischer Informationsassistenten, auch Chatbots oder Chatterbots genannt, ist ein seit dem Jahr 2004 zu beobachtender Trend im deutschen Bibliothekswesen. Die Arbeit stellt die vier Chatbots ASKademicus, Stella, INA und das Sachsen-I vor. Am Beispiel von Stella aus der SUB Hamburg werden dann die Funktionsweise von Chatbots sowie die Anforderungen an die Konzeption dieser virtuellen Berater erläutert. Den Schwerpunkt der Arbeit bilden der Vergleich von C...

  9. Identification of sentinel lymph nodes in vulvar carcinoma patients with the aid of a patent blue V injection: a multicenter study

    NARCIS (Netherlands)

    Ansink, A. C.; Sie-Go, D. M.; van der Velden, J.; Sijmons, E. A.; de Barros Lopes, A.; Monaghan, J. M.; Kenter, G. G.; Murdoch, J. B.; ten Kate, F. J.; Heintz, A. P.

    1999-01-01

    BACKGROUND: The aim of this multicenter study was to investigate the feasibility and negative predictive value of sentinel lymph node detection with blue dye in vulvar carcinoma patients. METHODS: In patients with squamous cell carcinoma of the vulva without suspicious groin lymph nodes, patent blue

  10. 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...

  11. MIT-Skywalker: On the use of a markerless system.

    Science.gov (United States)

    Goncalves, Rogerio S; Hamilton, Taya; Krebs, Hermano I

    2017-07-01

    This paper describes our efforts to employ the Microsoft Kinect as a low cost vision control system for the MIT-Skywalker, a robotic gait rehabilitation device. The Kinect enables an alternative markerless solution to control the MIT-Skywalker and allows a more user-friendly set-up. A study involving eight healthy subjects and two stroke survivors using the MIT-Skywalker device demonstrates the advantages and challenges of this new proposed approach.

  12. Optimierung der Hupkraftverteilung eines airbagintegrierten Automobillenkrades mit Hilfe einer Parameterstudie

    OpenAIRE

    Pietsch, Karsten

    2011-01-01

    Die Hupkraftverteilung eines airbagintegrierten Automobillenkrades wird mit Hilfe einer Parameterstudie in MathCAD so optimiert, das an jeder Krafteinleitungsposition die Hupe mit einer geforderten Mindestkraft betätigt werden kann. Nach der Modellierung in MathCAD der zugehörigen Geometrie und der Dimensionierung der Federlagerung ist das zugehörige mechanische Ersatzmodell mit Hilfe einer Parameterstudie verändert worden, so dass die Hupkraftforderung erfüllt wird.

  13. [Bernt Ahrenholz : Verweise mit Demonstrativa im Gesprochenen Deutsch...] / Klaus Geyer

    Index Scriptorium Estoniae

    Geyer, Klaus

    2008-01-01

    Arvustus: Ahrenholz, Bernt. Verweise mit Demonstrativa im gesprochenen Deutsch : Grammatik, Zweitspracherwerb und Deutsch als Fremdsprache. Berlin ; New York : de Gruyter, 2007. (Linguistik - Impulse & Tendenzen ; 17)

  14. Predictive factors for a one-year improvement in nontuberculous mycobacterial pulmonary disease: An 11-year retrospective and multicenter study.

    Science.gov (United States)

    Cadelis, Gilbert; Ducrot, Rodolphe; Bourdin, Arnaud; Rastogi, Nalin

    2017-08-01

    Nontuberculous mycobacterial pulmonary disease (NTM-PD) has become an emerging infectious disease and is responsible for more deaths than tuberculosis in industrialized countries. NTM-PD mortality remains high in some series reportedly ranging from 25% to 40% at five years and often due to unfavorable evolution of NTM-PD despite established treatment. The purpose of our study was to search for early factors that could predict the favorable or unfavorable evolution of NTM-PD at the first year of treatment. In this retrospective and multicenter study, we selected 119 patients based on clinical, radiological and microbiological data from 2002 to 2012 from three French university hospitals (Guadeloupe, Martinique, Montpellier) with definite (meeting the criteria of the American Thoracic Society and the Infectious Disease Society of America in 2007; ATS/IDSA) or probable (one positive sputum culture) NTM-PD. We compared two patient groups: those who improved at one year (clinical symptoms, radiological lesions and microbiology data) and those who did not improve at one year. The data were analyzed for all patients as well as for subgroups by gender, HIV-positive patients, and Mycobacterium avium complex (MAC) infection. The average patient age was 50 years ± 19.4; 58% had respiratory comorbidities, 24% were HIV positive and 19% had cystic fibrosis. Coughing concerned 66% of patients and bronchiectasis concerned 45%. The most frequently isolated NTM were MAC (46%). 57% (n = 68) of patients met the ATS criteria and improved status concerned 38.6% (n = 46). The improvement factors at one year of NTM-PD were associated with the duration of ethambutol treatment: (Odds ratio adjusted [ORa]: 2.24, 95% Confidence interval [CI]; 2.11-3.41), HIV-positive status: (ORa: 3.23, 95% CI; 1.27-8.45), and male gender: (ORa: 2.34, 95% CI; 1.26-8.16). For the group with NTM-PD due to MAC, improvement was associated with the duration of macrolide treatment (ORa: 3.27, 95% CI; 1

  15. Predictive factors for a one-year improvement in nontuberculous mycobacterial pulmonary disease: An 11-year retrospective and multicenter study.

    Directory of Open Access Journals (Sweden)

    Gilbert Cadelis

    2017-08-01

    Full Text Available Nontuberculous mycobacterial pulmonary disease (NTM-PD has become an emerging infectious disease and is responsible for more deaths than tuberculosis in industrialized countries. NTM-PD mortality remains high in some series reportedly ranging from 25% to 40% at five years and often due to unfavorable evolution of NTM-PD despite established treatment. The purpose of our study was to search for early factors that could predict the favorable or unfavorable evolution of NTM-PD at the first year of treatment.In this retrospective and multicenter study, we selected 119 patients based on clinical, radiological and microbiological data from 2002 to 2012 from three French university hospitals (Guadeloupe, Martinique, Montpellier with definite (meeting the criteria of the American Thoracic Society and the Infectious Disease Society of America in 2007; ATS/IDSA or probable (one positive sputum culture NTM-PD. We compared two patient groups: those who improved at one year (clinical symptoms, radiological lesions and microbiology data and those who did not improve at one year. The data were analyzed for all patients as well as for subgroups by gender, HIV-positive patients, and Mycobacterium avium complex (MAC infection.The average patient age was 50 years ± 19.4; 58% had respiratory comorbidities, 24% were HIV positive and 19% had cystic fibrosis. Coughing concerned 66% of patients and bronchiectasis concerned 45%. The most frequently isolated NTM were MAC (46%. 57% (n = 68 of patients met the ATS criteria and improved status concerned 38.6% (n = 46. The improvement factors at one year of NTM-PD were associated with the duration of ethambutol treatment: (Odds ratio adjusted [ORa]: 2.24, 95% Confidence interval [CI]; 2.11-3.41, HIV-positive status: (ORa: 3.23, 95% CI; 1.27-8.45, and male gender: (ORa: 2.34, 95% CI; 1.26-8.16. For the group with NTM-PD due to MAC, improvement was associated with the duration of macrolide treatment (ORa: 3.27, 95% CI; 1

  16. MIT - Mighty Steps toward Energy Sustainability

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Settlemyre, Kevin [Sustainable IQ, Inc., Arlington, MA (United States); Bosnic, Zorana [HOK, San Francisco, CA (United States)

    2012-07-01

    Massachusetts Institute of Technology (MIT) partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to retrofit existing buildings to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program.1 Lawrence Berkeley National Laboratory (LBNL) provided technical expertise in support of this DOE program. MIT is one of the U.S.’s foremost higher education institutions, occupying a campus that is nearly 100 years old, with a building floor area totaling more than 12 million square feet. The CBP project focused on improving the energy performance of two campus buildings, the Ray and Maria Stata Center (RMSC) and the Building W91 (BW91) data center. A key goal of the project was to identify energy saving measures that could be applied to other buildings both within MIT’s portfolio and at other higher education institutions. The CBP retrofits at MIT are projected to reduce energy consumption by approximately 48%, including a reduction of around 72% in RMSC lighting energy and a reduction of approximately 55% in RMSC server room HVAC energy. The energy efficiency measure (EEM) package proposed for the BW91 data center is expected to reduce heating, ventilation, and air-conditioning (HVAC) energy use by 30% to 50%, depending on the final air intake temperature that is established for the server racks. The RMSC, an iconic building designed by Frank Gehry, houses the Computer Science and Artificial Intelligence Laboratory, the Laboratory for Information and Decision Systems, and the Department of Linguistics and Philosophy.

  17. Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast

    International Nuclear Information System (INIS)

    Perlet, C.; Sittek, H.; Schneider, P.; Reiser, M.; Heinig, A.; Stets, C.; Heywang-Koebrunner, S.H.; Prat, X.; Lamarque, J.; Taourel, P.; Casselman, J.; Baath, L.; Anderson, I.

    2002-01-01

    The purpose of this multicenter study was to determine the accuracy and clinical value of a dedicated breast biopsy system which allows for MR-guided vacuum biopsy (VB) of contrast-enhancing lesions. In five European centers, MR-guided 11-gauge VB was performed on 341 lesions. In 7 cases VB was unsuccessful. This was immediately realized on postinterventional images or direct follow-up combined with histopathology-imaging correlation; thus, a false-negative diagnosis was avoided. Histology of 334 successful biopsies yielded 84 (25%) malignancies, 17 (5%) atypical ductal hyperplasias, and 233 (70%) benign entities. Verification of malignant or borderline lesions included reexcision of the biopsy cavity. Benign histologic biopsy results were verified by retrospective correlation with the pre- and postinterventional MRI and by subsequent follow-up. Our results indicate that MR-guided VB, in combination with the dedicated biopsy coil, offers the possibility to accurately diagnose even very small lesions that can only be visualized or localized by MRI. (orig.)

  18. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study.

    Science.gov (United States)

    Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

    2015-09-01

    To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to the study protocol (per-protocol group), and 24 dropped out (dropout group). Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS), especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, Psilodosin monotherapy exhibits good efficacy in improving nocturia and nocturnal polyuria; however, the mean NPi was still >0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results.

  19. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

    Directory of Open Access Journals (Sweden)

    Young Won Kim

    2015-09-01

    Full Text Available Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33, aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6% completed the study according to the study protocol (per-protocol group, and 24 dropped out (dropout group. Results: Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS, especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, P0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results.

  20. [The thermoformable spiral metallic stents in the treatment of localized ureteral stenosis: an alternative to JJ stent? Prospective multicenter study].

    Science.gov (United States)

    Bonniol, R; Meria, P; Safsaf, A; Albouy, B; Sibert, L

    2011-06-01

    Evaluation of the effectiveness and tolerance of thermoformable metallic spiral stents Memokath(®) 051 (Bard, Pnn Medical) in the treatment of localized ureteral stenosis in non-operable patients who have JJ ureteral stents. Prospective, descriptive and multicenter study of patients with ureteral strictures treated with metallic ureteral stents Memokath(®) 051. Assessment criteria (recurrent stenotic, permeability, tolerance) were measured by clinical, biological and radiological examination at 1 month, and then every 3 months. Fifteen stents (average length: 9.15 cm, range 6-15 cm) were implanted in 14 patients (mean age: 55 years, range: 38-72 years) with secondary suspended ureteral stenosis during 2 years in two centers. The median follow-up was 11 months (range 6 to 24 months). Technical difficulty was observed with two patients. Stents are still up in four patients. The stenosis recurred in four patients with spontaneous progression of stenosis but without endoprosthetics tissue invasion. Two and three migration were observed with spontaneous expulsions. Two lower urinary infections and one high occurred, resolved on antibiotic therapy, no inlay or hematuria, no pain (mean VAS score=3/10) or urinary disorders of the lower unit have been identified. Stents Memokath(®) 051 are well tolered and seem to position themselves as an interesting alternative to JJ ureteral stent in some frails patients. The refinement of contraindication should help to improve the stent's efficacity and to reduce the risk of migration and expulsion. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  1. Comparative analysis of MR imaging, Ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study

    Energy Technology Data Exchange (ETDEWEB)

    Zaknun, John J. [University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Vienna (Austria); IAEA, Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, P.O. Box 100, Wien (Austria); Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Maes, Alex [Katholieke Universiteit Leuven, Leuven (Belgium); AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn [Chulalongkorn University, Nuclear Medicine Division, Department of Radiology, Bangkok (Thailand); Vazquez, Silvia [Instituto de Investigaciones Neurologicas, FLENI, Department of Radiology, Buenos Aires (Argentina); Dupont, Patrick [Katholieke Universiteit Leuven, Leuven (Belgium); Dondi, Maurizio [Ospedale Maggiore, Department of Nuclear Medicine, Bologna (Italy); International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Vienna (Austria)

    2008-01-15

    MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (orig.)

  2. Comparative analysis of MR imaging, Ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study

    International Nuclear Information System (INIS)

    Zaknun, John J.; Bal, Chandrasekhar; Maes, Alex; Tepmongkol, Supatporn; Vazquez, Silvia; Dupont, Patrick; Dondi, Maurizio

    2008-01-01

    MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (orig.)

  3. European multicenter study on melanoma immunoscintigraphy by means of 99mTc-labelled monoclonal antibody fragments

    International Nuclear Information System (INIS)

    Siccardi, A.G.; Viale, G.; Natali, P.G.; Scassellati, G.A.; Ferrone, S.

    1990-01-01

    A total of 493 melanoma patients were investigated by 20 European nuclear medicine departments by means of the same 99m Tc-labelled immunoradiopharmaceutical and the same immunoscintigraphy (ISG) protocol. (i) No chemical or clinical toxicity was detected during or following the studies. (ii) Positive results were obtained in 287/363 (79%) patients (321 carrying known lesions and 42 carrying previously occult lesions): In 231 (80%) of them, 402/402 lesions were imaged; in the remaining 56 ISG-positive patients, 108/204 lesions were imaged; in 76 patients 0/122 lesions were imaged. (iii) The fraction of melanoma lesions visualized by ISG was 510/728 (70.1%); 605 of these lesions were already documented at the time of the study, and 123 were previously occult. (iv) A total of 218 documented melanoma lesions (30%) were not visualized by ISG in 132 patients: About 70% of the ISG-negative lesions were of small size (less than 2 cm diameter). (v) The melanoma nature of 69/123 previously occult lesions was confirmed by clinical criteria and/or additional investigations in follow-up studies. The results obtained in this study are similar to those obtained in the Italian Multicenter Study which had previously been carried out with 258 melanoma patients. (orig.)

  4. [The mental health of only children and of siblings with cancer - first results of a multicenter study in Germany].

    Science.gov (United States)

    Bojanowski, Sabine; Führer, Daniel; Romer, Georg; Bergelt, Corinna; von Klitzing, Kai; Brähler, Elmar; Keller, Monika; Resch, Franz; Flechtner, Hans-Henning; Lehmkuhl, Ulrike; Weschenfelder-Stachwitz, Heike

    2014-07-01

    Children of parents with cancer are at risk of developing mental disorders. RESULTS from divorce research also reveal that sibling relationships can protect the mental health of children in difficult times. Does having a sibling help to cope with an oncological disease of a parent and thus act as a protective factor? A group of 271 children were examined in a multicenter study. 54 % made use of the offered psychosocial support. Only children (N = 89) and children with siblings (N = 182) were compared with respect to their mental health (Strength and Difficulties Questionnaire, SDQ, parental and self-assessment). The group comparison between only children and siblings showed no significant differences in the SDQ (assessed by healthy/ill parent). In the self-assessment 2 % of the only children and 9 % of the siblings showed significant results on the SDQ. The group comparison between only children and children with siblings failed to reveal any important differences in mental health. The study indicates that a negative relationship quality (Sibling Relationship Questionnaire, SRQ) is associated with increased problems in the peer group. The existence of a sibling is not per se a protective factor. Only children do not show more signs of emotional stress than children with siblings.

  5. Clinical and microbiological characteristics of infections caused by various Nocardia species in Taiwan: a multicenter study from 1998 to 2010.

    Science.gov (United States)

    Liu, W L; Lai, C C; Ko, W C; Chen, Y H; Tang, H J; Huang, Y L; Huang, Y T; Hsueh, P R

    2011-11-01

    This multicenter study in Taiwan investigated the clinical presentations of various Nocardia species infections based on 16S rRNA sequence analysis. Patients with nocardiosis in four large medical centers from 1998 to 2010 were included. A total of 100 preserved nonduplicate isolates causing human infection were identified as Nocardia species. Sequencing analysis of 16S rRNA confirmed that 35 of 36 N. asteroides isolates identified by conventional tests were non-asteroides Nocardia species, and that two of 50 N. brasiliensis isolates had also been initially misidentified. N. brasiliensis (50%) was the most common pathogen, followed by N. cyriacigeorgica (18%). In addition, several rare pathogens were identified, including N. asiatica, N. rhamnosiphila, N. abscessus, N. transvalensis, N. elegans, and N. carnea. Primary cutaneous infection was the most common presentation, noted in 55 (55%) patients, while pulmonary infection presented in 26 (26%) patients. The crude mortality rate was 6.7% (6/89), and was lowest for primary cutaneous infection (2.2%) and highest for disseminated disease and pulmonary infection (16.7%). In conclusion, N. brasiliensis and N. cyriacigeorgica were the most common pathogens causing nocardiosis in Taiwan. Molecular methods for identifying Nocardia to the species level are mandatory for better understanding the epidemiology and clinical characteristics of patients with nocardiosis.

  6. Short-term results of a prospective randomized evaluator blinded multicenter study comparing TVT and TVT-Secur.

    Science.gov (United States)

    Andrada Hamer, Maria; Larsson, Per-Göran; Teleman, Pia; Etén-Bergqvist, Christina; Persson, Jan

    2011-07-01

    The aim of this prospective randomized multicenter study was to compare TVT (tension-free vaginal tape) with TVT-Secur in terms of efficacy and safety. We set out to enrol 280 stress incontinent women with a half time interim analysis of short-term cure and a continuous registration of adverse events. Of 133 randomized women, 126 were operated and 123 (TVT n = 62, TVT-Secur n = 61) available for 2 months follow-up. No significant differences were found between groups regarding demographics or grade of incontinence. At 2 months follow-up, subjective cure rate following TVT-Secur was significantly lower than for TVT (72% and 92%, respectively, p = 0.01). Three major complications occurred in the TVT-Secur group: tape erosion into the urethra, a tape inadvertently placed inside the bladder, and an immediate postoperative bleeding from the corona mortis. No major complications occurred in the TVT group. No significant differences were found between groups regarding perioperative bleeding, hospital stay, urge symptoms, or postoperative urinary tract infections. Median time for surgery was 13 and 22 min for TVT-Secur and TVT, respectively (p TVT-Secur procedure had a significantly lower subjective cure rate than the retropubic TVT procedure. Due to this, in addition to three serious complications in the TVT-Secur group, we decided to stop further enrolment after the interim analysis. We discourage from further use of the TVT-Secur.

  7. Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: A prospective Japanese multicenter study

    Science.gov (United States)

    Sasaki, Reina; Sakai, Yuji; Tsuyuguchi, Toshio; Nishikawa, Takao; Fujimoto, Tatsuya; Mikami, Shigeru; Sugiyama, Harutoshi; Yokosuka, Osamu

    2016-01-01

    AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction. METHODS: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, self-expandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline. RESULTS: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients (10.3%) in the form of mild pneumonitis. No other morbidities or mortalities were observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients (7.7%) on account of tumor growth. CONCLUSION: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients’ quality of life. PMID:27076769

  8. Clinical effect of intratympanic dexamethasone injection in acute unilateral tinnitus: A prospective, placebo-controlled, multicenter study.

    Science.gov (United States)

    Lee, Hyun-Jin; Kim, Min-Beom; Yoo, Shin-Young; Park, Shi Nae; Nam, Eui-Cheol; Moon, In Seok; Lee, Ho-Ki

    2018-01-01

    The purpose of this study was to investigate the effectiveness of intratympanic dexamethasone injection (ITDI) in acute tinnitus of presumed cochlear origin. A prospective, randomized, placebo-controlled, double-blinded, multicenter study. Between August 2013 and December 2015, 54 patients with unilateral tinnitus were enrolled at four different centers. Patients were assigned either to an ITDI (n = 27) or an intratympanic normal saline injection (ITNI; n = 27) group through block randomization. Intratympanic injections were administered four times over 2 weeks. At 4 weeks after initial injection, we analyzed the improvement rates of tinnitus using the tinnitus handicap Inventory (THI) and visual analogue scale (VAS) for loudness, awareness, and annoyance. We defined improvement as the reduction of more than 7 points or of more than 20% in the final THI score compared to the initial THI score. The initial mean hearing thresholds and VAS and THI scores of the two groups did not differ significantly. At 4 weeks after initial injection, the mean VAS and THI scores of both groups had significantly reduced. However, the improvement rate did not differ significantly between the groups (ITDI, 51.9%; ITNI, 59.3%). The results indicate that ITDI might not be more effective than ITNI for the treatment of acute unilateral tinnitus. Therefore, ITDI should not be considered as the main treatment for patients presenting with acute tinnitus as the primary symptom. 1b. Laryngoscope, 128:184-188, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Controlled, cross-sectional, multi-center study of physical capacity and associated factors in women with fibromyalgia.

    Science.gov (United States)

    Larsson, Anette; Palstam, Annie; Bjersing, Jan; Löfgren, Monika; Ernberg, Malin; Kosek, Eva; Gerdle, Björn; Mannerkorpi, Kaisa

    2018-04-19

    Health and physical capacity are commonly associated with disease, age, and socioeconomic factors. The primary objective of this study was to investigate the degree to which physical capacity, defined as muscle strength and walking ability, is decreased in women with fibromyalgia (FM), as compared to healthy women, who are matched for age and level of education. The secondary aim was to investigate whether muscle strength and walking ability are associated with age, symptom duration, activity limitations and, Body Mass Index (BMI) in women with FM and control subjects. This controlled, cross-sectional, multi-center study comprised 118 women with FM and 93 age- and education-level-matched healthy women. The outcome measures were isometric knee-extension force, isometric elbow-flexion force, isometric hand-grip force, and walking ability. Differences between the groups were calculated, and for the women with FM analyses of correlations between the measures of physical capacity and variables were performed. The women with FM showed 20% (p BMI. It seems important to address this problem and to target interventions to prevent decline in muscle strength. Assessments of muscle strength and walking ability are easy to administer and should be routinely carried out in the clinical setting for women with FM. ClinicalTrials.gov identification number: NCT01226784 , Oct 21, 2010.

  10. Thyroid hemiagenesis with immunthyropathy; Schilddruesenhemiagenesie mit Immunthyreopathie

    Energy Technology Data Exchange (ETDEWEB)

    Mikosch, P.; Gallowitsch, H.J.; Kresnik, E.; Lind, P. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie

    1999-06-01

    A case of Graves` disease occurring in a patient with hemiagenesis is presented. The detection of the rare occurrence of a congential hemiagenesis is often made by either clinical symptoms of thyroid dysfunction or anatomical abnormalities such as nodular goiter. The symptoms of hyperthyroidism in the current case led to the diagnostic confirmation by scintiscanning and ultrasonography of an absent lobe. Anti-thyroid antibody studies documented the presence of Graves` disease within the remaining lobe. (orig.) [Deutsch] Die Hemiagenesie der Schilddruese stellt eine seltene angeborene Veraenderung dar. Diese angeborene Variante der Schilddruesenanlage wird in den meisten Faellen durh Auffaelligkeiten der Funktion oder der Groesse des vorhandenen Schilddruesenlappens zufaellig gefunden. Der Fall einer 57jaehrigen Frau mit einer Schilddruesenhemiagenesie in Kombination mit einer Immunthyreopatie Basedow wird vorgestellt. Die Zuweisung der Patientin zur Untersuchung erfolgte wegen einer Schilddruesenueberfunktion. Die erforderlichen diagnostischen Schritte zur Erstellung dieser beiden Schilddruesenveraenderungen waren ein 99m-Tc-Schilddruesenszintigramm, Ultraschall und Laborparameter der Schilddruese (fT4, TT3, bTSH, TAK, TPO, TRAK). (orig.)

  11. Physik gestern und heute: Visualisierung mit der Schlierenmethode

    Science.gov (United States)

    Heering, Peter

    2006-07-01

    Der Name des österreichischen Forschers Ernst Mach ist heute noch mit der Schallgeschwindigkeit verbunden. Diese Auszeichnung resultiert aus Machs Untersuchungen, wie sich Projektile mit Überschallgeschwindigkeit durch die Luft bewegen. Gerade in jüngster Zeit hat die Anwendung derartiger Methoden durch technische Modifikationen wieder einen Aufschwung erfahren.

  12. MACH MIT: Deutsches Wochenende am Karlsfluss (MACH MIT: a German Week-End on the Charles River).

    Science.gov (United States)

    Reizes, Sonia; Kramsch, Claire J.

    1980-01-01

    Describes a joint high school/college pilot program planned by Massachusetts foreign language teachers and hosted by M.I.T. The success of the program dubbed "MACH MIT Total Immersion German Weekend" is attributed to the concept of active involvement, which was implemented through games, seminars, shows, cooking and other activities.…

  13. Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Klarlund, Mette; Lassere, M

    2001-01-01

    and iv Gd (Techniques A and C), these rates were 86% (synovitis) and 97% (bone lesions). Corresponding intraclass correlation coefficients (quadratic weighted kappas) were 0.44-0.68, mean 0.58 (synovitis), and 0.44-0.69, mean 0.62 (bone lesion), i.e., in the moderate to good range. Unweighted kappa...... values were in the low to moderate range, generally lowest for JSN (... in assessing synovitis and bone destruction in RA multicenter studies....

  14. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study.

    Science.gov (United States)

    Auer, Matthias K; Fuss, Johannes; Nieder, Timo O; Briken, Peer; Biedermann, Sarah V; Stalla, Günter K; Beckmann, Matthias W; Hildebrandt, Thomas

    2018-05-01

    Many trans individuals undergo medical interventions that result in irreversible loss of fertility. Little is known about their desire to have children and attitudes toward fertility preservation options. To study how the desire for children and the use of fertility preservation options varies among trans women and trans men in different transitioning stages in Germany. In this cross-sectional multi-center study, N = 99 trans women and N = 90 trans men were included. Of these, 26 of each sex were just about to start medical treatment. Outcome parameter were the prevalence and determinants of a desire to have children in trans persons. Before treatment, a desire for children was significantly higher in trans men compared to trans women (P = .016). In contrast, in those who had already started treatment, a current desire to have children was equally present in about one fourth of participants of both genders while the interest in having children in the future was significantly higher in trans women (69.9%) than in trans men (46.9%; P = .034). Although 76.1% of trans women and 76.6% of trans men indicated that they had at least thought about preserving germ cells before starting medical transition, only 9.6% of trans women and 3.1% of trans men had put this idea into practice. Most trans men in both groups indicated that insemination of a female partner with sperm from an unrelated donor was a suitable option to fulfill their child wish, potentially explaining their low interest in preserving their own germ cells. Finally, a logistic regression analysis accounting for potential confounders revealed that overall trans women were more than twice as likely to have a current desire to have children (odds ratio 2.58), and this wish was on average 5.3% lower with each year of increasing age. A low level of fertility preservation among trans persons is contrasted by a high level of desire for children. This highlights the importance of counseling trans individuals regarding fertility preservation options. To our knowledge, this is the first study that addresses desire to have children in a clinical sample of trans women. It is also the first that investigates this issue among trans men who have not started medical treatment, and the first comparison of both genders. A limitation for the generalization of our results is the special legal context in Germany that forbids oocyte donation for reciprocal in vitro fertilization. Reproductive desire is high among trans individuals, but the use of reproductive options is surprisingly low. Auer MK, Fuss J, Nieder TO, et al. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study. J Sex Med 2018;15:757-767. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  15. Serum ARCHITECT PIVKA-II reference interval in healthy Chinese adults: Sub-analysis from a prospective multicenter study.

    Science.gov (United States)

    Yan, Cunling; Hu, Jian; Yang, Jia; Chen, Zhaoyun; Li, Huijun; Wei, Lianhua; Zhang, Wei; Xing, Hao; Sang, Guoyao; Wang, Xiaoqin; Han, Ruilin; Liu, Ping; Li, Zhihui; Li, Zhiyan; Huang, Ying; Jiang, Li; Li, Shunjun; Dai, Shuyang; Wang, Nianyue; Yang, Yongfeng; Ma, Li; Soh, Andrew; Beshiri, Agim; Shen, Feng; Yang, Tian; Fan, Zhuping; Zheng, Yijie; Chen, Wei

    2018-04-01

    Protein induced by vitamin K absence or antagonist-II (PIVKA-II) has been widely used as a biomarker for liver cancer diagnosis in Japan for decades. However, the reference intervals for serum ARCHITECT PIVKA-II have not been established in the Chinese population. Thus, this study aimed to measure serum PIVKA-II levels in healthy Chinese subjects. This is a sub-analysis from the prospective, cross-sectional and multicenter study (ClinicalTrials.gov Identifier: NCT03047603). A total of 892 healthy participants (777 Han and 115 Uygur) with complete health checkup results were recruited from 7 regional centers in China. Serum PIVKA-II level was measured by ARCHITECT immunoassay. All 95% reference ranges were estimated by nonparametric method. The distribution of PIVKA-II values showed significant difference with ethnicity and sex, but not age. The 95% reference range of PIVKA-II was 13.62-40.38 mAU/ml in Han Chinese subjects and 15.16-53.74 mAU/ml in Uygur subjects. PIVKA-II level was significantly higher in males than in females (P < 0.001). The 95% reference range of PIVKA-II was 15.39-42.01 mAU/ml in Han males while 11.96-39.13 mAU/ml in Han females. The reference interval of serum PIVKA-II on the Architect platform was established in healthy Chinese adults. This will be valuable for future clinical and laboratory studies performed using the Architect analyzer. Different ethnic backgrounds and analytical methods underline the need for redefining the reference interval of analytes such as PIVKA-II, in central laboratories in different countries. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  16. Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E-POD hilar study.

    Science.gov (United States)

    Nakai, Yousuke; Yamamoto, Ryuichi; Matsuyama, Masato; Sakai, Yuji; Takayama, Yukiko; Ushio, Jun; Ito, Yukiko; Kitamura, Katsuya; Ryozawa, Shomei; Imamura, Tsunao; Tsuchida, Kouhei; Hayama, Jo; Itoi, Takao; Kawaguchi, Yoshiaki; Yoshida, Yu; Sugimori, Kazuya; Shimura, Kenji; Mizuide, Masafumi; Iwai, Tomohisa; Nishikawa, Ko; Yagioka, Hiroshi; Nagahama, Masatsugu; Toda, Nobuo; Saito, Tomotaka; Yasuda, Ichiro; Hirano, Kenji; Togawa, Osamu; Nakamura, Kenji; Maetani, Iruru; Sasahira, Naoki; Isayama, Hiroyuki

    2018-05-01

    Endoscopic nasobiliary drainage (ENBD) is often recommended in preoperative biliary drainage (PBD) for hilar malignant biliary obstruction (MBO), but endoscopic biliary stent (EBS) is also used in the clinical practice. We conducted this large-scale multicenter study to compare ENBD and EBS in this setting. A total of 374 cases undergoing PBD including 281 ENBD and 76 EBS for hilar MBO in 29 centers were retrospectively studied. Extrahepatic cholangiocarcinoma (ECC) accounted for 69.8% and Bismuth-Corlette classification was III or more in 58.8% of the study population. Endoscopic PBD was technically successful in 94.6%, and adverse event rate was 21.9%. The rate of post-endoscopic retrograde cholangiopancreatography pancreatitis was 16.0%, and non-endoscopic sphincterotomy was the only risk factor (odds ratio [OR] 2.51). Preoperative re-intervention was performed in 61.5%: planned re-interventions in 48.4% and unplanned re-interventions in 31.0%. Percutaneous transhepatic biliary drainage was placed in 6.4% at the time of surgery. The risk factors for unplanned procedures were ECC (OR 2.64) and total bilirubin ≥ 10 mg/dL (OR 2.18). In surgically resected cases, prognostic factors were ECC (hazard ratio [HR] 0.57), predraiange magnetic resonance cholangiopancreatography (HR 1.62) and unplanned re-interventions (HR 1.81). EBS was not associated with increased adverse events, unplanned re-interventions, or a poor prognosis. Our retrospective analysis did not demonstrate the advantage of ENBD over EBS as the initial PBD for resectable hilar MBO. Although the technical success rate of endoscopic PBD was high, its re-intervention rate was not negligible, and unplanned re-intervention was associated with a poor prognosis in resected hilar MBO. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  17. Prognostic factors of liver cirrhosis mortality after a first episode of spontaneous bacterial peritonitis. A multicenter study.

    Science.gov (United States)

    Melcarne, Luigi; Sopeña, Julia; Martínez-Cerezo, Francisco José; Vergara, Mercedes; Miquel, Mireia; Sánchez-Delgado, Jordi; Dalmau, Blai; Machlab, Salvador; Portilla, Dustin; González-Padrón, Yonaisy; Real Álvarez, Mónica; Carpintero, Chantal; Casas, Meritxell

    2018-02-01

    Spontaneous bacterial peritonitis is an infectious complication with a negative impact on survival of patients with cirrhosis. To analyze the short- and long-term survival after a first episode of bacterial peritonitis and the associated prognostic factors. This was a retrospective, multicenter study of patients admitted to hospital for spontaneous bacterial peritonitis between 2008 and 2013. Independent variables related to mortality were analyzed by logistic regression. The prognostic power of the Child Pugh Score, the Model for End-Stage Liver Disease (MELD) and the Charlson index was analyzed by ROC curve. A total of 159 patients were enrolled, 72% were males with a mean age of 63.5 years and a mean MELD score of 19 (SD ± 9.5). Mortality at 30 and 90 days and one and two years was 21%, 31%, 55% and 69%, respectively. Hepatic encephalopathy (p = 0.008, OR 3.5, 95% CI 1.4-8.8) and kidney function (p = 0.026, OR 2.7, 95% CI 1.13-16.7) were independent factors for short- and long-term mortality. MELD was a good marker of short- and long-term survival (area under the curve [AUC] 0.7: 95% CI 1.02-1.4). The Charlson index was related to long-term mortality (AUC 0.68: 95% CI 0.6-0.77). Short- and long-term mortality of spontaneous bacterial peritonitis is still high. The main prognostic factors for mortality are impairment of liver and kidney function. MELD and the Charlson index are good markers of survival.

  18. The Safety and Feasibility of Image-Guided BrainPath-Mediated Transsulcul Hematoma Evacuation: A Multicenter Study.

    Science.gov (United States)

    Labib, Mohamed A; Shah, Mitesh; Kassam, Amin B; Young, Ronald; Zucker, Lloyd; Maioriello, Anthony; Britz, Gavin; Agbi, Charles; Day, J D; Gallia, Gary; Kerr, Robert; Pradilla, Gustavo; Rovin, Richard; Kulwin, Charles; Bailes, Julian

    2017-04-01

    Subcortical injury resulting from conventional surgical management of intracranial hemorrhage may counteract the potential benefits of hematoma evacuation. To evaluate the safety and potential benefits of a novel, minimally invasive approach for clot evacuation in a multicenter study. The integrated approach incorporates 5 competencies: (1) image interpretation and trajectory planning, (2) dynamic navigation, (3) atraumatic access system (BrainPath, NICO Corp, Indianapolis, Indiana), (4) extracorporeal optics, and (5) automated atraumatic resection. Twelve neurosurgeons from 11 centers were trained to use this approach through a continuing medical education-accredited course. Demographical, clinical, and radiological data of patients treated over 2 years were analyzed retrospectively. Thirty-nine consecutive patients were identified. The median Glasgow Coma Scale (GCS) score at presentation was 10 (range, 5-15). The thalamus/basal ganglion regions were involved in 46% of the cases. The median hematoma volume and depth were 36 mL (interquartile range [IQR], 27-65 mL) and 1.4 cm (IQR, 0.3-2.9 cm), respectively. The median time from ictus to surgery was 24.5 hours (IQR, 16-66 hours). The degree of hematoma evacuation was ≥90%, 75% to 89%, and 50% to 74% in 72%, 23%, and 5.0% of the patients, respectively. The median GCS score at discharge was 14 (range, 8-15). The improvement in GCS score was statistically significant ( P < .001). Modified Rankin Scale data were available for 35 patients. Fifty-two percent of those patients had a modified Rankin Scale score of ≤2. There were no mortalities. The approach was safely performed in all patients with a relatively high rate of clot evacuation and functional independence. Copyright © 2016 by the Congress of Neurological Surgeons

  19. Three-Year Outcomes of a Canadian Multicenter Study of Accelerated Partial Breast Irradiation Using Conformal Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Berrang, Tanya S., E-mail: tberrang@bccancer.bc.ca [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Olivotto, Ivo [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Kim, Do-Hoon [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Nichol, Alan [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Cho, B.C. John [Princess Margaret Hospital, Ontario (Canada); University of Toronto, Ontario (Canada); Mohamed, Islam G. [British Columbia Cancer Agency-Southern Interior, BC (Canada); University of British Columbia, BC (Canada); Parhar, Tarnjit [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Wright, J.R. [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Truong, Pauline [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Tyldesley, Scott [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Sussman, Jonathan [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Wai, Elaine [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Whelan, Tim [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada)

    2011-12-01

    Purpose: To report 3-year toxicity, cosmesis, and efficacy of a multicenter study of external beam, accelerated partial breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: Between March 2005 and August 2006, 127 women aged {>=}40 years with ductal carcinoma in situ or node-negative invasive breast cancer {<=}3 cm in diameter, treated with breast-conserving surgery achieving negative margins, were accrued to a prospective study involving five Canadian cancer centers. Women meeting predefined dose constraints were treated with APBI using 3 to 5 photon beams, delivering 35 to 38.5 Gy in 10 fractions, twice a day, over 1 week. Patients were assessed for treatment-related toxicities, cosmesis, and efficacy before APBI and at specified time points for as long as 3 years after APBI. Results: 104 women had planning computed tomography scans showing visible seromas, met dosimetric constraints, and were treated with APBI to doses of 35 Gy (n = 9), 36 Gy (n = 33), or 38.5 Gy (n = 62). Eighty-seven patients were evaluated with minimum 3-year follow-up after APBI. Radiation dermatitis, breast edema, breast induration, and fatigue decreased from baseline levels or stabilized by the 3-year follow-up. Hypopigmentation, hyperpigmentation, breast pain, and telangiectasia slightly increased from baseline levels. Most toxicities at 3 years were Grade 1. Only 1 patient had a Grade 3 toxicity with telangiectasia in a skin fold inside the 95% isodose. Cosmesis was good to excellent in 86% (89/104) of women at baseline and 82% (70/85) at 3 years. The 3-year disease-free survival was 97%, with only one local recurrence that occurred in a different quadrant away from the treated site and two distant recurrences. Conclusions: At 3 years, toxicity and cosmesis were acceptable, and local control and disease-free survival were excellent, supporting continued accrual to randomized APBI trials.

  20. Skeletal involvement in Gaucher disease: An observational multicenter study of prognostic factors in the Argentine Gaucher disease patients.

    Science.gov (United States)

    Drelichman, Guillermo; Fernández Escobar, Nicolás; Basack, Nora; Aversa, Luis; Larroude, María Silvia; Aguilar, Gabriela; Szlago, Marina; Schenone, Andrea; Fynn, Alcyra; Cuello, María Fernanda; Aznar, Marcela; Fernández, Ramiro; Ruiz, Alba; Reichel, Paola; Guelbert, Norberto; Robledo, Hugo; Watman, Nora; Bolesina, Moira; Elena, Graciela; Veber, S Ernesto; Pujal, Graciela; Galván, Graciela; Chain, Juan José; Arizo, Adriana; Bietti, Julieta; Bar, Daniel; Dragosky, Marta; Marquez, Marisa; Feldman, Leonardo; Muller, Katja; Zirone, Sandra; Buchovsky, Greogorio; Lanza, Victoria; Sanabria, Alba; Fernández, Ignacio; Jaureguiberry, Rossana; Contte, Marcelo; Barbieri María, Angie; Maro, Alejandra; Zárate, Graciela; Fernández, Gabriel; Rapetti, María Cristina; Donato, Hugo; Degano, Adriana; Kantor, Gustavo; Albina, Roberto; Á Lvarez Bollea, María; Brun, María; Bacciedoni, Viviana; Del Río, Francis; Soberón, Bárbara; Boido, Nazario; Schweri, Maya; Borchichi, Sandra; Welsh, Victoria; Corrales, Marcela; Cedola, Alejandra; Carvani, Analía; Diez, Blanca; Richard, Lucía; Baduel, Ccecilia; Nuñez, Gabriela; Colimodio, Rubén; Barazzutti, Lucía; Medici, Hugo; Meschengieser, Susana; Damiani, Germán; Nucifora, María; Girardi, Beatriz; Gómez, Sergio; Papucci, Maura; Verón, David; Quiroga, Luis; Carro, Gustavo; De Ambrosio, Patricia; Ferro, José; Pujol, Marcelo; Castella, Cristina Cabral; Franco, Liliana; Nisnovich, Gisela; Veloso, María; Pacheco, Isabel; Savarino, Mario; Marino, Andrés; Saavedra, José Luis

    2016-10-01

    Patients with Gaucher type 1 (GD1) throughout Argentina were enrolled in the Argentine bone project to evaluate bone disease and its determinants. We focused on presence and predictors of bone lesions (BL) and their relationship to therapeutic goals (TG) with timing and dose of enzyme replacement therapy (ERT). A total of 124 patients on ERT were enrolled in a multi-center study. All six TG were achieved by 82% of patients: 70.1% for bone pain and 91.1% for bone crisis. However, despite the fact that bone TGs were achieved, residual bone disease was present in 108 patients on ERT (87%) at time 0. 16% of patients showed new irreversible BL (bone infarcts and avascular osteonecrosis) despite ERT, suggesting that they appeared during ERT or were not detected at the moment of diagnosis. We observed 5 prognostic factors that predicted a higher probability of being free of bone disease: optimal ERT compliance; early diagnosis; timely initiation of therapy; ERT initiation dose ≥45 UI/kg/EOW; and the absence of history of splenectomy. Skeletal involvement was classified into 4 major phenotypic groups according to BL: group 1 (12.9%) without BL; group 2 (28.2%) with reversible BL; group 3 (41.9%) with reversible BL and irreversible chronic BL; and group 4 (16.9%) with acute irreversible BL. Our study identifies prognostic factors for achieving best therapeutic outcomes, introduces new risk stratification for patients and suggests the need for a redefinition of bone TG. Am. J. Hematol. 91:E448-E453, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. A multicenter study to standardize reporting and analyses of fluorescence-activated cell-sorted murine intestinal epithelial cells

    Science.gov (United States)

    Magness, Scott T.; Puthoff, Brent J.; Crissey, Mary Ann; Dunn, James; Henning, Susan J.; Houchen, Courtney; Kaddis, John S.; Kuo, Calvin J.; Li, Linheng; Lynch, John; Martin, Martin G.; May, Randal; Niland, Joyce C.; Olack, Barbara; Qian, Dajun; Stelzner, Matthias; Swain, John R.; Wang, Fengchao; Wang, Jiafang; Wang, Xinwei; Yan, Kelley; Yu, Jian

    2013-01-01

    Fluorescence-activated cell sorting (FACS) is an essential tool for studies requiring isolation of distinct intestinal epithelial cell populations. Inconsistent or lack of reporting of the critical parameters associated with FACS methodologies has complicated interpretation, comparison, and reproduction of important findings. To address this problem a comprehensive multicenter study was designed to develop guidelines that limit experimental and data reporting variability and provide a foundation for accurate comparison of data between studies. Common methodologies and data reporting protocols for tissue dissociation, cell yield, cell viability, FACS, and postsort purity were established. Seven centers tested the standardized methods by FACS-isolating a specific crypt-based epithelial population (EpCAM+/CD44+) from murine small intestine. Genetic biomarkers for stem/progenitor (Lgr5 and Atoh 1) and differentiated cell lineages (lysozyme, mucin2, chromogranin A, and sucrase isomaltase) were interrogated in target and control populations to assess intra- and intercenter variability. Wilcoxon's rank sum test on gene expression levels showed limited intracenter variability between biological replicates. Principal component analysis demonstrated significant intercenter reproducibility among four centers. Analysis of data collected by standardized cell isolation methods and data reporting requirements readily identified methodological problems, indicating that standard reporting parameters facilitate post hoc error identification. These results indicate that the complexity of FACS isolation of target intestinal epithelial populations can be highly reproducible between biological replicates and different institutions by adherence to common cell isolation methods and FACS gating strategies. This study can be considered a foundation for continued method development and a starting point for investigators that are developing cell isolation expertise to study physiology and

  2. [Extracellular hydration status and residual urinary sodium excretion in chronic hemodialysis patients: a cross-sectional multicenter study].

    Science.gov (United States)

    Crochette, Romain; Lobbedez, Thierry; Hanoy, Mélanie; Le Roy, Frank; Potier, Jacky; Besselièvre, Thibault; Cardineau, Éric; Landru, Isabelle; Ficheux, Maxence; Ryckelynck, Jean-Philippe; Henri, Patrick

    2014-04-01

    In dialysis patients, a misevaluation of dry weight may lead to an increased morbidity and mortality. The aim of this cross-sectional multicenter study was to evaluate the association between residual urinary sodium excretion and extracellular volume status in chronically treated hemodialysis patients. Dry weight was determined clinically and by whole-body bioimpedance spectroscopy (Body Composition Monitor, Fresenius Medical Care) prior to a mid-week session in 40 chronic hemodialysis patients with significant residual diuresis (more than 250 mL per day) and receiving treatment in four dialysis centers. Regarding their hydration status assessed by the Body Composition Monitor and in comparison to a healthy reference population, patients were assigned to 1 of the 3 categories: overhydrated, normohydrated and dehydrated. Urine output, urinary sodium excretion and residual renal function were measured for all patients within 30 days before dry weight assessment. The median post-HD session FO was of-0.40 L (IQR: from-1.95 to+0.90) and the median residual urinary sodium excretion was of 64 mmol/L (IQR: 46-79). Among these patients, 16 were normohydated, 16 were dehydrated and 8 were overhydrated. There was a linear relationship between the hydration status after HD session and the urinary sodium excretion (estimate: 5.6±1.5; phydration status evaluated by whole-body bioimpedance spectroscopy. Copyright © 2013 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  3. Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study.

    Science.gov (United States)

    Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif

    2015-01-01

    The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. An international multicenter study comparing arrhythmia prevalence between the intracardiac lateral tunnel and the extracardiac conduit type of Fontan operations.

    Science.gov (United States)

    Balaji, Seshadri; Daga, Ankana; Bradley, David J; Etheridge, Susan P; Law, Ian H; Batra, Anjan S; Sanatani, Shubayan; Singh, Anoop K; Gajewski, Kelly K; Tsao, Sabrina; Singh, Harinder R; Tisma-Dupanovic, Svjetlana; Tateno, Shigeru; Takamuro, Motoki; Nakajima, Hiromichi; Roos-Hesselink, Jolien W; Shah, Maully

    2014-08-01

    The study objective was to determine whether the extracardiac conduit Fontan confers an arrhythmia advantage over the intracardiac lateral tunnel Fontan. This multicenter study of 1271 patients compared bradyarrhythmia (defined as need for pacing) and tachyarrhythmia (defined as needing antiarrhythmic therapy) between 602 patients undergoing the intracardiac Fontan and 669 patients undergoing the extracardiac Fontan. The median age at the time of the Fontan procedure was 2.1 years (interquartile range, 1.6-3.2 years) for the intracardiac group and 3.0 years (interquartile range, 2.4-3.9) for the extracardiac group (P 30 days) bradyarrhythmia occurred in 105 patients (18%) in the intracardiac group and 63 patients (9%) in the extracardiac group (P 30 days) tachyarrhythmia occurred in 58 patients (10%) in the intracardiac group and 23 patients (3%) in the extracardiac group (P factoring time since surgery, more patients in the extracardiac group had early bradycardia (odds ratio, 2.9; 95% confidence interval, 1.8-4.6), with no difference in early tachycardia, late bradycardia, or late tachycardia. Overall arrhythmia burden is similar between the 2 groups, but the extracardiac Fontan group had a higher incidence of early bradyarrhythmias. There was no difference in the incidence of late tachyarrhythmias over time between the 2 operations. Therefore, the type of Fontan performed should be based on factors other than an anticipated reduction in arrhythmia burden from the extracardiac conduit. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  5. Effects of Frequent Glove Change on Outcomes of Orthopaedic Surgical Procedures - A Multicenter Study on Surgical Gloves

    Directory of Open Access Journals (Sweden)

    Nishit Palo

    2017-10-01

    Full Text Available Introduction: Intact surgical gloves are a barrier to microorganisms migration between surgical team members and the patient. The surgical gloves are changed at various junctures but the effects of changing gloves during surgical procedures on various surgical parameters or clinical outcomes are not established. Aim: To determine rationale of glove change during orthopaedic procedures, differences amongst surgical parameters with and without changing the surgical gloves and whether frequent glove change affected surgical parameters or clinical outcomes. Materials and Methods: A prospective multicenter study conducted at three centers from January 2014 to January 2016. A 250 patients were divided into 2 groups (n=125 each in Group 1, surgical team operated with regular changing of gloves. In Group 2, only 1 set of double gloves were worn throughout the procedure. Surgical parameters or clinical outcomes were assessed for both the groups. Statistical analyses included the median, mode, range, Interquartile Range (IQR and sample standard deviation (s and independent-samples t-test. Bacterial counts were expressed as median with (IQR. Results: Surgical Timing Difference was 10 (S.D.- 4.2 minutes more in Group-1 (<0.05, Surgical Cost was higher in Group-1 by Rs.150-450 (<0.05. Outer glove micro-perforation rate was 5.85% and 8.15% in group-1 and 2 respectively with no inner glove perforation or Surgical Site Infections. Outer glove micro perforations were proportional to duration of surgery; operations lasting 120-210 and 61-120 minutes had 66.6% and 37.2% micro perforation rates respectively (p<0.05. Conclusion: Under standard operating conditions, procedures performed without glove change are shorter and cost effective than procedures performed with regular glove change with similar surgical and functional results. Judicious use of surgical gloves is a patient and environment friendly option, thereby reducing the hospital’s biomedical waste load.

  6. Inventory of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in France as Assessed by a Multicenter Study.

    Science.gov (United States)

    Robin, F; Beyrouthy, R; Bonacorsi, S; Aissa, N; Bret, L; Brieu, N; Cattoir, V; Chapuis, A; Chardon, H; Degand, N; Doucet-Populaire, F; Dubois, V; Fortineau, N; Grillon, A; Lanotte, P; Leyssene, D; Patry, I; Podglajen, I; Recule, C; Ros, A; Colomb-Cotinat, M; Ponties, V; Ploy, M C; Bonnet, R

    2017-03-01

    The objective of this study was to perform an inventory of the extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae isolates responsible for infections in French hospitals and to assess the mechanisms associated with ESBL diffusion. A total of 200 nonredundant ESBL-producing Enterobacteriaceae strains isolated from clinical samples were collected during a multicenter study performed in 18 representative French hospitals. Antibiotic resistance genes were identified by PCR and sequencing experiments. The clonal relatedness between isolates was investigated by the use of the DiversiLab system. ESBL-encoding plasmids were compared by PCR-based replicon typing and plasmid multilocus sequence typing. CTX-M-15, CTX-M-1, CTX-M-14, and SHV-12 were the most prevalent ESBLs (8% to 46.5%). The three CTX-M-type EBSLs were significantly observed in Escherichia coli (37.1%, 24.2%, and 21.8%, respectively), and CTX-M-15 was the predominant ESBL in Klebsiella pneumoniae (81.1%). SHV-12 was associated with ESBL-encoding Enterobacter cloacae strains (37.9%). qnrB , aac(6 ' )-Ib-cr , and aac(3)-II genes were the main plasmid-mediated resistance genes, with prevalences ranging between 19.5% and 45% according to the ESBL results. Molecular typing did not identify wide clonal diffusion. Plasmid analysis suggested the diffusion of low numbers of ESBL-encoding plasmids, especially in K. pneumoniae and E. cloacae However, the ESBL-encoding genes were observed in different plasmid replicons according to the bacterial species. The prevalences of ESBL subtypes differ according to the Enterobacteriaceae species. Plasmid spread is a key determinant of this epidemiology, and the link observed between the ESBL-encoding plasmids and the bacterial host explains the differences observed in the Enterobacteriaceae species. Copyright © 2017 American Society for Microbiology.

  7. Bevacizumab for the treatment of nonsquamous non-small-cell lung cancer in Portugal: a retrospective, multicenter study

    International Nuclear Information System (INIS)

    Estevinho, Fernanda; Soares, Marta; Azevedo, Isabel; Queiroga, Henrique; Parente, Bárbara; Brito, Ulisses; Teixeira, Encarnação; Sotto-Mayor, Renato; Araújo, António

    2012-01-01

    Lung cancer is the leading cause of cancer-related mortality. In patients with nonsquamous non-small-cell lung cancer (NSCLC) stage IIIB/IV treatment with chemotherapy plus bevacizumab led to significant improvements in progression-free and median overall survival (OS). To report the experience of five Portuguese centers in treating patients with nonsquamous NSCLC in stage IIIB or IV with bevacizumab and chemotherapy regarding survival and toxicity outcomes. This was a retrospective, multicenter study on patients with nonsquamous stage IIIB/IV NSCLC treated with bevacizumab and chemotherapy from November 2007 to August 2010 through special use permits. We reviewed the medical records, registry of demographic characteristics, treatments provided, treatment responses, adverse events, and dates of death. Statistical analysis was performed with SPSS statistics software. Median OS and event-free survival (EFS) were calculated using the Kaplan–Meier method. From an eligible population of 41 patients, 37 participants were registered. Study participants were predominantly male (78.4%) with a median age of 53 years (29–75 years). In total, 83.8% patients had stage IV disease (TNM, 6th Ed.). The OS was 21.5 months (95% confidence interval [CI]: 12.6–30.5] and median EFS was 9.4 months (95% CI9: 7.1–11.7). Hematologic toxicity grade 3/4 occurred in 35.1% of patients, and nonhematologic toxicity in 24.3% patients. One fatal thromboembolic event was recorded (2.7%). The results of chemotherapy plus bevacizumab treatment for nonsquamous NSCLC obtained from the daily clinical practice of the centers involved in this study were similar to those of published clinical trials. Collaboration between the different Portuguese centers is crucial for this kind of study

  8. Quality of life is modestly improved in older patients with mild primary hyperparathyroidism postoperatively: results of a prospective multicenter study.

    Science.gov (United States)

    Blanchard, Claire; Mathonnet, Muriel; Sebag, Frédéric; Caillard, Cécile; Kubis, Caroline; Drui, Delphine; van Nuvel, Elise; Ansquer, Catherine; Henry, Jean-François; Masson, Damien; Kraeber-Bodéré, Françoise; Hardouin, Jean-Benoît; Zarnegar, Rasa; Hamy, Antoine; Mirallié, Eric

    2014-10-01

    The objectives of this study were to evaluate, in mild primary hyperparathyroidism (pHPT) patients, the quality of life (QoL) using the SF-36 questionnaire before and after parathyroidectomy and to detect preoperatively patients who benefit the most from surgery. Most pHPT patients present a mild pHPT defined by calcemia ≤11.4 mg/dL. For these patients, there is debate about whether they should be managed with surveillance, medical therapy, or surgery. A prospective multicenter study investigated QoL (SF-36) in patients with mild pHPT before and after parathyroidectomy in four university hospitals. Laboratory results and SF-36 scores were obtained preoperatively and postoperatively (3, 6, and 12 months). One hundred sixteen patients were included. After surgery, the biochemical cure rate was 98%. Preoperatively, the mental component summary and the physical component summary (PCS) were 38.69 of 100 and 39.53 of 100, respectively. At 1 year, the MCS and the PCS were 41.29 of 100 and 42.03 of 100. The subgroup analysis showed a more significant improvement in patients < 70 years and with calcemia ≥10.4 mg/dL. Postoperative PCS was correlated with age and preoperative PCS: variation = 32.11 - 0.21 × age - 0.4 × preoperative PCS. Men did not improve their MCS postoperatively. Only women with a preoperative MCS <43.6 of 100 showed postoperative improvement. This study showed, in patients with mild pHPT, an improvement of QoL 1 year after parathyroidectomy. Patients <70 years and with calcemia ≥10.4 mg/dL had a more significant improvement.

  9. A global multicenter study on reference values: 1. Assessment of methods for derivation and comparison of reference intervals.

    Science.gov (United States)

    Ichihara, Kiyoshi; Ozarda, Yesim; Barth, Julian H; Klee, George; Qiu, Ling; Erasmus, Rajiv; Borai, Anwar; Evgina, Svetlana; Ashavaid, Tester; Khan, Dilshad; Schreier, Laura; Rolle, Reynan; Shimizu, Yoshihisa; Kimura, Shogo; Kawano, Reo; Armbruster, David; Mori, Kazuo; Yadav, Binod K

    2017-04-01

    The IFCC Committee on Reference Intervals and Decision Limits coordinated a global multicenter study on reference values (RVs) to explore rational and harmonizable procedures for derivation of reference intervals (RIs) and investigate the feasibility of sharing RIs through evaluation of sources of variation of RVs on a global scale. For the common protocol, rather lenient criteria for reference individuals were adopted to facilitate harmonized recruitment with planned use of the latent abnormal values exclusion (LAVE) method. As of July 2015, 12 countries had completed their study with total recruitment of 13,386 healthy adults. 25 analytes were measured chemically and 25 immunologically. A serum panel with assigned values was measured by all laboratories. RIs were derived by parametric and nonparametric methods. The effect of LAVE methods is prominent in analytes which reflect nutritional status, inflammation and muscular exertion, indicating that inappropriate results are frequent in any country. The validity of the parametric method was confirmed by the presence of analyte-specific distribution patterns and successful Gaussian transformation using the modified Box-Cox formula in all countries. After successful alignment of RVs based on the panel test results, nearly half the analytes showed variable degrees of between-country differences. This finding, however, requires confirmation after adjusting for BMI and other sources of variation. The results are reported in the second part of this paper. The collaborative study enabled us to evaluate rational methods for deriving RIs and comparing the RVs based on real-world datasets obtained in a harmonized manner. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  10. One-year results of a prospective randomized, evaluator-blinded, multicenter study comparing TVT and TVT Secur.

    Science.gov (United States)

    Andrada Hamer, Maria; Larsson, Per-Göran; Teleman, Pia; Bergqvist, Christina Eten; Persson, Jan

    2013-02-01

    The aim of this prospective randomized multicenter study was to compare retropubic tension-free vaginal tape (TVT) with TVT Secur in terms of efficacy and safety. We set out to enrol 280 stress urinary incontinent (SUI) women with a half-time interim analysis of short-term cure and adverse events. The short-term results have previously been published. Of the 133 randomized women, 125 underwent surgery, and 121 (TVT n = 61, TVT Secur n = 60) were available for follow-up 1 year postsurgery. No significant differences were found between groups regarding demographics or incontinence grade. One year after surgery, both subjective and objective cure rates were significantly lower for TVT Secur than for TVT (subjective cure: TVT 98 %, TVT Secur 80 %, p = 0.03; objective cure: TVT 94 %, TVT Secur 71 % for cough test, p = 0.01; TVT 76 %, TVT Secur 58 % for pad test, p = 0.05 ). Three major complications occurred in the TVT Secur group: one tape erosion into the urethra, one tape inadvertently placed into the bladder, and one immediate postoperative bleeding due to injury to the corona mortis. No major complications occurred in the TVT group. No significant differences were found between groups regarding peroperative bleeding, hospital stay, urge symptoms, residual urinary volume, subjective bladder emptying problems, postoperative urinary tract infections, and minor complications. The TVT Secur group used more antimuscarine medication after surgery than the TVT group (p = 0.03). Median time for surgery was 13 and 22 min for TVT Secur and TVT, respectively (p TVT Secur procedure had significantly inferior subjective and objective cure rates compared with the retropubic TVT procedure. Three serious adverse events occurred in the TVT Secur group. We therefore discourage further use of TVT Secur.

  11. Surgical treatment for osteoporotic thoracolumbar vertebral collapse using vertebroplasty with posterior spinal fusion: a prospective multicenter study.

    Science.gov (United States)

    Katsumi, Keiichi; Hirano, Toru; Watanabe, Kei; Ohashi, Masayuki; Yamazaki, Akiyoshi; Ito, Takui; Sawakami, Kimihiko; Sano, Atsuki; Kikuchi, Ren; Endo, Naoto

    2016-11-01

    The study aimed to investigate the clinical outcomes and limitations after vertebroplasty with posterior spinal fusion (VP+PSF) without neural decompression for osteoporotic vertebral collapse. We conducted a prospective multicenter study including 45 patients (12 men and 33 women, mean age: 77.0 years) evaluated between 2008 and 2012. Operation time, blood loss, visual analog scale (VAS) of back pain, neurological status, kyphosis angle in the fused area, and vertebral union of the collapsed vertebra were evaluated. The mean operation time was 162 min and blood loss was 381 mL. The postoperative VAS score significantly improved, and the neurological status improved in 35 patients (83 %), and none of the remaining patients demonstrated a deteriorating neurological status at two years post-operatively. The mean kyphosis angle pre-operatively, immediately post-operatively, and two years post-operatively was 23.8°, 10.7°, and 24.3°, respectively, and there was no significant difference between the angles pre-operatively and two years post-operatively. The extensive correction of kyphosis >16° was a risk factor for a higher correction loss and subsequent fracture. Union of the collapsed vertebra was observed in 43 patients (95 %) at two years post-operatively. The present study suggests that spinal stabilization rather than neural decompression is essential to treat OVC. Short-segment VP+PSF can achieve a high union rate of collapsed vertebra and provide a significant improvement in back pain or neurological status with less invasive surgery, but has a limit of kyphosis correction more than 16°.

  12. Is the timing of surgery associated with avascular necrosis after unstable slipped capital femoral epiphysis? A multicenter study.

    Science.gov (United States)

    Kohno, Yusuke; Nakashima, Yasuharu; Kitano, Toshio; Irie, Taichi; Kita, Atsushi; Nakamura, Tomoyuki; Endo, Hirosuke; Fujii, Yosuke; Kuroda, Takayuki; Mitani, Shigeru; Kitoh, Hiroshi; Matsushita, Masaki; Hattori, Tadashi; Iwata, Koji; Iwamoto, Yukihide

    2017-01-01

    An unstable slipped capital femoral epiphysis (SCFE) is associated with a high rate of avascular necrosis (AVN). The etiology of AVN seems to be multifactorial, although it is not thoroughly known. The aims of our study were to determine the rate of AVN after an unstable SCFE and to investigate the risk factors for AVN, specifically evaluating the notion of an "unsafe window", during which medical interventions would increase the risk for AVN. This retrospective multicenter study included 60 patients with an unstable SCFE diagnosed between 1985 and 2014. Timing of surgery was evaluated for three time periods, from acute onset of symptoms to surgery: period I, 7 days. Multivariate logistic regression analysis was used to identify risk factors for AVN. Closed reduction and pinning was performed in 43 patients and in situ pinning in 17. Among these cases, 16 patients (27%) developed AVN. The rate of AVN was significantly higher in patients treated by closed reduction and pinning (15/43, 35%) than in those treated by in situ pinning (1/17, 5.9%) (p = 0.022). In patients treated by closed reduction and pinning, the incidence of AVN was 2/11 (18%) in period I, 10/13 (77%) in period II and 3/15 (20%) in period III, showing the significantly higher rate in period II (p = 0.002). The surgery provided in period II was identified as an independent risk factor for the development of AVN. Our rate of AVN was 27% using two classical treatment methods. Time-to-surgery, between 24 h and 7 days, was independently associated with AVN, supporting the possible existence of an "unsafe window" in patients with unstable SCFE treated by closed reduction and pinning. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  13. Fragility Hip Fractures in Elderly Patients in Bhubaneswar, India (2012-2014): A Prospective Multicenter Study of 1031 Elderly Patients.

    Science.gov (United States)

    Dash, Sunil K; Panigrahi, Ranajit; Palo, Nishit; Priyadarshi, Ashok; Biswal, Manas

    2015-03-01

    Elderly patients with hip fracture constitute Single Largest Group of Emergency Orthopaedics Admissions. In 2050, 6.26 million hip fractures worldwide, approximately 50%, will occur in Asia. Only small number of reports on incidence of hip fractures in the Asian population exist. India lacks data registry for fragility hip fractures, therefore, the magnitude and standard of patient care are not known. A prospective multicenter study was conducted from January 2012 to April 2014 to describe population-based longitudinal trends, namely, age-specific incidence, fracture type, timing of presentation, kilometers traveled, timing of surgery, hospital stay, man hours lost, pressure ulcers, weight bearing, 30-day return, 3-month mortality, and so on, of fragility hip fractures. A total of 1031 patients were included with 59.7% females and 40.3% of male patients, with a female-male ratio of 1.5:1. Commonest mode: Falls 45%. 56.4% IT fractures. 66.2%patients operated, Operative/Conservative Ratio of 2.8:1. Patients travel a mean distance of 86.4 kilometers for quality treatment. Of the patients, 85.9 % presented late due to ignorance and misguiding quack practice. Incidence of delayed surgery was 69.3%. Persistent electrolytes imbalance and hyperglycemia normalized in 81.2% by second or third postoperative day. The man hours lost was 157.85 hours/person. Medical complications was more (90%) in patients who had delays in surgeries and presentation. Mortality rate was 6.2 %. Patients travel long for quality treatment, most of them are misguided, present late with significant complications and sufferings, and their pockets half drained depriving them off best treatment. Early presentation and operation have better prognosis and rehabilitation, facilitates early return to work, and independence. Increased pressure sores, infections, hospital stay, treatment cost, depression, and mortality are directly related to delays in surgeries and presentation. Estimated losses according to

  14. Anticoagulants Resumption after Warfarin-Related Intracerebral Haemorrhage: The Multicenter Study on Cerebral Hemorrhage in Italy (MUCH-Italy).

    Science.gov (United States)

    Poli, Loris; Grassi, Mario; Zedde, Marialuisa; Marcheselli, Simona; Silvestrelli, Giorgio; Sessa, Maria; Zini, Andrea; Paciaroni, Maurizio; Azzini, Cristiano; Gamba, Massimo; Toriello, Antonella; Tassi, Rossana; Giorli, Elisa; Calabrò, Rocco Salvatore; Ritelli, Marco; De Vito, Alessandro; Pugliese, Nicola; Martini, Giuseppe; Lanari, Alessia; Lodigiani, Corrado; Padroni, Marina; De Giuli, Valeria; Caria, Filomena; Morotti, Andrea; Costa, Paolo; Strambo, Davide; Corato, Manuel; Pascarella, Rosario; Del Sette, Massimo; Malferrari, Giovanni; Colombi, Marina; Padovani, Alessandro; Pezzini, Alessandro

    2018-03-01

    Whether to resume antithrombotic treatment after oral anticoagulant-related intracerebral haemorrhage (OAC-ICH) is debatable. In this study, we aimed at investigating long-term outcome associated with OAC resumption after warfarin-related ICH, in comparison with secondary prevention strategies with platelet inhibitors or antithrombotic discontinuation. Participants were patients who sustained an incident ICH during warfarin treatment (2002-2014) included in the Multicenter Study on Cerebral Hemorrhage in Italy. Primary end-point was a composite of ischemic stroke/systemic embolism (SE) and all-cause mortality. Secondary end-points were ischemic stroke/SE, all-cause mortality and major recurrent bleeding. We computed individual propensity score (PS) as the probability that a patient resumes OACs or other agents given his pre-treatment variables, and performed Cox multivariable analysis using Inverse Probability of Treatment Weighting (IPTW) procedure. A total of 244 patients qualified for the analysis. Unlike antiplatelet agents, OAC resumption was associated with a lower rate of the primary end-point (weighted hazard ratio [HR], 0.21; 95% confidence interval [CI], 0.09-0.45), as well as of overall mortality (weighted HR, 0.17; 95% CI, 0.06-0.45) and ischemic stroke/SE (weighted HR, 0.19; 95% CI, 0.06-0.60) with no significant increase of major bleeding in comparison with patients receiving no antithrombotics. In the subgroup of patients with atrial fibrillation, OACs resumption was also associated with a reduction of the primary end-point (weighted HR, 0.22; 95% CI, 0.09-0.54), and the secondary end-point ischemic stroke/SE (weighted HR, 0.09; 95% CI, 0.02-0.40). In conclusion, in patients who have an ICH while receiving warfarin, resuming anticoagulation results in a favorable trade-off between bleeding susceptibility and thromboembolic risk. Schattauer GmbH Stuttgart.

  15. A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer.

    Science.gov (United States)

    Troyer, Dean A; Jamaspishvili, Tamara; Wei, Wei; Feng, Ziding; Good, Jennifer; Hawley, Sarah; Fazli, Ladan; McKenney, Jesse K; Simko, Jeff; Hurtado-Coll, Antonio; Carroll, Peter R; Gleave, Martin; Lance, Raymond; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; Brooks, James D; Squire, Jeremy A

    2015-08-01

    Loss of the phosphatase and tensin homolog (PTEN) tumor suppressor gene is a promising marker of aggressive prostate cancer. Active surveillance and watchful waiting are increasingly recommended to patients with small tumors felt to be low risk, highlighting the difficulties of Gleason scoring in this setting. There is an urgent need for predictive biomarkers that can be rapidly deployed to aid in clinical decision-making. Our objectives were to assess the incidence and ability of PTEN alterations to predict aggressive disease in a multicenter study. We used recently developed probes optimized for sensitivity and specificity in a four-color FISH deletion assay to study the Canary Retrospective multicenter Prostate Cancer Tissue Microarray (TMA). This TMA was constructed specifically for biomarker validation from radical prostatectomy specimens, and is accompanied by detailed clinical information with long-term follow-up. In 612 prostate cancers, the overall rate of PTEN deletion was 112 (18.3%). Hemizygous PTEN losses were present in 55/612 (9.0%) of cancers, whereas homozygous PTEN deletion was observed in 57/612 (9.3%) of tumors. Significant associations were found between PTEN status and pathologic stage (P free survival (number of events = 189), pre-operative prostate specific antigen (PSA) (P free survival in multivariate models, as were seminal vesicle invasion, extracapsular extension, and Gleason score, and preoperative PSA. Furthermore, these data demonstrate that the assay can be readily introduced at first diagnosis in a cost effective manner analogous to the use of FISH for analysis of HER2/neu status in breast cancer. Combined with published research beginning 17 years ago, both the data and tools now exist to implement a PTEN assay in the clinic. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc.

  16. Knowledge and attitudes of nurses on pressure ulcer prevention: a cross-sectional multicenter study in Belgian hospitals.

    Science.gov (United States)

    Beeckman, Dimitri; Defloor, Tom; Schoonhoven, Lisette; Vanderwee, Katrien

    2011-09-01

    Evidence-based guidelines for pressure ulcer prevention have been developed and promoted by authoritative organizations. However, nonadherence to these guidelines is frequently reported. Negative attitudes and lack of knowledge may act as barriers to using guidelines in clinical practice. To study the knowledge and attitudes of nurses about pressure ulcer prevention in Belgian hospitals and to explore the correlation between knowledge, attitudes, and the application of adequate prevention. A cross-sectional multicenter study was performed in a random sample of 14 Belgian hospitals, representing 207 wards. Out of that group, 94 wards were randomly selected (2105 patients). Clinical observations were performed to assess the adequacy of pressure ulcer prevention and pressure ulcer prevalence. From each participating ward, a random selection of at least five nurses completed an extensively validated knowledge and attitude instrument. In total, 553 nurses participated. A logistic regression analysis was performed to evaluate the correlation between knowledge, attitudes, and the application of adequate prevention. Pressure ulcer prevalence (Category I-IV) was 13.5% (284/2105). Approximately 30% (625/2105) of the patients were at risk (Bradenscore pressure ulcer). Only 13.9% (87/625) of these patients received fully adequate prevention whilst in bed and when seated. The mean knowledge and attitude scores were 49.7% and 71.3%, respectively. The application of adequate prevention on a nursing ward was significantly correlated with the attitudes of the nurses (OR = 3.07, p = .05). No independent correlation was found between knowledge and the application of adequate prevention (OR = 0.75, p = .71). Knowledge of nurses in Belgian hospitals about the prevention of pressure ulcers is inadequate. The attitudes of nurses toward pressure ulcers are significantly correlated with the application of adequate prevention. No correlation was found between knowledge and the

  17. Ultrasound therapy for recalcitrant diabetic foot ulcers: results of a randomized, double-blind, controlled, multicenter study.

    Science.gov (United States)

    Ennis, William J; Foremann, Phil; Mozen, Neal; Massey, Joi; Conner-Kerr, Teresa; Meneses, Patricio

    2005-08-01

    An estimated 15% of patients with diabetes will develop a foot ulcer sometime in their life, making them 30 to 40 times more likely to undergo amputation due to a non-healing foot ulcer than the non-diabetic population. To determine the safety and efficacy of a new, non-contact, kilohertz ultrasound therapy for the healing of recalcitrant diabetic foot ulcers - as well as to evaluate the impact on total closure and quantitative bacterial cultures and the effect on healing of various levels of sharp/surgical debridement - a randomized, double-blinded, sham-controlled, multicenter study was conducted in hospital-based and private wound care clinics. Patients (55 met criteria for efficacy analysis) received standard of care, which included products that provide a moist environment, offloading diabetic shoes and socks, debridement, wound evaluation, and measurement. The "therapy" was either active 40 KHz ultrasound delivered by a saline mist or a "sham device" which delivered a saline mist without the use of ultrasound. After 12 weeks of care, the proportion of wounds healed (defined as complete epithelialization without drainage) in the active ultrasound therapy device group was significantly higher than that in the sham control group (40.7% versus 14.3%, P = 0.0366, Fisher's exact test). The ultrasound treatment was easy to use and no difference in the number and type of adverse events between the two treatment groups was noted. Of interest, wounds were debrided at baseline followed by a quantitative culture biopsy. The results of these cultures demonstrated a significant bioburden (greater than 10(5)) in the majority of cases, despite a lack of clinical signs of infection. Compared to control, this therapeutic modality was found to increase the healing rate of recalcitrant, diabetic foot ulcers.

  18. Acoustic Radiation Force Impulse Elastography for fibrosis evaluation in patients with chronic hepatitis C: An international multicenter study

    Energy Technology Data Exchange (ETDEWEB)

    Sporea, Ioan, E-mail: isporea@umft.ro [Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara (Romania); Bota, Simona, E-mail: bota_simona1982@yahoo.com [Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara (Romania); Peck-Radosavljevic, Markus, E-mail: markus.peck@meduniwien.ac.at [Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna (Austria); Sirli, Roxana, E-mail: roxanasirli@gmail.com [Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara (Romania); Tanaka, Hironori, E-mail: hironori@hyo-med.ac.jp [Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya (Japan); Iijima, Hiroko, E-mail: hiroko.iijima@nifty.com [Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya (Japan); Badea, Radu, E-mail: rbadea2003@yahoo.com [3rd Medical Clinic, University of Medicine, Cluj Napoca (Romania); Lupsor, Monica, E-mail: monica.lupsor@umfcluj.ro [3rd Medical Clinic, University of Medicine, Cluj Napoca (Romania); Fierbinteanu-Braticevici, Carmen, E-mail: cfierbinteanu@yahoo.com [2nd Medical Clinic and Gastroenterology, University Hospital, Bucharest (Romania); Petrisor, Ana, E-mail: ana1petrisor@yahoo.com [2nd Medical Clinic and Gastroenterology, University Hospital, Bucharest (Romania); Saito, Hidetsugu, E-mail: hidetsugusaito@gmail.com [Department of Internal Medicine, School of Medicine, Keio University, Tokyo (Japan); Ebinuma, Hirotoshi, E-mail: ebinuma@a5.keio.jp [Department of Internal Medicine, School of Medicine, Keio University, Tokyo (Japan); Friedrich-Rust, Mireen, E-mail: Mireen.Friedrich-Rust@kgu.de [Department of Internal Medicine, J.W. Goethe University, Frankfurt/Main (Germany); Sarrazin, Christoph, E-mail: sarrazin@em.uni-frankfurt.de [Department of Internal Medicine, J.W. Goethe University, Frankfurt/Main (Germany); and others

    2012-12-15

    Aim: The aim of this international multicenter study was to evaluate the reliability of Acoustic Radiation Force Impulse (ARFI) elastography for predicting fibrosis severity, in patients with chronic hepatitis C. Patients and methods: We compared ARFI to liver biopsy (LB) in 914 patients (10 centers, 5 countries) with chronic hepatitis C. In each patient LB (evaluated according to the METAVIR score) and ARFI measurements were performed (median of 5–10 valid measurements, expressed in meters/second – m/s). In 400 from the 914 patients, transient elastography (TE) was also performed (median of 6–10 valid measurements, expressed in kiloPascals – kPa). Results: Valid ARFI measurements were obtained in 911 (99.6%) of 914 cases. On LB 61 cases (6.7%) had F0, 241 (26.4%) had F1, 202 (22.1%) had F2, 187 (20.4%) had F3, and 223 (24.4%) had F4 fibrosis. A highly significant correlation (r = 0.654) was found between ARFI measurements and fibrosis (p < 0.0001). The predictive values of ARFI for various stages of fibrosis were: F ≥ 1 – cut-off > 1.19 m/s (AUROC = 0.779), F ≥ 2 – cut-off > 1.33 m/s (AUROC = 0.792), F ≥ 3 – cut-off > 1.43 m/s (AUROC = 0.829), F = 4 – cut-off > 1.55 m/s (AUROC = 0.842). The correlation with histological fibrosis was not significantly different for TE in comparison with ARFI elastography: r = 0.728 vs. 0.689, p = 0.28. TE was better than ARFI for predicting the presence of liver cirrhosis (p = 0.01) and fibrosis (F ≥ 1, METAVIR) (p = 0.01). Conclusion: ARFI elastography is a reliable method for predicting fibrosis severity in chronic hepatitis C patients.

  19. Stevens-Johnson syndrome and toxic epidermal necrolysis in childhood-onset systemic lupus erythematosus patients: a multicenter study

    Directory of Open Access Journals (Sweden)

    Ana Paula Sakamoto

    2017-07-01

    Full Text Available Objective: To assess Stevens-Johnson syndrome (SJS and toxic epidermal necrolysis (TEN in a large population of childhood-onset systemic lupus erythematosus (cSLE patients. Methods: Multicenter study including 852 cSLE patients followed in Pediatric Rheumatology centers in São Paulo, Brazil. SJS was defined as epidermal detachment below 10% of body surface area (BSA, overlap SJS-TEN 10-30% and TEN greater than 30% of BSA. Results: SJS and TEN was observed in 5/852 (0.6% cSLE female patients, three patients were classified as SJS and two patients were classified as overlap SJS-TEN; TEN was not observed. The mean duration of SJS and overlap SJS-TEN was 15 days (range 7-22 and antibiotics induced four cases. Regarding extra-cutaneous manifestations, hepatomegaly was observed in two cSLE patients, nephritis in two and neuropsychiatric involvement and conjunctivitis were observed respectively in one patient. Hematological involvement included lymphopenia in four, leucopenia in three and thrombocytopenia in two patients. The mean SLEDAI-2K score was 14.8 (range 6-30. Laboratory analysis showed low C3, C4 and/or CH50 in two patients and the presence of anti-dsDNA autoantibody in two patients. One patient had lupus anticoagulant and another one had anticardiolipin IgG. All patients were treated with steroids and four needed additional treatment such as intravenous immunoglobulin in two patients, hydroxychloroquine and azathioprine in two and intravenous cyclophosphamide in one patient. Sepsis was observed in three cSLE patients. Two patients required intensive care and death was observed in one patient. Conclusion: Our study identified SJS and overlap SJS-TEN as rare manifestations of active cSLE associated with severe multisystemic disease, with potentially lethal outcome.

  20. Kunden- und wettbewerbsorientierte Produktentwicklung mit QFD: Kundenorientierte Produktentwicklung mit Hilfe von Quality Function Deployment (QFD)

    OpenAIRE

    Schloske, Alexander

    2013-01-01

    Die Produktentwicklung von heute muss in immer kürzeren Zeiträumen kunden- und kostenorientierte Produkte entwickeln. Zur systematischen Unterstützung dieser Aufgabe im Rahmen der Produktentwicklung wird die Methode Quality Function Deployment (QFD) eingesetzt. Die konsequente Umsetzung der Stimme des Kunden in die Sprache des Unternehmens gelingt mit Quality Function Deployment (QFD). Die Methode wertet systematisch Kundenanforderungen an Produkte aus und führt zu innovativen Lösungen, die s...

  1. Peniskarzinom mit exulzerierten Lymphknotenmetastasen links inguinal

    Directory of Open Access Journals (Sweden)

    Presich K

    2003-01-01

    Full Text Available Im Oktober 2001 wurde ein 53jähriger Patient mit ausgedehnten exulzerierten Lymphknotenmetastasen rechts inguinal an einer auswärtigen chirurgischen Abteilung vorgestellt. Im Rahmen der Durchuntersuchung fand sich eine verhärtete, von einem nicht retrahierbaren Präputium verdeckte Glans als mögliches Primum. Eine Circumcision sowie Biopsie aus der Glans ergaben das histologische Ergebnis eines invasiven, schwach verhornenden Plattenepithelkarzinoms mittleren Differenzierungsgrades (G2-G3. In einer Unterbauch-Computertomographie wurde rechts inguinal ein ausgedehnter, ca. 10 cm messender, teils solider, teils nekrotischer Prozeß, bis an die großen Gefäße heranreichend, beschrieben. Die linke Leiste war unauffällig.

  2. Current activities at the MIT Research Reactor

    International Nuclear Information System (INIS)

    Hu Linwen; Bernard, John A.; Harling, Otto K.; Kohse, Gordon E.; Ames, Michael; Olmez, Ilhan

    1998-01-01

    The MIT Research Reactor (MITR) is a MW nuclear research reactor that is owned and operated by the Massachusetts Institute of Technology to further its educational and research goals at both the undergraduate and graduate level. The reactor first achieved criticality in 1958. It was largely rebuilt in 1973/1974 by MIT staff and students, and its current license expires in August 1999. The current facility, which is designated as the MITR-H, uses a compact core with finned, aluminum-clad, plate-type fuel that is cooled and moderated by light water and reflected by heavy water. The reactor core can hold twenty-seven fuel elements. However, the normal configuration is twenty-four elements. A maximum of four fuel elements can be replaced with in-core experimental facilities. A unique feature of the MITR-II's design is that fixed absorber plates can be inserted in the upper half of the core. These cause the flux to peak in the lower half which benefits experimenters and also facilitates a fuel strategy that involves inversion of fuel elements midway through their life cycle. The MITR-II currently operates continuously for four weeks followed by shutdown of a few days for maintenance. This paper provides an overview of current activities at the MITR including preparations for re-licensing. The status of an on-going Phase-I clinical trial of boron neutron capture therapy for both glioblastoma multiforme and metastatic melanoma is described as well as the design of a fission converter facility for BNCT. Environmental research using neutron activation analysis is summarized as well as in-pile research focussed on LWR water chemistry and structural materials. (author)

  3. Teaching ``The Physics of Energy'' at MIT

    Science.gov (United States)

    Jaffe, Robert

    2009-05-01

    New physics courses on energy are popping up at colleges and universities across the country. Many require little or no previous physics background, aiming to introduce a broad audience to this complex and critical problem, often augmenting the scientific message with economic and policy discussions. Others are advanced courses, focussing on highly specialized subjects like solar voltaics, nuclear physics, or thermal fluids, for example. About two years ago Washington Taylor and I undertook to develop a course on the ``Physics of Energy'' open to all MIT students who had taken MIT's common core of university level calculus, physics, and chemistry. By avoiding higher level prerequisites, we aimed to attract and make the subject relevant to students in the life sciences, economics, etc. --- as well as physical scientists and engineers --- who want to approach energy issues in a sophisticated and analytical fashion, exploiting their background in calculus, mechanics, and E & M, but without having to take advanced courses in thermodynamics, quantum mechanics, or nuclear physics beforehand. Our object was to interweave teaching the fundamental physics principles at the foundations of energy science with the applications of those principles to energy systems. We envisioned a course that would present the basics of statistical, quantum, and fluid mechanics at a fairly sophisticated level and apply those concepts to the study of energy sources, conversion, transport, losses, storage, conservation, and end use. In the end we developed almost all of the material for the course from scratch. The course debuted this past fall. I will describe what we learned and what general lessons our experience might have for others who contemplate teaching energy physics broadly to a technically sophisticated audience.

  4. Coordination of international multicenter studies: governance and administrative structure Coordinación de estudios multicéntricos internacionales: estructura administrativa y reglamentación

    Directory of Open Access Journals (Sweden)

    Shrikant I. Bangdiwala

    2003-01-01

    Full Text Available A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. The organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. The elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. The experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (WorldSAFE, illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators.La ejecución de estudios multicéntricos requiere el establecimiento de procedimientos uniformes, control de calidad, asegurar estandarización, y la colaboración entre las instituciones participantes. Este trabajo describe la estructura y la dinámica de los estudios multicéntricos internacionales, enfocando los aspectos de administración y reglamentación. Se describe la estructura organizativa de un estudio multicéntrico, así como los roles de los integrantes de un sistema de supervisión y coordinación. Se presentan los elementos de un documento de reglamentación y se describen algunas guías y políticas para una colaboración eficaz. La experiencia del estudio internacional colaborativo World Studies of Abuse in the Family Environment (WorldSAFE se utiliza como ejemplo de la aplicación de estas normas. Un centro de coordinación estadística, así como un documento de auto-reglamentación son

  5. Final Technical Report for the MIT Annular Fuel Research Project

    International Nuclear Information System (INIS)

    Mujid S. Kazimi; Pavel Hejzlar

    2008-01-01

    MIT-NFC-PR-082 (January 2006) Abstract This summary provides an overview of the results of the U.S. DOE funded NERI (Nuclear Research Energy Initiative) program on development of the internally and externally cooled annular fuel for high power density PWRs. This new fuel was proposed by MIT to allow a substantial increase in power density (on the order of 30% or higher) while maintaining or improving safety margins. A comprehensive study was performed by a team consisting of MIT (lead organization), Westinghouse Electric Corporation, Gamma Engineering Corporation, Framatome ANP(formerly Duke Engineering) and Atomic Energy of Canada Limited

  6. Radiation exposure to patient and radiologist during transcatheter arterial embolization therapy for hepatocellular carcinoma. Multicenter study in Japan

    International Nuclear Information System (INIS)

    Ishiguchi, T.; Nakamura, H.; Okazaki, M.

    2000-01-01

    Transcatheter arterial embolization (TAE) is now most commonly used as a treatment of hepatocellular carcinoma. Present multicenter study was carried out to evaluate radiation exposure to patients and interventional radiologists during the procedure. Thirty-nine procedures of TAE for hepatocellular carcinoma in eight institutes were analyzed. Radiation exposure to the patients and the interventional radiologists were evaluated with LiF thermoluminescence dosimeters (TLDs) placed on the patient's skin at the posterior hepatic portion and the pelvis and the operator's forehead and abdomen (in front and back of the lead apron). A real-time dosimeter was also used to evaluate skin dose of the patient. TAE was performed by angiographic techniques, using a microcatheter advanced to the hepatic artery branch(es) under the guidance of X-ray fluoroscopy and digital subtraction angiography (DSA), and then injecting chemotherapeutic agents mixed with oily contrast material and followed by gelatin sponge particles. The mean fluoroscopic time was 21 minutes and the mean number of DSA acquisition was 6. TLD dosimetry showed that the mean entrance surface dose of the patient at the hepatic portion was 973±681 mSv (mean±SD), and the anterior skin dose at the pelvis was 0.98±0.69 mSv. The doses of the radiologist were 0.04±0.04 mSv at the forehead, 0.15±0.19 mSv at the abdomen in front of the lead apron, and 0.005±0.01 mSv behind it. The real-time dosimetry showed that 56% of the surface dose at the hepatic portion was from DSA and 44% was from fluoroscopy. The radiation exposure to the patients and the interventional radiologists during TAE for hepatocellular carcinoma was considered to be acceptable when proper techniques are used. Further effort to reduce radiation doses during the procedure will be directed toward both digital angiographic and fluoroscopic techniques. (author)

  7. Accuracy of a Computer-Aided Surgical Simulation (CASS) Protocol for Orthognathic Surgery: A Prospective Multicenter Study

    Science.gov (United States)

    Hsu, Sam Sheng-Pin; Gateno, Jaime; Bell, R. Bryan; Hirsch, David L.; Markiewicz, Michael R.; Teichgraeber, John F.; Zhou, Xiaobo; Xia, James J.

    2012-01-01

    Purpose The purpose of this prospective multicenter study was to assess the accuracy of a computer-aided surgical simulation (CASS) protocol for orthognathic surgery. Materials and Methods The accuracy of the CASS protocol was assessed by comparing planned and postoperative outcomes of 65 consecutive patients enrolled from 3 centers. Computer-generated surgical splints were used for all patients. For the genioplasty, one center utilized computer-generated chin templates to reposition the chin segment only for patients with asymmetry. Standard intraoperative measurements were utilized without the chin templates for the remaining patients. The primary outcome measurements were linear and angular differences for the maxilla, mandible and chin when the planned and postoperative models were registered at the cranium. The secondary outcome measurements were: maxillary dental midline difference between the planned and postoperative positions; and linear and angular differences of the chin segment between the groups with and without the use of the template. The latter was measured when the planned and postoperative models were registered at mandibular body. Statistical analyses were performed, and the accuracy was reported using root mean square deviation (RMSD) and Bland and Altman's method for assessing measurement agreement. Results In the primary outcome measurements, there was no statistically significant difference among the 3 centers for the maxilla and mandible. The largest RMSD was 1.0mm and 1.5° for the maxilla, and 1.1mm and 1.8° for the mandible. For the chin, there was a statistically significant difference between the groups with and without the use of the chin template. The chin template group showed excellent accuracy with largest positional RMSD of 1.0mm and the largest orientational RSMD of 2.2°. However, larger variances were observed in the group not using the chin template. This was significant in anteroposterior and superoinferior directions, as in

  8. Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study

    Directory of Open Access Journals (Sweden)

    Tellez-Vazquez J

    2016-04-01

    Full Text Available Jesús Tellez-Vazquez On behalf of the Dry Eye In Glaucoma Study Group (DEIGSG Glaucoma Section, Ophthalmology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Purpose: The purpose of this study is to assess the effectiveness and tolerability of a dietary supplement with a combination of omega-3 fatty acids and antioxidants on dry eye symptoms caused by chronic instillation of antihypertensive eye drops in patients with glaucoma. Patients and methods: A total of 1,255 patients with glaucoma and dry eye symptoms related to antiglaucoma topical medication participated in an open-label, uncontrolled, prospective, and multicenter study and were instructed to take three capsules a day of the nutraceutical formulation (Brudypio® 1.5 g for 12 weeks. Dry eye symptoms (graded as 0–3 [none to severe, respectively], conjunctival hyperemia, tear breakup time, Schirmer I test, Oxford grading scheme, and intraocular pressure were assessed. Results: After 12 weeks of administration of the dietary supplement, all dry eye symptoms improved significantly (P<0.001 (mean 1.3 vs 0.6 for scratching, 1.4 vs 0.7 for stinging sensation, 1.6 vs 0.7 for grittiness, 1.0 vs 0.4 for tired eyes, 1.1 vs 0.5 for grating sensation, and 0.8 vs 0.3 for blurry vision. The Schirmer test scores and the tear breakup time also increased significantly. There was an increase in the percentage of patients grading 0–I in the Oxford scale and a decrease in those grading IV–V. Compliance was recorded in 62.5% of patients. In compliant patients, the mean differences at 12 weeks vs baseline of dry eye symptoms were statistically significant as compared to noncompliant patients. Conclusion: Dietary supplementation with Brudypio® may be a clinically valuable additional option for the treatment of dry eye syndrome in patients with glaucoma using antiglaucoma eye drops. These results require confirmation with an appropriately designed randomized controlled study

  9. Analysis of Inappropriate Admissions of Residents of Medicalized Nursing Homes to Emergency Departments: A Prospective Multicenter Study in Burgundy.

    Science.gov (United States)

    Manckoundia, Patrick; Menu, Didier; Turcu, Alin; Honnart, Didier; Rossignol, Sylvie; Alixant, Jean-Christophe; Sylvestre, Franck-Henry; Bailly, Vanessa; Dion, Michèle; Putot, Alain

    2016-07-01

    To determine the rate of inappropriate admissions to emergency departments (EDs) and to identify determinants of these admissions. Prospective multicenter study. Burgundy (France), EDs and medical nursing homes (MNHs). 1000 Burgundy MNH residents admitted to EDs, from April 17 to June 20, 2013. For each subject, a questionnaire was completed. Data included age, gender, type of health professional who referred the resident to the ED (THP), whether or not a medical dispatcher organized the transfer to the ED, transport mode, reason for admission to the ED, level of independence according to the Groupes Iso-Ressource score (GIRS), and diagnosis made in the ED. The French version of the Appropriateness Evaluation Protocol grid was applied to each admission to the ED, and in some situations, the expert committee ruled on the appropriateness of the admission to the ED. MNH characteristics were also recorded. Two groups were constituted according to the appropriateness or not of admission to the ED. Mean age of the 1000 residents was 87. There were 706 women. Two-thirds were referred to the EDs by a physician, mainly a general practitioner. In 91.7%, the transfer to the ED was organized by a medical dispatcher, and 8.8% were transported by medicalized transport. More than 95% had a GIRS ≤4. Among the admissions to EDs, 18.1% were inappropriate. Female gender (P = .017), nonmedicalized transport (P = .002), public MNH (P = .044), and nonaccess to a geriatric opinion in an emergency (P = .043) were determinants of inappropriate admission to EDs. In this first study on admissions to EDs of MNH residents using French data, we found a lower rate of admissions to the ED than that reported in the literature. Female gender, nonmedicalized transport, public MNH, and nonaccess to a geriatric opinion in an emergency were associated with inappropriate admission to EDs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier

  10. Is the impact of fatigue related to walking capacity and perceived ability in persons with multiple sclerosis? A multicenter study.

    Science.gov (United States)

    Dalgas, U; Langeskov-Christensen, M; Skjerbæk, A; Jensen, E; Baert, I; Romberg, A; Santoyo Medina, C; Gebara, B; Maertens de Noordhout, B; Knuts, K; Béthoux, F; Rasova, K; Severijns, D; Bibby, B M; Kalron, A; Norman, B; Van Geel, F; Wens, I; Feys, P

    2018-04-15

    The relationship between fatigue impact and walking capacity and perceived ability in patients with multiple sclerosis (MS) is inconclusive in the existing literature. A better understanding might guide new treatment avenues for fatigue and/or walking capacity in patients with MS. To investigate the relationship between the subjective impact of fatigue and objective walking capacity as well as subjective walking ability in MS patients. A cross-sectional multicenter study design was applied. Ambulatory MS patients (n = 189, age: 47.6 ± 10.5 years; gender: 115/74 women/men; Expanded Disability Status Scale (EDSS): 4.1 ± 1.8 [range: 0-6.5]) were tested at 11 sites. Objective tests of walking capacity included short walking tests (Timed 25-Foot Walk (T25FW), 10-Metre Walk Test (10mWT) at usual and fastest speed and the timed up and go (TUG)), and long walking tests (2- and 6-Minute Walk Tests (MWT). Subjective walking ability was tested applying the Multiple Sclerosis Walking Scale-12 (MSWS-12). Fatigue impact was measured by the self-reported modified fatigue impact scale (MFIS) consisting of a total score (MFIS total ) and three subscales (MFIS physical , MFIS cognitive and MFIS psychosocial ). Uni- and multivariate regression analysis were performed to evaluate the relation between walking and fatigue impact. MFIS total was negatively related with long (6MWT, r = -0.14, p = 0.05) and short composite (TUG, r = -0.22, p = 0.003) walking measures. MFIS physical showed a significant albeit weak relationship to walking speed in all walking capacity tests (r = -0.22 to -0.33, p < .0001), which persisted in the multivariate linear regression analysis. Subjective walking ability (MSWS-12) was related to MFIS total (r = 0.49, p < 0.0001), as well as to all other subscales of MFIS (r = 0.24-0.63, p < 0.001), showing stronger relationships than objective measures of walking. The physical impact of fatigue is weakly

  11. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects.

    Science.gov (United States)

    Tack, Cornelius; Pohlmeier, Harald; Behnke, Thomas; Schmid, Volkmar; Grenningloh, Marco; Forst, Thomas; Pfützner, Andreas

    2012-04-01

    This multicenter study was conducted to evaluate the performance of five recently introduced blood glucose (BG) monitoring (BGM) devices under daily routine conditions in comparison with the YSI (Yellow Springs, OH) 2300 Stat Plus glucose analyzer. Five hundred one diabetes patients with experience in self-monitoring of BG were randomized to use three of five different BGM devices (FreeStyle Lite® [Abbott Diabetes Care Inc., Alameda, CA], FreeStyle Freedom Lite [Abbott Diabetes Care], OneTouch® UltraEasy® [LifeScan Inc., Milpitas, CA], Accu-Chek® Aviva [Roche Diagnostics, Mannheim, Germany], and Contour® [Bayer Vital GmbH, Leverkusen, Germany]) in a daily routine setting. All devices and strips were purchased from local regular distribution sources (pharmacies, four strip lots per device). The patients performed the finger prick and the glucose measurement on their own. In parallel, a healthcare professional performed the glucose assessment with the reference method (YSI 2300 Stat Plus). The primary objective was the comparison of the mean absolute relative differences (MARD). Secondary objectives were compliance with the International Organization for Standardization (ISO) accuracy criteria under these routine conditions and Clarke and Parkes Error Grid analyses. MARD ranged from 4.9% (FreeStyle Lite) to 9.7% (OneTouch UltraEasy). The ISO 15197:2003 requirements were fulfilled by the FreeStyle Lite (98.8%), FreeStyle Freedom Lite (97.5%), and Accu-Chek Aviva (97.0%), but not by the Contour (92.4%) and OneTouch UltraEasy (91.1%). The number of values in Zone A of the Clarke Error Grid analysis was highest for the FreeStyle Lite (98.8%) and lowest for the OneTouch Ultra Easy (90.4%). FreeStyle Lite, FreeStyle Freedom Lite, and Accu-Chek Aviva performed very well in this study with devices and strips purchased through regular distribution channels, with the FreeStyle Lite achieving the lowest MARD in this investigation.

  12. Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: A multicenter study.

    Science.gov (United States)

    de Miranda, Sandra; Pochard, Frédéric; Chaize, Marine; Megarbane, Bruno; Cuvelier, Antoine; Bele, Nicolas; Gonzalez-Bermejo, Jesus; Aboab, Jérome; Lautrette, Alexandre; Lemiale, Virginie; Roche, Nicolas; Thirion, Marina; Chevret, Sylvie; Schlemmer, Benoit; Similowski, Thomas; Azoulay, Elie

    2011-01-01

    To determine the prevalence and risk factors of symptoms of anxiety, depression, and posttraumatic stress disorder-related symptoms in patients with chronic obstructive pulmonary disease and their relatives after an intensive care unit stay. Prospective multicenter study. Nineteen French intensive care units. One hundred twenty-six patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and 102 relatives. None. Patients and relatives were interviewed at intensive care unit discharge and 90 days later to assess symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HADS) and posttraumatic stress disorder-related symptoms using the Impact of Event Scale (IES). At intensive care unit discharge, 90% of patients recollected traumatic psychological events in the intensive care unit. At day 90, we were able to conduct telephone interviews with 53 patients and 47 relatives. Hospital Anxiety and Depression Scale scores indicated symptoms of anxiety and depression in 52% and 45.5% of patients at intensive care unit discharge and in 28.3% and 18.9% on day 90, respectively. Corresponding prevalence in relatives were 72.2% and 25.7% at intensive care unit discharge and 40.4% and 14.9% on day 90, respectively. The Impact of Event Scale indicated posttraumatic stress disorder-related symptoms in 20.7% of patients and 29.8% of relatives on day 90. Peritraumatic dissociation assessed using the Peritraumatic Dissociative Experiences Questionnaire was independently associated with posttraumatic stress disorder-related symptoms in the patients and relatives. Previous intensive care unit experience and recollection of bothersome noise in the intensive care unit predicted posttraumatic stress disorder-related symptoms in the patients. Psychiatric symptoms were found to be common in a group of 126 patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and their relatives at intensive care

  13. Mentored peer review of standardized manuscripts as a teaching tool for residents: a pilot randomized controlled multi-center study.

    Science.gov (United States)

    Wong, Victoria S S; Strowd, Roy E; Aragón-García, Rebeca; Moon, Yeseon Park; Ford, Blair; Haut, Sheryl R; Kass, Joseph S; London, Zachary N; Mays, MaryAnn; Milligan, Tracey A; Price, Raymond S; Reynolds, Patrick S; Selwa, Linda M; Spencer, David C; Elkind, Mitchell S V

    2017-01-01

    There is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality. A partially blinded, randomized, controlled multi-center study was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts. Sixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (-8.5%) and non-mentored (-13.9%) residents ( p  = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p  = 0.001), understanding of manuscripts (3.73 vs 2.87; p  = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p  = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p  = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p  = 0.50). We used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice.

  14. Standardization of D2 lymphadenectomy and surgical quality control (KLASS-02-QC): a prospective, observational, multicenter study [NCT01283893

    International Nuclear Information System (INIS)

    Kim, Hyoung-Il; Hur, Hoon; Kim, Youn Nam; Lee, Hyuk-Joon; Kim, Min-Chan; Han, Sang-Uk; Hyung, Woo Jin

    2014-01-01

    Extended systemic lymphadenectomy (D2) is standard procedure for surgical treatment of advanced gastric cancer (AGC) although less extensive lymphadenectomy (D1) can be applied to early gastric cancer. Complete D2 lymphadenectomy is the mandatory procedure for studies that evaluate surgical treatment results of AGC. However, the actual extent of D2 lymphadenectomy varies among surgeons because of a lacking consensus on the anatomical definition of each lymph node station. This study is aimed to develop a consensus for D2 lymphadenectomy and also to qualify surgeons that can perform both laparoscopic and open D2 gastrectomy. This (KLASS-02-QC) is a prospective, observational, multicenter study to qualify the surgeons that will participate in the KLASS-02-RCT, which is a prospective, randomized, clinical trial comparing laparoscopic and open gastrectomy for AGC. Surgeons and reviewers participating in the study will be required to complete a questionnaire detailing their professional experience and specific gastrectomy surgical background/training, and the gastrectomy metrics of their primary hospitals. All surgeons must submit three laparoscopic and three open D2 gastrectomy videos, respectively. Each video will be allocated to five peer reviewers; thus each surgeon’s operations will be assessed by a total of 30 reviews. Based on blinded assessment of unedited videos by experts’ review, a separate review evaluation committee will decide whether or not the evaluated surgeon will participate in the KLASS-02-RCT. The primary outcome measure is each surgeon’s proficiency, as assessed by the reviewers based on evaluation criteria for completeness of D2 lymphadenectomy. We believe that our study for standardization of D2 lymphadenectomy and surgical quality control (KLASS-02-QC) will guarantee successful implementation of the subsequent KLASS-02-RCT study. After making consensus on D2 lymphadenectomy, we developed evaluation criteria for completeness of D2

  15. MIT gets good marks for fighting gender discrimination

    Science.gov (United States)

    Gwynne, Peter

    2011-05-01

    The Massachusetts Institute of Technology (MIT) has made "significant progress" in increasing the number of female faculty members, with their numbers in science and engineering almost doubling over the last decade.

  16. Behandlung des chronischen Tinnitus mit repetitiver transkranieller Magnetstimulation

    OpenAIRE

    Kleinjung, T

    2012-01-01

    Tinnitus ist eine Funktionsstörung des Hörsystems, die von verschiedenen Strukturen und Ebenen ausgehen kann. Tinnitus geht mit neuroplastischen Veränderungen im zentralen auditorischen System einher. Existenz eines „Tinnitus-Netzwerkes“.

  17. Laser mit instabilem Resonator fuer ringfoermige aktive Medien

    OpenAIRE

    Jarosch, U.K.; Habich, U.; Plum, H.D.

    1996-01-01

    Beschrieben werden Laser mit instabilen Resonatoren, die ringfoermige Medien effektiv ausnutzen, unabhaengig davon, ob es sich um feste, fluessige oder gasfoermige Medien handelt. Die Erfindung zeichnet sich dadurch aus, dass die Auskopplung des Strahles (5.1) eines Ringresonators entlang eines Spaltes oder eines Kreisringes ueber dem gesamten Umfang vorgesehen ist, wobei der Laserresonator durch Ringspiegel (1,2) mit torusfoermiger Spiegelflaeche gebildet und von den Waenden des Ringspaltes ...

  18. MIT CSAIL and Lincoln Laboratory Task Force Report

    Science.gov (United States)

    2016-08-01

    funded through MIT LL, most notably through by the MIT LL Technology Office (TO). TO funding has come through a diverse set of venues: ASD (R&E) Line...many and varied opportunities to participate could better cohere research interests at each institution and between them as well. 3.4.2 Autonomy-at...applications. Near-data processing is about migrating selected processing operations from the central processing unit (CPU) of traditional computer

  19. Molekulargenetische Charakterisierung einer Familie mit Usher-Syndrom

    OpenAIRE

    Zimmer, AJ; Arndt, S; Aschendorff, A; Birkenhäger, R

    2009-01-01

    Einleitung: Das Usher-Syndrom definiert eine genetisch und klinisch heterogene autosomal rezessiv vererbte Erkrankung mit dem gleichzeitigen Auftreten von Innenohrschwerhörigkeit bis hin zur Taubheit, teilweise Vestibularisausfall und Netzhautdegeneration (Retinitis Pigmentosa). Bisher wird das Usher-Syndrom in drei verschiedene Hauptgruppen (USH1-3) mit unterschiedlicher phänotypischer Ausprägung eingeteilt. Für das Usher-Syndrom sind 12 Genorte bekannt, für die bereits acht Gene identifizi...

  20. A geometrodynamical approach to the MIT confinement scheme

    International Nuclear Information System (INIS)

    Martellini, M.; Sodano, P.

    1978-01-01

    Starting from the strong gravity theory of Salam-Isham-Strathdee the M.I.T. bag is identified as a certain region of the global extension of a De Sitter-Schwarzschild solution. As a result the M.I.T. bag radius, a geometrical interpretation of the binding Lagrangian term and a rate of decaying of the ''bag manifold'' into the flat space (which, however, does not lead to observable quark wave functions) are obtained. (author)

  1. Rigiscan®-Monitoring der Erektion unter audiovisueller sexueller Stimulation ohne/mit Viagra™ bei Patienten mit erektiler Dysfunktion

    Directory of Open Access Journals (Sweden)

    Perabo FGE

    2000-01-01

    Full Text Available Die orale Medikation mit Sildenafil (Viagra™ hat sich zur Therapie der erektilen Dysfunktion etabliert und relativiert die Differentialdiagnose zwischen psychogener und organischer Dysfunktion mit den entsprechenden therapeutischen Konsequenzen. Diesem Problem widmet sich diese Studie zur Prüfung der erektilen Antwort unter RigiScan®-Monitoring ohne/mit 50 mg Viagra™. 64 Patienten (mittleres Alter 48 Jahre mit einer erektilen Dysfunktion arteriogener (n = 10, venöser (n = 7, gemischt neurogen/vaskulärer (n = 15 und psychogener (n = 32 Genese von mehr als 6 Monaten Dauer wurden in die Studie aufgenommen. Alle Patienten wurden eingehend diagnostisch abgeklärt, inklusive Hormonlabor, dynamischer Pharmako-Duplexsonographie und, falls indiziert, mit einer Cavernosometrie/ -graphie. Zur Testung der penilen Rigidität und zur Objektivierung der Erektion wurde das "real-time" RigiScan® verwendet. In zwei konsekutiven Messungen wurden sowohl die direkte erektile Antwort auf visuelle Stimulation als auch die nächtlichen Erektionen abgeleitet und die Meßergebnisse mit den Begleiterkrankungen, "lifestyle"-Faktoren und dem Ergebnis der Pharmako-Duplexsonographie korreliert. Es fand sich keine Korrelation zwischen der Ätiologie der erektilen Dysfunktion in bezug auf organische oder psychogene Genese und dem Alter der Patienten, der Dauer der Erektionsstörung, dem Nikotinabusus, den Blutfetten, den Testosteronwerten, dem klinischen Ergebnis der Pharmakotestung (Erektionsgrad und dem duplexsonographisch gemessenen Fluß der penilen Arterien. Hingegen zeigte sich eine positive Korrelation zwischen Genese der erektilen Dysfunktion (organisch bzw. psychogen und dem RigiScan®-Meßergebnis (r = 0,29. Patienten mit psychogen bedingter Erektionsstörung profitierten am meisten von Viagra™, während Patienten mit vaskulärer Genese oder gemischt neurogener/vaskulärer Genese deutlich schlechter auf Viagra™ ansprachen. Es bestand keine Korrelation

  2. Prospect of mechanical engineering. Report from MIT; Kikai kogaku no atarashii tenkai. MIT kara no hokoku

    Energy Technology Data Exchange (ETDEWEB)

    Asada, H [Massachusetts Inst. of Technology, Cambridge, MA (United States)

    1996-01-05

    The author of this article is a professor of Department of Mechanical Engineering of Massachusetts Institute of Technology (MIT) and the director general of Laboratory for Information Systems and Technology of the institute. At Department of Mechanical Engineering of Engineering Faculty of world-famous MIT, Laboratory for Information Systems and Technology was established in 1994 and in the same year, the curricula of the department were greatly revised after 30 years for its enforcement from the new semester starting from September, 1995. These two occasions are suggestive for guessing the future of mechanical engineering, hence its aim and meaning are introduced. Department of Mechanical Engineering aims to bring up system integrators who can consolidate systems based on wide-ranged knowledge, and its basic subjects are divided into 4 subjects namely dynamics and control, heat and fluid, system engineering and control, and design and production, and it has been decided that each of them is taught in equal weight and in parallel. Also as a new study field in the above Department of Mechanical Engineering, nanotechnology and artificial intelligence, and high-technological aircraft and networks are shown as examples.

  3. Comparative characteristics of the efficiency of different methods of operational treatment for pectus excavatum in children: a multicenter study

    Directory of Open Access Journals (Sweden)

    Aleksandr Yu. Razumovsky

    2018-03-01

    Full Text Available Background. Congenital malformations of the chest are observed in 1%–4% of the population, and the most common among these is pectus excavatum (90%. Aim. We aimed to conduct a retrospective multicenter study to compare the effectiveness of various methods of operative removal of pectus excavatum in children. Material and methods. We retrospectively analyzed the results of the surgical treatment of funnel-like deformity of the thorax in children conducted in clinics of pediatric surgery in seven regions of Russia (1,226 patients. The ratio of boys to girls in the study population was 2.2:1. The study population was divided as per their age into the following groups: 4–7 years (n = 180, 14.7%, 8–14 years (n = 731, 59.6%, and > 14 years (n = 315, 25.7%. The average age at which most children were operated was 11.83 ± 1.24 years. All children underwent a standard preoperative laboratory examination, including a general blood test, urine tests, a biochemical blood test, a hemostasiogram; radiographic diagnostic methods were used with the calculation of the Gizycka index; functional methods of investigation, such as electrocardiography, spirography, and radioisotope scintigraphy of the lungs were also used. Children with second- or third-degree pectus excavatum underwent surgical treatment almost exclusively. The symmetrical forms of the pectus excavatum were more prevalent. In most cases, the main pathological course was complicated. Results and discussion. The operated patients were divided into the following 3 groups: the first (n = 62: operations with the resection of the curved cartilages and external fixation of the sternum-rib complex (Bairov’s operation, the second (n = 374: thoracoplasty with the resection of warped cartilages using internal metal fixators by Timoshchenko, Ravitch, Paltia, Kondrashin, and the third (n = 790: minimally invasive operations without resection with internal fixation (Nuss operations: original and modified

  4. The diagnosis accuracy and safety of 99Tcm-MIBI myocardial perfusion imaging-a retrospective multicenter study

    International Nuclear Information System (INIS)

    Wang Rongfu; Qiu Yanli; Wang Liqin

    2012-01-01

    Objective: To evaluate the diagnostic accuracy and safety of 99 Tc m -MIBI MPI by retrospectively analyzing data from this multicenter study. Methods: Participating centers included six hospitals: Peking University First Hospital, Beijing Fuwai Hospital of Chinese Academy of Medical Science and Peking Union Medical College, Anzhen Hospital of Capital Medical University, Beijing Hospital of Health Ministry, Beijing Tongren Hospital of Capital Medical University and Peking University People's Hospital. According to the inclusion and exclusion criteria, 500 subjects (335 male, 165 female, mean age (60.1 ±11.1) years) who underwent MPI between April 1998 and April 2006 were enrolled. All subjects were investigated with stress/rest MPI and CAG within 1 month. Stress test was performed with bicycle ergometry or with intravenous dipyridamole, adenosine or ATP. Perfusion defects on MPI were allocated to corresponding coronary arteries. During the stress and imaging period,any discomfort or symptoms were recorded. Coronary stenosis with ≥ 50% luminal narrowing was considered significant in CAG and taken as the gold standard. 99 Tc m -MIBI MPI results for the number of stenosed vessels, stenotic severity and coronary artery allocation were compared using χ 2 test. Results: There were 280 subjects that underwent exercise stress tests and the remaining 220 received pharmacological stress tests (117 adenosine, 32 dipyridamole, 71 ATP). Two hundred and forty-nine patients had significant coronary stenosis and 251 had normal CAG. Out of the 249 patients with positive CAG results, 101 had one-vessel, 66 had two-vessel and 82 had three-vessel disease. Significant stenosis of the LAD was present in 205 patients, 144 had RCA stenosis and 130 had stenosis of the LCX. The sensitivity,specificity, accuracy, positive predictive and negative predictive values of MPI for detection of coronary artery disease were 65.1% (162/249), 81.3% (204/251), 73.2% (366/500), 77.5% (162

  5. Axial Globe Position Measurement: A Prospective Multi-center Study by the International Thyroid Eye Disease Society

    Science.gov (United States)

    Bingham, Chad M.; Sivak-Callcott, Jennifer A.; Gurka, Matthew J.; Nguyen, John; Hogg, Jeffery P.; Feldon, Steve E.; Fay, Aaron; Seah, Lay-Leng; Strianese, Diego; Durairaj, Vikram D.; Uddin, Jimmy; Devoto, Martin H.; Harris, Matheson; Saunders, Justin; Osaki, Tammy H.; Looi, Audrey; Teo, Livia; Davies, Brett W.; Elefante, Andrea; Shen, Sunny; Realini, Tony; Fischer, William; Kazim, Michael

    2015-01-01

    Purpose Identify a reproducible measure of axial globe position (AGP) for multicenter studies of patients with thyroid eye disease (TED). Methods This is a prospective, international, multicenter, observational study in which 3 types of AGP evaluation were examined: radiologic, clinical, and photographic. In this study, computed tomography (CT) was the modality to which all other methods were compared. CT AGP was measured from an orthogonal line between the anterior lateral orbital rims to the cornea. All CT measurements were made at a single institution by 3 individual clinicians. Clinical evaluation was performed with exophthalmometry. Three clinicians from each clinical site assessed AGP with 3 different exophthalmometers and horizontal palpebral width using a ruler. Each physician made 3 separate measurements with each type of exophthalmometer, not in succession. All photographic measurements were made at a single institution. AGP was measured from lateral photographs in which a standard marker was placed at the anterior lateral orbital rim. Horizontal and vertical palpebral fissure were measured from frontal photographs. Three trained readers measured 3 separate times, not in succession. Exophthalmometry and photography method validity was assessed by agreement with CT (mean differences calculation, ICC’s, Bland-Altman figures). Correlation between palpebral fissure and CT AGP was assessed with Pearson correlation. Intraclinician and interclinician reliability was evaluated using intraclass correlation coefficients (ICC). Results Sixty-eight patients from 7 centers participated. CT mean AGP was 21.37mm (15.96 – 28.90mm) right, 21.22mm (15.87 – 28.70mm) left (ICC 0.996 and 0.995). Exophthalmometry AGP fell between 18mm and 25mm. Intraclinician agreement across exophthalmometers was ideal (ICC 0.948 – 0.983). Agreement between clinicians was greater than 0.85 for all upright exophthalmometry measurements. Photographic mean AGP was 20.47mm (10.92 – 30

  6. [Postoperative adjuvante Therapie mit einem Mistelextrakt (Viscum album ssp. album) bei Hündinnen mit Mammatumoren].

    Science.gov (United States)

    Biegel, Ulrike; Stratmann, Nina; Knauf, Yvonne; Ruess, Katja; Reif, Marcus; Wehrend, Axel

    2017-01-01

    Hintergrund: Canine Mammatumoren (CMT) sind wegen ihrer Häufigkeit und hohen Malignitätsrate eine Herausforderung für die Veterinärmedizin. Bisher ist noch keine postoperative adjuvante Therapie als wirksamer Standard etabliert und in den nächsten Jahren wohl auch nicht zu erwarten. Zusätzlich ist die Frage nach der Verträglichkeit einer adjuvanten Therapie mit Erhaltung oder Verbesserung der Lebensqualität (LQ) wichtig. Die Therapie mit Mistelextrakten (Viscum album L.; VAE) ist in der Humanonkologie nach adjuvanter Tumorbasistherapie (Chemotherapie und Bestrahlung) eine sehr häufig verwendete, zusätzliche adjuvante Behandlungsmethode. Auch bei verschiedenen Tierarten werden inzwischen Mistelpräparate in der Onkologie erfolgreich angewendet. Methoden: Überprüfung von Wirkung und Nutzen einer postoperativen, adjuvanten Misteltherapie beim CMT sowie Erfassung der LQ unter der VAE-Behandlung. Ausgewertet wurden 56 Hündinnen mit Mammaadenokarzinom, 33 ausschließlich operierte Kontrolltiere und 23 operierte Tiere, die adjuvant VAE erhielten. Ergebnisse: Die mediane Überlebenszeit (MST) aller Tiere (n = 56) betrug 32 Monate (Interquartilbereich 13-51 Monate). Im deskriptiven Vergleich der Überlebenszeiten (ST) nach Kaplan-Meier waren nach 12, 24, 36 bzw. 48 Monaten noch 24, 20, 15 bzw. 5 Hündinnen (entsprechend 72,7%, 60,6%, 45,1%, 12,4%) der Kontrollgruppe sowie 19, 14, 11 und 1 Hündin (82,6%, 60,9%, 47,8%, 4,3%) der VAE-Gruppe am Leben. Die VAE-Therapie führte zu einem geringeren Gesamtversterberisiko, das statistisch nicht signifikant war (Hazard Ratio (HR) 0,530, 95%-Konfidenzintervall (KI) 0,222-1,262; p = 0,15). Tendenziell (p = 0,07) zeigte sich eine Verringerung des tumorbedingten Sterberisikos auf 25% (HR 0,251, 95%-KI 0,056-1,122). Schlussfolgerungen: Es kann eine Tendenz zur Senkung des tumorbedingten Sterberisikos der VAE-Gruppe bei guter Verträglichkeit der Therapie angenommen werden. Die LQ der Tiere blieb über die gesamte

  7. The micro turbine: the MIT example; La micro turbine: l'exemple du MIT

    Energy Technology Data Exchange (ETDEWEB)

    Ribaud, Y. [Office National d' Etudes et de Recherches Aerospatiales (ONERA-DEFA), 92 - Chatillon (France)

    2001-10-01

    The micro turbine study began a few years ago at the MIT, with the participation of specialists from different fields. The purpose is the development of a MEMS (micro electro mechanical systems) based, 1 cm in diameter, micro gas turbine. Potential applications are devoted to micro drone propulsion, electric power generation for portable power sources in order to replace heavy Lithium batteries, satellite motorization, the surface distributed power for boundary suction on plane wings. The manufacturing constraints at such small scales lead to 2-D extruded shapes. The physical constraints stem from viscous effects and from limitations given by 2-D geometry. The time scales are generally shorter than for conventional machines. Otherwise the material properties are better at such length scales. Transposition from conventional turbomachinery laws is no more applicable and new design methods must be established. The present paper highlights the project progress and the technology breakthroughs. (author)

  8. Islam, Migration und Integration: Konflikte jugendlicher Migranten mit islamischem Hintergrund

    Directory of Open Access Journals (Sweden)

    Ilhan Kizilhan

    2008-04-01

    Full Text Available Der Islam mit seinen verschiedenen Verhaltensweisen und Verboten spielt direkt oder indirekt immer noch eine wichtige Rolle im alltäglichen Leben vieler Migranten. Religiöse Vorschriften zeichnen sich dadurch aus, dass ihrer Achtung nicht juristisch, sondern durch sozialen Druck Nachdruck verliehen wird (Verwandtschaft, religiöse Lehrer, islamische Gemeinde, religiöse Vereine etc. und dass ihre Missachtung mit Folgen in Form von Ausgrenzung, Missachtung und Diskriminierung einhergeht. Die kulturellen Vorstellungen der ersten Generation unterscheiden sich auf Grund der unterschiedlichen Biografien von denen der zweiten und dritten durch den Grad der Verwurzelung in der kulturellen Identität und der Verbundenheit mit traditionellen Wertvorstellungen. Fehlende Integrationskonzepte, Ausgrenzung im Migrationsland auf der einen und weltweite staatliche und halbstaatliche Konflikte im Namen des Islams bis hin zum Terrorismus auf der anderen Seite haben einen erheblichen Einfluss auf den Integrationsgrad von jugendlichen Migranten im Aufnahmeland.

  9. Professionell entwickeln mit Java EE 7 das umfassende Handbuch

    CERN Document Server

    Salvanos, Alexander

    2014-01-01

    Ein praxisorientiertes Lehrbuch zur JEE 7 und zugleich ein Standardwerk, das Sie auf Ihrem Weg zum Enterprise-Entwickler begleitet. Inklusive Best Practices für leichtgewichtige Enterprise Applications, Standards zu servicebasierten Anwendungen, Persistence API, Dependency Injection, HTML5 und Performance-Tuning. Aus dem Inhalt: Grundlagen und Installation Software-Architektur mit Java EE Webanwendungen mit HTML5 und CSS3 Java Standard Tag Library Asynchrone Servlets und Non-blocking I/O Datenbanken anbinden mit der JDBC API Java Server Faces Datenbank-Organisation Java Persistence API Objektrelationales Mapping Transaktionssicherheit Performance-Tuning Internationalisierung Enterprise Java Beans WebSockets PrimeFaces Deployment Galileo Press heißt von jetzt an Rheinwerk Verlag.

  10. Fallstudie SIG - Supply Chain Prototyp mit Coca Cola Beverages

    OpenAIRE

    Senger, Enrico

    2003-01-01

    SIG, ein führender Lieferant von Verpackungsmaterialien für Getränke, hat mit Coca Cola CPFR, collaborative planning, forecasting and replenishment realisiert. Das Unternehmen kann elektronisch und ohne Zeitverzug (vorher mit bis zu 15 Tagen Verspätung) auf die Lagerbestände und Verkaufsvorhersagen bei Coca Cola zugreifen. Coca Cola erhält die exakten Liefermengen und zeiten. Coca Cola konnte dadurch den Lagerbestand von Verpackungsmaterial um 50% senken. Dies reduziert die Bearbeitungszeit d...

  11. Untersuchungen zur Farbreaktion von Amilorid, Chlorhexidin und Proguanil mit Hypobromit

    OpenAIRE

    Huth, Silke

    2004-01-01

    Bei der Reaktion von Amiloridhydrochlorid (1· HCl) mit Brom in alkalischer Lösung wird ein gelbbraunes Dehydrierungsprodukt erhalten, daß als 3-(3-Amino-1,2,4-oxadiazol-5-yl)-5-chlor-2,6-pyrazindiamin (6) identifiziert werden konnte. Durch Vergleich von Massen- und NMR-Spektren der Verbindung 6 mit Spektren von 1· HCl und Referenzsubstanzen I-III konnte auf die verbindung 6 geschlossen werden. Die Struktur wurde durch eine Röntgenstrukturanalyse abgesichert. Erhitzen von Amiloridhydrochlorid ...

  12. Hinderniserkennung und -verfolgung mit einer PMD-kamera im automobil

    Science.gov (United States)

    Schamm, Thomas; Vacek, Stefan; Natroshvilli, Koba; Marius Zöllner, J.; Dillmann, Rüdiger

    Die Detektion von Hindernissen vor dem Automobil ist eine Hauptanforderung an moderne Fahrerassistenzsysteme (FAS). In dieser Arbeit wird ein System vorgestellt, das mit Hilfe einer PMDKamera (Photomischdetektor) Hindernisse auf der Fahrspur erkennt und deren relevante Parameter bestimmt. Durch die PMD-Kamera werden zunächst 3D-Tiefenbilder der Fahrzeugumwelt generiert. Nach einem initialen Filterprozess werden im Tiefenbild mit Hilfe eines Bereichswachstumsverfahrens Hindernisse gesucht. Zur Stabilisierung des Verfahrens und zur Parameterberechnung wird ein Kaiman Filter eingesetzt. Das Ergebnis ist eine Liste aller Hindernisse im Fahrbereich des Automobils.

  13. Untersuchungen zum Riechvermögen bei Patienten mit schizophrenen Störungen

    OpenAIRE

    Minovi, A; Dombrowski, T; Brüne, M; Dazert, S; Juckel, G

    2014-01-01

    Einleitung: Riechstörungen werden bei Patienten mit einer Schizophrenie in vielen Studien beschrieben. Im Rahmen einer prospektiv angelegten Studie untersuchten wir das Riechvermögen von 18 Patienten mit einer Schizophrenie im Vergleich zu einer Kontrollgruppe (n=13). Weiterhin erfolgte eine immunhistochemische Untersuchung der Riechschleimhaut bei 8 Patienten mit einer Schizophrenie.Methoden: Die Riechprüfung erfolgte mit Hilfe der erweiterten Sniffin' Sticks-Testbatterie. Nach Biopsie der...

  14. Parallelization experience with four canonical econometric models using ParMitISEM

    NARCIS (Netherlands)

    Baştürk, N.; Grassi, S.; Hoogerheide, L.; van Dijk, H.K.

    2016-01-01

    This paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm, introduced by Hoogerheide et al. (2012), provides an automatic and flexible method to approximate a non-elliptical target density using adaptive mixtures of

  15. Parallelization Experience with Four Canonical Econometric Models Using ParMitISEM

    NARCIS (Netherlands)

    N. Basturk (Nalan); S. Grassi (Stefano); L.F. Hoogerheide (Lennart); H.K. van Dijk (Herman)

    2016-01-01

    textabstractThis paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm, introduced by Hoogerheide, Opschoor and Van Dijk (2012), provides an automatic and flexible method to approximate a non-elliptical target density

  16. Parallelization experience with four canonical econometric models using ParMitISEM

    NARCIS (Netherlands)

    Bastürk, Nalan; Grassi, S.; Hoogerheide, L.; van Dijk, Herman K.

    2016-01-01

    This paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm provides an automatic and flexible method to approximate a non-elliptical target density using adaptive mixtures of Student-t densities, where only a kernel of

  17. [The tinnitus questionnaire. A standard instrument for grading the degree of tinnitus. Results of a multicenter study with the tinnitus questionnaire].

    Science.gov (United States)

    Goebel, G; Hiller, W

    1994-03-01

    The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. The present paper describes traditional diagnostic methods of ENT practice as well as the Tinnitus Questionnaire (TQ) which has been evaluated in a number of studies. This instrument differentiates between emotional and cognitive distress, auditory perceptual difficulties and self-experienced intrusiveness produced by the tinnitus. The results of a German multicenter study are presented which show that the TQ can be used to demonstrate differences of tinnitus distress under different clinical conditions (e.g., ENT clinic vs psychosomatic clinic and in- vs out-patient care). The TQ can be employed for comparative studies in different tinnitus-related institutions and for the evaluation of the relative effects of different treatment approaches.

  18. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Science.gov (United States)

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  19. How Many Samples and How Many Culture Media To Diagnose a Prosthetic Joint Infection: a Clinical and Microbiological Prospective Multicenter Study.

    Science.gov (United States)

    Bémer, Pascale; Léger, Julie; Tandé, Didier; Plouzeau, Chloé; Valentin, Anne Sophie; Jolivet-Gougeon, Anne; Lemarié, Carole; Kempf, Marie; Héry-Arnaud, Geneviève; Bret, Laurent; Juvin, Marie Emmanuelle; Giraudeau, Bruno; Corvec, Stéphane; Burucoa, Christophe

    2016-02-01

    Although numerous perioperative samples and culture media are required to diagnose prosthetic joint infection (PJI), their exact number and types have not yet been definitely determined with a high level of proof. We conducted a prospective multicenter study to determine the minimal number of samples and culture media required for accurate diagnosis of PJI. Over a 2-year period, consecutive patients with clinical signs suggesting PJI were included, with five perioperative samples per patient. The bacteriological and PJI diagnosis criteria were assessed using a random selection of two, three, or four samples and compared with those obtained using the recommended five samples (references guidelines). The results obtained with two or three culture media were then compared with those obtained with five culture media for both criteria. The times-to-positivity of the different culture media were calculated. PJI was confirmed in 215/264 suspected cases, with a bacteriological criterion in 192 (89%). The PJI was monomicrobial (85%) or polymicrobial (15%). Percentages of agreement of 98.1% and 99.7%, respectively, for the bacteriological criterion and confirmed PJI diagnosis were obtained when four perioperative samples were considered. The highest percentages of agreement were obtained with the association of three culture media, a blood culture bottle, a chocolate agar plate, and Schaedler broth, incubated for 5, 7, and 14 days, respectively. This new procedure leads to significant cost saving. Our prospective multicenter study showed that four samples seeded on three culture media are sufficient for diagnosing PJI. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  20. MIT wavelength tables. Volume 2. Wavelengths by element

    International Nuclear Information System (INIS)

    Phelps, F.M. III.

    1982-01-01

    This volume is the first stage of a project to expand and update the MIT wavelength tables first compiled in the 1930's. For 109,325 atomic emission lines, arranged by element, it presents wavelength in air, wavelength in vacuum, wave number and intensity. All data are stored on computer-readable magnetic tape

  1. MIT Orients Course Materials Online to K-12

    Science.gov (United States)

    Cavanagh, Sean

    2008-01-01

    Many science and mathematics educators across the country are taking advantage of a Web site created by the Massachusetts Institute of Technology (MIT), the famed research university located in Cambridge, Massachusetts, which offers free video, audio, and print lectures and course material taken straight from the school's classes. Those resources…

  2. MIT Mints a Valuable New Form of Academic Currency

    Science.gov (United States)

    Carey, Kevin

    2012-01-01

    The Massachusetts Institute of Technology (MIT) has invented or improved many world-changing things--radar, information theory, and synthetic self-replicating molecules, to name a few. Last month the university announced, to mild fanfare, an invention that could be similarly transformative, this time for higher education itself. It is called MITx.…

  3. Possibilities of transport with monorails; Moeglichkeiten des Transports mit Einschienenhaengebahnen

    Energy Technology Data Exchange (ETDEWEB)

    Bolz, P. [Deutsche Montan Technologie GmbH, Bochum (Germany)

    2001-08-02

    The safety limits of transport by monorails were determined within the framework of a test project. The safety-related components of the system, in particular the rail system with its suspensions and the drive and braking system, were investigated for normal and heavy load transport. In addition to operational measurements for actual stressing of the components tests were conducted on test benches to determine the dynamic strength. The concept of a new forward-looking monorail system with greater safety was subsequently developed with the aid of the results obtained. The compatibility with the previous components was ensured. Compared to the determined load capacity limits a development requirement for monorail suspension anchor bolts, diesel- and battery-operated trolleys as well as braking trolleys for ropeways were derived. The other components are already adequately dimensioned. (orig.) [German] Im Rahmen eines Untersuchungsvorhabens wurden die sicherheitlichen Grenzen des Transports mit EHB ermittelt. Die sicherheitsrelevanten Bauteile des Systems, insbesondere das Schienensystem mit seinen Aufhaengungen sowie das Antriebs- und Bremssystem, wurden fuer den Normal- und den Schwerlasttransport untersucht. Neben Betriebsmessungen zur tatsaechlichen Beanspruchung der Bauteile erfolgten Pruefstandsuntersuchungen zur dynamischen Festigkeit. Mit Hilfe der gewonnenen Ergebnisse wurde anschliessend das Konzept fuer ein neues, zukunftsorientiertes EHB-System mit erhoehter Sicherheit erarbeitet. Die Kompatibilitaet zu den bisherigen Bauteilen wurde dabei gewaehrleistet. Im Vergleich zu den ermittelten Belastbarkeitsgrenzen wurde daraus ein Entwicklungsbedarf bei EHB-Aufhaengeankern, Diesel- und Batteriekatzen sowie Bremskatzen fuer Seilbahnen abgeleitet. Die uebrigen Bauteile sind bereits jetzt ausreichend bemessen. (orig.)

  4. Interaktion mit virtuellen Agenten? Zur Aneignung eines ungewohnten Artefakts

    DEFF Research Database (Denmark)

    Krummheuer, Antonia Lina

    sprechen, schließt der soziologische Interaktionsbegriff nichtmenschliche Gesprächspartner aus. Es stellt sich daher die Frage, mit welchen Konzepten die Soziologie dieses neue Phänomen fassen kann. Vor dem Hintergrund der techniksoziologischen Debatte um die Handlungsträgerschaft von Artefakten werden die...

  5. Collimator optimization studies for the new MIT epithermal neutron beam

    International Nuclear Information System (INIS)

    Riley, K.J.; Ali, S.J.; Harling, O.K.

    2000-01-01

    A patient collimator has been designed for the epithermal neutron facility now being commissioned at MIT. Collimator performance both in and out of field was evaluated using the Monte Carlo code MCNP. A two piece design that can accommodate different circular field sizes will be manufactured using a composite lead, epoxy, boron and lithium mixture. (author)

  6. Interaktion mit RFID Ausleih- und Rückgabeautomaten

    DEFF Research Database (Denmark)

    Greifeneder, Elke; Heyroth, Melanie; Klingbeil, Karin

    2011-01-01

    Der Artikel untersucht mittels Beobachtung die Interaktion zwischen RFID-Ausleih- und Rückgabeautomaten sowie Bibliotheksbenutzern in vier deutschen Bibliotheken. Die Ergebnisse belegen, dass die Interaktion grundsätzlich funktioniert. Die Benutzer zeigten Gelassenheit und Routine im Umgang mit den...

  7. Chronisch-dekompensierter Tinnitus: ein heterogenes Krankheitsbild mit Auswirkungen auf den Behandlungserfolg

    OpenAIRE

    Ivansic, D; Müller, B; Dobel, C; Guntinas-Lichius, O

    2017-01-01

    Einleitung: Bei etwa 5% der Patienten mit chronischem Tinnitus gehen die Ohrgeräusche mit erheblichem Leidensdruck, häufig auch mit psychiatrischen Störung einher. Da es aktuell keine wirksame Behandlung gibt, welche zu Beseitigung des chronischen Tinnitus führt, ist das Therapieziel die Reduktion der Tinnitus-Belastung. Methodik: Es wurden von 7/13 bis 12/14 308 Patienten mit chronischen Tinnitus tagesklinisch interdisziplinär behandelt. Die Tinnitus-Belastung wurde mit Tinnitus-Fragebogen...

  8. MIT-Skywalker: Evaluating comfort of bicycle/saddle seat.

    Science.gov (United States)

    Goncalves, Rogerio S; Hamilton, Taya; Daher, Ali R; Hirai, Hiroaki; Krebs, Hermano I

    2017-07-01

    The MIT-Skywalker is a robotic device developed for the rehabilitation of gait and balance after a neurological injury. This device has been designed based on the concept of a passive walker and provides three distinct training modes: discrete movement, rhythmic movement, and balance training. In this paper, we present our efforts to evaluate the comfort of a bicycle/saddle seat design for the system's novel actuated body weight support device. We employed different bicycle and saddle seats and evaluated comfort using objective and subjective measures. Here we will summarize the results obtained from a study of fifteen healthy subjects and one stroke patient that led to the selection of a saddle seat design for the MIT-Skywalker.

  9. MIT LMFBR blanket research project. Final summary report

    International Nuclear Information System (INIS)

    Driscoll, M.J.

    1983-08-01

    This is a final summary report on an experimental and analytical program for the investigation of LMFBR blanket characteristics carried out at MIT in the period 1969 to 1983. During this span of time, work was carried out on a wide range of subtasks, ranging from neutronic and photonic measurements in mockups of blankets using the Blanket Test Facility at the MIT Research Reactor, to analytic/numerical investigations of blanket design and economics. The main function of this report is to serve as a resource document which will permit ready reference to the more detailed topical reports and theses issued over the years on the various aspects of project activities. In addition, one aspect of work completed during the final year of the project, on doubly-heterogeneous blanket configurations, is documented for the record

  10. Endokrinologische Behandlung der Geschlechtsdysphorie bei Menschen mit Geschlechtsinkongruenz

    Directory of Open Access Journals (Sweden)

    Flütsch N

    2015-01-01

    Full Text Available Es gibt Menschen, die die innere Gewissheit besitzen, dass ihre Geschlechtsidentität nicht zu ihrem biologischen Ursprungsgeschlecht passt. Durch die Entwicklungen in der Medizin in den letzten hundert Jahren ist es möglich geworden, die körperlichen Geschlechtsmerkmale an das innerlich erlebte Geschlecht anzupassen. Die Zahl der Hilfesuchenden in den ärztlichen Ambulanzen und Privatpraxen hat in den vergangenen Jahren deutlich zugenommen. Das Vorgehen bei der Diagnostik und Therapieeinleitung erlebt zurzeit eine deutliche Veränderung hin zu mehr Patientenzentriertheit und Individualisierung des Transitionsprozesses. Dabei bildet die geschlechtsangleichende Hormontherapie ein wesentliches Standbein in der körperlichen Angleichung an das Gegengeschlecht. Unter Beachtung von bestimmten Sicherheitsaspekten ist eine Hormontherapie mit Sexualhormonen sicher und einfach durchzuführen. Regelmäßige Verlaufskontrollen sowie der offene und affirmative Umgang mit den Betroffenen tragen zudem wesentlich zur Sicherheit in der Behandlung bei.

  11. Are the N and Δ deformed MIT bags

    International Nuclear Information System (INIS)

    Clement, G.; Maamache, M.

    1985-01-01

    The influence of the one-gluon exchange interaction, zero-point energy, and centre-of-mass correction, on the deformation of the nucleon and Δ bags, is studied in the MIT bag model. If the sharp MIT boundary conditions are taken seriously, the strong dependence of the zero-point energy on the deformation leads to the collapse of the N and Δ bags for realistic values of the strong fine structure constant α/sub S/. If on the other hand the zero-point energy is ignored altogether, then the nucleon, spherical for α/sub S/ 3.25, while the Δ is always prolate. The various predictions of the model are, for α/sub S/> or approx. =3.25, consistent with experiment, except for the proton magnetic moment which is only about 40% of the experimental value

  12. Properties of hybrid stars in an extended MIT bag model

    International Nuclear Information System (INIS)

    Bao Tmurbagan; Liu Guangzhou; Zhu Mingfeng

    2009-01-01

    The properties of hybrid stars are investigated in the framework of the relativistic mean field theory (RMFT) and an MIT bag model with density-dependent bag constant to describe the hadron phase (HP) and quark phase (QP), respectively. We find that the density-dependent B(ρ) decreases with baryon density ρ; this decrement makes the strange quark matter become more energetically favorable than ever; which makes the threshold densities of the hadron-quark phase transition lower than those of the original bag constant case. In this case, the hyperon degrees of freedom can not be considered. As a result, the equations of state of a star in the mixed phase (MP) become softer whereas those in the QP become stiffer, and the radii of the star obviously decrease. This indicates that the extended MIT bag model is more suitable to describe hybrid stars with small radii. (authors)

  13. Elektrochemisches Verhalten von Lithium-Schwefel-Zellen mit unterschiedlicher Kathodenstruktur

    OpenAIRE

    Scherr, Christopher

    2014-01-01

    Die elektrochemische Energiespeicherung ist in der Elektromobilität und dezentralen Energieversorgung einer der wichtigsten Bausteine. Der Lithium-Schwefel-Akkumulator mit seinen hohen theoretischen Kennwerte hat das Potential in Zukunft, hierbei eine gewichtige Rolle zu spielen. Je nach Zusammensetzung und Herstellung der Kathode variieren die Kennwerte jedoch sehr stark. In dieser Arbeit wurde der Einfluss der Kathodenstruktur und -zusammensetzung auf die Kapazität und Lebensdauer untersuch...

  14. Quark matter revisited with non-extensive MIT bag model

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Pedro H.G.; Nunes da Silva, Tiago; Menezes, Debora P. [Universidade Federal de Santa Catarina, Departamento de Fisica, CFM, Florianopolis (Brazil); Deppman, Airton [Instituto de Fisica da Universidade de Sao Paulo, Sao Paulo (Brazil)

    2017-10-15

    In this work we revisit the MIT bag model to describe quark matter within both the usual Fermi-Dirac and the Tsallis statistics. We verify the effects of the non-additivity of the latter by analysing two different pictures: the first order phase transition of the QCD phase diagram and stellar matter properties. While the QCD phase diagram is visually affected by the Tsallis statistics, the resulting effects on quark star macroscopic properties are barely noticed. (orig.)

  15. Configuration management plan for Machine Interface Test System (MITS)

    International Nuclear Information System (INIS)

    O'Neill, C.K.

    1980-01-01

    The discipline required by this plan will apply from the establishment of a configuration baseline until completion of the final test in the MITS. The plan applies to configured items of hardware and software as well as to the specifications and drawings for these items. The plan encompasses establishment of the facility baseline, interface definition, classes of change, change control, change paper, organizational responsibilities and relationships, test configuration (as opposed to facility), and configuration data retention

  16. Optische Bildgebung der Autoimmunarthritis mit DiD markierten Leukozyten

    OpenAIRE

    Kau, Julia

    2008-01-01

    Zielsetzung: Ziel der vorliegenden Studie war es, zu untersuchen, ob die Optische Bildgebung nach Injektion von ex vivo DiD markierten Leukozyten, in der Lage ist, eine Entzündung der Synovialmembran in Ratten mit einer Antigen-induzierten Monoarthritis des rechten Kniegelenkes aufzudecken. Die Optische Bildgebung wurde auf ihre Fähigkeit zur Unterscheidung zwischen arthritischen und gesunden Kniegelenken und zwischen nichttherapierten und Kortison-therapierten Kniegelenken unt...

  17. Psychologie - Fachdatenbank mit europäischem Fokus

    OpenAIRE

    Schön, Dana

    2010-01-01

    Die Sichtbarkeit von europäischer Wissenschaftsliteratur ist notwendige Voraussetzung für deren Rezeption im internationalen Kontext. Ein bibliographisches Nachweissystem psychologischer Fachliteratur auf der Basis moderner Suchtechnologie mit Fokus auf europäischen Werken kann einen wichtigen Beitrag dazu leisten. Mehrere europäische Institute stellen ihre bibliographischen Datenbestände zum Aufbau einer umfassenden europäischen Fachdatenbank für die Psychologie zur Verfügung. Die Bereitstel...

  18. Qanti-QG hermaphrodite mesons in the MIT bag model

    International Nuclear Information System (INIS)

    Barnes, T.; Close, F.E.; Viron, F. de

    1982-10-01

    It is suggested that hermaphrodite (qanti-qg) mesons could exist with rather light masses. The spectrum of the ground state nonets, Jsup(PC) = (0, 1, 2) -+ ; 1 -- is calculated in the MIT bag model including 0(αsub(s)) energy shifts. Hadronic transitions among these states are discussed, considering their possible production at LEAR and SPEAR and indicating some interesting decay signatures. (author)

  19. Strategien zur HLA-Typisierung mit PyrosequencingTM

    OpenAIRE

    Entz, Patricia

    2006-01-01

    Der Haupthistokompatibilitätskomplex ist durch seine biologische Funktion eine für die Diagnostik und Forschung äußerst wichtige Region im humanen Genom. Die Untersuchung von HLA-Genorten stellt ein wichtiges Instrument in der molekulargenetischen Praxis dar. Die Pyrosequencing-Technik ist gut geeignet, um kurze DNA-Abschnitte mit weitgehend bekannter Sequenz schnell und effizient zu untersuchen. Ziel dieser Arbeit war die Entwicklung von Pyrosequencing-basierten Methoden zur HLA-Typisierung....

  20. Cost accounting in Kernforschungsanlage Juelich Gesellschaft mit beschraenkter Haftung (KFA)

    International Nuclear Information System (INIS)

    Seidel, G.; Schilling, H.

    1979-01-01

    The paper gives an overview about the organization and the research program of the Kernforschungsanalage Juelich Gesellschaft mit beschraenkter Haftung (KFA). The cost accounting system is discussed in detail, cost categories, cost centers, units of production and the data flow of the cost accounting are described. The distribution of the resulting management accounting reports and all sorts of EDP-result listings of the cost accounting system is described. (A.N.)

  1. Kundenorientierte Produktentwicklung mit Hilfe von Quality Function Deployment (QFD)

    OpenAIRE

    Schloske, Alexander

    2011-01-01

    Die Produktentwicklung von heute muss in immer kürzeren Zeiträumen kunden- und kostenorientierte Produkte entwickeln. Zur systematischen Unterstützung dieser Aufgabe im Rahmen der Produktentwicklung wird die Methode Quality Function Deployment (QFD) eingesetzt. Die konsequente Umsetzung der Stimme des Kunden in die Sprache des Unternehmens gelingt mit Quality Function Deployment (QFD). Die Methode wertet systematisch Kundenanforderungen an Produkte aus und führt zu innovativen Lösungen, die s...

  2. Phylogenetic relationships of the Gomphales based on nuc-25S-rDNA, mit-12S-rDNA, and mit-atp6-DNA combined sequences

    Science.gov (United States)

    Admir J. Giachini; Kentaro Hosaka; Eduardo Nouhra; Joseph Spatafora; James M. Trappe

    2010-01-01

    Phylogenetic relationships among Geastrales, Gomphales, Hysterangiales, and Phallales were estimated via combined sequences: nuclear large subunit ribosomal DNA (nuc-25S-rDNA), mitochondrial small subunit ribosomal DNA (mit-12S-rDNA), and mitochondrial atp6 DNA (mit-atp6-DNA). Eighty-one taxa comprising 19 genera and 58 species...

  3. Nagelbefall kann bei Patienten mit Psoriasis auf eine Enthesiopathie hinweisen.

    Science.gov (United States)

    Castellanos-González, Maria; Joven, Beatriz Esther; Sánchez, Julio; Andrés-Esteban, Eva María; Vanaclocha-Sebastián, Francisco; Romero, Pablo Ortiz; Díaz, Raquel Rivera

    2016-11-01

    Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren. Es wurde eine monozentrische prospektive Studie mit insgesamt 90 Psoriasis-Patienten durchgeführt, um mittels Ultraschall das Vorliegen von Enthesenanomalien zu untersuchen und eine Korrelation mit dem Befall der Nägel festzustellen. Enthesenanomalien wurden bei 23 Patienten (25,5 %) gefunden, von denen 19 (82,6 %) Nagelbefall aufwiesen. Bei 4 Patienten waren die Nägel nicht betroffen. Enthesiopathie lag bei 31,1 % (19/61) der Patienten mit Onychopathie vor, von den Patienten ohne Nagelbefall litten nur 13,8 % (4/29) an Enthesiopathie (p = 0,07). Zwischen dem Target-NAPSI-Score und dem Vorliegen einer Enthesiopathie bestand eine signifikante Korrelation. Eine signifikante Korrelation bestand darüber hinaus auch zwischen dem Vorliegen einer Enthesiopathie und der Anzahl der betroffenen Nägel (p = 0,035). Klinische Belege für eine Onychopathie können der Schlüssel für die frühe Diagnose einer Enthesiopathie bei Psoriasis-Patienten sein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. The high prevalence of impulse control behaviors in patients with early-onset Parkinson's disease: A cross-sectional multicenter study.

    Science.gov (United States)

    Vela, L; Martínez Castrillo, J C; García Ruiz, P; Gasca-Salas, C; Macías Macías, Y; Pérez Fernández, E; Ybot, I; Lopez Valdés, E; Kurtis, M M; Posada Rodriguez, I J; Mata, M; Ruiz Huete, C; Eimil, M; Borrue, C; Del Val, J; López-Manzanares, L; Rojo Sebastian, A; Marasescu, R

    2016-09-15

    In Parkinson's disease patients, impulse control disorders (ICDs) have been associated with younger age and early disease onset, yet the prevalence of ICDs in early-onset Parkinson's disease (EOPD) patients has yet to be studied. Thus, we set out to compare the prevalence of impulse control behaviors (ICBs) in a cohort of EOPD patients with that in age and gender matched healthy controls (HCs), as well as to analyze the association of these symptoms with the use of dopaminergic drugs and other clinical or demographic factors. A cross-sectional, multicenter study was carried out on patients recruited from outpatient Movement Disorder Clinics, assessing ICBs using the short form of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). In addition, depression and quality of life (QoL) were measured, along with other demographic and clinical variables. Of the 87 EOPD patients, 49 (58.3%) displayed an ICB, as did 28 of the 87 HCs (32.9%; p=0.001). Most of the EOPD patients that displayed an ICB (91.8%) were medicated with a dopamine agonist (DA) and accordingly, DA treatment was associated with a 7-fold increased risk of developing an ICB. Patients with ICBs had a higher depression score and a worse QoL. ICBs are much more prevalent in EOPD patients than in HCs and they are associated with DA intake, depression and a worse QoL. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Brazilian multicenter study on efficacy and tolerability of trandolapril in mild-to-moderate essential arterial hypertension. EMBATHE substudy with ambulatory blood pressure monitoring

    Directory of Open Access Journals (Sweden)

    Osvaldo Kohlmann Jr

    1999-05-01

    Full Text Available OBJECTIVE: A double-blind, placebo-controlled multicenter study involving 34 centers from different Brazilian regions was performed to evaluate the antihypertensive efficacy and tolerability of trandolapril, an angiotensin I converting enzyme inhibitor, in the treatment of mild-to-moderate systemic arterial hypertension. METHODS: Of 262 patients enrolled in this study, 127 were treated with trandolapril 2 mg/day for 8 consecutive weeks, and the remaining 135 patients received placebo for the same period of time. Reduction in blood pressure (BP and the occurrence of adverse events during this period were evaluated in both groups. RESULTS: Significant reductions in both systolic and diastolic pressures were observed in patients treated with trandolapril when compared with those on placebo. Antihypertensive efficacy was achieved in 57.5% of the patients on trandolapril and in 42% of these normal values of BP were obtained. The efficacy of trandolapril was similar in all centers, regardless of the area of the country. In a subset of 30 patients who underwent ABPM, responders showed a significant hypotensive effect to trandolapril throughout the 24 hour day. The adverse event profile was similar in both trandolapril and placebo groups. CONCLUSION: Our results demonstrate, for the first time in a large group of hypertensive patients from different regions in Brazil, good efficacy and tolerability of trandolapril during treatment of mild-to-moderate essential systemic hypertension.

  6. Serum reference interval of ARCHITECT alpha-fetoprotein in healthy Chinese Han adults: Sub-analysis of a prospective multi-center study.

    Science.gov (United States)

    Yan, Cunling; Yang, Jia; Wei, Lianhua; Hu, Jian; Song, Jiaqi; Wang, Xiaoqin; Han, Ruilin; Huang, Ying; Zhang, Wei; Soh, Andrew; Beshiri, Agim; Fan, Zhuping; Zheng, Yijie; Chen, Wei

    2018-02-01

    Alpha-fetoprotein (AFP) has been widely used in clinical practice for decades. However, large-scale survey of serum reference interval for ARCHITECT AFP is still absent in Chinese population. This study aimed to measure serum AFP levels in healthy Chinese Han subjects, which is a sub-analysis of an ongoing prospective, cross-sectional, multi-center study (ClinicalTrials.gov Identifier: NCT03047603). This analysis included a total of 530 participants (41.43±12.14years of age on average, 48.49% males), enrolled from 5 regional centers. Serum AFP level was measured by ARCHITECT immunoassay. Statistical analysis was performed using SAS 9.4 and R software. AFP distribution did not show significant correlation with age or sex. The overall median and interquartile range of AFP was 2.87 (2.09, 3.83) ng/mL. AFP level did not show a trend of increasing with age. The new reference interval was 2.0-7.07ng/mL (LOQ- 97.5th percentiles). The reference interval for ARCHITECT AFP is updated with the data of adequate number of healthy Han adults. This new reference interval is more practical and applicable in Chinese adults. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  7. The success of opening single chronic total occlusion lesions to improve myocardialviabilitytrial (SOS-COMEDY): Study protocol of a prospective multicenter study.

    Science.gov (United States)

    Huang, Rongchong; Song, Xiantao; Zhang, Haishan; Tian, Wen; Huang, Zheng; Zhang, Xingwei; Yang, Junqing; Zhang, Dongfeng; Wu, Jian; Zhong, Lei; Ting, Henry H

    2018-04-01

    Success of opening single (SOS)-comedy is a prospective multicenter study to compare the improvement in the decrease of myocardial viability by percutaneous coronary intervention (PCI) with that by optimal medical therapy (OMT) alone in patients with chronic total occlusion (CTO) of a single coronary artery. The risks and the benefits of both options (PCI and OMT) were listed in a CTO decision aid (DA). Eligible participants detected by invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) were divided into PCI or OMT groups according to patients' choice after shared-decision making process with DA. Participants will undergo positron emission tomography/computed tomography (PET/CT), cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE), and proceed to ICA and revascularization if possible. Blinded core laboratory interpretation will be performed for ICA, CCTA, PET/CT, CMR, and TTE. All participants will be followed up for 12 months. The primary endpoint is the improvement to the decrease of myocardial viability from baseline assessed with the use of PET/CT after 12-month follow-up. All of the patients are appropriately consented before enrolling in this study, which has been approved by the Ethics Committee. Results of SOS-COMEDY will be helpful to develop a strategy for single CTO patients.

  8. An Open-Label Uncontrolled, Multicenter Study for the Evaluation of the Efficacy and Safety of the Dermal Filler Princess VOLUME in the Treatment of Nasolabial Folds

    Directory of Open Access Journals (Sweden)

    Daisy Kopera

    2015-01-01

    Full Text Available The dermal filler Princess VOLUME is a highly cross-linked, viscoelastic hyaluronic acid injectable gel implant used for aesthetic treatment. To evaluate the efficacy and safety of Princess VOLUME in the treatment of nasolabial folds, an open-label uncontrolled, multicenter study was conducted. Forty-eight subjects were recruited who had moderate to deep wrinkles, according to the Modified Fitzpatrick Wrinkle Scale (MFWS. Subjects received Princess VOLUME in both nasolabial folds at Day 0. Nasolabial fold severity was evaluated at 30, 90, 180, and 270 days after treatment, using the MFWS and the Global Aesthetic Improvement Scale (GAIS. Adverse events and treatment site reactions were recorded. Among the 48 subjects, 93.8% were female with a median age of 52 years. There were significant improvements (P<0.0001 in the MFWS scores at 30, 180, and 270 days after treatment compared with those at baseline, with a mean decrease of 1.484 (±0.408, 1.309 (±0.373, and 1.223 (±0.401, respectively; hence the primary endpoint was achieved and clinical efficacy demonstrated. Princess VOLUME was well tolerated, and most adverse events were injection site reactions of mild to moderate severity. Subject satisfaction (97.9%, subject recommendation of the treatment (93.6%, and investigators GAIS scores (97.9% improvement were high.

  9. A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

    Science.gov (United States)

    Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

    2000-01-01

    The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

  10. Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study

    Directory of Open Access Journals (Sweden)

    Zhangbin Yu

    2014-06-01

    Full Text Available OBJECTIVE: to prospectively validate a previously constructed transcutaneous bilirubin (TcB nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. METHODS: this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. RESULTS: in the present study, 972 neonates (10.6% developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV (18.9%. Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%, but with low sensitivity (28.3%. The 75th percentile was highly specific (81.9% and moderately sensitive (79.8%. The area under the curve (AUC for the TcB nomogram was 0.875. CONCLUSIONS: this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.

  11. Functional Recovery and Life Satisfaction in the First Year After Severe Traumatic Brain Injury: A Prospective Multicenter Study of a Norwegian National Cohort.

    Science.gov (United States)

    Anke, Audny; Andelic, Nada; Skandsen, Toril; Knoph, Rein; Ader, Tiina; Manskow, Unn; Sigurdardottir, Solrun; Røe, Cecilie

    2015-01-01

    (1) To examine the impact of demographic and acute injury-related variables on functional recovery and life satisfaction after severe traumatic brain injury (sTBI) and (2) to test whether postinjury functioning, postconcussive symptoms, emotional state, and functional improvement are related to life satisfaction. Prospective national multicenter study. Level 1 trauma centers in Norway. 163 adults with sTBI. Functional recovery between 3 and 12 months postinjury measured with Glasgow Outcome Scale Extended, Rivermead Postconcussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale, and satisfaction with life situation. 60% of cases experienced functional improvement from 3 to 12 months postinjury. Multivariate logistic regression analysis revealed that discharge to a rehabilitation department from acute care (odds ratio [OR] = 2.14; P life situation. Regression analysis revealed that older age (>65 years), low education, better functional outcome, and the absence of depressive and postconcussion symptoms were significant (P life satisfaction. Functional improvement was significantly associated with emotional state but not to life satisfaction. Following sTBI, approximately two-thirds of survivors improve between 3 and 12 months postinjury and are satisfied with their life. Direct discharge from acute care to specialized rehabilitation appears to increase functional recovery.

  12. Physikalische Grundlagen von chemischen Raman-Sensoren mit Schwerpunkt auf faseroptischen SERS-Sonden

    OpenAIRE

    Viets, Carmen

    2001-01-01

    Faseroptische SERS-Sensoren wurden durch die Beschichtung der Endflächen von optischen Fasern mit rauhen Metallfilmen erzeugt. Zu den verschiedenen Präparationstechniken, die angewendet und verglichen wurden, gehörten das langsame Aufdampfen von Metall-Inselfilmen und das Bedampfen von Nanopartikeln, aufgerauhten oder elektronenlithographisch strukturierten Oberflächen mit Metallfilmen. Der Einfluß der Laserleistung auf die Messungen mit SERS-Sensoren wurde untersucht, und es wurden maximale ...

  13. Quantitative Datenanalyse: Arbeiten mit SPSS Statistics : Eine Einführung

    OpenAIRE

    Hoidn, Sabine

    2012-01-01

    Bei diesem Buch handelt es sich um eine verständliche Einführung in das Arbeiten mit dem quantitativen Datenanalyseprogramm SPSS Statistics. Die Studierenden setzen sich mit den Grundlagen zum Arbeiten mit SPSS Statistics auseinander, können selbständig eine SPSS Statistics-Datei erstellen, Daten einlesen, zusammenfügen und modifizieren, erfasste Daten managen und die gebräuchlichsten tabellarischen und grafischen Grundauswertungen sowie Analyseverfahren durchführen und interpretieren. Au...

  14. The development of form two mathematics i-Think module (Mi-T2)

    Science.gov (United States)

    Yao, Foo Jing; Abdullah, Mohd Faizal Nizam Lee; Tien, Lee Tien

    2017-05-01

    This study aims to develop a training module i-THINK Mathematics Form Two (Mi-T2) to increase the higher-order thinking skills of students. The Mi-T2 training module was built based on the Sidek Module Development Model (2001). Constructivist learning theory, cognitive learning theory, i-THINK map and higher order thinking skills were the building blocks of the module development. In this study, researcher determined the validity and reliability of Mi-T2 module. The design being used in this study was descriptive study. To determine the needs of Mi-T2 module, questionnaires and literature review were used to collect data. When the need of the module was determined, the module was built and a pilot study was conducted to test the reliability of the Mi-T2 module. The pilot study was conducted at a secondary school in North Kinta, Perak. A Form Two class was selected to be the sample study through clustered random sampling. The pilot study was conducted for two months and one topic had been studied. The Mi-T2 module was evaluated by five expert panels to determine the content validity of the module. The instruments being used in the study were questionnaires about the necessity of the Mi-T2 module for guidance, questionnaires about the validity of the module and questionnaires concerning the reliability of the module. Statistical analysis was conducted to determine the validity and reliability coefficients of the Mi-T2 module. The content validity of Mi-T2 module was determined by Cohen's Kappa's (1968) agreement coefficient and the reliability of Mi-T2 module was determined by Cronbach Alpha's value scale. The content validity of Mi-T2 module was 0.89 and the Cronbach Alpha's value of Mi-T2 module was 0.911.

  15. Der Ritter mit dem Hemd : drei Fassungen einer mittelalterlichen Erzählung

    OpenAIRE

    Dunphy, Graeme

    2011-01-01

    Unter den zahlreichen Motiven, die in der mittelalterlichen Literatur mit Frauendienst verbunden sind, gehört das vom Ritter mit dem Hemd zu den besonders interessanten. Es erscheint zunächst in dem ersten von fünf Fabliaux aus einer verlorenen Turiner Handschrift, die dem sonst unbekannten altfranzösischen Dichter Jacques de Baisieux zugeschrieben werden, einer heiteren Kurzgeschichte mit dem Titel "Des trois chevaliers et del chainse". In der vorliegenden Untersuchung gilt es, der Frage der...

  16. Wirksamkeit und Sicherheit von Fumarsäureestern in Kombination mit Phototherapie bei Patienten mit moderater bis schwerer Plaque-Psoriasis (FAST).

    Science.gov (United States)

    Weisenseel, Peter; Reich, Kristian; Griemberg, Wiebke; Merten, Katharina; Gröschel, Christine; Gomez, Natalie Nunez; Taipale, Kirsi; Bräu, Beate; Zschocke, Ina

    2017-02-01

    Die Behandlung von Psoriasis-Patienten mit einer Kombination aus Fumarsäureestern (FSE, Fumaderm ® ) und Phototherapie (UV) ist verbreitet, wurde aber im Rahmen von Studien wenig untersucht. Bisher liegen lediglich Daten aus einer kleinen Pilotstudie vor. Intention dieser Studie war, eine FSE/UV-Kombinationsbehandlung an einem größeren Patientenkollektiv mit mittelschwerer bis schwerer Psoriasis zu untersuchen. In dieser prospektiven, multizentrischen, nichtinterventionellen Studie wurden Daten von Patienten mit FSE/UV-Kombinationstherapie hinsichtlich der Wirksamkeit (PGA' PASI, DLQI, EQ-5D), Sicherheit und Dosierung über einen Zeitraum von zwölf Monaten erfasst und mit Daten einer retrospektiven Studie mit FSE-Monotherapie verglichen. Es wurden Daten von 363 Patienten ausgewertet. Unter der Kombinationstherapie verbesserten sich alle Wirksamkeitsparameter deutlich. Im Vergleich zur Monotherapie mit FSE konnte durch die Kombination mit UV ein schnellerer Wirkeintritt erzielt werden, wobei nach zwölf Monaten kein Unterschied in der Wirksamkeit bestand. Die Dauer und Art der Phototherapie zeigte keinen Einfluss auf die Wirksamkeitsparameter. Allgemein wurde die Kombinationstherapie gut vertragen. Unerwünschte Ereignisse wurden bei 7 % der Patienten berichtet. Die FSE/UV Kombinationstherapie zeigt eine gute Wirksamkeit und Verträglichkeit und kann zu einem schnelleren Wirkeintritt führen. Eine Kombinationstherapie erscheint vor allem in den ersten drei Monaten der FSE Behandlung sinnvoll. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  17. Kompressionstherapie - Versorgungspraxis: Informationsstand von Patienten mit Ulcus cruris venosum.

    Science.gov (United States)

    Protz, Kerstin; Heyer, Kristina; Dissemond, Joachim; Temme, Barbara; Münter, Karl-Christian; Verheyen-Cronau, Ida; Klose, Katharina; Hampel-Kalthoff, Carsten; Augustin, Matthias

    2016-12-01

    Eine Säule der kausalen Therapie bei Patienten mit Ulcus cruris venosum ist die Kompressionstherapie. Sie unterstützt die Abheilung, reduziert Schmerzen und Rezidive und steigert die Lebensqualität. Bislang existieren kaum wissenschaftliche Daten zu dem Versorgungsstand und fachspezifischem Wissen von Patienten mit Ulcus cruris venosum. Standardisierte Fragebögen wurden bundesweit in 55 Pflegediensten, 32 Arztpraxen, vier Wundzentren und -sprechstunden sowie einem Pflegetherapiestützpunkt von Patienten mit Ulcus cruris venosum bei Erstvorstellung anonym ausgefüllt. Insgesamt nahmen 177 Patienten (Durchschnittsalter 69,4 Jahre; 75,1 % Frauen) teil. Ein florides Ulcus cruris venosum bestand im Mittel 17 Monate. 31,1 % hatten keine Kompressionstherapie, 40,1 % Binden und 28,8 % Strümpfe. Bei der Bestrumpfung hatten 13,7 % Kompressionsklasse III, 64,7 % Kompressionsklasse II und 19,6 % Kompressionsklasse I. 70,6 % legten die Strümpfe nach dem Aufstehen an, 21,1 % trugen sie Tag und Nacht. 39,2 % bereiteten die Strümpfe Beschwerden. Lediglich 11,7 % hatten eine An- und Ausziehhilfe. Die Binden wurden im Mittel 40,7 Wochen getragen und bei 69 % nicht unterpolstert. Bei 2,8 % wurde der Knöchel- und Waden-Umfang zur Erfolgskontrolle gemessen. Venensport machten 45,9 %. Ein Drittel hatte keine Kompressionsversorgung, obwohl diese eine Basismaßnahme der Therapie des Ulcus cruris venosum ist. Zudem ist deren korrekte Auswahl und Anwendung angesichts der langen Bestandsdauer der Ulzerationen zu hinterfragen. Weiterführende Fachkenntnisse bei Anwendern und Verordnern sowie Patientenschulungen sind erforderlich. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  18. Comments on the MIT Assessment of the Mars One Plan

    Science.gov (United States)

    Jones, Harry W.

    2015-01-01

    The MIT assessment of the Mars One mission plan reveals design assumptions that would cause significant difficulties. Growing crops in the crew chamber produces excessive oxygen levels. The assumed in-situ resource utilization (ISRU) equipment has too low a Technology Readiness Level (TRL). The required spare parts cause a large and increasing launch mass logistics burden. The assumed International Space Station (ISS) Environmental Control and Life Support (ECLS) technologies were developed for microgravity and therefore are not suitable for Mars gravity. Growing food requires more mass than sending food from Earth. The large number of spares is due to the relatively low reliability of ECLS and the low TRL of ISRU. The Mars One habitat design is similar to past concepts but does not incorporate current knowledge. The MIT architecture analysis tool for long-term settlements on the Martian surface includes an ECLS system simulation, an ISRU sizing model, and an analysis of required spares. The MIT tool showed the need for separate crop and crew chambers, the large spare parts logistics, that crops require more mass than Earth food, and that more spares are needed if reliability is lower. That ISRU has low TRL and ISS ECLS was designed for microgravity are well known. Interestingly, the results produced by the architecture analysis tool - separate crop chamber, large spares mass, large crop chamber mass, and low reliability requiring more spares - were also well known. A common approach to ECLS architecture analysis is to build a complex model that is intended to be all-inclusive and is hoped will help solve all design problems. Such models can struggle to replicate obvious and well-known results and are often unable to answer unanticipated new questions. A better approach would be to survey the literature for background knowledge and then directly analyze the important problems.

  19. Occupational noise, smoking, and a high body mass index are risk factors for age-related hearing impairment and moderate alcohol consumption is protective: A European population-based multicenter study

    DEFF Research Database (Denmark)

    Fransen, E.; Topsakal, V.; Hendrickx, J.J.

    2008-01-01

    A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pur...... as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment Udgivelsesdato: 2008/9...

  20. Elastolysen und Hauterkrankungen mit Verlust der elastischen Fasern.

    Science.gov (United States)

    Tronnier, Michael

    2018-02-01

    Die elastischen Fasern sind neben den kollagenen Fasern der wichtigste Bestandteil des Bindegewebsgerüstes der Haut. Eine Verminderung oder ein Verlust der elastischen Fasern ist bei einer Vielzahl von klinisch sich unterschiedlich präsentierenden Erkrankungen, hereditär oder erworben, beschrieben. Bei den Erkrankungen, die mit einer Entzündung einhergehen ist die Elastophagozytose ein wichtiges histologisches Merkmal. Die Therapie der Erkrankungen dieser Gruppe ist grundsätzlich schwierig. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  1. Innovative facades with photovoltaics; Innovative Fassaden mit Photovoltaik

    Energy Technology Data Exchange (ETDEWEB)

    Eicker, U. [Hochschule fuer Technik, Stuttgart (Germany)

    1999-10-01

    Having grown at a rate of 15% since the middle of the 1980s the photovoltaic market today commands an annual module production of more than 100 MW{sub p}. In Germany altogether 10,000 PV systems with a total power output of 10 MW{sub p} were newly installed in 1997 alone. In 1990 the market was boosted by the heavily subsidised 1000 roofs programme, under which in the end more than 2,000 systems were installed on the roofs of mostly one-family houses. With power ratings ranging from 1 to 5 kW these decentral plants require roof surface areas between 10 and 50 m-2. On average they generate 800 kWh of electricity per kW of installed power. According to a number of studies carried out in the early 1990s the total surface area on buildings available for photovoltaics amounts to an enormous potential of 1,000 km-2, which is equivalent to an electricity generating potential of 130 TWh (100 TWh on roofs and 30 TWh on facades), or 25% of Germany`s total electricity demand. The degree to which this potential will be realised in the long term will notably depend on whether convincing architectural solutions are found for integrating photovoltaic plants in roofs and facades. [Deutsch] Der Photovoltaikmarkt waechst weltweit seit Mitte der 80er Jahre um durchschnittlich 15% und liegt heute bei einer Jahresmodulproduktion ueber 100 MW{sub p}. In Deutschland wurden alleine 1997 etwa 10.000 PV-Systeme mit einer Gesamtleistung von 10 MW{sub p} installiert. Die Marktentwicklung wurde 1990 mit dem stark subventionierten 1000-Daecher Programm angestossen, in welchem schliesslich mehr als 2000 Systeme meist auf Daechern von Einfamilienhaeusern installiert wurden. Diese dezentralen Anlagen mit Leistungen zwischen 1 und 5 kW erfordern Dachflaechen zwischen 10 und 50 m{sup 2} und erzeugen im Schnitt 800 kWh Strom pro kW installierter Leistung. Das verfuegbare Flaechenpotential von Gebaeuden wurde Anfang der 90er Jahre in einer Reihe von Studien ermittelt und stellt mit etwa 1000 km{sup 2

  2. Die Behandlung des Akustikusneurinoms mit dem Gamma-Knife

    OpenAIRE

    Hempel, Elizabeta

    2005-01-01

    Das Akustikusneurinom ist mit ca. 6% der häufigste intrakranielle Tumor und hat eine jährliche Inzidenz von 1:100000. Die durchschnittliche Wachstumsrate beträgt 2 mm pro Jahr, wobei es auch Akustikusneurinome gibt, die sehr viel schneller wachsen können. Bei der Behandlung des Schwannoms stehen uns zwei Modalitäten zur Verfügung. Die konventionelle Chirurgie und die stereotaktische Radiochirurgie, zu der die Gamma-Knife Therapie und der Linearbeschleuniger zählen. Sorgfältig ausgesuchte P...

  3. Content Management von Leittexten mit XML Topic Maps

    Directory of Open Access Journals (Sweden)

    Johannes Busse

    2003-07-01

    Full Text Available Die Autoren definieren den Umgang mit internet- basierten Informations- und Kommunikationstechnologien als Schlüsselqualifikation für Studierende aller Fachrichtungen. Im vorliegenden Aufsatz beschreiben sie ein Projekt, das der Fachbereich Erziehungswissenschaften der Universität Heidelberg seit 2001 durchführt. Hier werden Studierende der Geistes- und Sozialwissenschaften zu "Lernberatern" ausgebildet, die als Multiplikatoren die notwendigen Kenntnisse erwerben. Die Teilnehmenden erarbeiten nach der "Leittextmethode" selbstgesteuert xml-basierte Contents. Dies setzt den Erwerb von informationstechnischen Kenntnissen voraus, der neben dem Aufbau eines (sowohl technischen als auch sozialen Netzwerks einen Schwerpunkt bildet.

  4. Automatic control and monitoring of the MIT fission converter beam

    International Nuclear Information System (INIS)

    Wilson, B.A.; Riley, K.J.; Harling, O.K.

    2000-01-01

    An automated control and monitoring system for the new MIT high intensity epithermal neutron irradiation facility has been designed and constructed. The neutron beam is monitored with fission counters located at the periphery of the beam near the patient position. Control of the beam is accomplished with redundant Programmable Logic Controllers (PLCs). These industrial controllers open and close the three shutters of the Fission Converter Beam. The control system uses a series of robust components to assure that the prescribed fluence is delivered. This paper discusses the design and implementation of this system. (author)

  5. M1-transitions in the MIT bag model

    International Nuclear Information System (INIS)

    Hackman, R.H.; Deshpande, N.G.; Dicus, D.A.; Teplitz, V.L.

    1977-03-01

    In the MIT bag model, the M1-transitions of low lying hadrons are investigated. The following calculations are performed: 32 hadron masses are recomputed with a choice of bag parameters designed to give the correct values for the proton magnetic moment, μ/sub p/, and several masses, M/sub rho/ M/sub ω/ M/sub Δ/ M/sub Ω/, and M/sub D/; (2) eta, eta', eta/sub c/ mixing is computed in an untrustworthy approximation; and the widths for 38 M1-transitions are computed

  6. Recent work at MIT on uranium recovery from seawater

    International Nuclear Information System (INIS)

    Driscoll, M.J.

    1984-01-01

    Recent work at MIT has confirmed the superiority of fiber-form ion exchange media for uranium recovery from seawater, subject to demonstration of the ability to control fouling by suspended particulate matter. Calculations and laboratory experiments indicate loading rates of several hundred ppm U/day: an order of magnitude faster than for bead-type sorbers in fixed or fluidized beds. A high performance, modular, sorber cartridge/seawater contactor system capable of a lifetime-levelized cost of product in the range 100-150 $/1b U 3 O 8 has been designed. (author)

  7. Primary limited lumbar discectomy with an annulus closure device: one-year clinical and radiographic results from a prospective, multi-center study.

    Science.gov (United States)

    Lequin, Michiel B; Barth, Martin; Thomė, Claudius; Bouma, Gerrit J

    2012-12-01

    Discectomy as a treatment for herniated lumbar discs results in outcomes after surgery that are not uniformly positive. Surgeons face the dilemma between limited nucleus removal which is associated with a higher risk of recurrence, or more aggressive nucleus removal which may lead to disc height loss and persistent back-pain. annulus closure devices may allow for the benefits of limited nucleus removal without the increased risk of recurrence. This is an interim report of an ongoing 24-month post-marketing study of the Barricaid® annulus closure device, consisting of a flexible polymer mesh that blocks the defect, held in place by a titanium bone anchor. We prospectively enrolled 45 patients at four hospitals, and implanted the Barricaid® after a limited discectomy. annulus defect size and volume of removed nucleus were recorded. Reherniations were reported, pain and function were monitored and imaging was performed at regular intervals during 24 months of follow-up. At 12 months postsurgery, pain and function were significantly improved, comparing favorably to reported results from limited discectomy. Disc height has been well maintained. One reherniation has occurred (2.4%), which was associated with a misplaced device. No device fracture, subsidence or migration has been observed. The use of an annulus closure device may provide a reduction in reherniation rate for lumbar discectomy patients with large annulus defects who are at the greatest risk of recurrence. Using such a device should provide the surgeon increased confidence in minimizing nucleus removal, which, in turn, may preserve disc height and biomechanics, reducing degeneration and associated poor clinical outcomes in the long-term. A randomized multicenter study evaluating limited discectomy with and without the Barricaid® is currently underway, and will provide a higher level of evidence.

  8. Biomarker-driven trial in metastatic pancreas cancer: feasibility in a multicenter study of saracatinib, an oral Src inhibitor, in previously treated pancreatic cancer

    International Nuclear Information System (INIS)

    Arcaroli, John; Quackenbush, Kevin; Dasari, Arvind; Powell, Rebecca; McManus, Martine; Tan, Aik-Choon; Foster, Nathan R; Picus, Joel; Wright, John; Nallapareddy, Sujatha; Erlichman, Charles; Hidalgo, Manuel; Messersmith, Wells A

    2012-01-01

    Src tyrosine kinases are overexpressed in pancreatic cancers, and the oral Src inhibitor saracatinib has shown antitumor activity in preclinical models of pancreas cancer. We performed a CTEP-sponsored Phase II clinical trial of saracatinib in previously treated pancreas cancer patients, with a primary endpoint of 6-month survival. A Simon MinMax two-stage phase II design was used. Saracatinib (175 mg/day) was administered orally continuously in 28-day cycles. In the unselected portion of the study, 18 patients were evaluable. Only two (11%) patients survived for at least 6 months, and three 6-month survivors were required to move to second stage of study as originally designed. The study was amended as a biomarker-driven trial (leucine rich repeat containing protein 19 [LRRC19] > insulin-like growth factor-binding protein 2 [IGFBP2] “top scoring pairs” polymerase chain reaction [PCR] assay, and PIK3CA mutant) based on preclinical data in a human pancreas tumor explant model. In the biomarker study, archival tumor tissue or fresh tumor biopsies were tested. Biomarker-positive patients were eligible for the study. Only one patient was PIK3CA mutant in a 3′ untranslated region (UTR) portion of the gene. This patient was enrolled in the study and failed to meet the 6-month survival endpoint. As the frequency of biomarker-positive patients was very low (<3%), the study was closed. Although we were unable to conclude whether enriching for a subset of second/third line pancreatic cancer patients treated with a Src inhibitor based on a biomarker would improve 6-month survival, we demonstrate that testing pancreatic tumor samples for a biomarker-driven, multicenter study in metastatic pancreas cancer is feasible

  9. Prognostic Factors of Patients with Gastric Gastrointestinal Stromal Tumor after Curative Resection: A Retrospective Analysis of 406 Consecutive Cases in a Multicenter Study.

    Science.gov (United States)

    Kim, In-Hwan; Kwak, Sang-Gyu; Chae, Hyun-Dong

    2015-01-01

    Gastric gastrointestinal stromal tumors (GISTs) have a highly variable clinical course, and recurrent disease sometimes develops despite curative surgery. This study was undertaken to investigate the surgical role in treating gastric GISTs and evaluate the clinicopathological features of a large series of patients who underwent curative resection for gastric GISTs to clarify which features were independent prognostic factors. The clinicopathological data of 406 patients with gastric GISTs who underwent curative resection at 4 university hospitals in Daegu, South Korea, from March 1998 to March 2012 were reviewed. All cases were confirmed as gastric GISTs by immunohistochemical staining, in which CD117 or CD34 was positive. Clinical follow-up was performed periodically, and disease-free survival rates were retrospectively investigated using the medical records. The mean follow-up period was 42.9 months (range: 2-166). There were 11 recurrent patients (2.7%). Due to the small number of recurrences, age, sex and location were controlled using propensity score matching before performing any statistical analysis. Tumor size, mitotic count, NIH classification, and cellularity were judged to be independent prognostic factors for recurrence by univariate analysis. In a multivariate analysis, tumor size and mitotic count were significantly and independently related to recurrence, and tumor size was determined to be the most important prognostic factor for recurrence after curative resection (hazard ratio: 1.204; p < 0.01). The results of this multicenter study demonstrate that disease-free survival rates are good. Tumor size was disclosed as the most important factor for recurrence in gastric GIST patients who underwent radical resection. 2015 S. Karger AG, Basel.

  10. A multicenter study on the validation of the Burnout Battery: a new visual analog scale to screen job burnout in oncology professionals.

    Science.gov (United States)

    Deng, Yao-Tiao; Liu, Jie; Zhang, Jie; Huang, Bo-Yan; Yi, Ting-Wu; Wang, Yu-Qing; Zheng, Bo; Luo, Di; Du, Pei-Xin; Jiang, Yu

    2017-08-01

    The objective of the study is to develop a novel tool-the Burnout Battery-for briefly screening burnout among oncology professionals in China and assessing its validity. A multicenter study was conducted in doctors and nurses of the oncology departments in China from November 2014 to May 2015. The Burnout Battery was administered with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Doctors' Job Burnout Questionnaire. Of 538 oncology doctors and nurses who completed all the survey, using MBI-HSS as the standard tool for measuring burnout, 52% had emotional exhaustion, 39.4% had depersonalization, and 59.3% had a low sense of personal accomplishment. Receiver operating characteristic curve analyses showed that the best cut-off of the Burnout Battery was the battery with 3 bars, which yielded best sensitivity and specificity against all the 3 subscales of MBI-HSS. With this cut-off, nearly half of Chinese oncology professionals (46.8%) had burnout. The Burnout Battery correlated significantly with subscales of the MBI-HSS and the Doctors' Job Burnout Questionnaire. In multiple logistic regression analysis, those who worked more than 60 hours per week and who thought clinical work was the most stressful part of their job were more likely to experience burnout. Chinese oncology professionals exhibit high levels of burnout. The Burnout Battery appears to be a simple and useful tool for screening burnout. Working long hours and perceiving clinical work as the most stressful part of the job were the main factors associated with burnout. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Mental health self-assessment in patients with moderate to severe psoriasis: an observational, multicenter study of 1164 patients in Spain (the VACAP Study).

    Science.gov (United States)

    Pujol, R M; Puig, L; Daudén, E; Sánchez-Carazo, J L; Toribio, J; Vanaclocha, F; Yébenes, M; Sabater, E; Casado, M A; Caloto, M T; Aragón, B

    2013-12-01

    Poor self-assessed mental health appears to be related to the severity of psoriasis. To evaluate the impact of psoriasis severity on mood and anxiety disorders. A prospective, observational, multicenter study was conducted by 123 dermatologists in Spain. Patients (n=164; mean [SD] age, 45.11 [13.92] years; 60.8% males) with moderate to severe psoriasis were evaluated at baseline and 4 months later. Psoriasis severity was measured using the Psoriasis Area and Severity Index (PASI), with a score range of 0 (mild) to 72 (severe); body surface area involvement (BSA); and physician global assessment (PGA) scores, with a range of 1 (mild) to 7 (severe). Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with a total possible score of 0-42 (higher scores representing worse mental health). Mean first and second visit scores were compared. Mean (SD) scores improved between the first and second visit as follows: 13.24 (9.50) to 5.07 (6.03) for PASI, 12.52 (7.92) to 10.78 (7.32) for overall HADS, 7.83 (4.55) to 6.85 (4.21) for the HADS anxiety subscale, and 4.72 (4.12) to 3.95 (3.76) for the HADS depression subscale (P<.001 in all cases). Multivariate analyses showed that the main factors related to anxiety were psoriasis severity, sex, and completion of graduate studies. The independent variables included in the model for depression were psoriasis severity, sex, and psoriasis located on the head. Reductions in disease severity improve self-assessed mood and anxiety disorders in patients with moderate to severe psoriasis. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  12. A multi-center study on the regenerative effects of erythropoietin in burn and scalding injuries: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Günter, Christina Irene; Bader, Augustinus; Dornseifer, Ulf; Egert, Silvia; Dunda, Sebastian; Grieb, Gerrit; Wolter, Thomas; Pallua, Norbert; von Wild, Tobias; Siemers, Frank; Mailänder, Peter; Thamm, Oliver; Ernert, Carsten; Steen, Michael; Sievers, Reiner; Reichert, Bert; Rahmanian-Schwarz, Afshin; Schaller, Hans; Hartmann, Bernd; Otte, Max; Kehl, Victoria; Ohmann, Christian; Jelkmann, Wolfgang; Machens, Hans-Günther

    2013-05-03

    Although it was initially assumed that erythropoietin (EPO) was a hormone that only affected erythropoiesis, it has now been proposed that EPO plays an additional key role in the regulation of acute and chronic tissue damage. This is a large, prospective, randomized, double-blind, multi-center study, funded by the German Federal Ministry of Education and Research, and fully approved by the designated ethics committee. The trial, which is to investigate the effects of EPO in severely burned patients, is in its recruitment phase and is being carried out in 13 German burn care centers. A total of 150 patients are to be enrolled to receive study medication every other day for 21 days (EPO 150 IU/kg body weight or placebo). A follow-up of one year is planned. The primary endpoint of this study is the time until complete re-epithelialization of a defined skin graft donor site is reached. Furthermore, clinical parameters such as wound healing, scar formation (using the Vancouver scar scale), laboratory values, quality of life (SF-36), angiogenic effects, and gene- and protein-expression patterns are to be determined. The results will be carefully evaluated for gender differences. We are seeking new insights into the mechanisms of wound healing in thermally injured patients and more detailed information about the role EPO plays, specifically in these complex interactions. We additionally expect that the biomimetic effects of EPO will be useful in the treatment of acute thermal dermal injuries. EudraCT Number: 2006-002886-38, Protocol Number: 0506, ISRCT Number: http://controlled-trials.com/ISRCTN95777824/ISRCTN95777824.

  13. The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study.

    Science.gov (United States)

    Rossetti, Francesca; Pittiruti, Mauro; Lamperti, Massimo; Graziano, Ugo; Celentano, Davide; Capozzoli, Giuseppe

    2015-01-01

    The Italian Group for Venous Access Devices (GAVeCeLT) has carried out a multicenter study investigating the safety and accuracy of intracavitary electrocardiography (IC-ECG) in pediatric patients. We enrolled 309 patients (age 1 month-18 years) candidate to different central venous access devices (VAD) - 56 peripherally inserted central catheters (PICC), 178 short term centrally inserted central catheters (CICC), 65 long term VADs, 10 VADs for dialysis - in five Italian Hospitals. Three age groups were considered: A (ECG was applicable in 307 cases. The increase of the P wave on IC-ECG was detected in all cases but two. The tip of the catheter was positioned at the cavo-atrial junction (CAJ) (i.e., at the maximal height of the P wave on IC-ECG) and the position was checked during the procedure by fluoroscopy or chest x-ray, considering the CAJ at 1-2 cm (group A), 1.5-3 cm (group B), or 2-4 cm (group C) below the carina. There were no complications related to IC-ECG. The overall match between IC-ECG and x-ray was 95.8% (96.2% in group A, 95% in group B, and 96.8% in group C). In 95 cases, the IC-ECG was performed with a dedicated ECG monitor, specifically designed for IC-ECG (Nautilus, Romedex): in this group, the match between IC-ECG and x-ray was 98.8%. We conclude that the IC-ECG method is safe and accurate in the pediatric patients. The applicability of the method is 99.4% and its feasibility is 99.4%. The accuracy is 95.8% and even higher (98.8%) when using a dedicated ECG monitor.

  14. Clinical effectiveness of hymenoptera venom immunotherapy: a prospective observational multicenter study of the European academy of allergology and clinical immunology interest group on insect venom hypersensitivity.

    Science.gov (United States)

    Ruëff, Franziska; Przybilla, Bernhard; Biló, Maria Beatrice; Müller, Ulrich; Scheipl, Fabian; Seitz, Michael J; Aberer, Werner; Bodzenta-Lukaszyk, Anna; Bonifazi, Floriano; Campi, Paolo; Darsow, Ulf; Haeberli, Gabrielle; Hawranek, Thomas; Küchenhoff, Helmut; Lang, Roland; Quercia, Oliviero; Reider, Norbert; Schmid-Grendelmeier, Peter; Severino, Maurizio; Sturm, Gunter Johannes; Treudler, Regina; Wüthrich, Brunello

    2013-01-01

    Treatment failure during venom immunotherapy (VIT) may be associated with a variety of risk factors. Our aim was to evaluate the association of baseline serum tryptase concentration (BTC) and of other parameters with the frequency of VIT failure during the maintenance phase. In this observational prospective multicenter study, we followed 357 patients with established honey bee or vespid venom allergy after the maintenance dose of VIT had been reached. In all patients, VIT effectiveness was either verified by sting challenge (n = 154) or patient self-reporting of the outcome of a field sting (n = 203). Data were collected on BTC, age, gender, preventive use of anti-allergic drugs (oral antihistamines and/or corticosteroids) right after a field sting, venom dose, antihypertensive medication, type of venom, side effects during VIT, severity of index sting reaction preceding VIT, and duration of VIT. Relative rates were calculated with generalized additive models. 22 patients (6.2%) developed generalized symptoms during sting challenge or after a field sting. A strong association between the frequency of VIT failure and BTC could be excluded. Due to wide confidence bands, however, weaker effects (odds ratios <3) of BTC were still possible, and were also suggested by a selective analysis of patients who had a sting challenge. The most important factor associated with VIT failure was a honey bee venom allergy. Preventive use of anti-allergic drugs may be associated with a higher protection rate. It is unlikely that an elevated BTC has a strong negative effect on the rate of treatment failures. The magnitude of the latter, however, may depend on the method of effectiveness assessment. Failure rate is higher in patients suffering from bee venom allergy.

  15. Clinical effectiveness of hymenoptera venom immunotherapy: a prospective observational multicenter study of the European academy of allergology and clinical immunology interest group on insect venom hypersensitivity.

    Directory of Open Access Journals (Sweden)

    Franziska Ruëff

    Full Text Available BACKGROUND: Treatment failure during venom immunotherapy (VIT may be associated with a variety of risk factors. OBJECTIVE: Our aim was to evaluate the association of baseline serum tryptase concentration (BTC and of other parameters with the frequency of VIT failure during the maintenance phase. METHODS: In this observational prospective multicenter study, we followed 357 patients with established honey bee or vespid venom allergy after the maintenance dose of VIT had been reached. In all patients, VIT effectiveness was either verified by sting challenge (n = 154 or patient self-reporting of the outcome of a field sting (n = 203. Data were collected on BTC, age, gender, preventive use of anti-allergic drugs (oral antihistamines and/or corticosteroids right after a field sting, venom dose, antihypertensive medication, type of venom, side effects during VIT, severity of index sting reaction preceding VIT, and duration of VIT. Relative rates were calculated with generalized additive models. RESULTS: 22 patients (6.2% developed generalized symptoms during sting challenge or after a field sting. A strong association between the frequency of VIT failure and BTC could be excluded. Due to wide confidence bands, however, weaker effects (odds ratios <3 of BTC were still possible, and were also suggested by a selective analysis of patients who had a sting challenge. The most important factor associated with VIT failure was a honey bee venom allergy. Preventive use of anti-allergic drugs may be associated with a higher protection rate. INTERPRETATION: It is unlikely that an elevated BTC has a strong negative effect on the rate of treatment failures. The magnitude of the latter, however, may depend on the method of effectiveness assessment. Failure rate is higher in patients suffering from bee venom allergy.

  16. Health-related quality of life assessment in people with multiple sclerosis and their family caregivers. A multicenter study in Catalonia (Southern Europe)

    Science.gov (United States)

    Aymerich, Marta; Guillamón, Imma; Jovell, Albert J

    2009-01-01

    Objectives: To measure the health-related quality of life (HRQoL) of multiple sclerosis (MS) patients and their caregivers, and to assess which factors can best describe HRQoL. Methods: A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL. Results: A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS) and 551 caregivers (mean age 45.4 years) participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1–40.6; mental SF-36: 44.4; 95% CI: 43.5–45.3). Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5–47.3). Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL. Conclusions: Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers’ HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context. PMID:19936174

  17. Cubital tunnel syndrome: comparative results of a multicenter study of 4 surgical techniques with a mean follow-up of 92 months.

    Science.gov (United States)

    Bacle, G; Marteau, E; Freslon, M; Desmoineaux, P; Saint-Cast, Y; Lancigu, R; Kerjean, Y; Vernet, E; Fournier, J; Corcia, P; Le Nen, D; Rabarin, F; Laulan, J

    2014-06-01

    Cubital tunnel syndrome is the second most frequent entrapment syndrome. Physiopathology is mixed, and treatment options are multiple, none having yet proved superior efficacy. The present retrospective multicenter study compared results and rates of complications and recurrence between the 4 main cubital tunnel syndrome treatments, to identify trends and optimize outcome. Patients presenting with primary clinical cubital tunnel syndrome diagnosed on electroneuromyography were included and operated on using 1 of the following 4 techniques: open or endoscopic in situ decompression, or subcutaneous or submuscular anterior transposition. Four specialized upper-limb surgery centers participated, each systematically performing 1 of the above procedures. Subjective and objective results and rates of complications and recurrence were compared at end of follow-up. Five hundred and two patients were included and 375 followed up for a mean 92 months (range, 9-144 months); 103 were lost to follow-up and 24 died. Whichever the procedure, more than 90% of patients were cured or showed improvement. There was a single case of scar pain at end of follow-up, managed by endoscopic decompression; there were no other long-term complications. None of the 4 techniques aggravated symptoms. There were 6 recurrences by end of follow-up: 1 associated with open in situ decompression and 5 with submuscular transposition. Surgery was effective in treating cubital tunnel syndrome. Submuscular anterior transposition was associated with recurrence. In contrast to literature reports, subcutaneous anterior transposition, which is a reliable and valid technique, was not associated with a higher complication rate than in situ decompression. Level IV. Multicenter retrospective. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study.

    Science.gov (United States)

    Yu, Zhangbin; Han, Shuping; Wu, Jinxia; Li, Mingxia; Wang, Huaiyan; Wang, Jimei; Liu, Jiebo; Pan, Xinnian; Yang, Jie; Chen, Chao

    2014-01-01

    to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40(th) percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95(th) percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75(th) percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875. this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Reduced variability of visual left ventricular ejection fraction assessment with reference images: The Japanese Association of Young Echocardiography Fellows multicenter study.

    Science.gov (United States)

    Kusunose, Kenya; Shibayama, Kentaro; Iwano, Hiroyuki; Izumo, Masaki; Kagiyama, Nobuyuki; Kurosawa, Koji; Mihara, Hirotsugu; Oe, Hiroki; Onishi, Tetsuari; Onishi, Toshinari; Ota, Mitsuhiko; Sasaki, Shunsuke; Shiina, Yumi; Tsuruta, Hikaru; Tanaka, Hidekazu

    2018-07-01

    Visual estimation of left ventricular ejection fraction (LVEF) is widely applied to confirm quantitative EF. However, visual assessment is subjective, and variability may be influenced by observer experience. We hypothesized that a learning session might reduce the misclassification rate. Protocol 1: Visual LVEFs for 30 cases were measured by 79 readers from 13 cardiovascular tertiary care centers. Readers were divided into 3 groups by their experience: limited (1-5 years, n=28), intermediate (6-11 years, n=26), and highly experienced (12-years, n=25). Protocol 2: All readers were randomized to assess the effect of a learning session with reference images only or feedback plus reference images. After the session, 20 new cases were shown to all readers following the same methodology. To assess the concordance and accuracy pre- and post-intervention, each visual LVEF measurement was compared to overall average values as a reference. Experience affected the concordance in visual EF values among the readers. Groups with intermediate and high experience showed significantly better mean difference (MD), standard deviation (SD), and coefficient of variation (CV) than those with limited experience at baseline. The learning session with reference image reduced the MD, SD, and CV in readers with limited experience. The learning session with reference images plus feedback also reduced proportional bias. Importantly, the misclassification rate for mid-range EF cases was reduced regardless of experience. This large multicenter study suggested that a simple learning session with reference images can successfully reduce the misclassification rate for LVEF assessment. Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  20. Signal-to-noise assessment for diffusion tensor imaging with single data set and validation using a difference image method with data from a multicenter study

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhiyue J., E-mail: jerry.wang@childrens.com [Department of Radiology, Children' s Medical Center, Dallas, Texas 75235 and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390 (United States); Chia, Jonathan M. [Clinical Science, Philips Healthcare, Cleveland, Ohio 44143 (United States); Ahmed, Shaheen; Rollins, Nancy K. [Department of Radiology, Children' s Medical Center, Dallas, TX 75235 and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390 (United States)

    2014-09-15

    Purpose: To describe a quantitative method for determination of SNR that extracts the local noise level using a single diffusion data set. Methods: Brain data sets came from a multicenter study (eight sites; three MR vendors). Data acquisition protocol required b = 0, 700 s/mm{sup 2}, fov = 256 × 256 mm{sup 2}, acquisition matrix size 128 × 128, reconstruction matrix size 256 × 256; 30 gradient encoding directions and voxel size 2 × 2 × 2 mm{sup 3}. Regions-of-interest (ROI) were placed manually on the b = 0 image volume on transverse slices, and signal was recorded as the mean value of the ROI. The noise level from the ROI was evaluated using Fourier Transform based Butterworth high-pass filtering. Patients were divided into two groups, one for filter parameter optimization (N = 17) and one for validation (N = 10). Six white matter areas (the genu and splenium of corpus callosum, right and left centrum semiovale, right and left anterior corona radiata) were analyzed. The Bland–Altman method was used to compare the resulting SNR with that from the difference image method. The filter parameters were optimized for each brain area, and a set of “global” parameters was also obtained, which represent an average of all regions. Results: The Bland–Altman analysis on the validation group using “global” filter parameters revealed that the 95% limits of agreement of percent bias between the SNR obtained with the new and the reference methods were −15.5% (median of the lower limit, range [−24.1%, −8.9%]) and 14.5% (median of the higher limits, range [12.7%, 18.0%]) for the 6 brain areas. Conclusions: An FT-based high-pass filtering method can be used for local area SNR assessment using only one DTI data set. This method could be used to evaluate SNR for patient studies in a multicenter setting.

  1. The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study--Milan-Paris-Lyon experience of 646 lipofilling procedures.

    Science.gov (United States)

    Petit, Jean Yves; Lohsiriwat, Visnu; Clough, Krishna B; Sarfati, Isabelle; Ihrai, Tarik; Rietjens, Mario; Veronesi, Paolo; Rossetto, Fabio; Scevola, Anna; Delay, Emmanuel

    2011-08-01

    Lipofilling is now performed to improve the breast contour, after both breast-conserving surgery and breast reconstruction. However, injection of fat into a previous tumor site may create a new environment for cancer and adjacent cells. There is also no international agreement regarding lipofilling after breast cancer treatment. The authors included three institutions specializing in both breast cancer treatment and breast reconstruction (European Institute of Oncology, Milan, Italy; Paris Breast Center, Paris, France; and Leon Berard Centre, Lyon, France) for a multicenter study. A collective chart review of all lipofilling procedures after breast cancer treatment was performed. From 2000 to 2010, the authors reviewed 646 lipofilling procedures from 513 patients. There were 370 mastectomy patients and 143 breast-conserving surgery patients. There were 405 patients (78.9 percent) with invasive carcinoma and 108 (21.1 percent) with carcinoma in situ. The average interval between oncologic surgical interventions and lipofilling was 39.7 months. Average follow-up after lipofilling was 19.2 months. The authors observed a complication rate of 2.8 percent (liponecrosis, 2.0 percent). Twelve radiologic images appeared after lipofilling in 119 breast-conserving surgery cases (10.1 percent). The overall oncologic event rate was 5.6 percent (3.6 percent per year). The locoregional event rate was 2.4 percent (1.5 percent per year). Lipofilling after breast cancer treatment leads to a low complication rate and does not affect radiologic follow-up after breast-conserving surgery. A prospective clinical registry including high-volume multicenter data with a long follow-up is warranted to demonstrate the oncologic safety. Until then, lipofilling should be performed in experienced hands, and a cautious oncologic follow-up protocol is advised. Therapeutic, IV [corrected].

  2. Anti-HMGCR antibodies as a biomarker for immune-mediated necrotizing myopathies: A history of statins and experience from a large international multi-center study.

    Science.gov (United States)

    Musset, Lucile; Allenbach, Yves; Benveniste, Olivier; Boyer, Olivier; Bossuyt, Xavier; Bentow, Chelsea; Phillips, Joe; Mammen, Andrew; Van Damme, Philip; Westhovens, René; Ghirardello, Anna; Doria, Andrea; Choi, May Y; Fritzler, Marvin J; Schmeling, Heinrike; Muro, Yoshinao; García-De La Torre, Ignacio; Ortiz-Villalvazo, Miguel A; Bizzaro, Nicola; Infantino, Maria; Imbastaro, Tiziana; Peng, Qinglin; Wang, Guochun; Vencovský, Jiří; Klein, Martin; Krystufkova, Olga; Franceschini, Franco; Fredi, Micaela; Hue, Sophie; Belmondo, Thibaut; Danko, Katalin; Mahler, Michael

    2016-10-01

    In an effort to find naturally occurring substances that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), statins were first discovered by Endo in 1972. With the widespread prescription and use of statins to decrease morbidity from myocardial infarction and stroke, it was noted that approximately 5% of all statin users experienced muscle pain and weakness during treatment. In a smaller proportion of patients, the myopathy progressed to severe morbidity marked by proximal weakness and severe muscle wasting. Remarkably, Mammen and colleagues were the first to discover that the molecular target of statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), is an autoantibody target in patients that develop an immune-mediated necrotizing myopathy (IMNM). These observations have been confirmed in a number of studies but, until today, a multi-center, international study of IMNM, related idiopathic inflammatory myopathies (IIM), other auto-inflammatory conditions and controls has not been published. Accordingly, an international, multi-center study investigated the utility of anti-HMGCR antibodies in the diagnosis of statin-associated IMNM in comparison to different forms of IIM and controls. This study included samples from patients with different forms of IIM (n=1250) and patients with other diseases (n=656) that were collected from twelve sites and tested for anti-HMGCR antibodies by ELISA. This study confirmed that anti-HMGCR autoantibodies, when found in conjunction with statin use, characterize a subset of IIM who are older and have necrosis on muscle biopsy. Taken together, the data to date indicates that testing for anti-HMGCR antibodies is important in the differential diagnosis of IIM and might be considered for future classification criteria. Copyright © 2016. Published by Elsevier B.V.

  3. Surgical perspectives from a prospective, nonrandomized, multicenter study of breast conserving surgery and adjuvant electronic brachytherapy for the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Beatty J David

    2011-03-01

    Full Text Available Abstract Background Accelerated partial breast irradiation (APBI may be used to deliver radiation to the tumor bed post-lumpectomy in eligible patients with breast cancer. Patient and tumor characteristics as well as the lumpectomy technique can influence patient eligibility for APBI. This report describes a lumpectomy procedure and examines patient, tumor, and surgical characteristics from a prospective, multicenter study of electronic brachytherapy. Methods The study enrolled 65 patients of age 45-84 years with ductal carcinoma or ductal carcinoma in situ, and 44 patients, who met the inclusion and exclusion criteria, were treated with APBI using the Axxent® electronic brachytherapy system following lumpectomy. The prescription dose was 34 Gy in 10 fractions over 5 days. Results The lumpectomy technique as described herein varied by site and patient characteristics. The balloon applicator was implanted by the surgeon (91% or a radiation oncologist (9% during or up to 61 days post-lumpectomy (mean 22 days. A lateral approach was most commonly used (59% for insertion of the applicator followed by an incision site approach in 27% of cases, a medial approach in 5%, and an inferior approach in 7%. A trocar was used during applicator insertion in 27% of cases. Local anesthetic, sedation, both or neither were administered in 45%, 2%, 41% and 11% of cases, respectively, during applicator placement. The prescription dose was delivered in 42 of 44 treated patients. Conclusions Early stage breast cancer can be treated with breast conserving surgery and APBI using electronic brachytherapy. Treatment was well tolerated, and these early outcomes were similar to the early outcomes with iridium-based balloon brachytherapy.

  4. Age, renal dysfunction, cardiovascular disease, and antihyperglycemic treatment in type 2 diabetes mellitus: findings from the Renal Insufficiency and Cardiovascular Events Italian Multicenter Study.

    Science.gov (United States)

    Solini, Anna; Penno, Giuseppe; Bonora, Enzo; Fondelli, Cecilia; Orsi, Emanuela; Trevisan, Roberto; Vedovato, Monica; Cavalot, Franco; Cignarelli, Mauro; Morano, Susanna; Ferrannini, Ele; Pugliese, Giuseppe

    2013-08-01

    To assess the distribution of antihyperglycemic treatments according to age and renal function and its relationship with cardiovascular disease in type 2 diabetes mellitus (T2DM). Cross-sectional analysis. Nineteen hospital-based diabetes mellitus clinics in 2007 and 2008. Fifteen thousand seven hundred thirty-three individuals with T2DM from the Renal Insufficiency and Cardiovascular Events (RIACE) Italian Multicenter Study. Current antihyperglycemic treatments were recorded. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Albuminuria was measured using immunonephelometry or immunoturbidimetry. Prevalence of major acute cardiovascular events was calculated according to age quartiles, treatments, and categories of eGFR (1 = ≥90; 2 = 60-89; 3 = 30-59; and 4 = metformin or glitazones fell; percentage taking sulphonylureas and repaglinide rose, and percentage taking insulin remained stable. In eGFR categories 3 and 4, use of metformin was 41.4% and 14.5%, respectively, and that of sulphonylureas was 34.2% and 18.1%, respectively. Inappropriate prescription of these agents, especially sulphonylureas, increased with age. Metformin was independently associated with lower prevalence of cardiovascular disease for any age quartile and eGFR category than all other treatments. In real-life conditions, use of agents that are not recommended in elderly adults with diabetes mellitus with moderate to severe renal impairment is frequent, but metformin is associated with lower cardiovascular event rates even in these individuals. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  5. Head motion evaluation and correction for PET scans with 18F-FDG in the Japanese Alzheimer's disease neuroimaging initiative (J-ADNI) multi-center study.

    Science.gov (United States)

    Ikari, Yasuhiko; Nishio, Tomoyuki; Makishi, Yoko; Miya, Yukari; Ito, Kengo; Koeppe, Robert A; Senda, Michio

    2012-08-01

    Head motion during 30-min (six 5-min frames) brain PET scans starting 30 min post-injection of FDG was evaluated together with the effect of post hoc motion correction between frames in J-ADNI multicenter study carried out in 24 PET centers on a total of 172 subjects consisting of 81 normal subjects, 55 mild cognitive impairment (MCI) and 36 mild Alzheimer's disease (AD) patients. Based on the magnitude of the between-frame co-registration parameters, the scans were classified into six levels (A-F) of motion degree. The effect of motion and its correction was evaluated using between-frame variation of the regional FDG uptake values on ROIs placed over cerebral cortical areas. Although AD patients tended to present larger motion (motion level E or F in 22 % of the subjects) than MCI (3 %) and normal (4 %) subjects, unignorable motion was observed in a small number of subjects in the latter groups as well. The between-frame coefficient of variation (SD/mean) was 0.5 % in the frontal, 0.6 % in the parietal and 1.8 % in the posterior cingulate ROI for the scans of motion level 1. The respective values were 1.5, 1.4, and 3.6 % for the scans of motion level F, but reduced by the motion correction to 0.5, 0.4 and 0.8 %, respectively. The motion correction changed the ROI value for the posterior cingulate cortex by 11.6 % in the case of severest motion. Substantial head motion occurs in a fraction of subjects in a multicenter setup which includes PET centers lacking sufficient experience in imaging demented patients. A simple frame-by-frame co-registration technique that can be applied to any PET camera model is effective in correcting for motion and improving quantitative capability.

  6. Second-line therapy with levofloxacin after failure of treatment to eradicate helicobacter pylori infection: time trends in a Spanish Multicenter Study of 1000 patients.

    Science.gov (United States)

    Gisbert, Javier P; Pérez-Aisa, Angeles; Bermejo, Fernando; Castro-Fernández, Manuel; Almela, Pedro; Barrio, Jesús; Cosme, Angel; Modolell, Inés; Bory, Felipe; Fernández-Bermejo, Miguel; Rodrigo, Luis; Ortuño, Jesús; Sánchez-Pobre, Pilar; Khorrami, Sam; Franco, Alejandro; Tomas, Albert; Guerra, Iván; Lamas, Eloisa; Ponce, Julio; Calvet, Xavier

    2013-02-01

    Second-line bismuth-containing quadruple therapy is complex and frequently induces adverse effects. A triple rescue regimen containing levofloxacin is a potential alternative; however, resistance to quinolones is rapidly increasing. To evaluate the efficacy and tolerability of a second-line triple-regimen-containing levofloxacin in patients whose Helicobacter pylori eradication treatment failed and to assess whether the efficacy of the regimen decreases with time. Prospective multicenter study. In whom treatment with a regimen comprising a proton-pump inhibitor, clarithromycin, and amoxicillin had failed. Levofloxacin (500 mg bid), amoxicillin (1 g bid), and omeprazole (20 mg bid) for 10 days. Eradication was confirmed using the C-urea breath test 4 to 8 weeks after therapy. Compliance/tolerance: Compliance was determined through questioning and recovery of empty medication envelopes. Incidence of adverse effects was evaluated by means of a questionnaire. The study sample comprised 1000 consecutive patients (mean age, 49 ± 15 y, 42% men, 33% peptic ulcer) of whom 97% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 75.1% (95% confidence interval, 72%-78%) and 73.8% (95% confidence interval, 71%-77%). Efficacy (intention-to-treat) was 76% in the year 2006, 68% in 2007, 70% in 2008, 76% in 2009, 74% in 2010, and 81% in 2011. In the multivariate analysis, none of the studied variables (including diagnosis and year of treatment) were associated with success of eradication. Adverse effects were reported in 20% of patients, most commonly nausea (7.9%), metallic taste (3.9%), myalgia (3.1%), and abdominal pain (2.9%). Ten-day levofloxacin-containing therapy is an encouraging second-line strategy, providing a safe and simple alternative to quadruple therapy in patients whose previous standard triple therapy has failed. The efficacy of this regimen remains stable with time.

  7. Importance of cerebrospinal fluid analysis in the era of McDonald 2010 criteria: a German-Austrian retrospective multicenter study in patients with a clinically isolated syndrome.

    Science.gov (United States)

    Huss, André M; Halbgebauer, Steffen; Öckl, Patrick; Trebst, Corinna; Spreer, Annette; Borisow, Nadja; Harrer, Andrea; Brecht, Isabel; Balint, Bettina; Stich, Oliver; Schlegel, Sabine; Retzlaff, Nele; Winkelmann, Alexander; Roesler, Romy; Lauda, Florian; Yildiz, Özlem; Voß, Elke; Muche, Rainer; Rauer, Sebastian; Bergh, Florian Then; Otto, Markus; Paul, Friedemann; Wildemann, Brigitte; Kraus, Jörg; Ruprecht, Klemens; Stangel, Martin; Buttmann, Mathias; Zettl, Uwe K; Tumani, Hayrettin

    2016-12-01

    The majority of patients presenting with a first clinical symptom suggestive of multiple sclerosis (MS) do not fulfill the MRI criteria for dissemination in space and time according to the 2010 revision of the McDonald diagnostic criteria for MS and are thus classified as clinically isolated syndrome (CIS). To re-evaluate the utility of cerebrospinal fluid (CSF) analysis in the context of the revised McDonald criteria from 2010, we conducted a retrospective multicenter study aimed at determining the prevalence and predictive value of oligoclonal IgG bands (OCBs) in patients with CIS. Patients were recruited from ten specialized MS centers in Germany and Austria. We collected data from 406 patients; at disease onset, 44/406 (11 %) fulfilled the McDonald 2010 criteria for MS. Intrathecal IgG OCBs were detected in 310/362 (86 %) of CIS patients. Those patients were twice as likely to convert to MS according to McDonald 2010 criteria as OCB-negative individuals (hazard ratio = 2.1, p = 0.0014) and in a shorter time period of 25 months (95 % CI 21-34) compared to 47 months in OCB-negative individuals (95 % CI 36-85). In patients without brain lesions at first attack and presence of intrathecal OCBs (30/44), conversion rate to MS was 60 % (18/30), whereas it was only 21 % (3/14) in those without OCBs. Our data confirm that in patients with CIS the risk of conversion to MS substantially increases if OCBs are present at onset. CSF analysis definitely helps to evaluate the prognosis in patients who do not have MS according to the revised McDonald criteria.

  8. Immediate provisionalization in the esthetic zone: 1-year interim results from a prospective single-cohort multicenter study evaluating 3.0-mm-diameter tapered implants.

    Science.gov (United States)

    Kolinski, Martin; Hess, Pablo; Leziy, Sonia; Friberg, Bertil; Bellucci, Gionata; Trisciuoglio, Davide; Wagner, Wilfried; Moergel, Maximilian; Pozzi, Alessandro; Wiltfang, Jörg; Behrens, Eleonore; Zechner, Werner; Vasak, Christoph; Weigl, Paul

    2018-07-01

    The aim of this interim analysis of a 5-year prospective multicenter study is to evaluate clinical and radiological performance of immediately provisionalized 3.0-mm-diameter tapered implants. Patients needing implant rehabilitation of maxillary lateral incisors or mandibular lateral and central incisors were treated with 3.0-mm-diameter implants placed in extraction or healed sites and immediately provisionalized. Clinical and radiographic examinations were performed at implant insertion, 6 months thereafter, and are ongoing. Marginal bone levels and changes, complications, the papilla, plaque, and bleeding indices, and the pink esthetic score (PES) were evaluated at each follow-up visit. Of 112 enrolled patients, 77 patients (91 implants) met the inclusion criteria. Seventy-one patients with 82 implants completed the 1-year follow-up. Three implants failed yielding a CSR of 96.7%. All failures occurred within the first 3 months after implant insertion. Marginal bone level changes from insertion to 6 months was - 0.57 ± 1.30 mm (n = 75) and from insertion to 12 months - 0.25 ± 1.38 mm (n = 72). Fifteen non-serious complications were recorded. Papilla index score and PES improved at the 1-year follow-up. Plaque formation and bleeding-on-probing showed no statistically significant differences between the 6-month and the 1-year visit. This 1-year analysis demonstrated high survival, stable bone levels, and healthy soft tissue with 3.0-mm-diameter implants. Narrow diameter implants are a safe and predictable treatment option in patients with limited bone volume and/or limited interdental space and eligible for immediate loading protocols.

  9. A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument.

    Science.gov (United States)

    Merola, Andrew A; Haher, Thomas R; Brkaric, Mario; Panagopoulos, Georgia; Mathur, Samir; Kohani, Omid; Lowe, Thomas G; Lenke, Larry G; Wenger, Dennis R; Newton, Peter O; Clements, David H; Betz, Randal R

    2002-09-15

    A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24). To evaluate the patient based outcome of the surgical treatment of adolescent idiopathic scoliosis. A paucity of information exists with respect to patient measures of outcome regarding the surgical treatment of adolescent idiopathic scoliosis. To our knowledge, no prospective outcome study on this topic thus far exists. Using the SRS 24 questionnaire, seven scoliosis centers agreed to prospectively assess outcome for surgically treated patients with adolescent idiopathic scoliosis. Data were collected before surgery and at 24 months after surgery. Data were analyzed using paired and independent samples t test for all seven SRS 24 questionnaire domains (Pain, General Self-Image, Postoperative Self-Image, Postoperative Function, Function From Back Condition, General Level of Activity, and Satisfaction) using Statistical Package for Social Science. The domains were analyzed with respect to the total cohort, gender, curve magnitude, and type of surgery using independent-samples t tests. A total of 242 patients were included in our analysis. A baseline preoperative pain level of 3.68 of 5 was found. This improved to 4.63 after surgery, representing an improvement of 0.95 points. Surgical intervention was associated with improving outcome when compared with preoperative status. Pain, General Self-Image, Function From Back Condition, and Level of Activity all demonstrated statistically significant improvement as compared with preoperative status (P adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with

  10. Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators.

    Science.gov (United States)

    Roach, G W; Kanchuger, M; Mangano, C M; Newman, M; Nussmeier, N; Wolman, R; Aggarwal, A; Marschall, K; Graham, S H; Ley, C

    1996-12-19

    Acute changes in cerebral function after elective coronary bypass surgery is a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of -- and the use of resources associated with -- perioperative adverse neurologic events, including cerebral injury. In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures). Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of 3.1 percent had type I neurologic outcomes (8 died of cerebral injury, 55 had nonfatal strokes, 2 had transient ischemic attacks, and 1 had stupor), and 3.0 percent had type II outcomes (55 had deterioration of intellectual function and 8 had seizures). Patients with adverse cerebral outcomes had higher in-hospital mortality (21 percent of patients with type I outcomes died, vs. 10 percent of those with type II and 2 percent of those with no adverse cerebral outcome; P<0.001 for all comparisons), longer hospitalization (25 days with type I outcomes, 21 days with type II, and 10 days with no adverse outcome; P<0.001), and a higher rate of discharge to facilities for intermediate- or long-term care (69 percent, 39 percent, and 10 percent ; P<0.001). Predictors of type I outcomes were proximal aortic atherosclerosis, a history of neurologic disease, and older age; predictors of type II outcomes were older age, systolic hypertension on admission, pulmonary disease, and excessive consumption of alcohol. Adverse cerebral outcomes after coronary bypass surgery are relatively common and serious; they are associated with substantial increases in mortality, length of hospitalization, and use of intermediate- or long-term care facilities. New diagnostic and therapeutic strategies must be developed to lessen such injury.

  11. Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

    Science.gov (United States)

    Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

    2018-03-06

    In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

  12. Clinical characteristics and treatment outcomes of patients with major depressive disorder and comorbid anxiety disorders - results from a European multicenter study.

    Science.gov (United States)

    Dold, Markus; Bartova, Lucie; Souery, Daniel; Mendlewicz, Julien; Serretti, Alessandro; Porcelli, Stefano; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

    2017-08-01

    This naturalistic European multicenter study aimed to elucidate the association between major depressive disorder (MDD) and comorbid anxiety disorders. Demographic and clinical information of 1346 MDD patients were compared between those with and without concurrent anxiety disorders. The association between explanatory variables and the presence of comorbid anxiety disorders was examined using binary logistic regression analyses. 286 (21.2%) of the participants exhibited comorbid anxiety disorders, 10.8% generalized anxiety disorder (GAD), 8.3% panic disorder, 8.1% agoraphobia, and 3.3% social phobia. MDD patients with comorbid anxiety disorders were characterized by younger age (social phobia), outpatient status (agoraphobia), suicide risk (any anxiety disorder, panic disorder, agoraphobia, social phobia), higher depressive symptom severity (GAD), polypsychopharmacy (panic disorder, agoraphobia), and a higher proportion receiving augmentation treatment with benzodiazepines (any anxiety disorder, GAD, panic disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder). The results in terms of treatment response were conflicting (better response for panic disorder and poorer for GAD). The logistic regression analyses revealed younger age (any anxiety disorder, social phobia), outpatient status (agoraphobia), suicide risk (agoraphobia), severe depressive symptoms (any anxiety disorder, GAD, social phobia), poorer treatment response (GAD), and increased administration of benzodiazepines (any anxiety disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder) to be associated with comorbid anxiety disorders. Our findings suggest that the various anxiety disorders subtypes display divergent clinical characteristics and are associated with different variables. Especially comorbid GAD appears to be characterized by high symptom severity and poor treatment response. Copyright © 2017 Elsevier Ltd. All

  13. A prospective multicenter study of venous thromboembolism in patients with newly-diagnosed high-grade glioma: hazard rate and risk factors.

    Science.gov (United States)

    Streiff, Michael B; Ye, Xiaobu; Kickler, Thomas S; Desideri, Serena; Jani, Jayesh; Fisher, Joy; Grossman, Stuart A

    2015-09-01

    Venous thromboembolism (VTE) is a common complication in patients with high-grade gliomas. The purpose of this prospective multicenter study was to determine the hazard rate of first symptomatic VTE in newly-diagnosed glioma patients and identify clinical and laboratory risk factors. On enrollment, demographic and clinical information were recorded and a comprehensive coagulation evaluation was performed. Patients were followed until death. The study end point was objectively-documented symptomatic VTE. One hundred seven patients were enrolled with a median age of 57 years (range 29-85) between June 2005 and April 2008. Ninety-one (85 %) had glioblastoma multiforme (GBM). During an average survival of 17.7 months, 26 patients (24 %) (95 % CI 17-34 %) developed VTE (hazard rate 0.15 per person-year) and 94 patients (88 %) died. Median time to VTE was 14.2 weeks post-operation (range 3-126). Patients with an initial tumor biopsy were 3.0 fold more likely to suffer VTE (p = 0.02). Patients with an elevated factor VIII activity (>147 %) were 2.1-fold more likely to develop VTE. ABO blood group, D dimer and thrombin generation were not associated with VTE. No fatal VTE occurred. VTE is a common complication in patients with newly-diagnosed high grade gliomas, particularly in the first six months after diagnosis. Patients with an initial tumor biopsy and elevated factor VIII levels are at increased risk. However, VTE was not judged to be primarily responsible for any patient deaths. Therefore, outpatient primary VTE prophylaxis remains investigational until more effective primary prophylaxis strategies and therapies for glioma are identified.

  14. Evaluation of macrolide resistance and enhanced molecular typing of Treponema pallidum in patients with syphilis in Taiwan: a prospective multicenter study.

    Science.gov (United States)

    Wu, Hsiu; Chang, Sui-Yuan; Lee, Nan-Yao; Huang, Wen-Chi; Wu, Bing-Ru; Yang, Chia-Jui; Liang, Shiou-Haur; Lee, Chen-Hsiang; Ko, Wen-Chien; Lin, Hsi-Hsun; Chen, Yen-Hsu; Liu, Wen-Chun; Su, Yi-Ching; Hsieh, Chia-Yin; Wu, Pei-Ying; Hung, Chien-Ching

    2012-07-01

    Studies of macrolide resistance mutations and molecular typing using the newly proposed enhanced typing system for Treponema pallidum isolates obtained from HIV-infected patients in the Asia-Pacific region are scarce. Between September 2009 and December 2011, we conducted a survey to detect T. pallidum using a PCR assay using clinical specimens from patients with syphilis at six major designated hospitals for HIV care in Taiwan. The T. pallidum strains were genotyped by following the enhanced molecular typing methodology, which analyzed the number of 60-bp repeats in the acidic repeat protein (arp) gene, T. pallidum repeat (tpr) polymorphism, and the sequence of base pairs 131 to 215 in the tp0548 open reading frame of T. pallidum. Detection of A2058G and A2059G point mutations in the T. pallidum 23S rRNA was performed with the use of restriction fragment length polymorphism (RFLP). During the 2-year study period, 211 clinical specimens were obtained from 136 patients with syphilis. T. pallidum DNA was isolated from 105 (49.8%) of the specimens, with swab specimens obtained from chancres having the highest yield rate (63.2%), followed by plasma (49.4%), serum (35.7%), and cerebrospinal fluid or vitreous fluid (18.2%) specimens. Among the 40 fully typed specimens, 11 subtypes of T. pallidum were identified. Subtype 14f/f (18 isolates) was the most common isolates, followed by 14f/c (3), 14b/c (3), and 14k/f (3). Among the isolates examined for macrolide resistance, none had the A2058G or A2059G mutation. In conclusion, we found that type 14 f/f was the most common T. pallidum strain in this multicenter study on syphilis in Taiwan and that none of the isolates exhibited 23S rRNA mutations causing resistance to macrolides.

  15. Helicobacter sp. MIT 01-6451 infection during fetal and neonatal life in laboratory mice.

    Science.gov (United States)

    Yamanaka, Hitoki; Nakanishi, Tai; Takagi, Toshikazu; Ohsawa, Makiko; Kubo, Noriaki; Yamamoto, Naoto; Takemoto, Takahira; Ohsawa, Kazutaka

    2015-01-01

    Helicobacter sp. MIT 01-6451 has been detected in SPF mice kept in Japan. To characterize strain MIT 01-6451, its infection route during fetal and neonatal life and effects on pregnancy were investigated using immunocompetent and immunodeficient mouse strains (BALB/c, C57BL/6, and SCID). MIT 01-6451 was detected in the uterus, vagina, and mammary glands of 50% of infected SCID mice, whereas these tissues were all negative in immunocompetent mice. No fetal infections with MIT 01-6451 were detected at 16-18 days after pregnancy in any mouse strain. In newborn mice, MIT 01-6451 was detected in intestinal tissue of C57BL/6 and SCID mice at 9-11 days after birth, but not in BALB/c mice. The IgA and IgG titers to MIT 01-6451 in sera of C57BL/6 female mice were significantly lower than those of BALB/c mice. Although no significant differences in the number of newborns per litter were observed between MIT 01-6451-infected and MIT 01-6451-free dams, the birth rate was lower in infected SCID mice than in control SCID mice. The present results indicated that MIT 01-6451 infects newborn mice after birth rather than by vertical transmission to the fetus via the placenta and that MIT 01-6451 infection shows opportunistically negative effects on the birth rate. In addition, the maternal immune response may affect infection of newborn mice with MIT 01-6451 through breast milk.

  16. Oral cancer: A multicenter study.

    Science.gov (United States)

    Dhanuthai, K; Rojanawatsirivej, S; Thosaporn, W; Kintarak, S; Subarnbhesaj, A; Darling, M; Kryshtalskyj, E; Chiang, C-P; Shin, H-I; Choi, S-Y; Lee, S-S; Aminishakib, P

    2018-01-01

    To determine the prevalence and clinicopathologic features of the oral cancer patients. Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients.

  17. Oral cancer: A multicenter study

    Science.gov (United States)

    Rojanawatsirivej, Somsri; Thosaporn, Watcharaporn; Kintarak, Sompid; Subarnbhesaj, Ajiravudh; Darling, Mark; Kryshtalskyj, Eugene; Chiang, Chun-Pin; Shin, Hong-In; Choi, So-Young; Lee, Sang-shin; Shakib, Pouyan-Amini

    2018-01-01

    Background To determine the prevalence and clinicopathologic features of the oral cancer patients. Material and Methods Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Results Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Conclusions Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients. Key words:Oral cancer, prevalence, clinic-pathologic features, retrospective study. PMID:29274153

  18. Material Identification Technology (MIT) concept technical feasibility study

    International Nuclear Information System (INIS)

    Jones, J.L.; Harker, Y.D.; Yoon, W.Y.; Johnson, L.O.

    1993-09-01

    The Idaho National Engineering Laboratory (INEL) has initiated the design and development of a novel pulsed accelerator-based, active interrogation concept. The proposed concept, referred to as the Material Identification Technology (MIT), enables rapid (between accelerator pulses), non-destructive, elemental composition analysis of both nuclear and non-nuclear materials. Applications of this technique include material monitoring in support of counter-proliferation activities, such as export controls (at domestic and international inspection locations), SNM controls, nuclear weapon dismantlement, and chemical weapon verification. Material Identification Technology combines a pulsed, X-ray source (an electron accelerator) and a gamma detection system. The accelerator must maximize neutron production (pulse width, beam current, beam energy, and repetition rate) and minimize photon dose to the object. Current available accelerator technology can meet these requirements. The detection system must include detectors which provide adequate gamma energy resolution capability, rapid recovery after the initial X-ray interrogation pulse, and multiple single gamma event detection between accelerator pulses. Further research is required to develop the detection system. This report provides the initial feasibility assessment of the MIT concept

  19. MIT nuclear reactor laboratory high school teaching program

    International Nuclear Information System (INIS)

    Olmez, I.

    1991-01-01

    For the last 6 years, the Massachusetts Institute of Technology (MIT) Nuclear Reactor Laboratory's academic and scientific staff a have been conducting evening seminars for precollege science teachers, parents, and high school students from the New England area. These seminars, as outlined in this paper, are intended to give general information on nuclear technologies with specific emphasis on radiation physics, nuclear medicine, nuclear chemistry, and ongoing research activities at the MIT research reactor. The ultimate goal is to create interest or build on the already existing interest in science and technology by, for example, special student projects. Several small projects have already been completed ranging from environmental research to biological reactions with direct student involvement. Another outcome of these seminars was the change in attitudes of science teachers toward nuclear technology. Numerous letters have been received from the teachers and parents stating their previous lack of knowledge on the beneficial aspects of nuclear technologies and the subsequent inclusion of programs in their curriculum for educating students so that they may also develop a more positive attitude toward nuclear power

  20. Status of the MIT-Bates South Hall Ring commissioning

    International Nuclear Information System (INIS)

    Flanz, J.B.; Jacobs, K.D.; McAllister, B.; Averill, R.; Bradley, S.; Carter, A.; Dow, K.; Farkondeh, M.; Ihloff, E.; Kowalski, S.

    1993-01-01

    The MIT-Bates South Hall Ring construction project is now nearly complete. At this time the Energy Compression System, the SHR Injection Line and the South Hall Ring itself are complete. The SHR Extraction Line is complete but has not been connected to the ring. Commissioning with beam of the completed beam lines has been started. The MIT-Bates South Hall Ring (SHR) is an electron storage ring used with the 1 GeV Bates electron accelerator to increase the effective duty factor and luminosity. A beam can be stored for use with an internal target, thus allowing for high duty factor, high luminosity experiments. External beams with high duty factor can be obtained using resonant extraction. The new systems associated with the SHR include the Energy Compression System (ECS), the Injection line, and the Extraction line. The authors have commissioned the ECS, the new injection line and the SHR without RF. This includes transporting beam, measuring beam phase space parameters using critical injection elements including a high voltage electrostatic septum, a fast beam kicker, and storing a beam in the SHR

  1. Mobile-IT Education (MIT.EDU): M-Learning Applications for Classroom Settings

    Science.gov (United States)

    Sung, M.; Gips, J.; Eagle, N.; Madan, A.; Caneel, R.; DeVaul, R.; Bonsen, J.; Pentland, A.

    2005-01-01

    In this paper, we describe the Mobile-IT Education (MIT.EDU) system, which demonstrates the potential of using a distributed mobile device architecture for rapid prototyping of wireless mobile multi-user applications for use in classroom settings. MIT.EDU is a stable, accessible system that combines inexpensive, commodity hardware, a flexible…

  2. MIT domain of Vps4 is a Ca2+-dependent phosphoinositide-binding domain.

    Science.gov (United States)

    Iwaya, Naoko; Takasu, Hirotoshi; Goda, Natsuko; Shirakawa, Masahiro; Tanaka, Toshiki; Hamada, Daizo; Hiroaki, Hidekazu

    2013-05-01

    The microtubule interacting and trafficking (MIT) domain is a small protein module that is conserved in proteins of diverged function, such as Vps4, spastin and sorting nexin 15 (SNX15). The molecular function of the MIT domain is protein-protein interaction, in which the domain recognizes peptides containing MIT-interacting motifs. Recently, we identified an evolutionarily related domain, 'variant' MIT domain at the N-terminal region of the microtubule severing enzyme katanin p60. We found that the domain was responsible for binding to microtubules and Ca(2+). Here, we have examined whether the authentic MIT domains also bind Ca(2+). We found that the loop between the first and second α-helices of the MIT domain binds a Ca(2+) ion. Furthermore, the MIT domains derived from Vps4b and SNX15a showed phosphoinositide-binding activities in a Ca(2+)-dependent manner. We propose that the MIT domain is a novel membrane-associating domain involved in endosomal trafficking.

  3. Scratch that: MIT's Mitchel Resnick Says Kids Should Do It for Themselves

    Science.gov (United States)

    Traylor, Scott

    2008-01-01

    Mitchel Resnick is a researcher, inventor, and professor at MIT's Media Laboratory in Cambridge, MA, and the founder of the Lifelong Kindergarten Group at MIT. He is the lead innovator behind many cutting-edge learning technologies and projects for children, including the Computer Clubhouse, PicoCrickets, and the wildly successful consumer…

  4. Assessing International Product Design and Development Graduate Courses: The MIT-Portugal Program

    Science.gov (United States)

    Dori, Yehudit Judy; Silva, Arlindo

    2010-01-01

    The Product Design and Development (PDD) course is part of the graduate curriculum in the Engineering Design and Advanced Manufacturing (EDAM) study in the MIT-Portugal Program. The research participants included about 110 students from MIT, EDAM, and two universities in Portugal, Instituto Superior Técnico-Universidade Técnica de Lisboa (IST) and…

  5. Analyse von Kunststoffadditiven mittels Laserablation gekoppelt mit induktiv gekoppelter Plasma Massenspektrometrie

    OpenAIRE

    Börno, Fabian

    2016-01-01

    Die Laserablation gekoppelt mit der Massenspektrometrie mit induktiv gekoppeltem Plasma ist eine vielversprechende direkte Feststofftechnik, die sich jedoch bei der Analyse von Kunststoffen wegen des Mangels an matrixangepassten zertifizierten Referenzmaterialien nicht durchsetzen konnte. Vorherige Arbeiten belegen polymerabhängige Abtragsraten. Das oft als interner Standard verwendete Intensitätssignal des Kohlenstoffisotopes 13C zur Korrektur dieser Unterschiede wird in der Literatur kritis...

  6. Der Entwurf einer Musterwohnung für ältere Menschen mit Demenz

    NARCIS (Netherlands)

    Joost van Hoof

    2014-01-01

    Einführung Ältere Menschen mit Demenz brauchen Wohnungen, die sowohl altersgemäß ausgestattet sind als auch die erforderliche Pflege im Haus anbieten. Traditionelle Änderungen und entsprechende Technologien bieten in erster Linie Lösungen für Personen mit eingeschränkter Mobilität. Dies bedeutet,

  7. Klinische Ergebnisse in der Behandlung der rezidivierenden respiratorischen Papillomatose mit Microdebrider, intraläsionaler Cidofovir-Injektion und Impfung mit Gardasil

    OpenAIRE

    Schäfer, Fabian Axel

    2013-01-01

    Die Rekurrierende Respiratorische Papillomatose (RRP) ist eine seltene Erkrankung, die Kinder, aber auch Erwachsene betrifft. Sie ist charakterisiert durch eine Proliferation benigner Plattenepithel-Papillome innerhalb des Aerodigestiv-Traktes mit dem Larynx als Prädilektionsstelle. Hervorgerufen wird die RRP durch eine orale Infektion mit Humanen Papillomviren (HPV) der Typen 6 oder 11. Bei aggressiven Verlaufsformen, die eine Vielzahl von Papillomabtragungen im Abstand von wenigen Monaten o...

  8. Parallelization Experience with Four Canonical Econometric Models Using ParMitISEM

    Directory of Open Access Journals (Sweden)

    Nalan Baştürk

    2016-03-01

    Full Text Available This paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm provides an automatic and flexible method to approximate a non-elliptical target density using adaptive mixtures of Student-t densities, where only a kernel of the target density is required. The approximation can be used as a candidate density in Importance Sampling or Metropolis Hastings methods for Bayesian inference on model parameters and probabilities. We present and discuss four canonical econometric models using a Graphics Processing Unit and a multi-core Central Processing Unit version of the MitISEM algorithm. The results show that the parallelization of the MitISEM algorithm on Graphics Processing Units and multi-core Central Processing Units is straightforward and fast to program using MATLAB. Moreover the speed performance of the Graphics Processing Unit version is much higher than the Central Processing Unit one.

  9. [R]MIT Research Centre at Delft University of Technology: A Bridge between Research, Education, Society and Profession

    Science.gov (United States)

    Zijlstra, Hielkje

    2009-01-01

    In 2006, we launched the [R]MIT Research Centre (Modification, Intervention Transformation) at the Faculty of Architecture at Delft University of Technology. [R]MIT was founded to respond to the need for an integrated, multi-disciplinary approach to the transformation of the built environment. [R]MIT aims to bring momentum to the renewal of…

  10. Immediate and early function of Brånemark System implants placed in the esthetic zone: a 1-year prospective clinical multicenter study.

    Science.gov (United States)

    Maló, Paulo; Friberg, Bertil; Polizzi, Giovanni; Gualini, Federico; Vighagen, Torbjörn; Rangert, Bo

    2003-01-01

    Immediate/early implant function means great benefits for patients and therapists because treatment time and cost can be substantially reduced. This concept has become an accepted alternative for complete arch fixed restorations in the mandible, and clinical documentation is emerging for other indications. The purpose of this prospective clinical multicenter study was to evaluate the outcome of implants placed in incisor, canine, and premolar regions in maxillas or mandibles. Implants were loaded with provisional crowns and bridges on the same day or within a few days and were followed up for 1 year during function. Four centers treated 76 patients each in need of an implant-retained prosthesis in the anterior and premolar regions in the maxilla or mandible. A total of 116 titanium implants with machined surfaces (Brånemark System , Nobel Biocare AB, Gothenburg, Sweden) were placed: 74 in maxillas and 42 in mandibles. Eighty-seven prostheses were made, of which 63 were single crowns and 24 were bridges (supported by 53 splinted implants). Twenty-two implants in 14 patients were placed in fresh extraction sites. The goal with the preparation and insertion technique was to achieve good primary implant stability and a minimum implant insertion torque of 30 Ncm before the implant was completely seated. The occlusion was adjusted to eliminate direct contact with the provisional prostheses. After 6 months, the patients received their permanent prostheses. Sixty-seven patients were followed for 1 year. Five implants were lost in five patients, three in the maxilla and two in the mandible. Four of the lost implants were single-tooth replacements and one was splinted. The cumulative survival rate (CSR) was 95.7% for all implants after 1 year and 93.7% and 98.1% for single-tooth and splinted implants, respectively. There were no implant losses in the extraction sites. The CSR of 96% at 1 year indicates that immediate function of Brånemark System implants placed in incisor

  11. Level of Discomfort Decreases After the Administration of Continuous Palliative Sedation: A Prospective Multicenter Study in Hospices and Palliative Care Units.

    Science.gov (United States)

    van Deijck, Rogier H P D; Hasselaar, Jeroen G J; Verhagen, Stans C A H H V M; Vissers, Kris C P; Koopmans, Raymond T C M

    2016-09-01

    A gold standard or validated tool for monitoring the level of discomfort during continuous palliative sedation (CPS) is lacking. Therefore, little is known about the course of discomfort in sedated patients, the efficacy of CPS, and the determinants of discomfort during CPS. To identify the course of discomfort in patients receiving CPS. A prospective observational multicenter study in nine hospices and palliative care units was performed. The Discomfort Scale-Dementia of Alzheimer Type (DS-DAT) was independently assessed for monitoring of patient discomfort during CPS. The DS-DAT scores range from 0 (no observed discomfort) to a maximum of 27 (high level of observed discomfort). Using a mixed model, the mean group score of discomfort between four predefined time frames of CPS was compared, correcting for confounding patient characteristics. A total of 130 patients were sedated, and the DS-DAT was completed in 106 patients at least once. The median duration of the sedation in these 106 patients was 25.5 hours (range 2-161). The mean score of the DS-DAT in the phase before sedation was 12.16 (95% CI 9.83-14.50) and decreased significantly to 8.06 (95% CI 5.53-10.58) in the titration phase of sedation. The mean score of the DS-DAT in the final phase of sedation was 7.42 (95% CI 4.90-9.94). This study shows that CPS is associated with a decrease in the level of discomfort within an acceptable time frame, although in some sedated patients higher levels of discomfort in the last hours of life occurred. Although the DS-DAT seems to be of value for monitoring the level of discomfort during CPS, the results of this study should be interpreted within the constraints of the limitations, and further research on the psychometric properties of this tool is needed before the DS-DAT can be used in clinical practice. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  12. The multicenter study of a new assay for simultaneous detection of multiple anti-aminoacyl-tRNA synthetases in myositis and interstitial pneumonia.

    Directory of Open Access Journals (Sweden)

    Ran Nakashima

    Full Text Available OBJECTIVE: Autoantibodies to aminoacyl-tRNA synthetases (ARSs are useful in the diagnosis of idiopathic inflammatory myopathy (IIM with interstitial pneumonia (IP. We developed an enzyme-linked immunosorbent assay (ELISA system using a mixture of recombinant ARS antigens and tested its utility in a multicenter study. METHODS: We prepared six recombinant ARSs: GST-Jo-1, His-PL-12, His-EJ and GST-KS expressed in Escherichia coli, and His-PL-7 and His-OJ expressed in Hi-5 cells. After confirming their antigenic activity, with the exception of His-OJ, we developed our ELISA system in which the five recombinant ARSs (without His-OJ were mixed. Efficiency was confirmed using the sera from 526 Japanese patients with connective tissue disease (CTD (IIM n = 250, systemic lupus erythematosus n = 91, systemic sclerosis n = 70, rheumatoid arthritis n = 75, Sjögren's syndrome n = 27 and other diseases n = 13, 168 with idiopathic interstitial pneumonia (IIP and 30 healthy controls collected from eight institutes. IIPs were classified into two groups; idiopathic pulmonary fibrosis (IPF (n = 38 and non-IPF (n = 130. RESULTS were compared with those of RNA immunoprecipitation. RESULTS: Sensitivity and specificity of the ELISA were 97.1% and 99.8%, respectively when compared with the RNA immunoprecipitation assay. Anti-ARS antibodies were detected in 30.8% of IIM, 2.5% of non-myositis CTD, and 10.7% of IIP (5.3% of IPF and 12.3% of non-IPF. Anti-ARS-positive non-IPF patients were younger and more frequently treated with glucocorticoids and/or immunosuppressants than anti-ARS-negative patients. CONCLUSION: A newly established ELISA detected anti-ARS antibodies as efficiently as RNA immunoprecipitation. This system will enable easier and wider use in the detection of anti-ARS antibodies in patients with IIM and IIP.

  13. A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument.

    Science.gov (United States)

    Wilson, Philip L; Newton, Peter O; Wenger, Dennis R; Haher, Thomas; Merola, Andrew; Lenke, Larry; Lowe, Thomas; Clements, David; Betz, Randy

    2002-09-15

    A multicenter study examining the association between radiographic and outcomes measures in adolescent idiopathic scoliosis. To evaluate the association between an objective radiographic scoring system and patient quality of life measures as determined by the Scoliosis Research Society outcomes instrument. Although surgical correction of scoliosis has been reported to be positively correlated with patient outcomes, studies to date have been unable to demonstrate an association between radiographic measures of deformity and outcomes measures in patients with adolescent idiopathic scoliosis. A standardized radiographic deformity scoring system and the Scoliosis Research Society outcome tool were used prospectively in seven scoliosis centers to collect data on patients with adolescent idiopathic scoliosis. A total of 354 data points for 265 patients consisting of those with nonoperative or preoperative curves >or=10 degrees, as well as those with surgically treated curves, were analyzed. Correlation analysis was performed to identify significant relationships between any of the radiographic measures, the Harms Study Group radiographic deformity scores (total, sagittal, coronal), and the seven Scoliosis Research Society outcome domains (Total Pain, General Self-Image, General Function, Activity, Postoperative Self-Image, Postoperative Function, and Satisfaction) as well as Scoliosis Research Society outcomes instrument total scores. Radiographic measures that were identified as significantly correlated with Scoliosis Research Society outcome scores were then entered into a stepwise regression analysis. The coronal measures of thoracic curve and lumbar curve magnitude were found to be significantly correlated with the Total Pain, General Self-Image, and total Scoliosis Research Society scores (P Society domain and total scores. No radiographic measures taken after surgery were significantly correlated with the postoperative domains of the Scoliosis Research Society

  14. OUTCOME OF FRONTLINE TREATMENT WITH “GENERIC” IMATINIB IN ADULT PATIENTS WITH CHRONIC MYELOID LEUKEMIA IN ALGERIAN POPULATION: A MULTICENTER STUDY

    Directory of Open Access Journals (Sweden)

    Mohamed Amine BEKADJA

    2017-10-01

    Full Text Available Introduction: In a developing country like Algeria, such expensive therapy is not available. Alternative approaches are needed to help these adult. In Algeria ‘imatib’ (CIPLA-India was introduced in 2006; but no study has been published yet in the North Africa region regarding response and outcome of this copy in CML patients. The goal of this multicenter study is to characterize newly adult CML in the western region of Algeria and to assess the effectiveness and safety of imatib (IM, copy as frontline therapy for patients with CML. Patients and Methods: The study was carried out in 7 hematology centers in the western Algeria. Patients, who were diagnosed to be suffering from CML between January 1st, 2007 and  December 31st, 2014 were selected for data analysis. All patients received a copy preparation, consisting of the alpha crystal form of imatinib, (IM, copy at a oral dose of 400 mg daily and monitored for tolerance and side effects while on therapy. Results: Between January 2007 and December 2014, 355 patients with CML were treated with imatib (Copy. The median follow- up of the study was 46 months (range: 13–107 months. Complete hematological response (CHR was seen in 83% of patients within 3 months. According to the Sokal score, 72% patients with low, 78% with intermediate and 69% with high risk disease achieved a CHR in 3 months (p=0.26 and according to the EUTOS score, 81% of patients with low and 70% with high risk disease achieved a CHR in 3 months (p=0.08. The major molecular response (MMR at six months (M6, M9, M12, M18 and M24 was 21%, 38%, 35%, 51% and 67% respectively and 34% of patients achieved a complete molecular response (CMR. The projected 5-year overall survival (OS rate was 83%. Side effects of imatib (copy in this study were similar to those reported previously for the entire imatinib mesylate treatment study and only 8% of patients were intolerant to imatib (copy and treated with a second generation of BCR

  15. The Burden of Provider-Initiated Preterm Birth and Associated Factors: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP.

    Directory of Open Access Journals (Sweden)

    Renato T Souza

    Full Text Available About 15 million children are born under 37 weeks of gestation worldwide. Prematurity is the leading cause of neonatal deaths and short/long term morbidities, entailing consequences not only for the individual, but also their family, health agencies, facilities and all community. The provider-initiated preterm birth is currently one of the most important obstetric conditions related to preterm births, particularly in middle and high income countries, thus decreasing the need for therapeutic preterm birth is essential to reduce global prematurity. Therefore detailed knowledge on the factors associated with provider-initiated preterm birth is essential for the efforts to reduce preterm birth rates and its consequences. In this current analysis we aimed to assess the proportion of provider-initiated (pi-PTB among preterm births in Brazil and identify associated factors.This is an analysis of a multicenter cross-sectional study with a nested case-control component called Brazilian Multicenter Study on Preterm Birth (EMIP. EMIP was conducted in 20 referral obstetric hospitals located in the three most populated of the five Brazilian regions. We analysed data of women with pi-PTB, defined as childbirth occurring at less than 37 weeks, medically indicated for maternal/fetal compromise or both; and women with term birth, childbirth at or after 37 weeks. Maternal, sociodemographic, obstetric, prenatal care, delivery, and postnatal characteristics were assessed as possible factors associated with pi-PTB, compared to term births. The overall prevalence of preterm births was 12.3%. Of these, approximately one-third of cases were initiated by the provider. Hypertensive disorders, placental abruption, and diabetes were the main maternal conditions leading to pi-PTB. Caesarean section was the most common mode of delivery. Chronic hypertension (OR 7.47; 95%CI 4.02-13.88, preeclampsia/eclampsia/HELLP syndrome (OR 15.35; 6.57-35.88, multiple pregnancy (OR 12

  16. Prospective, randomized multicenter study of cervical arthroplasty versus anterior cervical discectomy and fusion: 5-year results with a metal-on-metal artificial disc.

    Science.gov (United States)

    Coric, Domagoj; Guyer, Richard D; Nunley, Pierce D; Musante, David; Carmody, Cameron; Gordon, Charles; Lauryssen, Carl; Boltes, Margaret O; Ohnmeiss, Donna D

    2018-03-01

    OBJECTIVE Seven cervical total disc replacement (TDR) devices have received FDA approval since 2006. These devices represent a heterogeneous assortment of implants made from various biomaterials with different biomechanical properties. The majority of these devices are composed of metallic endplates with a polymer core. In this prospective, randomized multicenter study, the authors evaluate the safety and efficacy of a metal-on-metal (MoM) TDR (Kineflex|C) versus anterior cervical discectomy and fusion (ACDF) in the treatment of single-level spondylosis with radiculopathy through a long-term (5-year) follow-up. METHODS An FDA-regulated investigational device exemption (IDE) pivotal trial was conducted at 21 centers across the United States. Standard validated outcome measures including the Neck Disability Index (NDI) and visual analog scale (VAS) for assessing pain were used. Patients were randomized to undergo TDR using the Kineflex|C cervical artificial disc or anterior cervical fusion using structural allograft and an anterior plate. Patients were evaluated preoperatively and at 6 weeks and 3, 6, 12, 24, 36, 48, and 60 months after surgery. Serum ion analysis was performed on a subset of patients randomized to receive the MoM TDR. RESULTS A total of 269 patients were enrolled and randomly assigned to undergo either TDR (136 patients) or ACDF (133 patients). There were no significant differences between the TDR and ACDF groups in terms of operative time, blood loss, or length of hospital stay. In both groups, the mean NDI scores improved significantly by 6 weeks after surgery and remained significantly improved throughout the 60-month follow-up (both p < 0.01). Similarly, VAS pain scores improved significantly by 6 weeks and remained significantly improved through the 60-month follow-up (both p < 0.01). There were no significant changes in outcomes between the 24- and 60-month follow-ups in either group. Range of motion in the TDR group decreased at 3 months but

  17. TU-AB-BRA-05: Repeatability of [F-18]-NaF PET Imaging Biomarkers for Bone Lesions: A Multicenter Study

    International Nuclear Information System (INIS)

    Lin, C; Bradshaw, T; Perk, T; Harmon, S; Jeraj, R; Liu, G

    2015-01-01

    Purpose: Quantifying the repeatability of imaging biomarkers is critical for assessing therapeutic response. While therapeutic efficacy has been traditionally quantified by SUV metrics, imaging texture features have shown potential for use as quantitative biomarkers. In this study we evaluated the repeatability of quantitative "1"8F-NaF PET-derived SUV metrics and texture features in bone lesions from patients in a multicenter study. Methods: Twenty-nine metastatic castrate-resistant prostate cancer patients received whole-body test-retest NaF PET/CT scans from one of three harmonized imaging centers. Bone lesions of volume greater than 1.5 cm"3 were identified and automatically segmented using a SUV>15 threshold. From each lesion, 55 NaF PET-derived texture features (including first-order, co-occurrence, grey-level run-length, neighbor gray-level, and neighbor gray-tone difference matrix) were extracted. The test-retest repeatability of each SUV metric and texture feature was assessed with Bland-Altman analysis. Results: A total of 315 bone lesions were evaluated. Of the traditional SUV metrics, the repeatability coefficient (RC) was 12.6 SUV for SUVmax, 2.5 SUV for SUVmean, and 4.3 cm"3 for volume. Their respective intralesion coefficients of variation (COVs) were 12%, 17%, and 6%. Of the texture features, COV was lowest for entropy (0.03%) and highest for kurtosis (105%). Lesion intraclass correlation coefficient (ICC) was lowest for maximum correlation coefficient (ICC=0.848), and highest for entropy (ICC=0.985). Across imaging centers, repeatability of texture features and SUV varied. For example, across imaging centers, COV for SUVmax ranged between 11–23%. Conclusion: Many NaF PET-derived SUV metrics and texture features for bone lesions demonstrated high repeatability, such as SUVmax, entropy, and volume. Several imaging texture features demonstrated poor repeatability, such as SUVtotal and SUVstd. These results can be used to establish response criteria

  18. Computer-assisted system for diagnosing degenerative dementia using cerebral blood flow SPECT and 3D-SSP. A multicenter study

    International Nuclear Information System (INIS)

    Ishii, Kazunari; Ito, Kengo; Nakanishi, Atsushi; Kitamura, Shin; Terashima, Akira

    2014-01-01

    Due to increasing numbers of patients with dementia, more physicians who do not specialize in brain nuclear medicine are being asked to interpret SPECT images of cerebral blood flow. We conducted a multicenter study to determine whether a computer-assisted diagnostic system Z-score summation analysis method (ZSAM) using three-dimensional stereotactic surface projections (3D-SSP) can differentiate Alzheimer's disease (AD)/dementia with Lewy bodies (DLB) and non-AD/DLB in institutions using various types of gamma cameras. We determined the normal thresholds of Z-sum (summed Z-score) within a template region of interest for each single photon emission computed tomography (SPECT) device and then compared them with the Z-sums of patients and calculated the accuracy of the differential diagnosis by ZSAM. We compared the diagnostic accuracy between ZSAM and visual assessment. We enrolled 202 patients with AD (mean age, 76.8 years), 40 with DLB (mean age 76.3 years) and 36 with non-AD/DLB (progressive supranuclear palsy, n=10; frontotemporal dementia, n=20; slowly progressive aphasia, n=2 and one each with idiopathic normal pressure hydrocephalus, corticobasal degeneration, multiple system atrophy and Parkinson's disease) who underwent N-isopropyl-p-[ 123 I] iodoamphetamine cerebral blood flow SPECT imaging at each participating institution. The ZSAM sensitivity to differentiate between AD/DLB and non-AD/DLB in all patients, as well as those with mini-mental state examination scores of ≥24 and 20-23 points were 88.0, 78.0 and 88.4%, respectively, with specificity of 50.0, 44.4 and 60.0%, respectively. The diagnostic accuracy rates were 83.1, 72.9 and 84.2%, respectively. The areas under receiver operating characteristics curves for visual inspection by four expert raters were 0.74-0.84, 0.66-0.85 and 0.81-0.93, respectively, in the same patient groups. The diagnostic accuracy rates were 70.9-89.2%, 50.9-84.8% and 76.2-93.1%, respectively. The diagnostic

  19. Health-related quality of life assessment in people with multiple sclerosis and their family caregivers. A multicenter study in Catalonia (Southern Europe

    Directory of Open Access Journals (Sweden)

    Marta Aymerich

    2009-10-01

    Full Text Available Marta Aymerich1, Imma Guillamón2, Albert J Jovell3,41Medical Sciences Department, University of Girona, Catalonia, Spain; 2Catalan Agency for Health Technology Assessment and Research, Barcelona, Catalonia, Spain; 3Fundació Biblioteca Josep Laporte, Barcelona, Catalonia, Spain; 4Autonomous University of Barcelona, Catalonia, SpainObjectives: To measure the health-related quality of life (HRQoL of multiple sclerosis (MS patients and their caregivers, and to assess which factors can best describe HRQoL.Methods: A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL.Results: A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS and 551 caregivers (mean age 45.4 years participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1–40.6; mental SF-36: 44.4; 95% CI: 43.5–45.3. Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5–47.3. Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL.Conclusions: Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers’ HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context.Keywords: health-related quality of life, multiple sclerosis

  20. Antenatal allopurinol for reduction of birth asphyxia induced brain damage (ALLO-Trial; a randomized double blind placebo controlled multicenter study

    Directory of Open Access Journals (Sweden)

    von Lindern Jeannette

    2010-02-01

    Full Text Available Abstract Background Hypoxic-ischaemic encephalopathy is associated with development of cerebral palsy and cognitive disability later in life and is therefore one of the fundamental problems in perinatal medicine. The xanthine-oxidase inhibitor allopurinol reduces the formation of free radicals, thereby limiting the amount of hypoxia-reperfusion damage. In case of suspected intra-uterine hypoxia, both animal and human studies suggest that maternal administration of allopurinol immediately prior to delivery reduces hypoxic-ischaemic encephalopathy. Methods/Design The proposed trial is a randomized double blind placebo controlled multicenter study in pregnant women at term in whom the foetus is suspected of intra-uterine hypoxia. Allopurinol 500 mg IV or placebo will be administered antenatally to the pregnant woman when foetal hypoxia is suspected. Foetal distress is being diagnosed by the clinician as an abnormal or non-reassuring foetal heart rate trace, preferably accompanied by either significant ST-wave abnormalities (as detected by the STAN-monitor or an abnormal foetal blood scalp sampling (pH Primary outcome measures are the amount of S100B (a marker for brain tissue damage and the severity of oxidative stress (measured by isoprostane, neuroprostane, non protein bound iron and hypoxanthine, both measured in umbilical cord blood. Secondary outcome measures are neonatal mortality, serious composite neonatal morbidity and long-term neurological outcome. Furthermore pharmacokinetics and pharmacodynamics will be investigated. We expect an inclusion of 220 patients (110 per group to be feasible in an inclusion period of two years. Given a suspected mean value of S100B of 1.05 ug/L (SD 0.37 ug/L in the placebo group this trial has a power of 90% (alpha 0.05 to detect a mean value of S100B of 0.89 ug/L (SD 0.37 ug/L in the 'allopurinol-treated' group (z-test2-sided. Analysis will be by intention to treat and it allows for one interim analysis

  1. Quality of life in women undergoing urinary diversion for bladder cancer: results of a multicenter study among long-term disease-free survivors.

    Science.gov (United States)

    Gacci, Mauro; Saleh, Omar; Cai, Tommaso; Gore, John L; D'Elia, Carolina; Minervini, Andrea; Masieri, Lorenzo; Giannessi, Claudia; Lanciotti, Michele; Varca, Virginia; Simonato, Alchiede; Serni, Sergio; Carmignani, Giorgio; Carini, Marco

    2013-03-12

    Women undergoing radical cystectomy (RC) and urinary diversion for bladder cancer experience substantial limitations in health-related quality of life (HRQOL). However, the level of discomfort caused by different urinary diversion has been never evaluated in long term survivors. The aim of this multicenter study is to evaluate differences in HRQOL among recurrence-free women undergoing cutaneous ureterostomy (CUS), Bricker's ileal conduit (BK-IC) and Orthotopic neobladder VIP (ONB-VIP) in disease-free females treated with radical cystectomy (RC), with long-term follow up (mean 60.1 months; range 36-122 months). All consecutively treated female patients from two urological institutions who underwent RC and urinary diversion from January 2000 to December 2008, with no evidence of tumor recurrence at a minimum follow up of 36 months, were included. Patients received the European Organisation for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer-specific instruments (QLQ-BLM30) and the Functional Assessment of Cancer Therapy for Bladder Cancer (FACT-BL). Clinical data and questionnaire results were analyzed in order to evaluate the HRQOL differences among diversion groups. We identified 37 females (median age: 68, range 45-82 years), including 12 status-post CUS, 16 who underwent BK-IC, and 9 who underwent ONB-VIP. Most were healthy (24/37 with no comorbidities, 4/37 Charlson 1-2, 9/37 Charlson 3 or greater - we didn't considered bladder cancer in Charlson evaluation because bladder cancer was the main inclusion criteria). Women undergoing CUS endorsed worse FACT-BL scores compared with BK-IC and ONB-VIP patients, worse HRQOL regarding physical and emotional well-being (p=0.008 and p=0.02, respectively), and a trend toward worse EORTC QLQ-C30 scores for appetite loss and fatigue (p=0.05 for both). In our study long-term disease-free females treated with CUS endorsed worse HRQOL compared with women who underwent BK-IC or ONB-VIP, mostly due

  2. Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study

    Energy Technology Data Exchange (ETDEWEB)

    Ruella, Marco [Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino (Italy); Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia (United States); Filippi, Andrea Riccardo [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy); Bruna, Riccardo [Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino (Italy); Di Russo, Anna [Radiation Oncology, Istituto Nazionale Tumori, Milano (Italy); Magni, Michele [Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy); Caracciolo, Daniele [Division of Haematology, San Giovanni Battista Hospital and University of Torino, Torino (Italy); Passera, Roberto [Division of Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Torino (Italy); Matteucci, Paola; Di Nicola, Massimo [Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy); Corradini, Paolo [Division of Haematology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy); Parvis, Guido [Division of Haematology, San Luigi Gonzaga Hospital, Orbassano, Torino (Italy); Gini, Guido; Olivieri, Attilio [Division of Haematology, Ospedali Riuniti, Ancona (Italy); Ladetto, Marco [Division of Haematology, San Giovanni Battista Hospital and University of Torino, Torino (Italy); Ricardi, Umberto [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy); Tarella, Corrado, E-mail: corrado.tarella@gmail.com [Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino (Italy); Hemato-Oncology Division, European Institute of Oncology, Milano (Italy); Devizzi, Liliana [Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy)

    2016-03-15

    Purpose: Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. Methods and Materials: Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab courses (375 mg/m{sup 2}, days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. Results: At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. Conclusions: This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.

  3. Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study

    International Nuclear Information System (INIS)

    Ruella, Marco; Filippi, Andrea Riccardo; Bruna, Riccardo; Di Russo, Anna; Magni, Michele; Caracciolo, Daniele; Passera, Roberto; Matteucci, Paola; Di Nicola, Massimo; Corradini, Paolo; Parvis, Guido; Gini, Guido; Olivieri, Attilio; Ladetto, Marco; Ricardi, Umberto; Tarella, Corrado; Devizzi, Liliana

    2016-01-01

    Purpose: Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. Methods and Materials: Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab courses (375 mg/m"2, days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. Results: At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. Conclusions: This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.

  4. Criteria for the successful completion of medical dissertations - A multicenter study [Kriterien für den erfolgreichen Abschluss medizinischer Dissertationen – eine multizentrische Studie

    Directory of Open Access Journals (Sweden)

    Harendza, Sigrid

    2010-05-01

    erfolgreiche Durchführung sind bisher trotz der weitreichenden Konsequenzen nur unzureichend untersucht. Methode: Mit Hilfe eines Fragebogens wurden 2003 insgesamt 467 Studierende im 9. Semester an fünf deutschen Universitäten untersucht (Rücklaufquote 93.5%. Untersuchte Inhalte betrafen eine aktuelle oder bereits fertig gestellte Doktorarbeit (Gruppe A, eine abgebrochene Doktorarbeit (Gruppe B oder den Nicht-Beginn einer Doktorarbeit (Gruppe C. Ergebnisse: Im Gruppenvergleich gaben Studierende der Gruppe A signifikant häufiger die „Person des Betreuers“ als wesentlich für die Wahl des Themas der Doktorarbeit an. Außerdem arbeiteten Studierende der Gruppe A signifikant häufiger mit anderen Studierenden in selbst organisierten Arbeitsgruppen zusammen, um sich gegenseitig bei methodischen Fragestellungen Hilfestellung zu geben. Die Studierenden der Gruppe A besprachen ihre Arbeit signifikant häufiger mit einem Statistiker. Für den Nicht-Beginn einer Arbeit gaben Studierende der Gruppe C die „Beeinträchtigung des Studiums durch die Dissertation“ und „keine Zeit“ als häufigste Gründe an. Schlussfolgerung: Der Betreuer scheint eine Schlüsselfunktion für den erfolgreichen Abschluss einer Dissertation darzustellen, weswegen Universitäten über professionelle Weiterbildungsprogramme nachdenken sollten, um die Betreuer auf diese Aufgabe speziell vorzubereiten. Begleitende Kurse für Doktoranden in Forschungsmethodik könnten ebenfalls eine nützliche Methode sein, um wissenschaftliche Projekte oder medizinische Doktorarbeiten erfolgreich zu beenden.

  5. Predicting material failure using mathematics; Mit Mathematik Materialversagen vorhersagen

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Christian [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany)

    2016-06-15

    Numerical simulations provide insights into materials, technical procedures or processes that are hardly possible by means of measurement technology, or require a lot of effort. In BAM's ConDrop research project (Numerical Drop Test Analyses of Steel Sheet Containers for the Konrad Repository), scientists are developing a method to predict the deformation and failure behaviour of containers for low- and intermediate- level radioactive waste for the Konrad repository. [German] Numerische Simulationen erlauben Einblicke in Materialien, technische Verfahren oder Prozesse, die mit Mitteln der Messtechnik kaum oder nur unter grossem Aufwand moeglich sind. Im BAM-Forschungsvorhaben ConDrop entwickeln Wissenschaftlerinnen und Wissenschaftler damit eine Methode, um das Verformungs- und Versagensverhalten von Behaeltern fuer schwach- und mittelradioaktive Abfaelle fuer das Endlager Konrad vorherzusagen.

  6. Operating experience with innovative environmental technologies; Betriebserfahrungen mit innovativen Umwelttechnologien

    Energy Technology Data Exchange (ETDEWEB)

    Spindler, H.; Bauermeister, U.; Kliche, H.; Seiffarth, K. (comps.)

    2000-03-01

    The MUT '99 (Merseburger Umwelt-Tag) discussed modern processes, technologies and plants for treatment and utilisation of waste. The conference was attended by industrial organisations and scientific institutions. [German] Der 9. Merseburger Umwelt-Tag MUT '99 steht unter dem Motto 'Betriebserfahrungen mit innovativen Umwelttechnologien - Moderne wirtschaftliche Verfahren, Technologien und Anlagen zur Behandlung/Verwertung nichtvermeidbaren Abfalls', wobei der Begriff 'Abfall' sich letztlich auf alle Umweltmedien bezieht. Entsprechend dem Motto dieser Tagung stellen Unternehmen, Betriebe und wissenschaftliche Einrichtungen ihre Erfahrungen auf dem Gebiet der Umwelttechnologien vor, um Entwicklungen auf diesem Gebiet einer breiten Diskussion zu eroeffnen. Dabei soll es insbesondere um die Behandlung nicht vermeidbarer Abfaelle und Abwaesser gehen. (orig.)

  7. LLIMAS: Revolutionizing integrating modeling and analysis at MIT Lincoln Laboratory

    Science.gov (United States)

    Doyle, Keith B.; Stoeckel, Gerhard P.; Rey, Justin J.; Bury, Mark E.

    2017-08-01

    MIT Lincoln Laboratory's Integrated Modeling and Analysis Software (LLIMAS) enables the development of novel engineering solutions for advanced prototype systems through unique insights into engineering performance and interdisciplinary behavior to meet challenging size, weight, power, environmental, and performance requirements. LLIMAS is a multidisciplinary design optimization tool that wraps numerical optimization algorithms around an integrated framework of structural, thermal, optical, stray light, and computational fluid dynamics analysis capabilities. LLIMAS software is highly extensible and has developed organically across a variety of technologies including laser communications, directed energy, photometric detectors, chemical sensing, laser radar, and imaging systems. The custom software architecture leverages the capabilities of existing industry standard commercial software and supports the incorporation of internally developed tools. Recent advances in LLIMAS's Structural-Thermal-Optical Performance (STOP), aeromechanical, and aero-optical capabilities as applied to Lincoln prototypes are presented.

  8. Mitä uutta Oulun ravintolatarjontaan? : markkinatutkimus uutta ravintolaa ajatellen

    OpenAIRE

    Korhonen, Kerttu

    2014-01-01

    Tämä opinnäytetyö käsittelee Oulun alueelle tehtävää markkinatutkimusta nuorten ravintolakäyttäytymisestä ja – toiveista. Tutkimuskysymys kuuluu: ”Millaista uutta ravintolaa nuoret kaipaavat Oulun ravintolamaailmaan?”. Tutkimus on tehty ajatellen uuden ravintolan perustamista. Markkinatutkimuksella selvitetään opiskelevien nuorten toiveita siitä, mitä hyvä ravintola pitää sisällään. Tutkimuksen avulla selvitetään myös kuinka paljon nuoret käyttävät rahaa ravintolakäynneillään sekä sitä, kuink...

  9. Plattenepithelkarzinom in Verbindung mit einer roten Tätowierung.

    Science.gov (United States)

    Schmitz, Inge; Prymak, Oleg; Epple, Matthias; Ernert, Carsten; Tannapfel, Andrea

    2016-06-01

    Obwohl Tätowierungen in den letzten Jahren außerordentlich beliebt geworden sind, wurde in der Literatur bisher nur über wenige Fälle schwerer Reaktionen berichtet, die zu einer malignen Transformation führten. Dies steht im Kontrast zu der praktisch unüberschaubaren Zahl an Tätowierungen weltweit. Die Zusammensetzung der für Tätowierungen verwendeten Farbstoffe variiert stark, und selbst gleiche Farbtöne können unterschiedliche Komponenten enthalten. Das Ziel unserer Studie war es zu untersuchen, auf welche Weise Tätowierungen möglicherweise Hautkrebs auslösen können. Wir berichten über den seltenen Fall einer 24-jährigen Frau, bei der sich sieben Monate nachdem sie eine Tätowierung auf dem Fußrücken erhalten hatte in unmittelbarer Nähe des verwendeten roten Farbstoffs ein Plattenepithelkarzinom entwickelte. Die Komplikationen begannen mit einer unspezifischen Schwellung. Die Läsion wurde histologisch untersucht. Die Zusammensetzung des inkorporierten Farbstoffs wurde mittels Rasterelektronenmikroskopie in Kombination mit energiedispersiver Elementanalyse analysiert. Zur weiteren Charakterisierung wurden Thermogravimetrie und Pulverdiffraktometrie eingesetzt. Der Tätowierungsfarbstoff enthielt hauptsächlich Bariumsulfat; Spuren von Al, S, Ti, P, Mg und Cl ließen sich ebenfalls nachweisen. Bei der Analyse zeigten sich Pigmentgranula unterschiedlicher Größe. In seltenen Fällen kann Tätowierungstinte karzinogene Effekte haben, die multifaktoriell zu sein scheinen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  10. MiT family translocation renal cell carcinoma.

    Science.gov (United States)

    Argani, Pedram

    2015-03-01

    The MiT subfamily of transcription factors includes TFE3, TFEB, TFC, and MiTF. Gene fusions involving two of these transcription factors have been identified in renal cell carcinoma (RCC). The Xp11 translocation RCCs were first officially recognized in the 2004 WHO renal tumor classification, and harbor gene fusions involving TFE3. The t(6;11) RCCs harbor a specific Alpha-TFEB gene fusion and were first officially recognized in the 2013 International Society of Urologic Pathology (ISUP) Vancouver classification of renal neoplasia. These two subtypes of translocation RCC have many similarities. Both were initially described in and disproportionately involve young patients, though adult translocation RCC may overall outnumber pediatric cases. Both often have unusual and distinctive morphologies; the Xp11 translocation RCCs frequently have clear cells with papillary architecture and abundant psammomatous bodies, while the t(6;11) RCCs frequently have a biphasic appearance with both large and small epithelioid cells and nodules of basement membrane material. However, the morphology of these two neoplasms can overlap, with one mimicking the other. Both of these RCCs underexpress epithelial immunohistochemical markers like cytokeratin and epithelial membrane antigen (EMA) relative to most other RCCs. Unlike other RCCs, both frequently express the cysteine protease cathepsin k and often express melanocytic markers like HMB45 and Melan A. Finally, TFE3 and TFEB have overlapping functional activity as these two transcription factors frequently heterodimerize and bind to the same targets. Therefore, on the basis of clinical, morphologic, immunohistochemical, and genetic similarities, the 2013 ISUP Vancouver classification of renal neoplasia grouped these two neoplasms together under the heading of "MiT family translocation RCC." This review summarizes our current knowledge of these recently described RCCs. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Pathophysiologie des Kollagenstoffwechsels bei Patienten mit Induratio penis plastica (IPP

    Directory of Open Access Journals (Sweden)

    Lahme S

    2000-01-01

    Full Text Available Die Pathogenese der IPP ist bis heute nicht geklärt. Histopathologische Untersuchungen zeigen, daß der Kollagenstoffwechsel eine Rolle spielt. Dies veranlaßte uns zur genauen Analyse der Kollagenstoffwechselparameter bei IPP. Bei 11 Patienten mit IPP und 11 Kontrollpersonen wurden Kollagenstoffwechselparameter (Prokollagen III [PIIIP], PMN-Elastase [PMN-E], Fibronektin [FN], Fibronektinrezeptor [FN-R] und alpha1-Proteinase-Inhibitor [alpha1-PI] im cavernösen und peripheren Blut bestimmt. PMN-E, PIIIP, FN und FN-R waren in den beiden Untersuchungsgruppen nicht unterschiedlich. Die peripher venösen unterschieden sich nicht von den cavernösen Blutproben. Sowohl im peripher venös (158,55 mg/dl als auch im cavernös entnommenen Blut (168,29 mg/dl war die Konzentration des a1-PI signifikant niedriger als in der Kontrollgruppe (214,82 mg/dl. An einem zweiten Kollektiv von 23 Patienten wurden Analysen des Phänotyps für alpha1-PI im Hinblick auf das Vorliegen von genetisch determinierten Mangelallelen vorgenommen. Hier zeigte sich kein signifikanter Unterschied zu einem Kontrollkollektiv von 19 gesunden Probanden. Die alpha1-PI Erniedrigung der IPP-Patienten ist signifikant und liegt unterhalb des Normalwertbereichs für die gesunde Population. Ein Mangel an alpha1-PI kann zur Aktivitätserhöhung der Proteasen und zum Umbau des Kollagengewebes führen. Möglicherweise kommt es zusammen mit einem lokal wirksamen Einflußfaktor schließlich zur dystrophen Kalzifikation. Die humangenetischen Untersuchungen sprechen nicht für eine genetische Determinierung des alpha1-PI-Mangels, sondern legen eine erworbene hepatische Störung nahe.

  12. Rekonstruktion mit Netz beim komplexen Prolaps der Frau: Was hilft es der Patientin wirklich?

    Directory of Open Access Journals (Sweden)

    Hierl J

    2010-01-01

    Full Text Available Einleitung: Der komplexe Genitaldeszensus der Frau geht oftmals mit einer deutlichen Einschränkung der Lebensqualität (LQ einher. Dennoch ist der Endpunkt der meisten klinischen Analysen rein anatomischer und funktioneller Natur. In der vorliegenden Untersuchung wurden die Einflüsse der operativen Rekonstruktion mit einem Netz prospektiv auf die LQ evaluiert. Patienten und Methoden: Bei insgesamt 111 Patientinnen mit Deszensus erfolgte zwischen 08/2005 und 12/2007 eine operative Versorgung mittels vaginaler Netzeinlage (anteriorer bzw. kompletter Mesh-Repair. Die LQ wurde prospektiv prä- und postoperativ anhand standardisierter LQ-Fragebögen erfasst. Ergebnisse: Präoperativ zeigte sich bei den Patientinnen eine signifikant reduzierte LQ gegenüber einem Normalkollektiv (p 0,01. Bei 7 % der Patientinnen mit anteriorem, und bei 11 % mit komplettem Mesh-Repair lag postoperativ kein adäquates klinisches Ergebnis vor. In diesem Kollektiv zeigte sich kein signifikanter Unterschied in den LQ-Tests prä- und postoperativ. Bei gutem postoperativem Ergebnis zeigte sich in der Gruppe mit anteriorer Netzeinlage lediglich bei 45 % (p = 0,021, bei kompletter Netzeinlage nur bei 31 % (p = 0,041 eine signifikant verbesserte LQ. Bei kleiner Fallzahl und kurzem Nachbeobachtungszeitraum kann eine gültige Aussage bezüglich der LQ nach Deszensuschirurgie mit Netzeinlage jedoch noch nicht getroffen werden.

  13. Evaluation of the MIT RMID 1000 system for the identification of Listeria species.

    Science.gov (United States)

    Ricardi, John; Haavig, David; Cruz, Lasaunta; Paoli, George; Gehring, Andrew

    2010-01-01

    The Micro Imaging Technology (MIT) 1000 Rapid Microbial Identification (RMID) System is a device that uses the principles of light scattering coupled with proprietary algorithms to identify bacteria after being cultured and placed in a vial of filtered water. This specific method is for pure culture identification of Listeria spp. A total of 81 microorganisms (55 isolates) were tested by the MIT 1000 System, of which 25 were Listeria spp. and 30 a variety of other bacterial species. In addition, a total of 406 tests over seven different ruggedness parameters were tested by the MIT 1000 System to determine its flexibility to the specifications stated in the MIT 1000 System User Guide in areas where they might be deviated by a user to shorten the test cycle. Overall, MIT concluded that the MIT 1000 System had an accuracy performance that should certify this Performance Test Method for the identification of Listeria spp. This report discusses the tests performed, results achieved, and conclusions, along with several reference documents to enable a higher understanding of the technology used by the MIT 1000 System.

  14. Gebrauch von Komplementärmedizin bei Patienten mit metastasierendem Melanom unter Therapie mit Ipilimumab innerhalb einer klinischen Studie.

    Science.gov (United States)

    Huebner, Jutta; Mohr, Peter; Simon, Jan-Christoph; Fluck, Michael; Berking, Carola; Zimmer, Lisa; Loquai, Carmen

    2016-05-01

    In Deutschland wenden 40-90 % aller Krebspatienten Methoden der komplementären and alternativen Medizin (KAM) an. Bis dato gibt es kein Datenmaterial zum Einsatz der KAM bei Melanompatienten. Das Ziel unserer Studie war es, Daten über den Gebrauch, die Informationsquellen und Ziele von Patienten mit metastasierendem Melanom zu erfassen. Einhundertsechsundfünfzig Patienten aus 25 Studienzentren nahmen an der DecOG-MM-PAL Multibasket Studie teil. Die beteiligten Personen wurden auch gebeten, an einer Nebenstudie teilzunehmen, die ihren Gebrauch von KAM erfassen sollte. Dazu wurde während der Behandlung ein standardisierter Fragebogen zu genau festgelegten Zeitpunkten ausgeteilt. Insgesamt gingen 55 Fragebögen von 32 (21 %) Melanompatienten ein. Von diesen gaben 17 (53 %) ein Interesse an KAM an, und sieben (22 %) machten von KAM Gebrauch. Die Hauptinformationsquellen (31 %) waren Familienmitglieder und Freunde, gefolgt von Ärzten (19 %). Die Hauptgründe für die Anwendung von KAM waren die Stärkung des Immunsystems (41 %) und des Körpers (34 %). Nahrungsergänzungsmittel (Vitamine und Spurenelemente) wurden am häufigsten angewendet (28 %). Eine relativ hohe Anzahl an Patienten mit metastasierendem Melanom machte trotz Teilnahme an einer klinischen Studie von KAM Gebrauch. Wechselwirkungen könnten durch biologisch basierte KAM auftreten, und hier besonders bei immunmodulierenden KAM- Strategien. Um Risiken zu vermeiden, sollte die Kommunikation zwischen den Ärzten und den Patienten verbessert werden. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  15. Skiing and snowboarding center at Bottrop; Mit Ski oder Snowboard runter von der Halde

    Energy Technology Data Exchange (ETDEWEB)

    Matthesius, M. [Lenze GmbH und Co KG, Hameln (Germany)

    2001-09-01

    The 'Alpincenter' at Bottrop is the biggest indoor winter sports center of the world. Its ventilation systems were equipped with specially selected frequency inverters. [German] Skifahren im Hochsommer? Mit dem Snowboard im Ruhrgebiet den Hang hinunter? Beste Wintersportverhaeltnisse an 365 Tagen im Jahr? Und das in Deutschland? Kein Problem. Seit Anfang des Jahres kommen in Bottrop Wintersportfreunde voll auf ihre Kosten. Nach einem halben Jahr Bauzeit hat das Alpincenter seine Pforten geoeffnet. Die Wintersporthalle ist die laengste Anlage auf der Welt. Die gesamte Belueftung wurde mit speziell auf die Klimatechnik (mit Drehzahl geregelten Ventilatoren) abgestimmten Frequenzumrichtern ausgeruestet. (orig./AKF)

  16. Estudio multicéntrico de fungemias por levaduras en la República Argentina Multicenter study of bloodstream infections due to yeasts in Argentina

    Directory of Open Access Journals (Sweden)

    L. Rodero

    2005-12-01

    Full Text Available La incidencia de candidemias aumentó aproximadamente en un 500% en hospitales de alta complejidad y se observó un cambio en la distribución de especies del género Candida, con un incremento de las levaduras no Candida albicans. Con el objeto de conocer la distribución de especies asociadas a fungemias por levaduras en Argentina y determinar su sensibilidad a los antifúngicos de uso convencional, se realizó un estudio multicéntrico durante el período abril 1999 a abril 2000. Participaron 36 instituciones del país. Se colectaron 265 aislamientos de levaduras provenientes de hemocultivos, que se identificaron utilizando pruebas morfológicas, fisiológicas y bioquímicas y la determinación de la concentración inhibitoria mínima se realizó en base al estándar del NCCLS. La distribución de especies fue: Candida albicans (40,75%, Candida parapsilosis (28,67%, Candida tropicalis (15,84%, Candida famata (3,77%, Cryptococcus neoformans (3,77%, Candida glabrata (2,64% y otras (4,53%. La mayoría de los aislamientos fueron sensibles a anfotericina B, fluconazol e itraconazol. La mortalidad asociada a las fungemias por levaduras estudiadas (n=265 fue del 30%, siendo más baja a lo descrito (33-54% y fue menor en los pacientes que recibieron tratamiento antifúngico (26,3%, que en los no tratados (47%.The incidence of candidemia has increased approximately 500% in high-complexity hospitals. A change in the spectrum of Candida infections due to species other than Candida albicans has also been detected. Between April 1999 and April 2000 a multicenter study was performed in order to determine the species distribution associated to candidemias in Argentina and the susceptibility profile of the isolates to the current antifungal drugs. Thirty six institutions have participated. All the 265 yeast strains isolated from blood cultures were identified by morphological, physiological, and biochemical tests. The antifungal susceptibility testing of

  17. Toward a standardized investigation protocol in sudden unexpected deaths in infancy in South Africa: a multicenter study of medico-legal investigation procedures and outcomes.

    Science.gov (United States)

    du Toit-Prinsloo, Lorraine; Dempers, Johan; Verster, Janette; Hattingh, Christa; Nel, Hestelle; Brandt, V D; Jordaan, Joyce; Saayman, Gert

    2013-09-01

    South Africa manifests a socio-economic dichotomy that shows features of both a developed and developing country. As a result of this, areas exist where a lack of resources and expertise prevents the implementation of a highly standardized protocol for the investigation of sudden and unexpected deaths in infants (SUDI). Although the medico-legal mortuaries attached to academic centers have the capacity to implement standardized protocols, a previous study conducted at two large medico-legal mortuaries indicated otherwise. This study also revealed that the exact number and incidence of sudden infant death syndrome (SIDS) cases was unknown. These findings prompted a multicenter study of the medico-legal investigation procedures and outcomes in five academic centers in South Africa. A retrospective case audit was conducted for a 5-year period (2005-2009) at medico-legal laboratories attached to universities in Bloemfontein, Cape Town-Tygerberg, Durban, Johannesburg, and Pretoria. The total case load as well as the total number of infants younger than 1 year of age admitted to these mortuaries was documented. The case files on all infants younger than 1 year of age who were admitted as sudden and unexpected or unexplained deaths were included in the study population. Data collected on the target population included demographic details, the nature and scope of the post-mortem examinations, as well as the final outcome (cause of death). A total case load of 80,399 cases were admitted to the mortuaries over the 5 year period with a total of 3,295 (6.5 %) infants. In the infant group, 591 (0.7 %) died from non-natural causes and 2,704 (3.3 %) cases of sudden, unexpected and/or unexplained deaths in infants were admitted and included in the detailed case analysis study. One hundred and ninety-nine babies were between 0 and 7 days of age and 210 babies between 8 and 30 days. The remaining 2,295 infants were between 1 month and 12 months of age. Death scene investigation was

  18. Real-time beam monitoring for error detection in IMRT plans and impact on dose-volume histograms. A multi-center study

    Energy Technology Data Exchange (ETDEWEB)

    Marrazzo, Livia; Arilli, Chiara; Casati, Marta [Careggi University Hospital, Medical Physic Unit, Florence (Italy); Pasler, Marlies [Lake Constance Radiation Oncology Center, Singen-Friedrichshafen (Germany); Kusters, Martijn; Canters, Richard [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Fedeli, Luca; Calusi, Silvia [University of Florence, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Talamonti, Cinzia; Pallotta, Stefania [Careggi University Hospital, Medical Physic Unit, Florence (Italy); University of Florence, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Simontacchi, Gabriele [Careggi University Hospital, Radiation Oncology Unit, Florence (Italy); Livi, Lorenzo [University of Florence, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Careggi University Hospital, Radiation Oncology Unit, Florence (Italy)

    2018-03-15

    ) ueberprueft. Des Weiteren wurde die Korrelation zwischen Detektorsignalaenderungen, verursacht durch kleine eingefuehrte Fehler, und anderen Parametern zur Bestimmung von Abweichungen zwischen berechneter und applizierter Dosisverteilung untersucht. Die Messungen mit dem Transmissionsdetektor wurden an drei Instituten durchgefuehrt. Sieben Fehlertypen wurden kuenstlich erzeugt und in neun klinischen S and S-IMRT-Plaenen (S and S: ''step-and-shoot'') induziert, indem die Anzahl der Monitoreinheiten (MU) sowie die Lamellenpositionen modifiziert wurden. Die Signalreproduzierbarkeit wurde fuer Kurz- und Langzeitstabilitaet untersucht. Die berechnete Dosisverteilung wurde mittels γ-Auswertung und verschiedener Dosis-Volumen-Histogramm(DVH)-Parameter (z. B. D{sub mean}, D{sub x%}, V{sub x%}) verglichen. Die Korrelation zwischen Signalabweichung, γ-Auswertung und DVH-Parametern wurde untersucht. Kurz- und Langzeitreproduzierbarkeit des Detektorsignals gab es in 1 %. Aenderungen der Monitoreinheiten konnten bis 1 MU pro Feld detektiert werden (∇Signal 1,1 ± 0,4 %). Aenderungen der Feldgroesse und -position um 1 mm wurden ebenso identifiziert (∇Signal 2,6 ± 1,0 %), was fuer eine hohe Sensitivitaet bei der Fehlerdetektion spricht. Die Korrelation zwischen Abweichungen des Detektorsignals und der γ-Auswertung waren maessig (R{sup 2} = 0,57-0,70), waehrend eine gute Korrelation mit DVH-Parametern (R{sup 2} = 0,75-0,98) gefunden wurde. Der Detektor kann kleine Fehler bei Lamellenpositionen und MU detektieren und ist ein hochsensitives Messmittel fuer die Dosisueberwachung im klinischen Betrieb fuer S and S-IMRT. Die Ergebnisse dieser Studie zeigen eine gute Korrelation zwischen Abweichungen von Detektorsignal und DVH-Parametern, weshalb klinische Toleranzgrenzen auf Basis der praesentierten Ergebnisse definiert werden koennen. (orig.)

  19. MIT/Draper Technology Development Partnership Project: Systems Analysis and On-Station Propulsion Subsystem Design

    National Research Council Canada - National Science Library

    Conklin, Theodore

    1998-01-01

    The objective of this thesis is to describe the process for, and the overall design that resulted from the MIT/Draper Project from August, 1996 to May, 1997, including the specific design of the on...

  20. Entwicklung und Anwendung neuer NMR-Methoden: Orientierungsmedien zur Strukturbestimmung mit anisotropen Parametern und Metabonomics

    OpenAIRE

    Büchler, Silke

    2014-01-01

    Das Ziel dieser Arbeit war die Entwicklung und Anwendung neuer Orientierungsmedien zur Strukturbestimmung mit anisotropen Parametern, sowie die Etablierung von Metabonomics-Studien an Flüssigzellkulturen und Reispflanzen.

  1. Ernährungszustand bei Patienten mit chronisch entzündlichen Darmerkrankungen

    OpenAIRE

    Blunk, Christine

    2009-01-01

    Zahlreiche internationale Studien konnten den negativen Einfluss einer bestehenden Malnutrition auf den Verlauf einer Erkrankung belegen. Dies gilt insbesondere für Patienten mit chronisch entzündlichen Darmerkrankungen wie Morbus Crohn und Colitis ulcerosa, die wie klinische Studien gezeigt haben besonders häufig unter einer Malnutrition leiden. In der vorliegenden Studie wurde der Ernährungszustand von 127 Patienten mit chronisch entzündlichen Darmerkrankungen anhand verschiedener etabli...

  2. "Drugwatch": Forschung mit Schlüsselprofessionellen und illegalen Drogenusern zur Identifikation von Drogentrends

    OpenAIRE

    Mason, Mark; Baker, Oswin; Hardy, Rebecca

    2007-01-01

    Die revidierte "United Kingdom Anti-Drugs Strategy" hat Lücken im Wissen über Drogen verdeutlicht: Insbesondere die Dynamiken, die mit der Entstehung regionalen Drogentrends einhergehen, erwiesen sich trotz mehrjährigem Bemühen als schwer fassbar, und einige hierzu in Großbritannien durchgeführte Studien waren mit erheblichen Problemen behaftet. Deshalb wurde vom "Drugs Analysis and Research Programme" und von "Market and Opinion Research International" (MORI) ein nationales Entwicklungsproje...

  3. Advanced modularity design for the MIT pebble bed reactor

    Energy Technology Data Exchange (ETDEWEB)

    Kadak, Andrew C. [Department of Nuclear Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 24-202 Cambridge, MA 02139-4307 (United States)]. E-mail: kadak@mit.edu; Berte, Marc V. [Department of Nuclear Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 24-202 Cambridge, MA 02139-4307 (United States)]. E-mail: mvberte@yahoo.com

    2006-03-15

    The future of all reactors will depend on whether they can be economically built and operated. One of the major impediments to new nuclear construction is the capital cost due in large part to the length of construction time and complexity of the plant. Pebble bed reactors offer the opportunity to reduce the complexity of the plant because the number of safety systems required is significantly reduced due to the inherent safety of the technology. However, because of its small size, the capital cost per kilowatt is likely to be large if traditional construction approaches are followed. This strongly suggests the need for innovative construction concepts to reduce the construction time and cost. MIT has proposed a modularity approach in which the plant is pre-built in space-frame type modules which are built in factories. These space frames would contain all the equipment contained in a given volume. Once equipment in the space frame is installed, the space frame would then be shipped to the site and assembled 'lego-style.' Studies presently underway have demonstrated the feasibility of the concept. Thermal stress analysis has been performed and an integrated design with the space frames has been developed. It is expected that this modularity approach will significantly shorten construction time and expense. This paper proposes a concept for further development, not a final design for the entire plant.

  4. Advanced modularity design for the MIT pebble bed reactor

    International Nuclear Information System (INIS)

    Kadak, Andrew C.; Berte, Marc V.

    2006-01-01

    The future of all reactors will depend on whether they can be economically built and operated. One of the major impediments to new nuclear construction is the capital cost due in large part to the length of construction time and complexity of the plant. Pebble bed reactors offer the opportunity to reduce the complexity of the plant because the number of safety systems required is significantly reduced due to the inherent safety of the technology. However, because of its small size, the capital cost per kilowatt is likely to be large if traditional construction approaches are followed. This strongly suggests the need for innovative construction concepts to reduce the construction time and cost. MIT has proposed a modularity approach in which the plant is pre-built in space-frame type modules which are built in factories. These space frames would contain all the equipment contained in a given volume. Once equipment in the space frame is installed, the space frame would then be shipped to the site and assembled 'lego-style.' Studies presently underway have demonstrated the feasibility of the concept. Thermal stress analysis has been performed and an integrated design with the space frames has been developed. It is expected that this modularity approach will significantly shorten construction time and expense. This paper proposes a concept for further development, not a final design for the entire plant

  5. Lessons learned from the MIT Tara control and data system

    International Nuclear Information System (INIS)

    Gaudreau, M.P.J.; Sullivan, J.D.; Fredian, T.W.; Irby, J.H.; Karcher, C.A.; Rameriz, R.A.; Sevillano, E.; Stillerman, J.A.; Thomas, P.

    1987-10-01

    The control and data system of the MIT Tara Tandem Mirror has worked successfully throughout the lifetime of the experiment (1983 through 1987). As the Tara project winds down, it is appropriate to summarize the lessons learned from the implementation and operation of the control and data system over the years and in its final form. The control system handled ∼2400 I/0 points in real time throughout the 5 to 10 minute shot cycle while the data system, in near real time, handled ∼1000 signals with a total of 5 to 7 Mbytes of data each shot. The implementation depended upon a consistent approach based on separating physics and engineering functions and on detailed functional diagrams with narrowly defined cross communication. This paper is a comprehensive treatment of the principal successes, residual problems, and dilemmas that arose from the beginning until the final hardware and software implementation. Suggestions for future systems of either similar size or of larger scale such as CIT are made in the conclusion. 11 refs., 1 fig

  6. Erste Erfahrungen mit RDA an wissenschaftlichen Universalbibliotheken in Deutschland - Ergebnisse aus Fokusgruppengesprächen mit Katalogisierenden

    Directory of Open Access Journals (Sweden)

    Heidrun Wiesenmüller

    2017-04-01

    Full Text Available Einige Monate nach dem Umstieg auf das neue Regelwerk "Resource Description and Access" (RDA wurden an 18 großen deutschen wissenschaftlichen Universalbibliotheken Fokusgruppengespräche mit Katalogisierererinnen und Katalogisierern durchgeführt. Die Katalogisierenden wurden u.a. befragt, wie sicher sie sich bei der Anwendung von RDA fühlen, was sie am neuen Regelwerk gut oder schlecht finden, wie sie den Aufwand im Vergleich zum früheren Regelwerk RAK einschätzen, welche Informations- und Hilfsmittel sie verwenden und wie sie zu den regelmäßigen Änderungen im Standard stehen. Der vorliegende Aufsatz dokumentiert die Ergebnisse der Gespräche.   Several months after the introduction of the new cataloging standard "Resource Description and Access" (RDA, focus-group interviews with catalogers were conducted at 18 large academic and state libraries in Germany. Among other things, the catalogers were asked how confident they feel in applying RDA, which aspects of the new cataloging code they like or do not like, how they estimate the expenditure of time in comparison to the former cataloging code RAK, which sources they use to get help or information, and what they think about the frequent changes to the new standard. The paper presents the results of these interviews.

  7. Knocking down mitochondrial iron transporter (MIT) reprograms primary and secondary metabolism in rice plants.

    Science.gov (United States)

    Vigani, Gianpiero; Bashir, Khurram; Ishimaru, Yasuhiro; Lehmann, Martin; Casiraghi, Fabio Marco; Nakanishi, Hiromi; Seki, Motoaki; Geigenberger, Peter; Zocchi, Graziano; Nishizawa, Naoko K

    2016-03-01

    Iron (Fe) is an essential micronutrient for plant growth and development, and its reduced bioavailability strongly impairs mitochondrial functionality. In this work, the metabolic adjustment in the rice (Oryza sativa) mitochondrial Fe transporter knockdown mutant (mit-2) was analysed. Biochemical characterization of purified mitochondria from rice roots showed alteration in the respiratory chain of mit-2 compared with wild-type (WT) plants. In particular, proteins belonging to the type II alternative NAD(P)H dehydrogenases accumulated strongly in mit-2 plants, indicating that alternative pathways were activated to keep the respiratory chain working. Additionally, large-scale changes in the transcriptome and metabolome were observed in mit-2 rice plants. In particular, a strong alteration (up-/down-regulation) in the expression of genes encoding enzymes of both primary and secondary metabolism was found in mutant plants. This was reflected by changes in the metabolic profiles in both roots and shoots of mit-2 plants. Significant alterations in the levels of amino acids belonging to the aspartic acid-related pathways (aspartic acid, lysine, and threonine in roots, and aspartic acid and ornithine in shoots) were found that are strictly connected to the Krebs cycle. Furthermore, some metabolites (e.g. pyruvic acid, fumaric acid, ornithine, and oligosaccharides of the raffinose family) accumulated only in the shoot of mit-2 plants, indicating possible hypoxic responses. These findings suggest that the induction of local Fe deficiency in the mitochondrial compartment of mit-2 plants differentially affects the transcript as well as the metabolic profiles in root and shoot tissues. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  8. Spin-dependent Nucleon Structure Studies at MIT/Bates

    International Nuclear Information System (INIS)

    Botto, T.

    2005-01-01

    We present preliminary results from recent measurements of the proton, neutron and deuterium electro-magnetic form factors obtained by the BLAST collaboration at the MIT/Bates Linear Accelerator Facility. BLAST (Bates Large Acceptance Spectrometer Toroid) is a large-acceptance multi-purpose detector dedicated to studies of exclusive spin-dependent electron scattering from internal polarized targets. BLAST makes use of stored electron beam currents in excess of 150 mA with a 60-70% polarization. The electron beam is let through a 15 mm diameter, 60 cm long open-ended storage cell which is fed with ultra-pure, high-polarization H1,D1 gas from an Atomic Beam Source. The target polarization can be rapidly reversed between different vector and tensor target states, thus minimizing systematic uncertainties. The target spin can be oriented to any in-plane direction via a set of Helmholtz coils. Target polarizations in the storage cell of up to 80% (vector) and 70% (tensor) have been routinely achieved over a period of several months. Our data on the D-vector(e-vector,e'n) reaction off vector polarized deuterium allow for a unique extraction of the neutron charge form factor G E n . At same time, complementary measurements of G M n , T20 and the spin-dependent nucleon momentum distributions in deuterium are obtained via the D-vector(e-vector,e'), D (e-vector,e'd) and D (e-vector,e'p) reactions. In addition, BLAST data on vector polarized hydrogen will provide novel measurements of the GE/GM form-factor ratio on the proton as well as of the spin-dependent electro-excitation of the Δ(1232) resonance. Such comprehensive program on few body physics is now well underway and preliminary data will be presented

  9. Verantwortlicher Umgang mit Antibiotika: Notwendigkeit der Antibiotikareduktion in der Aknetherapie.

    Science.gov (United States)

    Gollnick, Harald P M; Buer, Jan; Beissert, Stefan; Sunderkätter, Cord

    2016-12-01

    Der übermäßige oder unkritische weltweite Einsatz von Antibiotika in der Medizin hat die Ausbreitung von Antibiotikaresistenzen beschleunigt. In einigen Bereichen sind viele Antibiotika bei bakteriellen Infektionen, die zuvor noch gut auf antibakterielle Wirkstoffe reagierten, mittlerweile wirkungslos geworden. Dermatologen/Venerologen setzten orale und topische Antibiotika bei der Behandlung von Acne vulgaris routinemäßig ein, obwohl Akne weder eine infektiöse Erkrankung ist noch alleine durch das Propionibacterium getriggert wird. Vielmehr ist sie eine komplexe, chronische entzündliche Hauterkrankung, die durch verschiedene pathogenetische Faktoren wie follikuläre Hyperkeratose, erhöhter Sebumproduktion, bakterielle Proliferation und Entzündung zustande kommt. Folglich sollte eine erfolgreiche Therapie auf die Bekämpfung verschiedener pathogenetischer Faktoren und nicht nur auf die von Propionibacterium acnes abzielen. Daher wurden topische Retinoide und Benzoylperoxid als Mittel der ersten Wahl definiert. Monotherapien mit lokalen Antibiotika sollten insgesamt vermieden werden. Systemische Antibiotika der Tetrazyklin-Gruppe haben bei bestimmen Krankheitsstadien ihren Sinn, ihre Wirkung könnte aber eher auf der antientzündlichen als auf der antibiotischen Reaktion beruhen. Gesundheitsbehörden ermahnen alle Gesundheitsdienstleister, den Einsatz von Antibiotika einzuschränken. Das Nutzen-Risiko-Verhältnis muss bei der Entscheidung für oder gegen eine antibiotische Therapie bei einem einzelnen Patienten immer auch in Bezug auf das öffentliche Interesse am Erhalt der Wirksamkeit von Antibiotika abgewogen werden. Im Folgenden werden das aktuelle Krankheitskonzept zu Acne vulgaris und die sich daraus ableitenden Konsequenzen für den Einsatz von Antibiotika vorgestellt. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  10. Mit Bourdieu in die Stadt: Relevanz, Prinzipien, Anwendungen

    Directory of Open Access Journals (Sweden)

    Loïc Wacquant

    2017-06-01

    Full Text Available Dieser Beitrag zeigt die Relevanz der Soziologie Bourdieus für die Stadtforschung auf, indem er Bourdieus Frühwerk zu Macht, Raum und Urbanisierung im Béarn und Algerien aufgreift und es mit seinem Spätwerk verknüpft, in welchem er das soziale Leiden in der französischen Metropole analysiert. Es wirft ein Schlaglicht auf die vier übergreifenden Prinzipien, die Bourdieus Forschungspraxis antreiben und eine fruchtbare Anleitung für die Stadtforschung sein können: den Bachelardschen Imperativ des erkenntnistheoretischen Bruchs und der erkenntnistheoretischen Wachsamkeit; die Webersche Aufforderung zur dreifachen Historisierung des Handelnden (Habitus, der Welt (sozialer Raum, wovon das soziale Feld lediglich einen Untertypus darstellt und der Kategorien des Analytikers (erkenntnistheoretische Reflexivität; den Leibnizschen-Durkheimschen Vorschlag, eine topologische Denkweise zu nutzen, um den Wechselbeziehungen zwischen symbolischem, sozialem und physischem Raum nachzuspüren; sowie das Cassirersche Moment, das uns dazu anhält, die konstitutive Wirksamkeit symbolischer Strukturen zur Kenntnis zu nehmen. Ich möchte zudem auf drei Fallstricke hinweisen, die eine Stadtforschung auf den Spuren Bourdieus tunlichst vermeiden sollte: die Fetischisierung von Konzepten; die Verlockung, sich der Sprache Bourdieus zu bedienen („speaking Bourdieuse“, ohne die Forschungsschritte, die die Bourdieuschen Begriffe verlangen, tatsächlich durchzuführen; sowie das zwanghafte Überstülpen seines Theorierahmens als Ganzes auch in Fällen, in denen es produktiver wäre, einzelne Bausteine zu übertragen.

  11. Undergraduate Research and Education at MIT Haystack Observatory

    Science.gov (United States)

    Pratap, P.; Salah, J.

    2000-05-01

    The MIT Haystack Observatory Undergraduate Research Initiative is an NSF- funded program aimed at involving undergraduate students in active radio astronomical research. The project has two major thrusts - students get hands-on experience using a small radio telescope that has been developed at Haystack and which will be provided as a low cost kit early next year. Beta versions of this telescope are being built for a select group of institutions. The second component is a research experience with the Haystack 37-m telescope. Use of the 37-m telescope has ranged from classroom demonstrations to original research projects. The Small Radio Telescope (SRT) project consists of a 2m dish with a 1420 MHz receiver. The antenna has a two axis mount that provides full sky coverage. The telescope is intended to provide students and faculty with an introduction to radio astronomy and instrument calibration. Observations of the sun and the galactic HI line are possible with the current version of this telescope. The 37-m telescope program is aimed at providing students with a research experience that can result in publishable results. The telescope has also been used in providing students with an introduction to the scope of radio astronomical data including continuum and spectral line observations. Classroom demonstrations have also been tested with non-science majors. Extensive supporting materials for the project have been developed on the world wide web. These include a radio astronomy tutorial, hardware and software information about both telescopes and project descriptions. We also provide curriculum suggestions to aid faculty incorporate radio astronomy into their courses.

  12. Die Wirkung von Desacetylcefotaxin, einem Metaboliten von Cefotaxim, in vitro und auf die experimentelle Infektion mit Escherichia coli

    OpenAIRE

    Wirbelauer, J.; Hof, H.; Hacker, Jörg

    2009-01-01

    Die MHK-Werte von Desacetylcefotaxim gegen verschiedene, z. T. ampicillinresistente Stämme von Escherichia coH, die mit Hilfe einer Agardilutionsmethode erhoben wurden, waren höher als die von Cefotaxim und Ceftriaxon, jedoch niedriger als die von Cefoxitin. In einem Modell der systemischen Infektion der Maus mit einem plasmidtragenden, betalactamaseproduzierenden Stamm von E. coli führte die Therapie mit Desacetylcefotaxim zu einer starken Reduktion der Keime pro Leber. Im Vergleich zur Ther...

  13. Mit1 Transcription Factor Mediates Methanol Signaling and Regulates the Alcohol Oxidase 1 (AOX1) Promoter in Pichia pastoris.

    Science.gov (United States)

    Wang, Xiaolong; Wang, Qi; Wang, Jinjia; Bai, Peng; Shi, Lei; Shen, Wei; Zhou, Mian; Zhou, Xiangshan; Zhang, Yuanxing; Cai, Menghao

    2016-03-18

    The alcohol oxidase 1 (AOX1) promoter (P AOX1) of Pichia pastoris is the most powerful and commonly used promoter for driving protein expression. However, mechanisms regulating its transcriptional activity are unclear. Here, we identified a Zn(II)2Cys6-type methanol-induced transcription factor 1 (Mit1) and elucidated its roles in regulating PAOX1 activity in response to glycerol and methanol. Mit1 regulated the expression of many genes involved in methanol utilization pathway, including AOX1, but did not participate in peroxisome proliferation and transportation of peroxisomal proteins during methanol metabolism. Structural analysis of Mit1 by performing domain deletions confirmed its specific and critical role in the strict repression of P AOX1 in glycerol medium. Importantly, Mit1, Mxr1, and Prm1, which positively regulated P AOX1 in response to methanol, were bound to P AOX1 at different sites and did not interact with each other. However, these factors cooperatively activated P AOX1 through a cascade. Mxr1 mainly functioned during carbon derepression, whereas Mit1 and Prm1 functioned during methanol induction, with Prm1 transmitting methanol signal to Mit1 by binding to the MIT1 promoter (P MIT1), thus increasingly expressing Mit1 and subsequently activating P AOX1. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  14. The knockdown of OsVIT2 and MIT affects iron localization in rice seed.

    Science.gov (United States)

    Bashir, Khurram; Takahashi, Ryuichi; Akhtar, Shamim; Ishimaru, Yasuhiro; Nakanishi, Hiromi; Nishizawa, Naoko K

    2013-11-20

    The mechanism of iron (Fe) uptake in plants has been extensively characterized, but little is known about how Fe transport to different subcellular compartments affects Fe localization in rice seed. Here, we discuss the characterization of a rice vacuolar Fe transporter 2 (OsVIT2) T-DNA insertion line (osvit2) and report that the knockdown of OsVIT2 and mitochondrial Fe transporter (MIT) expression affects seed Fe localization. osvit2 plants accumulated less Fe in their shoots when grown under normal or excess Fe conditions, while the accumulation of Fe was comparable to that in wild-type (WT) plants under Fe-deficient conditions. The accumulation of zinc, copper, and manganese also changed significantly in the shoots of osvit2 plants. The growth of osvit2 plants was also slow compared to that of WT plants. The concentration of Fe increased in osvit2 polished seeds. Previously, we reported that the expression of OsVIT2 was higher in MIT knockdown (mit-2) plants, and in this study, the accumulation of Fe in mit-2 seeds decreased significantly. These results suggest that vacuolar Fe trafficking is important for plant Fe homeostasis and distribution, especially in plants grown in the presence of excess Fe. Moreover, changes in the expression of OsVIT2 and MIT affect the concentration and localization of metals in brown rice as well as in polished rice seeds.

  15. MITR-III: Upgrade and relicensing studies for the MIT Research Reactor. Second annual report

    International Nuclear Information System (INIS)

    Trosman, H.G.; Lanning, D.D.; Harling, O.K.

    1994-08-01

    The current operating license of the MIT research reactor will expire on May 7, 1996 or possibly a few years later if the US Nuclear Regulatory Commission agrees that the license period can start with the date of initial reactor operation. Driven by the imminent expiration of the operating license, a team of nuclear engineering staff and students have begun a study of the future options for the MIT Research Reactor. These options have included the range from a major rebuilding of the reactor to its decommissioning. This document reports the results of a two year intensive activity which has been supported by a $148,000 grant from the USDOE contract Number DEFG0293ER75859, approximately $100,000 of internal MIT funds and Nuclear Engineering Department graduate student fellowships as well as assistance from international visiting scientists and engineers

  16. MIT Clean Energy Prize: Final Technical Report May 12, 2010 - May 11, 2011

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, Chris [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Campbell, Georgina [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Salony, Jason [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Aulet, Bill [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

    2011-08-09

    The MIT Clean Energy Prize (MIT CEP) is a venture creation and innovation competition to encourage innovation in the energy space, specifically with regard to clean energy. The Competition invited student teams from any US university to submit student-led ventures that demonstrate a high potential of successfully making clean energy more affordable, with a positive impact on the environment. By focusing on student ventures, the MIT CEP aims to educate the next generation of clean energy entrepreneurs. Teams receive valuable mentoring and hard deadlines that complement the cash prize to accelerate development of ventures. The competition is a year-long educational process that culminates in the selection of five category finalists and a Grand Prize winner and the distribution of cash prizes to each of those teams. Each entry was submitted in one of five clean energy categories: Renewables, Clean Non-Renewables, Energy Efficiency, Transportation, and Deployment.

  17. An Approach for Prevention of MitM Attack Based on Rogue AP in Wireless Network

    Directory of Open Access Journals (Sweden)

    Zhendong Wu

    2014-12-01

    Full Text Available With the rapid development of WLAN, more and more schools and businesses have begun to provide the WLAN for users. However, WLAN is considerably more susceptible to MitM (man- in-the-middle attack. To overcome it, we propose a dynamic password technology named Two-way Dynamic Authentication Technology (TDAT. It uses two-factor during the initial authentication, and uses a two-way hash chain during the cross-domain authentication. TDAT effectively protects users' authentication credentials and improves users' experience. In an actual wireless network environment, we implement a MitM attack framework based on Rogue AP. Then we effectively prevent this MitM attack by using TDAT. Moreover we analyze the security of TDAT by using BAN logic.

  18. Long-lived mitochondrial (Mit) mutants of Caenorhabditis elegans utilize a novel metabolism.

    Science.gov (United States)

    Butler, Jeffrey A; Ventura, Natascia; Johnson, Thomas E; Rea, Shane L

    2010-12-01

    The Caenorhabditis elegans mitochondrial (Mit) mutants have disrupted mitochondrial electron transport chain (ETC) functionality, yet, surprisingly, they are long lived. We have previously proposed that Mit mutants supplement their energy needs by exploiting alternate energy production pathways normally used by wild-type animals only when exposed to hypoxic conditions. We have also proposed that longevity in the Mit mutants arises as a property of their new metabolic state. If longevity does arise as a function of metabolic state, we would expect to find a common metabolic signature among these animals. To test these predictions, we established a novel approach monitoring the C. elegans exometabolism as a surrogate marker for internal metabolic events. Using HPLC-ultraviolet-based metabolomics and multivariate analyses, we show that long-lived clk-1(qm30) and isp-1(qm150) Mit mutants have a common metabolic profile that is distinct from that of aerobically cultured wild-type animals and, unexpectedly, wild-type animals cultured under severe oxygen deprivation. Moreover, we show that 2 short-lived mitochondrial ETC mutants, mev-1(kn1) and ucr-2.3(pk732), also share a common metabolic signature that is unique. We show that removal of soluble fumarate reductase unexpectedly increases health span in several genetically defined Mit mutants, identifying at least 1 alternate energy production pathway, malate dismutation, that is operative in these animals. Our study suggests long-lived, genetically specified Mit mutants employ a novel metabolism and that life span may well arise as a function of metabolic state.

  19. The R Package MitISEM: Efficient and Robust Simulation Procedures for Bayesian Inference

    Directory of Open Access Journals (Sweden)

    Nalan Baştürk

    2017-07-01

    Full Text Available This paper presents the R package MitISEM (mixture of t by importance sampling weighted expectation maximization which provides an automatic and flexible two-stage method to approximate a non-elliptical target density kernel - typically a posterior density kernel - using an adaptive mixture of Student t densities as approximating density. In the first stage a mixture of Student t densities is fitted to the target using an expectation maximization algorithm where each step of the optimization procedure is weighted using importance sampling. In the second stage this mixture density is a candidate density for efficient and robust application of importance sampling or the Metropolis-Hastings (MH method to estimate properties of the target distribution. The package enables Bayesian inference and prediction on model parameters and probabilities, in particular, for models where densities have multi-modal or other non-elliptical shapes like curved ridges. These shapes occur in research topics in several scientific fields. For instance, analysis of DNA data in bio-informatics, obtaining loans in the banking sector by heterogeneous groups in financial economics and analysis of education's effect on earned income in labor economics. The package MitISEM provides also an extended algorithm, 'sequential MitISEM', which substantially decreases computation time when the target density has to be approximated for increasing data samples. This occurs when the posterior or predictive density is updated with new observations and/or when one computes model probabilities using predictive likelihoods. We illustrate the MitISEM algorithm using three canonical statistical and econometric models that are characterized by several types of non-elliptical posterior shapes and that describe well-known data patterns in econometrics and finance. We show that MH using the candidate density obtained by MitISEM outperforms, in terms of numerical efficiency, MH using a simpler

  20. Initiation of a phase-I trial of neutron capture therapy at the MIT research reactor

    International Nuclear Information System (INIS)

    Harling, O.K.; Bernard, J.A.; Yam, Chun-Shan

    1995-01-01

    The Massachusetts Institute of Technology (MIT), the New England Medical Center (NEMC), and Boston University Medical Center (BUMC) initiated a phase-1 trial of boron neutron capture therapy (BNCT) on September 6, 1994, at the 5-MW(thermal) MIT research reactor (MITR). A novel form of experimental cancer therapy, BNCT is being developed for certain types of highly malignant brain tumors such as glioblastoma and melanoma. The results of the phase-1 trials on patients with tumors in the legs or feet are described

  1. Rehkitzrettung mit dem Fliegenden Wildretter: Erfahrungen der ersten Feldeinsätze

    OpenAIRE

    Wimmer, Tilman; Israel, Martin; Haschberger, Peter; Weimann, Anita

    2013-01-01

    Der Fliegende Wildretter des Deutschen Zentrums für Luft- und Raumfahrt ist als prototypische Kleinserie seit dem Jahr 2010 erfolgreich in Deutsch-land und Österreich im Einsatz, um aus der Luft Wildtiere während der Wiesenmahd aufzuspüren, und diese so vor dem Tod durch das Mähwerk zu retten. Der Prototyp basiert auf einem ferngesteuerten Multikopter, der mit mehreren Kameras ausgestattet ist und damit im Flug zuverlässiger und wesentlich schneller Wildtiere er-kennen kann, als dies mit b...

  2. Verbesserte Visualisierung der Koronararterien in MSCT-Daten mit direkter Vergleichbarkeit zur Angiographie

    Science.gov (United States)

    Lacalli, Christina; Jähne, Marion; Wesarg, Stefan

    In diesem Beitrag stellen wir neue, automatisierte Verfahren zur Visualisierung der Koronararterien einerseits und für eine direkte Vergleichbarkeit mit konventionellen Angiogrammen andererseits vor. Unser Ansatz umfasst Methoden für die automatische Extraktion des Herzens aus kontrastverstärkten CT-Daten, sowie für die Maskierung grosser kontrastmittelgefüllter Kavitäten des Herzens, um die Sichtbarkeit der Koronararterien bei der Darstellung mittels Volumenrendering zu verbessern. Zum direkten Vergleich mit konventionellen Angiographien wurde ein Verfahren zur automatischen Generierung von Projektionsansichten aus den CT-Daten entwickelt.

  3. Therapie einer postoperativ entstandenen zystischen Raumforderung mit Picibanil (OK-432): Ein Fallbericht

    OpenAIRE

    Schlüter, A; Weller, P; Mattheis, S; Lang, S

    2014-01-01

    Einleitung: Picibanil (=OK432) ist ein Lysat bestehend aus Penicillin G und mit H2O2 attenuiertem Streptococcus pyogenes. In den letzten Jahrzehnten wurde Picibanil zur Therapie von Pleuraergüssen, Lymphangiomen, Chylusfisteln, medianen Halszysten und Ranulae eingesetzt. Es verursacht eine Immunreaktion mit aseptischer Entzündung. Dies führt zu einer Zerstörung des Endothels und konsekutiv zu einer Verklebung und Schrumpfung des Zystensacks.Falldarstellung: Wir berichten über einen 40-jähri...

  4. Mit1 Transcription Factor Mediates Methanol Signaling and Regulates the Alcohol Oxidase 1 (AOX1) Promoter in Pichia pastoris*

    Science.gov (United States)

    Wang, Xiaolong; Wang, Qi; Wang, Jinjia; Bai, Peng; Shi, Lei; Shen, Wei; Zhou, Mian; Zhou, Xiangshan; Zhang, Yuanxing; Cai, Menghao

    2016-01-01

    The alcohol oxidase 1 (AOX1) promoter (PAOX1) of Pichia pastoris is the most powerful and commonly used promoter for driving protein expression. However, mechanisms regulating its transcriptional activity are unclear. Here, we identified a Zn(II)2Cys6-type methanol-induced transcription factor 1 (Mit1) and elucidated its roles in regulating PAOX1 activity in response to glycerol and methanol. Mit1 regulated the expression of many genes involved in methanol utilization pathway, including AOX1, but did not participate in peroxisome proliferation and transportation of peroxisomal proteins during methanol metabolism. Structural analysis of Mit1 by performing domain deletions confirmed its specific and critical role in the strict repression of PAOX1 in glycerol medium. Importantly, Mit1, Mxr1, and Prm1, which positively regulated PAOX1 in response to methanol, were bound to PAOX1 at different sites and did not interact with each other. However, these factors cooperatively activated PAOX1 through a cascade. Mxr1 mainly functioned during carbon derepression, whereas Mit1 and Prm1 functioned during methanol induction, with Prm1 transmitting methanol signal to Mit1 by binding to the MIT1 promoter (PMIT1), thus increasingly expressing Mit1 and subsequently activating PAOX1. PMID:26828066

  5. eLearning in der Volksschule – ein Mehrwert? - Aspekte zu einem zukunftsorientierten Unterricht mit IKT

    Directory of Open Access Journals (Sweden)

    Ursula Dopplinger

    2011-09-01

    Full Text Available In einer Panelstudie wurde die Verbesserung der Schlüsselkompetenzen von Schülerinnen und Schülern durch eLearning in vier Volksschulen untersucht. Mit der verwendeten Webquest-Methode wurden bei drei von vier Untersuchten im Bereich der Schlüsselkompetenzen Erfolge erzielt.

  6. Energiemessungen bei Aspergillus niger mit Hilfe eines automatischen Mikro-Kompensations-Calorimeters

    NARCIS (Netherlands)

    Algera, Leendert

    1932-01-01

    Beschrieben wurde ein Calorimeter. Das Prinzip der Warmemessung besteht darin, dasz die entwickelte Wärme, sobald sie entsteht, durch eine entsprechende Kältemenge kompensiert wird. Sobald die Temperatur des Kulturgefaszes ein wenig ansteigt, wird trockne Luft gepumpt durch ein mit Wasser gefulltes

  7. Renaissance des Mittelalters (Teil 1) : oder Alte Fragen mit Neuen Antworten

    NARCIS (Netherlands)

    drs. Frans van den Reep

    2014-01-01

    Man kann das Heute mit keiner Zeit vorher vergleichen? Zu schnell sind die Veränderungen, zu gravierend die technologischen Möglichkeiten der Digitalisierung, des Internets? Frans van der Reep nähert sich in vielen überraschenden Parallelen in der gesellschaftlichen Entwicklung dem Gestern und

  8. Crash tests with Smartcrash barriers, a technology with a future; Zukunftssichere Crashtests mit Smartcrash-Barrieren

    Energy Technology Data Exchange (ETDEWEB)

    Barz, D.; Evers, W. [Kistler Instrumente AG (Switzerland). Geschaeftsbereich Fahrzeugmesstechnik

    2005-02-01

    The Smartcrash barrier by Kistler is a completely new technology. State-of-the-art data processing with Microdau modules is combined with a singular mechanical modularity which meets all requirements of present and future crash standards. Together with a piezo measuring system perfectly tuned to the highly dynamic processes during crash tests, this provides a basis for making crash laboratories economically efficient, with safe and accurate data, and compatible with other measuring systems. The system is a 'must' for every modern crash laboratory. (orig.) [German] Die Smartcrash-Barriere von Kistler setzt in jeder Hinsicht Massstaebe. Neueste Technologie der Datenverarbeitung beim Crash mit Microdau-Modulen, wie sie auch in Dummys eingesetzt werden, wird mit einer einzigartigen mechanischen Modularitaet kombiniert, die alle erforderlichen Voraussetzungen fuer bestehende und zukuenftige Crash-Standards bietet. In Verbindung mit der fuer die Messung von hochdynamischen Kraftverlaeufen beim Crash praedestinierte Piezo-Messtechnik ist hiermit die Basis geschaffen, Crash-Laboratorien wirtschaftlich und hinsichtlich des Datenakquisition sicher und kompatibel mit anderen Messgroessen im Labor auszuruesten. Ein 'Muss' fuer jedes moderne Crash-Labor. (orig.)

  9. Pack also the sauna. Integration of electricity storage; Auch die Sauna mit rein. Einbindung von Stromspeichern

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, Sven

    2013-10-01

    The installers have to handle with a variety of variables and options to plan and integrate the correct personal use system of solar power systems for their customers. [German] Die Installateure muessen mit einer Vielzahl von Variablen und Varianten zurechtkommen, um das richtige Eigenverbrauchssystem einer Solarstromanlage fuer ihre Kunden zu planen und einzubauen.

  10. Underground storage with floating cover. An overview; Erdbeckenspeicher mit schwimmender Abdeckung. Eine Uebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Heller, A.; Maureschat, G.; Duer, K. [Technical Univ. of Denmark, Lyngby (Denmark). Dept. of Buildings and Energy

    1998-12-31

    A number of underground stores have been developed in recent years in Denmark. The development has been subsidised with funds of `Development program renewable energy` launched by the Danish Ministry for Environment and Energy. First experience reports on underground storage show that more emphasis must be put on the development of storage sealing and cover construction. Hence research works currently focuses on the investigation of liner material and further development of floating cover constructions. The target is the development of underground storage using solar energy for heating that can compete with conventional heating systems technically and economically. (orig.) [Deutsch] In Daenemark hat man in den letzten Jahren eine Reihe von Erdbeckenspeichern entwickelt. Die Entwicklung wird mit Mitteln aus dem `Entwicklungsprogramm Erneuerbare Energie` vom daenischen Umwelt- und Energieministerium finanziell gefoerdert. Die ersten Erfahrungen mit Erdbeckenspeichern haben gezeigt, dass ein verstaerkter Einsatz bei der Entwicklung von Abdichtungen des Speichers und von Deckelkonstruktionen gefordert ist. Deshalb wird in Daenemark aktuell mit der Untersuchung von Linermaterialien und der Weiterentwicklung von schwimmenden Deckelkonstruktionen gearbeitet. Das Ziel dieser Arbeit ist es, Erdbeckenspeicher zu entwickeln, die die Ausnutzung von Sonnenenergie zur Waermeversorgung im Vergleich mit herkoemmlicher Waermeversorgung sowohl technisch als auch oekonomisch konkurrenzfaehig macht. (orig.)

  11. The R package MitISEM : efficient and robust simulation procedures for Bayesian inference

    NARCIS (Netherlands)

    Baştürk, N.; Grassi, S.; Hoogerheide, L.; Opschoor, A.; van Dijk, H.K.

    2015-01-01

    This paper presents the R package MitISEM (mixture of t by importance sampling weighted expectation maximization) which provides an automatic and flexible two-stage method to approximate a non-elliptical target density kernel - typically a posterior density kernel - using an adaptive mixture of

  12. MitBASE : a comprehensive and integrated mitochondrial DNA database. The present status

    NARCIS (Netherlands)

    Attimonelli, M.; Altamura, N.; Benne, R.; Brennicke, A.; Cooper, J. M.; D'Elia, D.; Montalvo, A.; Pinto, B.; de Robertis, M.; Golik, P.; Knoop, V.; Lanave, C.; Lazowska, J.; Licciulli, F.; Malladi, B. S.; Memeo, F.; Monnerot, M.; Pasimeni, R.; Pilbout, S.; Schapira, A. H.; Sloof, P.; Saccone, C.

    2000-01-01

    MitBASE is an integrated and comprehensive database of mitochondrial DNA data which collects, under a single interface, databases for Plant, Vertebrate, Invertebrate, Human, Protist and Fungal mtDNA and a Pilot database on nuclear genes involved in mitochondrial biogenesis in Saccharomyces

  13. Biogas - a new energy source saves fossil resources; Biogas - mit neuer Energie Ressourcen schonen

    Energy Technology Data Exchange (ETDEWEB)

    Thoss, C. (comp.)

    2001-07-01

    The new German Renewable Energy Sources Act (EEG) of 2000 made conditions for biogas more favourable - small wonder, as the German Biogas Association (Fachverband Biogas e.V.) co-operated with written expert opinions and many discussions with decision-makers. The subjects discussed at the 10th Biogas Conference reflect the current situation and will provide a basis for committee work in 2001. [German] Im Jahr 2000 haben sich die gesetzlichen Rahmenbedingungen fuer den Biogasbereich mit dem Inkrafttreten des erneuerbaren Energiegesetz (EEG) sehr positiv entwickelt. Der Fachverband Biogas e.V. hat mit schriftlichen Stellungnahmen und in vielen Gespraechen mit Entscheidungstraegern diese Bedingungen mitgestaltet. In Zukunft gibt es noch viele Aufgaben fuer eine effektive Interessenvertretung der Biogasbranche auf Laender- und Bundesebene. Die Themen, die auf der 10. Biogastagung diskutiert werden, spiegeln die Fragen wieder, die unter Experten derzeit intensiv diskutiert werden. Die Ergebnisse des Erfahrungsaustausches auf dieser Tagung werden die Grundlage fuer die Arbeit der Gremien im Fachverband Biogas im Jahr 2001 sein. Mit dem vorliegenden Tagungsband ist es gelungen, die Basis fuer die fachlichen Gespraeche waehrend und nach der Tagung schaffen. (orig.)

  14. Review of 'Where the action is, by Paul Dorish, MIT Press 2001

    DEFF Research Database (Denmark)

    Wentzer, Helle

    2008-01-01

    Bogen til human-computer interaction, HCI er ikke helt ny (MIT 2001/2004), men dog filosofisk aktuel som baggrund for nye tanker, forventninger og krav til sundhedsinformatikken. Den foranker forskningprogrammerne til ’tangible computing’ og ’social computing’ paradigmatisk i fænomenologien og...

  15. Evaluation of the MIT-Scan-T2 for non-destructive PCC pavement thickness determination.

    Science.gov (United States)

    2008-07-01

    The MIT-Scan-T2 device is marketed as a non-destructive way to determine pavement thickness on both : HMA and PCC pavements. PCC pavement thickness determination is an important incentivedisincentive : measurement for the Iowa DOT and contractors. Th...

  16. Schwerpunktseminar : "Dazugehören? Umgang mit Minderheiten" / Liliāna Vancāne

    Index Scriptorium Estoniae

    Vancāne, Liliāna

    2016-01-01

    17. -20. märtsini 2016 Tartus toimunud seminarist "Dazugehören? Umgang mit Minderheiten. Estland und Lettland gestern-heutu-morgen". Seminarist sotsiaalse kuuluvuse ja vähemuste teemal. Suurepäraselt korraldatud ürituse parim osa oli töötuba

  17. Nanomedical strategy to prolong survival period, heighten cure rate, and lower systemic toxicity of S180 mice treated with MTX/MIT.

    Science.gov (United States)

    Song, Ning; Zhao, Ming; Wang, Yuji; Hu, Xi; Wu, Jianhui; Jiang, Xueyun; Li, Shan; Cui, Chunying; Peng, Shiqi

    2016-01-01

    In spite of the usual combination form of methotrexate (MTX)/mitoxantrone (MIT) and various complex combination regimens of MTX/MIT with other anticancer drugs, the survival period, cure rate, and systemic toxicity still need to be improved. For this purpose, a nanostructured amino group-modified mesoporous silica nanoparticles (MSNN)-MTX/MIT was designed. In the preparation, the surface of mesoporous silica nanoparticles (MSNs) was modified with amino groups to form MSNN. The covalent modification of the amino groups on the surface of MSNN with MTX resulted in MSNN-MTX. The loading of MIT into the surface pores of MSNN-MTX produced nanostructured MSNN-MTX/MIT. Compared with the usual combination form (MTX/MIT), nanostructured MSNN-MTX/MIT increased the survival period greatly, heightened the cure rate to a great extent, and lowered the systemic toxicity of the treated S180 mice, significantly. These superior in vivo properties of nanostructured MSNN-MTX/MIT over the usual combination form (MTX/MIT) were correlated with the former selectively releasing MTX and MIT in tumor tissue and inside cancer cells in vitro. The chemical structure and the nanostructure of MSNN-MTX/MIT were characterized using infrared and differential scanning calorimeter spectra as well as transmission electron microscope images, respectively.

  18. [Stinging nettle root extract (Bazoton-uno) in long term treatment of benign prostatic syndrome (BPS). Results of a randomized, double-blind, placebo controlled multicenter study after 12 months].

    Science.gov (United States)

    Schneider, T; Rübben, H

    2004-03-01

    Phytotherapy of BPS has a long tradition in Germany; nevertheless, data referring to single phytotherapeutic agents are rare. We therefore performed a randomized, double-blind, placebo-controlled multicenter study for 1 year with Bazoton uno (459 mg dry extract of stinging nettle roots) with 246 patients. The IPSS decreased on average from 18.7+/-0.3 to 13.0+/-0.5 with a statistically significant difference compared to placebo (18.5+/-0.3 to 13.8+/-0.5; p=0.0233). The median Q(max) increased by 3.0+/-0.4 ml/s in comparison to 2.9+/-0.4 ml/s (placebo), thus not statistically significantly different, as well as the median volume of residual urine, which changed from 35.5+/-3.4 ml before therapy to 20.0+/-2.8 ml and from 40.0+/-4.0 ml to 21.0+/-2.9 ml under placebo application. The number of adverse events (29/38) as well as urinary infections etc. (3/10 events) was smaller under Bazoton uno therapy compared to placebo. Treatment with Bazoton uno can therefore be considered a safe therapeutic option for BPS, especially for reducing irritative symptoms and BPS-associated complications due to the postulated antiphlogistic and antiproliferative effects of the stinging nettle extract. A strong increase of Q(max) or reduction of residual urine are not to be expected.

  19. Risk for late-onset blood-culture proven sepsis in very-low-birth weight infants born small for gestational age: a large multicenter study from the German Neonatal Network.

    Science.gov (United States)

    Tröger, Birte; Göpel, Wolfgang; Faust, Kirstin; Müller, Thilo; Jorch, Gerhard; Felderhoff-Müser, Ursula; Gortner, Ludwig; Heitmann, Friedhelm; Hoehn, Thomas; Kribs, Angela; Laux, Reinhard; Roll, Claudia; Emeis, Michael; Mögel, Michael; Siegel, Jens; Vochem, Matthias; von der Wense, Axel; Wieg, Christian; Herting, Egbert; Härtel, Christoph

    2014-03-01

    It was the aim of this study to assess whether very-low-birth-weight (VLBW) infants born small for gestational age (SGA; birth weight less than 10th percentile) are at increased risk for late-onset sepsis. This was a prospective, multicenter study of the German Neonatal Network including VLBW infants from 23 to risk with coagulase-negative staphylococci in our SGA cohort. In a multivariate logistic regression analysis, higher gestational age [per week; odds ratio (OR): 0.75, 95% confidence interval (CI): 0.72-0.78, PGerman descendance (OR: 0.76, 95% CI: 0.63-0.91, P = 0.003) and prophylaxis with glycopeptide antibiotics (OR: 0.64, 95% CI: 0.47-0.87, P = 0.005) were shown to be protective against late-onset sepsis. In contrast, longer duration of parenteral nutrition (per day; OR: 1.016, 95% CI: 1.011-1.021, P risk factors (OR: 1.31, 95% CI: 1.02-1.68, P= 0.03). SGA contributes to the risk of late-onset sepsis in VLBW infants. Future studies are needed to investigate the underlying pathophysiology to guide individualized preventive measures in this vulnerable subgroup.

  20. Morning pulse pressure is associated more strongly with elevated albuminuria than systolic blood pressure in patients with type 2 diabetes mellitus: post hoc analysis of a cross-sectional multicenter study.

    Science.gov (United States)

    Ushigome, Emi; Fukui, Michiaki; Hamaguchi, Masahide; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Senmaru, Takafumi; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2013-09-01

    Recently, focus has been directed toward pulse pressure as a potentially independent risk factor for micro- and macrovascular disease. This study was designed to examine the relationship between pulse pressure taken at home and elevated albuminuria in patients with type 2 diabetes. This study is a post hoc analysis of a cross-sectional multicenter study. Home blood pressure measurements were performed for 14 consecutive days in 858 patients with type 2 diabetes. We investigated the relationship between systolic blood pressure or pulse pressure in the morning or in the evening and urinary albumin excretion using univariate and multivariate analyses. Furthermore, we measured area under the receiver-operating characteristic curve (AUC) to compare the ability to identify elevated albuminuria, defined as urinary albumin excretion equal to or more than 30 mg/g creatinine, of systolic blood pressure or pulse pressure. Morning systolic blood pressure (β=0.339, Ppressure (β=0.378, PAUC for elevated albuminuria in morning systolic blood pressure and morning pulse pressure were 0.668 (0.632-0.705; PAUC of morning pulse pressure was significantly greater than that of morning systolic blood pressure (P=0.040). Our findings implicate that morning pulse pressure is associated with elevated albuminuria in patients with type 2 diabetes, which suggests that lowering morning pulse pressure could prevent the development and progression of diabetic nephropathy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Hypoglycemia in noncritically ill patients receiving total parenteral nutrition: a multicenter study. (Study group on the problem of hyperglycemia in parenteral nutrition; Nutrition area of the Spanish Society of Endocrinology and Nutrition).

    Science.gov (United States)

    Olveira, Gabriel; Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Maria Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Matía, Pilar; Rubio, Miguel Ángel; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; Del Olmo, Dolores; Pereira, José Luis; Tous, María C

    2015-01-01

    Hypoglycemia is a common problem among hospitalized patients. Treatment of hyperglycemia with insulin is potentially associated with an increased risk for hypoglycemia. The aim of this study was to determine the prevalence and predictors of hypoglycemia (capillary blood glucose parenteral nutrition (TPN). This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill adults who were prescribed TPN were included, thus enabling us to collect data on capillary blood glucose and insulin dosage. The study included 605 patients of whom 6.8% (n = 41) had at least one capillary blood glucose <70 mg/dL and 2.6% (n = 16) had symptomatic hypoglycemia. The total number of hypoglycemic episodes per 100 d of TPN was 0.82. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes, a lower body mass index (BMI), and treatment with intravenous (IV) insulin. Patients with hypoglycemia also had a significantly longer hospital length of stay, PN duration, higher blood glucose variability, and a higher insulin dose. Multiple logistic regression analysis showed that a lower BMI, high blood glucose variability, and TPN duration were risk factors for hypoglycemia. Use of IV insulin and blood glucose variability were predictors of symptomatic hypoglycemia. The occurrence of hypoglycemia in noncritically ill patients receiving PN is low. A lower BMI and a greater blood glucose variability and TPN duration are factors associated with the risk for hypoglycemia. IV insulin and glucose variability were predictors of symptomatic hypoglycemia. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Die Dramatikerin Theresia Walser spricht mit Maria Aparecida Barbosa über das Theaterstück "King Kongs Töchter":Mit einer Einführung von Karina Schuller

    OpenAIRE

    Barbosa, M.A. (Maria)

    2012-01-01

    In ihrem Interview spricht die Literaturwissenschaftlerin Maria Aparecida Barbosa mit der Dramatikerin Theresia Walser. Am Beispiel des Theaterstücks King Kongs Töchter (1998), das sich auf groteske Art und Weise mit dem Alltag in einem Altenheim befasst, werden dabei verschiedene Themen angesprochen: Es geht um die Selbstreflexivität des Theaters, um Walsers Verständnis von poetischer Sprache und Realismus sowie um den kreativen Schreibprozess im Allgemeinen. Ergänzt wird das Interview durch...

  3. Verfahren zur Hydroformylierung, Liganden mit von Bisphenol A abgeleiteter Struktur und Katalysator umfassend einen Komplex dieser Liganden

    NARCIS (Netherlands)

    2002-01-01

    Die vorliegende Erfindung betrifft ein Verfahren zur Hydroformylierung ethylenisch ungesättigter Verbindungen, wobei man als Hydroformylierungskatalysator wenigstens einen Komplex eines Metalss der VIII. Nebengruppe mit wenigstens einer phosphorhaltigen Verbindung als Liganden einsetzt, wobei diese

  4. Dewatering of sludge using the hydrosoft high-pressure process; Entwaessern von Schlaemmen mit dem Hydrosoft-Hochdruckverfahren

    Energy Technology Data Exchange (ETDEWEB)

    Eder, C.; Eder, G. [Christian Eder Technology GbR, Neunkirchen (Germany)

    1999-07-01

    The hydrosoft process permits to dewater sludge, especially also sludge from municipal sewage treatment plant, until it contains a high proportion of dry substance. For existing dewatering systems equipped with the long-lived chamber filter presses, too, the dry matter content of the filter cake can be substantially increased using the hydrosoft process; only the pump system must be retrofitted. As a preliminary measure, tests with mobile pilot plants should be carried out. (orig.) [German] Mit dem Hydrosoft-Verfahren besteht die Moeglichkeit Schlaemme, insbesondere auch Schlaemme aus kommunalen Klaeranlagen, auf hohe Trockensubstanz-Gehalte zu entwaessern. Auch bei bestehenden Entwaesserungsanlagen, die mit den langlebigen Kammerfilterpressen ausgeruestet sind, koennen die Trockensubstanzgehalte der Filterkuchen mit dem Hydrosoft-Verfahren, fuer das dann nur noch das Pumpsystem nachgeruestet werden muss, wesentlich angehoben werden. Vorausgehen sollten jeweils Vorversuche mit mobilen Versuchsanlagen. (orig.)

  5. Contribution of occupational therapy for patients with depression / Beitrag der Ergotherapie in der Wahrnehmung von Menschen mit Depression

    Directory of Open Access Journals (Sweden)

    Treusch Yvonne

    2016-12-01

    Full Text Available In Bezug auf den professionellen Beitrag und die Wirkfaktoren der Ergotherapie bei Menschen mit Depression existieren bislang wenige Studien. Dies steht im Kontrast zum praktischen und quantitativen Beitrag dieser Therapieform.

  6. A review of the MIT experiments on the closed-loop digital control of reactor power

    International Nuclear Information System (INIS)

    Bernard, J.A.

    1989-01-01

    In this paper a review is provided of certain major experiments conducted from 1985 to 1988 as part of the MIT program on the development and demonstration of advanced technologies for the closed-loop digital control of nuclear reactors. Included are demonstrations of the supervisory control of neutronic power using an alternate formulation of the dynamic period equation, the use of the MIT-SNL Period-Generated Minimum Time Control Laws for the time-optimal control of neutronic power, and the evaluation of predictive displays as an operator aid. The significance of each of these advances is discussed in terms of the overall development of a multi-tiered controller that includes supervisory algorithms, predictive control laws, and automated reasoning

  7. Rethinking the Relationship Between Academia and Industry: Qualitative Case Studies of MIT and Stanford.

    Science.gov (United States)

    Zhu, Fengliang; Hawk, Soaring

    2016-10-01

    As knowledge has become more closely tied to economic development, the interrelationship between academia and industry has become stronger. The result has been the emergence of what Slaughter and Leslie call academic capitalism. Inevitably, tensions between academia and industry arise; however, universities such as MIT and Stanford with long traditions of industry interaction have been able to achieve a balance between academic and market values. This paper describes the strategies adopted by MIT and Stanford to achieve this balance. The results indicate that implicit culture is a stronger determinant of balance than are explicit rules. Finally, the author proposes a concept of balance to reconsider the relationship between academia and industry: today's universities, particularly those with strengths in engineering and management, are both symbiotic and interdependent with industry. A reasonable attitude toward the university-industry relationship is that of balance rather than strict separation. Universities can thus establish effective mechanisms to reach a balance between conflicting values.

  8. Coupling of the Magnetosphere-Ionosphere/Thermosphere and Oxygen Outflow-- MIT Mission

    Science.gov (United States)

    Fu, S.

    2017-12-01

    The goal of the MIT mission is to understand the coupling of the magnetosphere and ionosphere from the prospective of particles. It will focus on the outflow of the ionosphere particles (mainly oxygen ions) from the Earth, including the acceleration mechanisms of oxygen ions and their relative importance in different regions, the importance of these ions while transferred into the magnetosphere and the roles they played in magnetosphere activities. A constellation of four satellites orbiting at three elliptical orbits will provide the unique opportunities to observed there ions at three different altitude with temporal changes of the flux of these particles and the magnetic field environments. The conceptual design of the spacecraft and a summary of the payload will be presented. The MIT mission was selected as one of the five candidates for the upcoming mission plan in China.

  9. A Systems Approach to Healthcare Innovation Using the MIT Hacking Medicine Model.

    Science.gov (United States)

    Gubin, Tatyana A; Iyer, Hari P; Liew, Shirlene N; Sarma, Aartik; Revelos, Alex; Ribas, João; Movassaghi, Babak; Chu, Zen M; Khalid, Ayesha N; Majmudar, Maulik D; Lee, Christopher Xiang

    2017-07-26

    MIT Hacking Medicine is a student, academic, and community-led organization that uses systems-oriented "healthcare hacking" to address challenges around innovation in healthcare. The group has organized more than 80 events around the world that attract participants with diverse backgrounds. These participants are trained to address clinical needs from the perspective of multiple stakeholders and emphasize utility and implementation viability of proposed solutions. We describe the MIT Hacking Medicine model as a potential method to integrate collaboration and training in rapid innovation techniques into academic medical centers. Built upon a systems approach to healthcare innovation, the time-compressed but expertly guided nature of the events could enable more widely accessible preliminary training in systems-level innovation methodology, as well as creating a structured opportunity for interdisciplinary congregation and collaboration. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. KoelnArena has 18,000 seats; Die KoelnArena mit 18 000 Sitzplaetzen

    Energy Technology Data Exchange (ETDEWEB)

    Zerres, E.

    1999-06-01

    The ``Koelnarena`` is a new hall with 18,000 seats for sports events and cultural events, and with a skating rink in the hall center. In view of the many events (up to 180 per year), the skating rink must be glazed throughout the year (except for the summer holidays) in order to avoid the high cost of frequent freezing and thawing. [Deutsch] Die Koelnarena ist eine neue Halle fuer 18 000 Besucher in Koeln-Deutz, mit vielfacher Verwendbarkeit fuer Eishockey und Eistanz, Tennis, Volleyball, Boxen, Schausport, Showkonzerte, Oper und Tanzveranstaltungen. Das Kernstueck dieser MEGA-Halle ist die Eispiste in der Hallenmitte. Wegen der hohen Auslastung der Halle mit bis zu 180 Veranstaltungen pro Jahr muss die Eispiste ganzjaehrig (ausser waehrend der Sommerferien) vereist bleiben, um den sehr grossen Energieaufwand fuer haeufig Eisbildung (und Abtauen.) sowie die Kosten hierfuer zu vermeiden. (orig.)

  11. Center for Multiscale Plasma Dynamics: Report on Activities (UCLA/MIT), 2009-2010

    Energy Technology Data Exchange (ETDEWEB)

    Carter, Troy Alan [Univ. of California, Los Angeles, CA (United States)

    2014-10-03

    The final “phaseout” year of the CMPD ended July 2010; a no cost extension was requested until May 2011 in order to enable the MIT subcontract funds to be fully utilized. Research progress over this time included verification and validation activities for the BOUT and BOUT++ code, studies of spontaneous reconnection in the VTF facility at MIT, and studies of the interaction between Alfv´en waves and drift waves in LAPD. The CMPD also hosted the 6th plasma physics winter school in 2010 (jointly with the NSF frontier center the Center for Magnetic Self-Organization, significant funding came from NSF for this most recent iteration of theWinter School).

  12. Educational Outreach at the M.I.T. Plasma Fusion Center

    Science.gov (United States)

    Censabella, V.

    1996-11-01

    Educational outreach at the MIT Plasma Fusion Center consists of volunteers working together to increase the public's knowledge of fusion and plasma-related experiments. Seeking to generate excitement about science, engineering and mathematics, the PFC holds a number of outreach activities throughout the year, such as Middle and High School Outreach Days. Outreach also includes the Mr. Magnet Program, which uses an interactive strategy to engage elementary school children. Included in this year's presentation will be a new and improved C-MOD Jr, a confinement video game which helps students to discover how computers manipulate magnetic pulses to keep a plasma confined for as long as possible. Also on display will be an educational toy created by the Cambridge Physics Outlet, a PFC spin-off company. The PFC maintains a Home Page on the World Wide Web, which can be reached at http://cmod2.pfc.mit.edu/.

  13. Geschmackspapillendichte und Geschmackswahrnehmung bei Jugendlichen mit Essstörungen und einer gesunden Kontrollgruppe

    OpenAIRE

    Kaltenhofer, Alice

    2009-01-01

    Fragestellung Die Schmeckwahrnehmung wird u.a. über Lernprozesse, kognitive Vorgänge, genetische und biochemische Faktoren reguliert. Ess- und Diätverhalten werden durch sie beeinflusst. Den anatomisch und physiologisch ersten Abschnitt der Schmeckwahrnehmung bilden die fungiformen Geschmackspapillen. In den Geschmackspapillen liegen die Geschmacksknopsen, mit deren Hilfe die Schmeckstoffe aufgenommen und in Form von Aktionspotentialen zum Thalamus, dem limbischen System,dem Gyrus postzentral...

  14. Calculations of higher twist distribution functions in the MIT bag model

    International Nuclear Information System (INIS)

    Signal, A.I.

    1997-01-01

    We calculate all twist-2, -3 and -4 parton distribution functions involving two quark correlations using the wave function of the MIT bag model. The distributions are evolved up to experimental scales and combined to give the various nucleon structure functions. Comparisons with recent experimental data on higher twist structure functions at moderate values of Q 2 give good agreement with the calculated structure functions. (orig.)

  15. Einsatzverhalten genuteter CBN-Schleifscheiben mit keramischer Bindung beim Außenrund-Einstechschleifen

    OpenAIRE

    Kirchgatter, Mathias

    2010-01-01

    Industrielle Schleifprozesse für Bauteile aus gehärteten Stahlwerkstoffen werden vermehrt mit keramisch gebundenen CBN-Schleifscheiben durchgeführt, die sich bei vielen Anwendungen aufgrund ihres Eigenschaftsprofils und der erweiterten Einstellbarkeit der Bindungsspezifikationen gegenüber anderen Schleifwerkzeugtypen durchsetzen. Der Optimierungsdruck der Großserien- und Massenfertigungsprozesse hat bereits zu einer beachtlichen Entwicklung hinsichtlich der Leistungsfähigkeit dieses Werkzeugt...

  16. Hardware for quasi-single-shot multifrequency magnetic induction tomography (MIT): the Graz Mk2 system

    International Nuclear Information System (INIS)

    Scharfetter, H; Köstinger, A; Issa, S

    2008-01-01

    Magnetic induction tomography (MIT) has been suggested by several groups for the contact-less mapping of the passive electrical properties of tissues via AC magnetic fields in the frequency range between several tens of kHz and several tens of MHz. Multifrequency MIT as an analog to multifrequency EIT has been tried and first image reconstructions have been demonstrated with phantoms. MIT appears to yield comparable images to EIT but offers the advantage of being non-contacting. In the beta-dispersion range of most tissues the method is challenging because the signals are very small and buried in noise. In order to minimize drifts and systematic errors fast data acquisition is therefore pivotal. This paper presents a method for single-shot MIT which allows us to acquire the data for a multifrequency image with an analog bandwidth of 50 kHz–1.5 MHz which covers a good part of the β-dispersion of many tissues. The transmit (TX) coils are simultaneously driven by individual power amplifiers with a multisinus pattern with up to 3 A pp . The amplifiers are configured as current sources so as not to perturb the excitation fields by inappropriately terminated coils. The separation of the different TX channels after reception is achieved by splitting up the carrier frequencies into individual subcarriers with a narrow spacing of at most 300 Hz. In this way every TX coil is identifiable by its own subcarrier but the whole excitation band is contained within a few kHz. The real and imaginary parts of the received signals are extracted efficiently with FFT. The system noise and the sources for low-frequency perturbations are analyzed and characterized

  17. MIT Laboratory for Computer Science Progress Report No. 23, July 1985-June 1986

    Science.gov (United States)

    1986-06-01

    34An Expert System for Diagnosing Gait in Cerebral Palsy Patients," S.M. thesis, MIT Department of Electrical Engineering and Computer Science, Cambridge...barriers to program interoperability. Within our community, we perceive serious problems in building on the work of others, because the different...unmatched tokens. Of course, the name of the game is representation and access to the various data structures, and this has worked out very nicely. GITA

  18. Pionic corrections to the MIT bag model: The (3,3) resonance

    International Nuclear Information System (INIS)

    Theberge, S.; Thomas, A.W.; Miller, G.A.

    1980-01-01

    By incorporating chiral invariance in the MIT bag model, we are led to a theory in which the pion field is coupled to the confined quarks only at the bag surface. An equivalent quantized theory of nucleons and Δ's interacting with pions is then obtained. The pion-nucleon scattering amplitude in this model is found to give a good fit to experimental data on the (3,3) resonance, with a bag radius of about 0.72 fm

  19. An Approach for Prevention of MitM Attack Based on Rogue AP in Wireless Network

    OpenAIRE

    Zhendong Wu; Mengru Cai; Siyu Liang

    2014-01-01

    With the rapid development of WLAN, more and more schools and businesses have begun to provide the WLAN for users. However, WLAN is considerably more susceptible to MitM (man- in-the-middle) attack. To overcome it, we propose a dynamic password technology named Two-way Dynamic Authentication Technology (TDAT). It uses two-factor during the initial authentication, and uses a two-way hash chain during the cross-domain authentication. TDAT effectively protects users' authentication credentials a...

  20. Psychologie körperlicher Aktivität bei Patienten mit Rückenschmerzen

    OpenAIRE

    Leonhardt, Corinna

    2008-01-01

    Die vorliegende Arbeit setzt sich mit den psychologischen Determinanten und Fördermöglichkeiten von körperlicher Aktivität bei Rückenschmerzpatienten auseinander, wobei Daten einer multizentrischen cluster-randomisierten Studie (N= 1378) genutzt werden. Der theoretische Hintergrund aller Originalarbeiten gibt einen Überblick zu neuen Erkenntnissen zum Rückenschmerz und zur Aktivitätsförderung in der Gesundheitspsychologie und ...

  1. The neurosciences research program at MIT and the beginning of the modern field of neuroscience.

    Science.gov (United States)

    Adelman, George

    2010-01-15

    The interdisciplinary field, "neuroscience," began at MIT in 1962 with the founding of the Neurosciences Research Program (NRP) by Francis O. Schmitt and a group of US and international scientists - physical, biological, medical, and behavioral - interested in understanding the brain basis of behavior and mind. They organized and held specialist meetings of basic topics in neuroscience, and the journal and book publications over the next 20 years, based on these meetings, helped establish the new field.

  2. Schlafmedizinische Charakterisierung von Parkinson-Patienten mit Schlafattacken unter dopaminerger Therapie

    OpenAIRE

    Rethfeldt, Mira

    2006-01-01

    1999 wurden erstmals sogenannte Schlafattacken bei Parkinson-Patienten unter der Therapie mit Nonergolin-Dopaminagonisten berichtet. Später zeigten Studien, dass diese Schlafattacken unter jeglicher dopaminerger Therapie auftreten können. Bis heute ist jedoch die Pathophysiologie dieses Phänomens nicht hinreichend geklärt. Es wird diskutiert, ob diese Attacken als paroxysmales Symptom überhaupt bestehen oder nicht vielmehr ...

  3. Zielgerichtete Chemotherapie solider Tumoren durch thermosensitive Liposomen in Kombination mit Doxorubicin, Gemcitabin und Mitomycin C

    OpenAIRE

    Limmer, Simone

    2014-01-01

    Auf DPPG2 basierende thermosensitive Liposomen (TSL) mit Hyperthermie (HT) induzierter zielgerichteter Wirkstofffreisetzung sind eine viel-versprechende Behandlungsstrategie in der Krebstherapie. TSL können als Wirkstoffträgersysteme die Zirkulationszeit und Anreicherung von Wirkstoffen im Zielgewebe erhöhen. Die vielfältigen Krebserkrankungen zeigen unterschiedliches Tumoransprechen auf die routinemäßig eingesetzten Zytostatika. Daher wäre es vorteilhaft, verschiedene Wirkstoffe in TSL e...

  4. Verhaltenstherapie bei Enkopresis am Beispiel einer Patientin mit chronischem "Toiletten-Verweigerungssyndrom"

    OpenAIRE

    Hansen, Berit; Lehmkuhl, Ulrike

    2007-01-01

    Enkopresis gehört zu den wenig beforschten psychischen Störungen im Kindes- und Jugendalter. Auch Literatur zur psychotherapeutischen Behandlung der Störung findet man kaum. Das verhaltenstherapeutische Standardbehandlungsvorgehen soll beschrieben und anhand eines ausführlichen Fallbeispiels eines 7,9-jährigen Mädchens mit "Toilettenverweigerungssyndrom" erläutert werden. Schlagwörter Verhaltenstherapie - Kindesalter - Enkopresis- "Toilettenverweigerungssyndrom" Encopresis is one of...

  5. Neuropsychologische Aspekte der Diagnostik von Kindern mit umschriebenen Entwicklungsstörungen schulischer Fertigkeiten

    OpenAIRE

    Blender, Anja

    2004-01-01

    Die vorliegende Studie liefert empirische Evidenz für die Annahme von umschriebenen Entwicklungsstörungen schulischer Fertigkeiten als Manifestation einer auffälligen neuropsychologischen Entwicklung. Von allen untersuchten neuropsychologischen Funktionen erwies sich die phonologische Verarbeitung, insbesondere die phonologische Bewusstheit, als die am höchsten diskriminative Variable für umschriebene Lernstörungen im Lesen und/ oder Rechtschreiben sowie in der kombinierten Form mit Rechenstö...

  6. Trennung und Rekombination von Ladungsträgern in Solarzellen mit nanostrukturierter ZnO-Elektrode

    OpenAIRE

    Tornow, Julian

    2010-01-01

    In dieser Arbeit werden Elektroden aus hydrothermal auf leitfähigem Glassubstrat (Leitglas) abgeschiedenen ZnO-Nanostangen betrachtet. Die Elektroden selbst sind für sichtbares Licht transparent und werden für eine Anwendung als Solarzelle mit einer lichtabsorbierenden Schicht sensibilisiert; hier sind das entweder metallorganische Farbstoffmoleküle (N3) oder eine nur wenige Nanometer dicke Schicht aus Indiumsulfid. Für die elektrische Kontaktierung der sensibilisierten Elektrode wird entwed...

  7. Gasification together with other residual materials; Vergasung gemeinsam mit anderen Reststoffen

    Energy Technology Data Exchange (ETDEWEB)

    Lungwitz, H. [Berliner Wasserbetriebe, Berlin (Germany)

    1998-09-01

    The commonest method of thermal sewage sludge treatment at present is still combustion in mono-fluidised-bed plants. The possibilities described in the introduction of this paper give an impression of the great variety of disposal methods with a thermal final stage among which one can choose today. The solution that has been found to the disposal problems of four sewage plants in Berlin shows by way of example how a Europe-wide tender can lead to an inexpensive, permanent, secure, and flexible disposal system which includes recycling and figures as part of an integrated disposal system for different wastes. This disposal system has found ready acceptance on account of its environmental friendliness and sparing consumption of resources. Unlike incineration plants, its construction did not meet with public resistance. [Deutsch] Die zur Zeit noch haeufigste thermische Klaerschlammbehandlung ist die Verbrennung in Mono-Wirbelschichtanlagen. Die einleitend geschilderten Moeglichkeiten lassen jedoch die Vielfalt erkennen, die jetzt bei der Wahl eines Entsorgungsweges mit thermischer Endstufe gegeben sind. Die Loesung der Entsorgungsprobleme fuer 4 Berliner Klaerwerke hat beispielhaft gezeigt wie z.B. mittels eines europaweiten Ausschreibungsverfahrens ein kostenguenstiger, zeitlich nicht begrenzter, sicherer und flexibler Entsorgungsweg mit stofflicher Verwertung im Rahmen eines Verbundkonzeptes mit anderen Abfallstoffen gefunden werden kann. Ein Verwertungsweg, der allgemein wegen seiner Umweltvertraeglichkeit und Ressourcenschonung grosse Akzeptanz erfahren hat. Widerstand, wie beim Bau von Verbrennungsanlagen, hat es nicht gegeben. (orig.)

  8. [COPD und Klangtherapie: Pilotstudie zur Wirksamkeit einer Behandlung mit Körpertambura bei COPD-Patienten].

    Science.gov (United States)

    Hartwig, Bernhard; Schmidt, Stefan; Hartwig, Isabella

    2016-01-01

    Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD; GOLD-Stadium A oder B) erbringen kann. Patienten und Methoden: 54 Probanden konnten je zur Hälfte in eine Behandlungsgruppe (Körpertambura) und eine aktive Kontrollgruppe (Atemtherapie) randomisiert werden. Eine Bestimmung der Lungenfunktionsmessparameter «Einsekundenkapazität» (FEV1) und «inspiratorische Vitalkapazität» (IVC) zu den Zeitpunkten T1 (Baseline), T2 (direkt nach Behandlung) und als Follow-up etwa 3 Wochen nach T1 (T3). Ergebnisse: Die Behandlungsgruppe zeigte sich der Kontrollgruppe in beiden Werten signifikant überlegen. Die Zeit-×-Gruppe-Interaktion (Varianzanalyse) ergab p = 0,001 (FEV1) bzw. p = 0,04 (IVC). Die Behandlungsgruppe zeigte bei beiden Werten eine Verbesserung von klinischer Relevanz. Schlussfolgerung: Diese Ergebnisse zeigen, dass die Klangbehandlung mittels einer Körpertambura - neben den schulmedizinischen, leitliniengerechten Therapien - eine zusätzliche, nebenwirkungsarme, aber durchaus klinisch wirksame Option für die Behandlung von COPD-Patienten darstellen kann, um deren Lebensqualität zu stabilisieren und zu verbessern. © 2016 S. Karger GmbH, Freiburg.

  9. A metabolic signature for long life in the Caenorhabditis elegans Mit mutants.

    Science.gov (United States)

    Butler, Jeffrey A; Mishur, Robert J; Bhaskaran, Shylesh; Rea, Shane L

    2013-02-01

    Mit mutations that disrupt function of the mitochondrial electron transport chain can, inexplicably, prolong Caenorhabditis elegans lifespan. In this study we use a metabolomics approach to identify an ensemble of mitochondrial-derived α-ketoacids and α-hydroxyacids that are produced by long-lived Mit mutants but not by other long-lived mutants or by short-lived mitochondrial mutants. We show that accumulation of these compounds is dependent on concerted inhibition of three α-ketoacid dehydrogenases that share dihydrolipoamide dehydrogenase (DLD) as a common subunit, a protein previously linked in humans with increased risk of Alzheimer's disease. When the expression of DLD in wild-type animals was reduced using RNA interference we observed an unprecedented effect on lifespan - as RNAi dosage was increased lifespan was significantly shortened, but, at higher doses, it was significantly lengthened, suggesting that DLD plays a unique role in modulating length of life. Our findings provide novel insight into the origin of the Mit phenotype. © 2012 The Authors Aging Cell © 2012 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland.

  10. Clinical accuracy of inflationary oscillometry in pregnancy and pre-eclampsia: Omron-MIT Elite.

    Science.gov (United States)

    Chung, Y; Brochut, M C; de Greeff, A; Shennan, A H

    2012-10-01

    To evaluate the accuracy of the Omron MIT Elite in pregnancy and pre-eclampsia according to the British Hypertension Society protocol (BHS). Prospective observational study. Antenatal clinics and wards at St. Thomas' Hospital (London, UK). Forty-five pregnant women including 15 with pre-eclampsia. Nine sequential same arm blood pressure (BP) measurements were taken from each woman by trained observers, alternating between mercury sphygmomanometry and the test device. Grading criteria of the BHS protocol (A/B grade=pass; C/D=fail). The Omron MIT Elite achieved a grade A/A in both pregnancy and pre-eclampsia. The mean difference (SD) between the mercury standard and the device in pregnancy was -1.1 (5.2)mmHg and 1.5 (4.8)mmHg for systolic and diastolic BP respectively compared to 0.2 (5.3)mmHg and 2.2 (5.5)mmHg in pre-eclampsia. The Omron MIT Elite can be recommended for use in pregnancy and pre-eclampsia according to the BHS protocol. To date, this is the most accurate automated BP device validated in pre-eclampsia. Copyright © 2012. Published by Elsevier B.V.

  11. [Homöopathisch-phytotherapeutische Behandlung des Reizdarmsyndroms mit Magen-Darm-Entoxin N®: Eine Anwendungsbeobachtung].

    Science.gov (United States)

    Märtens, Diane; Range, Natasha; Günnewich, Nils; Gruber, Nicola; Schmidt, Stefan

    Hintergrund: In dieser Anwendungsbeobachtung wird zum ersten Mal die Behandlung des Reizdarmsyndroms (RDS) mit einem homöopathisch-phytotherapeutischen Komplexpräparat beschrieben. Methodik: Ziel der 6-wöchigen Therapie mit dem Magen-Darm-Entoxin N® war die Reduzierung der RDS-Symptomatik sowie die Verbesserung der Lebensqualität. Zielkriterien waren die Veränderungen in der Irritable Bowel Syndrome - Severity Scoring System (IBS-SSS) und der Irritable Bowel Syndrome - Quality-of-Life Scale (IBS-QoL). Die Patient/innen (N = 41; Alter 44,0 ± 15,74 Jahre) wurden zu gleichen Teilen in einer Hausarztpraxis (N = 20) und einer Heilpraktikerpraxis (N = 21) rekrutiert. Ergebnisse: Der IBS-QoL-Score verringerte sich signifikant (prä: 35,9 ± 16,3; post: 20,1 ± 13,4; t = 8,504; p mit einer Effektstärke von d = 1,24. Die Neben- und Wechselwirkungen waren minimal und signifikante Unterschiede zwischen beiden Praxen wurden nicht gefunden. Schlussfolgerungen: Magen-Darm-Entoxin N® ist eine sichere und sinnvolle Therapieoption bei der Behandlung des RDS. Allerdings sollten randomisierte kontrollierte Studien folgen, um die Spezifizität der Ergebnisse dieser Anwendungsbeobachtung zu stützen. © 2017 S. Karger GmbH, Freiburg.

  12. Embryonic expression of zebrafish MiT family genes tfe3b, tfeb, and tfec.

    Science.gov (United States)

    Lister, James A; Lane, Brandon M; Nguyen, Anhthu; Lunney, Katherine

    2011-11-01

    The MiT family comprises four genes in mammals: Mitf, Tfe3, Tfeb, and Tfec, which encode transcription factors of the basic-helix-loop-helix/leucine zipper class. Mitf is well-known for its essential role in the development of melanocytes, however the functions of the other members of this family, and of interactions between them, are less well understood. We have now characterized the complete set of MiT genes from zebrafish, which totals six instead of four. The zebrafish genome contain two mitf (mitfa and mitfb), two tfe3 (tfe3a and tfe3b), and single tfeb and tfec genes; this distribution is shared with other teleosts. We present here the sequence and embryonic expression patterns for the zebrafish tfe3b, tfeb, and tfec genes, and identify a new isoform of tfe3a. These findings will assist in elucidating the roles of the MiT gene family over the course of vertebrate evolution. Copyright © 2011 Wiley-Liss, Inc.

  13. A METABOLIC SIGNATURE FOR LONG-LIFE IN THE C. ELEGANS MIT MUTANTS

    Science.gov (United States)

    Butler, Jeffrey A.; Mishur, Robert J.; Bhaskaran, Shylesh; Rea, Shane L.

    2012-01-01

    SUMMARY Mit mutations that disrupt function of the mitochondrial electron transport chain can, inexplicably, prolong Caenorhabditis elegans lifespan. In this study we use a metabolomics approach to identify an ensemble of mitochondrial-derived α-ketoacids and α-hydroxyacids that are produced by long-lived Mit mutants but not by other long-lived mutants or by short-lived mitochondrial mutants. We show that accumulation of these compounds is dependent upon concerted inhibition of three α-ketoacid dehydrogenases that share dihydrolipoamide dehydrogenase (DLD) as a common subunit, a protein previously linked in humans with increased risk of Alzheimer’s disease. When the expression of DLD in wild type animals was reduced using RNA interference we observed an unprecedented effect on lifespan - as RNAi dosage was increased lifespan was significantly shortened but, at higher doses, it was significantly lengthened, suggesting DLD plays a unique role in modulating length of life. Our findings provide novel insight into the origin of the Mit phenotype. PMID:23173729

  14. Untersuchung perturbativer und nichtperturbativer Struktur der Momente hadronischer Ereignisformvariablen mit den Experimenten JADE und OPAL

    CERN Document Server

    Pahl, Christoph Johannes

    2007-01-01

    In Hadronproduktionsdaten der e+e− - Vernichtungsexperimente JADE und OPAL messen wir die ersten f¨unf Momente von zw¨olf hadronischen Ereignisformvariablen bei Schwerpunktsenergien von 14 bis 207GeV. Aus dem Vergleich der QCD NLO-Vorhersage mit den mittels MC-Modellen um Hadronisierung korrigierten Daten erhalten wir den Referenzwert der starken Kopplung αs(MZ0) = 0.1254 ± 0.0007(stat.) ± 0.0010(exp.)+0.0009 −0.0023(had.)+0.0069 −0.0053(theo.) . F¨ur einige, insbesondere h¨ohere, Momente sind systematische Unzul¨anglichkeiten in der QCD NLO-Vorhersage erkenntlich. Simultane Fits an zwei Momente unter Annahme identischer Renormierungsskalen ergeben Skalenwerte von xμ=0.057 bis xμ=0.196 . Wir pr¨ufen Vorhersagen verschiedener nichtperturbativer Modelle. Aus der Single Dressed Gluon - N¨aherung ergibt sich eine perturbative Vorhersage in O(α5 s ) mit zu vernachl¨assigender Energiepotenzkorrektur, die den Mittelwert von Thrust auf Hadronniveau gut beschreibt mit αs(MZ0) = 0.1186 ± 0.0007(st...

  15. Problembasiertes kollaboratives Lernen mit virtuellen Patienten in der Kinderheilkunde: ein Beispiel aus der Ausbildungspraxis

    Directory of Open Access Journals (Sweden)

    Sostmann, Kai

    2009-02-01

    Full Text Available Der studentische Unterricht in der Kinderheilkunde an der Charité hat seit 1999 mehrere Umstrukturierungen durchlaufen. Mit der Einführung der neuen ärztlichen Approbationsordnung 2004 im Regelstudiengang (RSG und dem Modellcurriculum Reformstudiengang Medizin (RSM 1999 müssen zwei Curricula parallel neu konzipiert und gepflegt werden. Durch den Schwerpunkt Unterricht am Krankenbett (UaK im RSG ergaben sich neue didaktische, pädagogische und infrastrukturelle Anforderungen. Die technische und inhaltliche Weiterentwicklung der Einsatzmöglichkeiten elektronischer Lernszenarien durch e-Learning im Rahmen des BMBF-geförderten Projektes ELWIS-MED, ermöglichte die Erprobung der curricularen Implementierung von e-Learning-Modulen im Pflichtunterricht. Der UaK wurde durch die Bearbeitung kinderheilkundlicher elektronischer Lernfälle online ergänzt. Die Studierenden sollten tutoriell betreute Diskussionen zu fachlichen Aufgabenstellungen online führen. In der ersten Erprobungsstufe wurde der Einsatz der Diskussionsforen in Verbindung mit den Lernfällen von den Studierenden und Lehrenden als sinnvolle Ergänzung betrachtet. In zukünftigen Einsatzszenarien sollte eine Messung des studentischen Lernerfolgs mit dieser Methode erfolgen.

  16. Magnetisches Tracking für die Navigation mit dem da Vinci® Surgical System

    Science.gov (United States)

    Nickel, Felix; Wegner, Ingmar; Kenngott, Hannes; Neuhaus, Jochen; Müller-Stich, Beat P.; Meinzer, Hans-Peter; Gutt, Carsten N.

    In dieser Studie wurde untersucht ob in einem typischen OP-Aufbau mit dem da Vinci® Telemanipulator elektromagnetisches Tracking für die Realisation eines Navigationssystems eingesetzt werden kann. Hierfür wurde in einem realen OP-Aufbau untersucht, wie stark metallische und ferromagnetisch wirksame Objekte wie Operationstisch und Telemanipulator das elektromagnetische Feld des Trackingsystems beeinflussen. Die Ergebnisse zeigen, dass der Telemanipulator nur unwesentlich die Störung des Magnetfeldes durch den OP-Tisch verstärkt. Insbesondere die Bewegung der Instrumente im Trackingvolumen verursachte keine zusätzliche relevante Störung des Magnetfeldes. Bei Begrenzung des Trackingvolumens auf eine Länge von 190 mm, Höhe von 200mm und Breite von 400 mm war der maximale Fehler in diesem Bereich an allen Messpunkten kleiner 10 mm. Der Einsatz von elektromagnetischem Tracking für die Navigation mit dem da Vinci® Surgical System ist somit in einem begrenzten Arbeitsvolumen mit hinreichender Genauigkeit möglich.

  17. Design of a propeller turbine with a variable revolution number; Entwicklung einer Propellerturbine mit variabler Drehzahl

    Energy Technology Data Exchange (ETDEWEB)

    Fella, G.; Wierer, C. [Fella GmbH Maschinen- und Apparatebau, Amorbach (Germany); Goede, E.; Batrekhy, S.; Ruprecht, A. [Stuttgart Univ. (Germany). Inst. fuer Stroemungsmechanik und Hydraulische Stroemungsmaschinen

    1997-12-31

    The small hydroelectric power station of Rupboden in the Oberfranken district was reactivated after having been decommissioned for 30 years. This new low pressure plant consists of an open-flume turbine with an adjustable diffusor and a firm rotor disk (propeller) with a vertical rod. A large range of operation at a constant height of fall is ensured by a variable revolution number. The profiles of the adjustable diffusor and rotor disk and the design of the draft tube were optimized using numerical flow calculation. First operating experience is very positive. The turbine runs extremely smoothly over the entire range. (orig.) [Deutsch] Das Kleinwasserkraftwerk Rupboden in Oberfanken wurde nach 30 Jahren Stillstand reaktiviert. Die neue Niederdruckanlage besteht aus einer Schachtturbine mit verstellbarem Leitapparat, feststehendem Laufrad (Propeller) mit senkrechter Welle. Zum Erzielen eines grossen Betriebsbereiches bei gleichbleibender Fallhoehe wurde eine variable Drehzahl vorgesehen. Die Profilierung von Leitapparat und Laufrad sowie die Formgebung fuer das Saugrohr wurden mit numerischer Stroemungsberechnung optimiert. Erste Betriebserfahrungen sind sehr positiv. Die Turbine laeuft im gesamten Leistungsbereich ausserordentlich ruhig. (orig.)

  18. Axial turbine with underwater generator for energy recovery; Axialturbine mit Unterwassergenerator zur Energierueckgewinnung

    Energy Technology Data Exchange (ETDEWEB)

    Welzel, B. [Stuttgart Univ. (Germany). Inst. fuer Stroemungsmechanik und Hydraulische Stroemungsmaschinen

    1997-12-31

    Within the framework of a project sponsored by the Stiftung Energieforschung Baden-Wuerttemberg, an axial turbine was developed as a flash evaporator, which permits energy recovery in all sectors where liquids in piping undergoes pressure relaxation. A specific feature of this turbine is that it forms part, complete with generator, of a single pipeline and that it does not cause any pressure variations worth mentioning in case of mains failure. The report describes the turbine, its advantages, and a pilot operation carried out with a prototype. The turbine`s performance is compared with a return pump. Further, the optimization of the hydraulic design by computer and the results of a market analysis are dealt with. (orig.) [Deutsch] Im Rahmen einer von der Stiftung Energieforschung Baden-Wuerttemberg gefoerderten Neuentwicklung wurde eine Axialturbine als Entspannungsturbine entwickelt, mit der eine Energierueckgewinnung in allen Bereichen erfolgen kann, in denen Fluessigkeiten in Rohrleitungssystemen entspannt werden. Die Turbine zeichnet sich unter anderem dadurch aus, dass sie komplett, inklusive Generator, innerhalb einer Rohrleitung angeordnet ist und bei Netzausfall keine nennenswerte Druckschwankung erzeugt. Es werden die Turbine, deren Vorteile sowie der mit einem Prototypen durchgefuehrte Betriebsversuch beschrieben. Weiterhin werden ein Vergleich des Betriebsverhaltens mit einer rueckwaertslaufenden Pumpe, die rechnerische Optimierung der hydraulischen Formgebung sowie die Ergebnisse einer Marktanalyse behandelt. (orig.)

  19. Automatizace MitM útoku pro dešifrování SSL/TLS

    OpenAIRE

    Marušic, Marek

    2016-01-01

    Protokoly SSL/TLS sú používané pre šifráciu sieťovéhej prevádzky. Poskytujú bezpečnú komunikáciu medzi klientmi a servermi. Komunikácia môže byť odpočúvaná pomocou MitM útoku. Táto práca je zameraná na atuomatizovanie MitM útoku a demonštráciu jej výsledkov. Automatizáciou sa zjednoduší spustenie útoku bez nutnosti študovania rôznych manuálových stránok a aby sa používatelia vyhli pracnej konfigurácii MitM zariadenia a mohli jednoducho zachytiť a analyzovať SSL/TLS komunikáciu. Automatizácia ...

  20. A phase-I clinical trial for cranial BNCT at Harvard-MIT

    International Nuclear Information System (INIS)

    Busse, P.M.; Palmer, M.R.; Harling, O.K.

    2000-01-01

    Phase I trial designed to determine the maximum tolerable dose to normal tissue for cranial BNCT (Boron Neutron Capture Therapy) irradiations was recently completed at Harvard Medical School and MIT. Twenty-two subjects diagnosed with either glioblastoma multiforme or intracranial melanoma were treated between 1996 and 1999. Subjects received either one or two administrations of boronophenylalanine intravenously at doses between 250 and 350 mg/kg body weight, then exposed in one, two or three fields to epithermal neutrons at the MIT Research Reactor in one or two fractions. Over the course of the study, the maximum normal tissue dose target was increased from 8.8 to 14.2 RBE (Relative Biological Effectiveness) Gy in 10% increments. Subjects have been followed clinically and radiographically. Of those patients surviving beyond six months, no MRI (Magnetic Resonance Image) white-matter changes were observed and no long-term complications attributable to BNCT were evident. Tumor responses were observed, particularly with the melanoma subjects. With increasing doses, difficulties arose from long irradiation times (approximately 3 hours) and the emergence of acute reactions in the skin and mucosa. The trial was stopped in May 1999. Future trials will be initiated with the new high intensity, low background fission converter beam at MIT. (author)

  1. Natural gas engine concept with EZEV potential; Erdgasmotorkonzept mit EZEV-Potential

    Energy Technology Data Exchange (ETDEWEB)

    Maier, F.; Mueller, P.; Heck, E.; Langen, P. [BMW AG (Germany)

    1997-09-01

    The first natural gas vehicles form BMW are designed for arbitrary gasoline or natural gas operation. It is possible only to a limited extent to take advantage of the benefits of natural gas as a fuel as long as this is the case. An analysis was made to determine possible improvements in terms of fuel economy, emissions, full load and maximum exhaust gas temperatures through selective optimisation for exclusive natural gas operation. The results of this analysis have been used in the design of natural gas engines for mid-sized vehicles. Vehicle examinations in FTP75 confirm the existing potential for satisfying EZEV standards discussed in California even with vehicles of the upper midsize category by using optimised natural gas engines. (orig.) [Deutsch] Die ersten Automobile mit Erdgasantrieb von BMW sind fuer den wahlweisen Benzin- oder Erdgasbetrieb ausgelegt. Deshalb koennen die Vorteile des Kraftstoffs Erdgas nur zum Teil genutzt werden. Es wurde untersucht, welche Verbesserungen durch gezielte Optimierung fuer den ausschliesslichen Erdgasbetrieb bei Kraftstoffverbrauch, Emissionen, Vollast und maximalen Abgastemperaturen moeglich sind. Die Ergebnisse wurden bei der Auslegung von Erdgasmotoren fuer Mittelklassefahrzeuge verwendet. Untersuchungen im FTP-75 bestaetigen, dass mit optimierten Erdgasmotoren das Potential besteht, selbst mit Automobilen der oberen Mittelklasse die in Kalifornien diskutierten EZEV-Standards zu erfuellen. (orig.)

  2. Insight into the adsorption profiles of the Saprolegnia monoica chitin synthase MIT domain on POPA and POPC membranes by molecular dynamics simulation studies.

    Science.gov (United States)

    Kuang, Guanglin; Liang, Lijun; Brown, Christian; Wang, Qi; Bulone, Vincent; Tu, Yaoquan

    2016-02-21

    The critical role of chitin synthases in oomycete hyphal tip growth has been established. A microtubule interacting and trafficking (MIT) domain was discovered in the chitin synthases of the oomycete model organism, Saprolegnia monoica. MIT domains have been identified in diverse proteins and may play a role in intracellular trafficking. The structure of the Saprolegnia monoica chitin synthase 1 (SmChs1) MIT domain has been recently determined by our group. However, although our in vitro assay identified increased strength in interactions between the MIT domain and phosphatidic acid (PA) relative to other phospholipids including phosphatidylcholine (PC), the mechanism used by the MIT domain remains unknown. In this work, the adsorption behavior of the SmChs1 MIT domain on POPA and POPC membranes was systematically investigated by molecular dynamics simulations. Our results indicate that the MIT domain can adsorb onto the tested membranes in varying orientations. Interestingly, due to the specific interactions between MIT residues and lipid molecules, the binding affinity to the POPA membrane is much higher than that to the POPC membrane. A binding hotspot, which is critical for the adsorption of the MIT domain onto the POPA membrane, was also identified. The lower binding affinity to the POPC membrane can be attributed to the self-saturated membrane surface, which is unfavorable for hydrogen-bond and electrostatic interactions. The present study provides insight into the adsorption profile of SmChs1 and additionally has the potential to improve our understanding of other proteins containing MIT domains.

  3. Mit sprog - mit arbejde - mit liv

    DEFF Research Database (Denmark)

    Pedersen, Michael Svendsen

    2006-01-01

    Med inspiration fra et økologisk perspektiv på sproglæring diskuteres mulighederne for videreudvikling af en kommunikativ pædagogik inden for arbejdspladsrelateret undervisning i dansk som andetsprog for voksne....

  4. Short- and long-term performance of a tripolar down-sized single lead for implantable cardioverter defibrillator treatment: a randomized prospective European multicenter study. European Endotak DSP Investigator Group.

    Science.gov (United States)

    Sandstedt, B; Kennergren, C; Schaumann, A; Herse, B; Neuzner, J

    1998-11-01

    A new, thinner (10 Fr) and more flexible, single-pass transvenous endocardial ICD lead, Endotak DSP, was compared with a conventional lead, Endotak C, as a control in a prospective randomized multicenter study in combination with a nonactive can ICD. A total of 123 patients were enrolled, 55 of whom received a down-sized DSP lead. Lead-alone configuration was successfully implanted in 95% of the DSP patients vs 88% in the control group. The mean defibrillation threshold (DFT) was determined by means of a step-down protocol, and was identical in the two groups, 10.5 +/- 4.8 J in the DSP group versus 10.5 +/- 4.8 J in the control group. At implantation, the DSP mean pacing threshold was lower, 0.51 +/- 0.18 V versus 0.62 +/- 0.35 V (p < 0.05) in the control group, and the mean pacing impedance higher, 594 +/- 110 omega vs 523 +/- 135 omega (p < 0.05). During the follow-up period, the statistically significant difference in thresholds disappeared, while the difference in impedance remained. Tachyarrhythmia treatment by shock or antitachycardia pacing (ATP) was delivered in 53% and 41%, respectively, of the patients with a 100% success rate. In the DSP group, all 28 episodes of polymorphic ventricular tachycardia or ventricular fibrillation were converted by the first shock as compared to 57 of 69 episodes (83%) in the control group (p < 0.05). Monomorphic ventricular tachycardias were terminated by ATP alone in 96% versus 94%. Lead related problems were minor and observed in 5% and 7%, respectively. In summary, both leads were safe and efficacious in the detection and treatment of ventricular tachyarrhythmias. There were no differences between the DSP and control groups regarding short- or long-term lead related complications.

  5. Prostate health index significantly reduced unnecessary prostate biopsies in patients with PSA 2-10 ng/mL and PSA >10 ng/mL: Results from a Multicenter Study in China.

    Science.gov (United States)

    Na, Rong; Ye, Dingwei; Qi, Jun; Liu, Fang; Helfand, Brian T; Brendler, Charles B; Conran, Carly A; Packiam, Vignesh; Gong, Jian; Wu, Yishuo; Zheng, Siqun L; Mo, Zengnan; Ding, Qiang; Sun, Yinghao; Xu, Jianfeng

    2017-08-01

    The performance of prostate health index (phi) in predicting prostate biopsy outcomes has been well established for patients with prostate-specific antigen (PSA) values between 2 and 10 ng/mL. However, the performance of phi remains unknown in patients with PSA >10 ng/mL, the vast majority in Chinese biopsy patients. We aimed to assess the ability of phi to predict prostate cancer (PCa) and high-grade disease (Gleason Score ≥7) on biopsy in a Chinese population. This is a prospective, observational, multi-center study of consecutive patients who underwent a transrectal ultrasound guided prostate biopsy at four hospitals in Shanghai, China from August 2013 to December 2014. In the cohort of 1538 patients, the detection rate of PCa was 40.2%. phi had a significantly better predictive performance for PCa than total PSA (tPSA). The areas under the receiver operating characteristic curve (AUC) were 0.90 and 0.79 for phi and tPSA, respectively, P 10 ng/mL (N = 838, 54.5%). The detection rates of PCa were 35.9% and 57.7% in patients with tPSA 10.1-20 and 20.1-50 ng/mL, respectively. The AUCs of phi (0.79 and 0.89, for these two groups, respectively) were also significantly higher than tPSA (0.57 and 0.63, respectively), both P 10 ng/mL). © 2017 Wiley Periodicals, Inc.

  6. Adjuvant Chemoradiation for Gastric Cancer Using Epirubicin, Cisplatin, and 5-Fluorouracil Before and After Three-Dimensional Conformal Radiotherapy With Concurrent Infusional 5-Fluorouracil: A Multicenter Study of the Trans-Tasman Radiation Oncology Group

    International Nuclear Information System (INIS)

    Leong, Trevor; Joon, Daryl Lim; Willis, David; Jayamoham, Jayasingham; Spry, Nigel; Harvey, Jennifer; Di Iulio, Juliana; Milner, Alvin; Mann, G. Bruce; Michael, Michael

    2011-01-01

    Purpose: The INT0116 study has established postoperative chemoradiotherapy as the standard of care for completely resected gastric adenocarcinoma. However, the optimal chemoradiation regimen remains to be defined. We conducted a prospective, multicenter study to evaluate an alternative chemoradiation regimen that combines more current systemic treatment with modern techniques of radiotherapy delivery. Methods and Materials: Patients with adenocarcinoma of the stomach who had undergone an R0 resection were eligible. Adjuvant therapy consisted of one cycle of epirubicin, cisplatin, and 5-FU (ECF), followed by radiotherapy with concurrent infusional 5-FU, and then two additional cycles of ECF. Radiotherapy was delivered using precisely defined, multiple-field, three-dimensional conformal techniques. Results: A total of 54 assessable patients were enrolled from 19 institutions. The proportion of patients commencing Cycles 1, 2, and 3 of ECF chemotherapy were 100%, 81%, and 67% respectively. In all, 94% of patients who received radiotherapy completed treatment as planned. Grade 3/4 neutropenia occurred in 66% of patients with 7.4% developing febrile neutropenia. Most neutropenic episodes (83%) occurred in the post-radiotherapy period during cycles 2 and 3 of ECF. Grade 3/4 gastrointestinal toxicity occurred in 28% of patients. In all, 35% of radiotherapy treatment plans contained protocol deviations that were satisfactorily amended before commencement of treatment. At median follow-up of 36 months, the 3-year overall survival rate was estimated at 61.6%. Conclusions: This adjuvant regimen using ECF before and after three-dimensional conformal chemoradiation is feasible and can be safely delivered in a cooperative group setting. A regimen similar to this is currently being compared with the INT0116 regimen in a National Cancer Institute-sponsored, randomized Phase III trial.

  7. Long-Term Efficacy and Safety of Cyclosporine in a Cohort of Steroid-Refractory Acute Severe Ulcerative Colitis Patients from the ENEIDA Registry (1989-2013): A Nationwide Multicenter Study.

    Science.gov (United States)

    Ordás, I; Domènech, E; Mañosa, M; García-Sánchez, V; Iglesias-Flores, E; Peñalva, M; Cañas-Ventura, A; Merino, O; Fernández-Bañares, F; Gomollón, F; Vera, M; Gutiérrez, A; Garcia-Planella, E; Chaparro, M; Aguas, M; Gento, E; Muñoz, F; Aguirresarobe, M; Muñoz, C; Fernández, L; Calvet, X; Jiménez, C E; Montoro, M A; Mir, A; De Castro, M L; García-Sepulcre, M F; Bermejo, F; Panés, J; Esteve, M

    2017-11-01

    To determine the efficacy and safety of cyclosporine (CyA) in a large national registry-based population of patients with steroid-refractory (SR) acute severe ulcerative colitis (ASUC) and to establish predictors of efficacy and adverse events. Multicenter study of SR-ASUC treated with CyA, based on data from the ENEIDA registry. SR-ASUC patients treated with infliximab (IFX) or sequential rescue therapy (CyA-IFX or IFX-CyA) were used as comparators. Of 740 SR-ASUC patients, 377 received CyA, 131 IFX and 63 sequential rescue therapy. The cumulative colectomy rate was higher in the CyA (24.1%) and sequential therapy (32.7%) than in the IFX group (14.5%; P=0.01) at 3 months and 5 years. There were no differences in early and late colectomy between CyA and IFX in patients treated after 2005. 62% of patients receiving CyA remained colectomy-free in the long term (median 71 months). There were no differences in mortality between CyA (2.4%), IFX (1.5%) and sequential therapy (0%; P=0.771). The proportion of patients with serious adverse events (SAEs) was lower in CyA (15.4%) than in IFX treated patients (26.5%) or sequential therapy (33.4%; P<0.001). This difference in favor of CyA was maintained when only patients treated after 2005 were analyzed. Treatment with CyA showed a lower rate of SAE and a similar efficacy to that of IFX thereby supporting the use of either CyA or IFX in SR-ASUC. In addition, the risk-benefit of sequential CyA-IFX for CyA non-responders is acceptable.

  8. A Retrospective, Multicenter Study of the Tolerance of Induction Chemotherapy With Docetaxel, Cisplatin, and 5-Fluorouracil Followed by Radiotherapy With Concomitant Cetuximab in 46 Cases of Squamous Cell Carcinoma of the Head and Neck

    International Nuclear Information System (INIS)

    Buiret, Guillaume; Combe, Claire; Favrel, Veronique; Pommier, Pascal; Martin, Laurent; Ecochard, Rene; Fayette, Jerome; Tartas, Sophie; Ramade, Antoine; Ceruse, Philippe

    2010-01-01

    Purpose: To investigate, in a multicenter study, the tolerance of induction chemotherapy (ICT) and external radiotherapy (ERT) with concomitant cetuximab in the treatment of patients with squamous cell carcinoma of the head and neck (SCCHN). Patients and Methods: Clinical data from 46 patients with Stage III or IV nonmetastatic SCCHN who received docetaxel, cisplatin, and 5-fluorouracil as ICT, followed by ERT with concomitant cetuximab, were retrospectively analyzed. Clinical safety (weight, allergy, mucositis, and dermatitis) and paraclinical safety (levels of hemoglobin, polynuclear neutrophils, and creatinine clearance) were studied. The primary objective was the proportion of patients who completed the protocol. Results: The percentage of patients completing ICT was 73.9%, ERT 93.5%, and cetuximab 69.6%. Induction chemotherapy was better tolerated than that previously reported. The rates of temporary suspensions of radiation (39.1%, mean duration of 13 days) and hospitalization (26.1%) during ERT with concomitant cetuximab were high. Weight loss during treatment (21.4% of patients lost >10% of their body weight), radiodermatitis, and radiomucositis were the main causes of temporary suspension of treatment, although Grade 4 dermatitis was not experienced. There were no allergic reactions to cetuximab. Conclusion: The completed protocol rate for SCCHN patients receiving ICT and ERT with concomitant cetuximab is high and the toxicity acceptable. Future improvements to protocol will be possible through early action and systematic implementation of nutritional support coupled with antibiotic treatment upon the first signs of radiodermatitis. These data could be useful for prospective studies on the safety and efficacy of this protocol.

  9. An open, parallel, randomized, comparative, multicenter study to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (intervention) vs silver sulfadiazine cream.

    Science.gov (United States)

    Silverstein, Paul; Heimbach, David; Meites, Herbert; Latenser, Barbara; Mozingo, David; Mullins, Fred; Garner, Warren; Turkowski, Joseph; Shupp, Jeffrey; Glat, Paul; Purdue, Gary

    2011-01-01

    An open, parallel, randomized, comparative, multicenter study was implemented to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (Mepilex Ag) vs silver sulfadiazine cream (control) in the treatment of partial-thickness thermal burns. Individuals aged 5 years and older with partial-thickness thermal burns (2.5-20% BSA) were randomized into two groups and treated with the trial products for 21 days or until healed, whichever occurred first. Data were obtained and analyzed on cost (direct and indirect), healing rates, pain, comfort, ease of product use, and adverse events. A total of 101 subjects were recruited. There were no significant differences in burn area profiles within the groups. The cost of dressing-related analgesia was lower in the intervention group (P = .03) as was the cost of background analgesia (P = .07). The mean total cost of treatment was $309 vs $513 in the control (P < .001). The average cost-effectiveness per treatment regime was $381 lower in the intervention product, producing an incremental cost-effectiveness ratio of $1688 in favor of the soft silicone foam dressing. Mean healing rates were 71.7 vs 60.8% at final visit, and the number of dressing changes were 2.2 vs 12.4 in the treatment and control groups, respectively. Subjects reported significantly less pain at application (P = .02) and during wear (P = .048) of the Mepilex Ag dressing in the acute stages of wound healing. Clinicians reported the intervention dressing was significantly easier to use (P = .03) and flexible (P = .04). Both treatments were well tolerated; however, the total incidence of adverse events was higher in the control group. The silver-containing soft silicone foam dressing was as effective in the treatment of patients as the standard care (silver sulfadiazine). In addition, the group of patients treated with the soft silicone foam dressing demonstrated decreased pain and lower costs associated

  10. Neodadjuvante und adjuvante Kurzzeit-Hormontherapie in Kombination mit konformaler HDR-Brachytherapie beim Prostatakarzinom

    Directory of Open Access Journals (Sweden)

    Martin T

    2004-01-01

    Full Text Available Zielsetzung: Auswertung der Behandlungsergebnisse der neoadjuvanten und adjuvanten Kurzzeit-Hormontherapie kombiniert mit konformaler HDR-Brachytherapie und externer Radiotherapie beim Prostatakarzinom. Patienten und Methoden: Von 01/97 bis 09/99 behandelten wir 102 Patienten mit Prostatakarzinomen im Stadium T1–3 N0 M0. Im Stadium T1–2 befanden sich 71, im Stadium T3 31 Patienten. Der mediane prätherapeutische PSA-Wert betrug 15,3 ng/ml. Nach ultraschallgesteuerter transrektaler Implantation von vier Afterloadingnadeln erfolgte die CT-gestützte 3D-Brachytherapie- Planung. Alle Patienten erhielten vier HDR-Implantate mit einer Referenzdosis von 5 Gy oder 7 Gy pro Implantat. Die Zeit zwischen jedem Implantat betrug jeweils 14 Tage. Nach der Brachytherapie folgte die externe Radiotherapie bis 39,6 Gy oder 45,0 Gy. Alle Patienten erhielten eine neoadjuvante und adjuvante Kurzzeit-Hormontherapie, die 2–19 Monate vor der Brachytherapie eingeleitet und 3 Monate nach Abschluß der externen Radiotherapie abgesetzt wurde (mediane Dauer: 9 Monate. Ergebnisse: Die mediane Nachbeobachtungszeit war 2,6 Jahre (range: 2,0–4,1 Jahre. Die biochemische Kontrollrate betrug 82 % nach 3 Jahren. Bei 14/102 Patienten registrierten wir ein biochemisches Rezidiv, bei 5/102 Patienten ein klinisches Rezidiv. Das Gesamtüberleben betrug 90 %, das krankheitsspezifische Überleben 98,0 % nach 3 Jahren. Ein Patient entwickelte eine prostato-urethro-rektale Fistel als späte Grad 4-Toxizität. Akute Grad-3 Toxizitäten traten bei 4 %, späte Grad-3 Toxizitäten bei 5 % der Patienten auf. Schlußfolgerung: Die neoadjuvante und adjuvante Kurzzeit-Hormontherapie kombiniert mit konformaler HDR-Brachytherapie und externer Radiotherapie erweist sich als sichere und wirksame Behandlungsmodalität beim Prostatakarzinom mit minimalen behandlungsbedingten Toxizitäten und einer vielversprechenden biochemischen Kontrollrate nach medianer Nachbeobachtungszeit von 2,6 Jahren.

  11. Furosemide urogram in patients with neobladder; Das Diureseurogramm bei Patienten mit Harnblasenersatz

    Energy Technology Data Exchange (ETDEWEB)

    Merkle, E.M. [Univ. Ulm (Germany). Abt. Radiologie; Aschoff, A.J. [Univ. Ulm (Germany). Abt. Radiologie; Bachor, R. [Univ. Ulm (Germany). Abt. fuer Urologie; Vogel, J. [Univ. Ulm (Germany). Abt. Radiologie; Merk, J. [Univ. Ulm (Germany). Abt. Radiologie; Brambs, H.J. [Univ. Ulm (Germany). Abt. Radiologie

    1996-11-01

    Purpose: To differentiate between urodynamically relevant obstruction and functionally unimportant dilation of the upper urinary tract in patients with neobladder using a modified furosemide urogram. Method: An excretory urogram with furosemide loading was carried out in 19 patients with neobladder and sonographically and urographically confirmed dilation of the upper urinary tract. Once strong contrasting of the renal pelves and calyces has been achieved, 20 mg of furosemide were applied and late radiographs were obtained at 15 min and 30 min, respectively. An obstruction was defined as increasing dilation of the renal pelves and calices during forced diuresis and lack of washout effect of the contrast medium. Results: In 32 cases, the renoureteral unit (RUU) was dilated on ultrasound. Of these, 25 RUU`s showed good emptyness of contrast medium upon stimulation of diuresis, six RUU`s returned a borderline findings, while one RUU was found to exhibit a decompensated anastomotic stenosis, which was dilated. Two further patients with bordeline findings were later treated surgically due to their pain symptoms. No patient required further preoperative diagnostic procedures. Conclusions: The modified furosemide urogram represents a cost-effective diagnostic orientation strategy in patients with neobladder and dilated renal pelves and calyses and is both well-tolerated by patients and meets with broad acceptance from the urologic staff. (orig.) [Deutsch] Ziel: Differenzierung zwischen urodynamisch relevanter Obstruktion und funktionell bedeutungsloser Dilatation des oberen Harntraktes bei Patienten mit Harnblasenersatz durch ein modifiziertes Diureseurogramm. Methodik: Bei 19 Patienten mit Harnableitung und sonographisch sowie urographisch nachgewiesener Erweiterung des oberen Harntraktes wurde ein Ausscheidungsurogramm mit Furosemidbelastung durchgefuehrt. Bei kraeftiger Kontrastierung des erweiterten Nierenbeckenkelchsystems (NBKS) wurden 20 mg Furosemid appliziert und

  12. Internalized stigma in psoriasis: A multicenter study.

    Science.gov (United States)

    Alpsoy, Erkan; Polat, Mualla; FettahlıoGlu-Karaman, Bilge; Karadag, Ayse Serap; Kartal-Durmazlar, Pelin; YalCın, Basak; Emre, Selma; Didar-Balcı, Didem; Bilgic-Temel, Asli; Arca, Ercan; Koca, Rafet; Gunduz, Kamer; Borlu, Murat; Ergun, Tulin; Dogruk-Kacar, Seval; Cordan-Yazici, Ayca; Dursun, Pınar; BilgiC, Ozlem; Gunes-Bilgili, Serap; Sendur, Neslihan; Baysal, Ozge; Halil-Yavuz, Ibrahim; Yagcioglu, Gizem; Yilmaz, Ertan; Kavuzlu, Ufuk; Senol, Yesim

    2017-08-01

    Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease. © 2017 Japanese Dermatological Association.

  13. MitProNet: A knowledgebase and analysis platform of proteome, interactome and diseases for mammalian mitochondria.

    Directory of Open Access Journals (Sweden)

    Jiabin Wang

    Full Text Available Mitochondrion plays a central role in diverse biological processes in most eukaryotes, and its dysfunctions are critically involved in a large number of diseases and the aging process. A systematic identification of mitochondrial proteomes and characterization of functional linkages among mitochondrial proteins are fundamental in understanding the mechanisms underlying biological functions and human diseases associated with mitochondria. Here we present a database MitProNet which provides a comprehensive knowledgebase for mitochondrial proteome, interactome and human diseases. First an inventory of mammalian mitochondrial proteins was compiled by widely collecting proteomic datasets, and the proteins were classified by machine learning to achieve a high-confidence list of mitochondrial proteins. The current version of MitProNet covers 1124 high-confidence proteins, and the remainders were further classified as middle- or low-confidence. An organelle-specific network of functional linkages among mitochondrial proteins was then generated by integrating genomic features encoded by a wide range of datasets including genomic context, gene expression profiles, protein-protein interactions, functional similarity and metabolic pathways. The functional-linkage network should be a valuable resource for the study of biological functions of mitochondrial proteins and human mitochondrial diseases. Furthermore, we utilized the network to predict candidate genes for mitochondrial diseases using prioritization algorithms. All proteins, functional linkages and disease candidate genes in MitProNet were annotated according to the information collected from their original sources including GO, GEO, OMIM, KEGG, MIPS, HPRD and so on. MitProNet features a user-friendly graphic visualization interface to present functional analysis of linkage networks. As an up-to-date database and analysis platform, MitProNet should be particularly helpful in comprehensive studies of

  14. Good planning for maximum efficiency. Part 1. Housing development of passive buildings with solar district heat supply; Sauber geplant is halb gewonnen. Teil 1. Passivhaussiedlung mit solarer Nahwaermeversorgung

    Energy Technology Data Exchange (ETDEWEB)

    Meissner, R. [Ritter Energie- und Umwelttechnik, Karlsbad (Germany)

    2003-06-01

    A new development of 12 single-family dwellings was constructed with complex technical facilities and many innovative elements by Gewerbepark Ritter and Messrs. Paradigma, a provider of thermal solar systems. [German] Der Gewerbepark Ritter und die auf thermische Solarindustrie spezialisierte Firma Paradigma haben bei der Errichtung einer Siedlung mit 12 Einfamilienhaeusern mit einem komplexen Haustechnikkonzept ein wegweisendes Projekt mit vielen innovativen Neuerungen erfolgreich in die Tat umgesetzt. (orig.)

  15. Binding of Substrates to the Central Pore of the Vps4 ATPase Is Autoinhibited by the Microtubule Interacting and Trafficking (MIT) Domain and Activated by MIT Interacting Motifs (MIMs).

    Science.gov (United States)

    Han, Han; Monroe, Nicole; Votteler, Jörg; Shakya, Binita; Sundquist, Wesley I; Hill, Christopher P

    2015-05-22

    The endosomal sorting complexes required for transport (ESCRT) pathway drives reverse topology membrane fission events within multiple cellular pathways, including cytokinesis, multivesicular body biogenesis, repair of the plasma membrane, nuclear membrane vesicle formation, and HIV budding. The AAA ATPase Vps4 is recruited to membrane necks shortly before fission, where it catalyzes disassembly of the ESCRT-III lattice. The N-terminal Vps4 microtubule-interacting and trafficking (MIT) domains initially bind the C-terminal MIT-interacting motifs (MIMs) of ESCRT-III subunits, but it is unclear how the enzyme then remodels these substrates in response to ATP hydrolysis. Here, we report quantitative binding studies that demonstrate that residues from helix 5 of the Vps2p subunit of ESCRT-III bind to the central pore of an asymmetric Vps4p hexamer in a manner that is dependent upon the presence of flexible nucleotide analogs that can mimic multiple states in the ATP hydrolysis cycle. We also find that substrate engagement is autoinhibited by the Vps4p MIT domain and that this inhibition is relieved by binding of either Type 1 or Type 2 MIM elements, which bind the Vps4p MIT domain through different interfaces. These observations support the model that Vps4 substrates are initially recruited by an MIM-MIT interaction that activates the Vps4 central pore to engage substrates and generate force, thereby triggering ESCRT-III disassembly. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  16. Binding of Substrates to the Central Pore of the Vps4 ATPase Is Autoinhibited by the Microtubule Interacting and Trafficking (MIT) Domain and Activated by MIT Interacting Motifs (MIMs)*

    Science.gov (United States)

    Han, Han; Monroe, Nicole; Votteler, Jörg; Shakya, Binita; Sundquist, Wesley I.; Hill, Christopher P.

    2015-01-01

    The endosomal sorting complexes required for transport (ESCRT) pathway drives reverse topology membrane fission events within multiple cellular pathways, including cytokinesis, multivesicular body biogenesis, repair of the plasma membrane, nuclear membrane vesicle formation, and HIV budding. The AAA ATPase Vps4 is recruited to membrane necks shortly before fission, where it catalyzes disassembly of the ESCRT-III lattice. The N-terminal Vps4 microtubule-interacting and trafficking (MIT) domains initially bind the C-terminal MIT-interacting motifs (MIMs) of ESCRT-III subunits, but it is unclear how the enzyme then remodels these substrates in response to ATP hydrolysis. Here, we report quantitative binding studies that demonstrate that residues from helix 5 of the Vps2p subunit of ESCRT-III bind to the central pore of an asymmetric Vps4p hexamer in a manner that is dependent upon the presence of flexible nucleotide analogs that can mimic multiple states in the ATP hydrolysis cycle. We also find that substrate engagement is autoinhibited by the Vps4p MIT domain and that this inhibition is relieved by binding of either Type 1 or Type 2 MIM elements, which bind the Vps4p MIT domain through different interfaces. These observations support the model that Vps4 substrates are initially recruited by an MIM-MIT interaction that activates the Vps4 central pore to engage substrates and generate force, thereby triggering ESCRT-III disassembly. PMID:25833946

  17. Vitex-agnus-castus-Extrakt (Ze 440 zur Symptombehandlung bei Frauen mit menstruellen Zyklusstörungen

    Directory of Open Access Journals (Sweden)

    Eltbogen R

    2015-01-01

    Full Text Available Ziel: Diese nichtinterventionelle Beobachtungsstudie (NIS wurde von Schweizer Gynäkologen und Allgemeinmedizinern im Rahmen der üblichen ärztlichen Grundversorgung durchgeführt. Das Ziel der NIS war es, die Wirksamkeit und Sicherheit von Vitex-agnus-castus-(VAC Extrakt (Ze 440: premens, Zeller Medical AG, Romanshorn, Schweiz bei Frauen, die unter menstruellen Zyklusstörungen wie Polymenorrhö, Oligomenorrhö oder Amenorrhö litten, zu untersuchen. Methode: Insgesamt 211 Patientinnen nahmen an dieser NIS teil. Symptome, die mit menstruellen Zyklusstörungen („menstrual cycle irregularities“ [MCIs] und der Menstruationsblutung in Verbindung stehen, wurden bei einer Erstuntersuchung („baseline visit“ [BV] und einer Kontrolluntersuchung („follow-up visit“ [FV] nach Behandlung mit VAC-Extrakt über einen Zeitraum von 3 aufeinanderfolgenden Menstruationszyklen beurteilt. Ergebnisse: Der Anteil der Patientinnen, bei denen eine Beschwerdefreiheit oder eine Besserung der MCIs (insgesamt und spezifischer Beschwerdebilder wie Polymenorrhö, Oligomenorrhö und Amenorrhö erzielt werden konnte, lag bei der FV bei 79–85 %. Bei Symptomen im Zusammenhang mit der Menstruationsblutung wie Dysmenorrhö, Zwischenblutungen, Hypermenorrhö, Menometrorrhagie, Ovulationsblutung, präoder postmenstrueller Blutung betrug der Anteil der Patientinnen, bei denen ein Rückgang oder eine Besserung festgestellt wurde, bei der FV zwischen 60 und 88 %. Von 53 Patientinnen, die bei der BV von einem unerfüllten Kinderwunsch berichteten, wurden 12 Frauen (23 % während der Behandlung mit VAC-Extrakt schwanger. Bei der FV waren 91 % der Ärzte und 92 % der Patientinnen mit den erzielten Behandlungsergebnissen „zufrieden“ oder „sehr zufrieden“ und 80 % der Patientinnen bestätigten, dass sie gerne mit der Behandlung mit VAC-Extrakt fortfahren wollen. Fazit: Diese Beobachtungsstudie im Bereich der ärztlichen Grundversorgung ergab, dass die Behandlung mit VAC

  18. Metacognitive Interpersonal Therapy in group (MIT-G) for young adults with personality disorders: A pilot randomized controlled trial.

    Science.gov (United States)

    Popolo, Raffaele; MacBeth, Angus; Canfora, Flaviano; Rebecchi, Daniela; Toselli, Cecilia; Salvatore, Giampaolo; Dimaggio, Giancarlo

    2018-04-06

    Young adults with personality disorders (PD) other than borderline are in urgent need of validated treatments to help them in managing important life transitions. Therapeutic interventions focused upon social and interpersonal difficulties may facilitate these individuals in maximizing opportunities for employment, forming stable romantic relationships, and belong to social groups. It is also important that they are offered evidence-based, first-line time-limited treatments in order to maximize effectiveness and reduce costs. We developed a 16-session programme of group-based Metacognitive Interpersonal Therapy (MIT-G) including psychoeducation on the main interpersonal motives, an experiential component enabling practice of awareness of mental states; and use of mentalistic knowledge for purposeful problem-solving. We report a feasibility, acceptability, and clinical significance randomized clinical trial. Participants meeting inclusion criteria were randomized to receive MIT-G (n = 10) or waiting list+TAU (n = 10). Dropout rate was low and session attendance high (92.19%). Participants in the MIT-G arm had symptomatic and functional improvements consistent with large effect sizes. In the MIT-G arm similarly large effects were noted for increased capacity to understand mental states and regulate social interactions using mentalistic knowledge. Results were sustained at follow-up. Our findings suggest potential for applying MIT-G in larger samples to further test its effectiveness in reducing PD-related symptoms and problematic social functioning. © 2018 The British Psychological Society.

  19. Eddy current testing with high penetration; WS-Pruefungen mit grosser Eindringtiefe

    Energy Technology Data Exchange (ETDEWEB)

    Becker, R.; Kroening, M. [Fraunhofer Inst. fuer Zerstoerungsfreie Pruefverfahren, Saarbruecken (Germany)

    1999-08-01

    The low-frequency eddy current testing method is used when penetration into very deep layers is required. The achievable penetration depth is determined among other parameters by the lowest testing frequency that can be realised together with the eddy current sensor. When using inductive sensors, the measuring effect declines proportional to the lowering frequency (induction effect). Further reduction of testing frequency requires other types of sensors, as e.g. the GMR (Giant Magnetic Resistance), which achieves a constant measuring sensitivity down to the steady field. The multi-frequency eddy current testing method MFEC 3 of IZFP described here can be operated using three different scanning frequencies at a time. Two variants of eddy current probes are used in this case. Both have an inductive winding at their emitters, of the type of a measuring probe. The receiver end is either also an inductive winding, or a magnetic field-responsive resistance (GMR). (orig./CB) [Deutsch] Das Niederfrequenz(NF)-Wirbelstrom(WS)-Verfahren wird eingesetzt, um eine grosse Eindringtiefe zu erzielen. Die erreichbare Tiefenreichweite wird u.a. durch die niedrigste Prueffrequenz bestimmt, die zusammen mit dem Wirbelstrom-Sensor realisiert werden kann. Bei Einsatz von induktiven Sensoren geht mit abnehmender Prueffrequenz der Messeffekt proportional zurueck (Induktionswirkung). Eine weitere Absenkung der Prueffrequenzen macht den Einsatz von andersartigen Sensoren notwendig, z.B. den GMR (Giant Magnetic Resistance), der eine gleichmaessige Messempfindlichkeit bis zum Gleichfeld besitzt. Das eingesetzte Mehrfrequenz-Wirbelstrom-Pruefverfahren MFEC 3 des IZFP arbeitet mit drei gleichzeitig eingespeisten Prueffrequenzen. Dabei werden zwei Varianten von WS-Sensoren eingesetzt. Beide besitzen auf der Senderseite eine induktive Wicklung in der Art einer Tastsonde. Die Empfaengerseite ist entweder ebenfalls eine induktive Wicklung oder ein magnetfeldempfindlicher Widerstand (GMR). (orig./DGE)

  20. Regional climate projection of the Maritime Continent using the MIT Regional Climate Model

    Science.gov (United States)

    IM, E. S.; Eltahir, E. A. B.

    2014-12-01

    Given that warming of the climate system is unequivocal (IPCC AR5), accurate assessment of future climate is essential to understand the impact of climate change due to global warming. Modelling the climate change of the Maritime Continent is particularly challenge, showing a high degree of uncertainty. Compared to other regions, model agreement of future projections in response to anthropogenic emission forcings is much less. Furthermore, the spatial and temporal behaviors of climate projections seem to vary significantly due to a complex geographical condition and a wide range of scale interactions. For the fine-scale climate information (27 km) suitable for representing the complexity of climate change over the Maritime Continent, dynamical downscaling is performed using the MIT regional climate model (MRCM) during two thirty-year period for reference (1970-1999) and future (2070-2099) climate. Initial and boundary conditions are provided by Community Earth System Model (CESM) simulations under the emission scenarios projected by MIT Integrated Global System Model (IGSM). Changes in mean climate as well as the frequency and intensity of extreme climate events are investigated at various temporal and spatial scales. Our analysis is primarily centered on the different behavior of changes in convective and large-scale precipitation over land vs. ocean during dry vs. wet season. In addition, we attempt to find the added value to downscaled results over the Maritime Continent through the comparison between MRCM and CESM projection. Acknowledgements.This research was supported by the National Research Foundation Singapore through the Singapore MIT Alliance for Research and Technology's Center for Environmental Sensing and Modeling interdisciplinary research program.

  1. MIT Project Apophis: Surface Evaulation & Tomography (SET) Mission Study for the April 2029 Earth Encounter

    Science.gov (United States)

    Binzel, R. P.; Earle, A. M.; Vanatta, M.; Miller, D. W.

    2017-12-01

    Nature is providing a once-per-thousand year opportunity to study the geophysical outcome induced on an unprecedentedly large (350 meter) asteroid making an extremely close passage by the Earth (inside the distance of geosynchronous satellites) on Friday April 13, 2029. The aircraft carrier-sized (estimated 20 million metric ton) asteroid is named Apophis. While many previous spacecraft missions have studied asteroids, none has ever had the opportunity to study "live" the outcome of planetary tidal forces on their shapes, spin states, surface geology, and internal structure. Beyond the science interest directly observing this planetary process, the Apophis encounter provides an invaluable opportunity to gain knowledge for any eventuality of a known asteroid found to be on a certain impact trajectory. MIT's Project Apophis [1] is our response to nature's generous opportunity by developing a detailed mission concept for sending a spacecraft to orbit Apophis with the objectives of surveying its surface and interior structure before, during, and after its 2029 near-Earth encounter. The Surface Evaluation & Tomography (SET) mission concept we present is designed toward accomplishing three key science objectives: (1) bulk physical characterization, (2) internal structure, and (3) long-term orbit tracking. For its first mission objective, SET will study Apophis' bulk properties, including: shape, size, mass, volume, bulk density, surface geology, and composition, rotation rate, and spin state. The second mission objective is to characterize Apophis' internal structure before and after the encounter to determine its strength and cohesion - including tidally induced changes. Finally, the third objective studies the process of thermal re-radiation and consequential Yarkovsky drift, whose results will improve orbit predictions for Apophis as well as other potentially hazardous asteroids. [1] https://eapsweb.mit.edu/mit-project-apophis

  2. Uso de analgésicos y ácido acetilsalicílico en un estudio multicéntrico en España Use of analgesics and aspirin in a Spanish multicenter study

    Directory of Open Access Journals (Sweden)

    Joan Fortuny

    2005-08-01

    Full Text Available Objetivo: Evaluar el consumo de paracetamol, metamizol y ácido acetilsalicílico (AAS en un estudio multicéntrico. Pacientes y método: Se analizaron los controles de un estudio de casos y controles hospitalarios (n = 1.029 sobre cáncer vesical mediante la aplicación de una matriz de medicamentos y principios activos. El motivo de ingreso de los controles no se asociaba con el uso crónico de analgésicos. Se utilizó un modelo de regresión logística. Resultados: El uso crónico de AAS fue del 8%, el de paracetamol, del 5% y el de metamizol, del 2%. El AAS fue más usado por personas con educación secundaria o superior (odds ratio [OR] = 2,0, intervalo de confianza [IC] del 95%, 1,52-2,93. Las mujeres usaron más paracetamol (OR = 1,91; IC del 95%, 1,30-2,80 y metamizol (OR = 2,80; IC del 95%, 1,49-4,47. Los menores de 65 años usaron más metamizol. Conclusión: El uso crónico de AAS y paracetamol es bajo comparado con el de Estados Unidos o el norte de Europa, aunque es parecido al del sur de Europa. Hay diferencias en el uso de analgésicos en función de las variables sociodemográficas.Objective: To evaluate the use of acetaminophen (paracetamol, aspirin and dipyrone (metamizol in a multicenter study. Patients and method: We analyzed the controls of a hospital-based case-control study (n = 1029 of bladder cancer using a matrix of drugs and active principles. The admission diagnosis of the study controls was not associated with chronic analgesic use. A logistic regression model was used. Results: Eight percent of the controls were regular users of aspirin, 5% regularly used acetaminophen and 2% regularly used dipyrone. Aspirin was more frequently used by subjects with at least secondary education (OR = 2.0; 95% CI, 1.52-2.93. Women more frequently used acetaminophen (OR = 1.91; 95% CI, 1.30-2.80 and dipyrone (OR = 2.80; 95% CI, 1.49-4.47. Subjects under 65 years old more frequently used dipyrone. Conclusion: Chronic use of aspirin

  3. Epidemiology, Seasonality and Factors Associated with Rotavirus Infection among Children with Moderate-to-Severe Diarrhea in Rural Western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS.

    Directory of Open Access Journals (Sweden)

    Richard Omore

    Full Text Available To evaluate factors associated with rotavirus diarrhea and to describe severity of illness among children <5 years old with non-dysenteric, moderate-to-severe diarrhea (MSD in rural western Kenya.We analyzed data from children <5 years old with non-dysenteric MSD enrolled as cases in the Global Enteric Multicenter Study (GEMS in Kenya. A non-dysenteric MSD case was defined as a child with ≥3 loose stools in 24 hrs. and one or more of the following: sunken eyes, skin tenting, intravenous rehydration, or hospitalization, who sought care at a sentinel health center within 7 days of illness onset. Rotavirus antigens in stool samples were detected by ELISA. Demographic and clinical information was collected at enrollment and during a single follow-up home visit at approximately 60 days. We analyzed diarrhea severity using a GEMS 17 point numerical scoring system adapted from the Vesikari score. We used logistic regression to evaluate factors associated with rotavirus infection.From January 31, 2008 to September 30, 2012, among 1,637 (92% non-dysenteric MSD cases, rotavirus was detected in stools of 245 (15.0%. Rotavirus-positive compared with negative cases were: younger (median age, 8 vs. 13 months; p<0.0001, had more severe illness (median severity score, 9 vs 8; p<0.0001 and had to be hospitalized more frequently (37/245 [15.1%] vs. 134/1,392 [9.6%], p <0.013. Independent factors associated with rotavirus infection included age 0-11 months old (aOR = 5.29, 95% CI 3.14-8.89 and presenting with vomiting ≥3 times/24hrs (aOR = 2.58, 95% CI [1.91-3.48]. Rotavirus was detected more commonly in warm and dry months than in the cool and rainy months (142/691 [20%] vs 70/673 [10%] p<0.0001.Diarrhea caused by rotavirus is associated with severe symptoms leading to hospitalization. Consistent with other settings, infants had the greatest burden of disease.

  4. Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study.

    Science.gov (United States)

    Baker, Kelly K; O'Reilly, Ciara E; Levine, Myron M; Kotloff, Karen L; Nataro, James P; Ayers, Tracy L; Farag, Tamer H; Nasrin, Dilruba; Blackwelder, William C; Wu, Yukun; Alonso, Pedro L; Breiman, Robert F; Omore, Richard; Faruque, Abu S G; Das, Sumon Kumar; Ahmed, Shahnawaz; Saha, Debasish; Sow, Samba O; Sur, Dipika; Zaidi, Anita K M; Quadri, Fahreen; Mintz, Eric D

    2016-05-01

    Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age. The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1-2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India. This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings

  5. A Prospective, Multicenter Study to Compare a Disposable, High-fluid Capacity Underpad to Nonpermeable, Disposable, Reusable Containment Products on Incontinence-associated Dermatitis Rates Among Skilled Nursing Facility Residents.

    Science.gov (United States)

    Motta, Glenda; Milne, Catherine T

    2017-12-01

    Due to the high prevalence of incontinence among skilled nursing facility (SNF) residents, incontinence-associated derma- titis (IAD) is a common occurrence. In addition, facility staff may mistakenly identify IAD as a pressure injury. A prospective, descriptive, multicenter study was conducted in 3 Connecticut facilities to evaluate the effect of substituting a disposable, high- uid capacity underpad for nonpermeable disposable and reusable containment products on the rate of IADs. Residents with and without IAD but with high IAD risk scores who were bed- or chairbound or ambulatory and used disposable nonpermeable briefs and underpads or reusable, laundered containment products when in bed longer than 2 hours were randomly enrolled and observed for a 4-week period. Facility staff were trained on the importance of differentiating between IAD and pressure injury; they substituted the study product (a disposable, high- uid capacity underpad) for all previously used containment products. Patient risk for IAD and skin condition were assessed using the Perineal Assessment Tool (PAT) and the Skin Condition Assessment Tool (SAT), respectively, at 5 time points: baseline, week 1, week 2, week 3, and week 4. The PAT is a 4-item instrument based conceptually on the 4 determinants in perineal skin breakdown; subscales are rated from 1 (least risk) to 3 (most risk), with a total score range of 4 to 12. The SAT is used to evaluate IAD speci cally, generating a cumulative severity score ranging from 0 to 3 on area of skin affected, degree of redness, and depth of ero- sion. Final data analysis was conducted on 40 residents: 25 had IAD present at enrollment and 15 were deemed high risk for developing IAD. Mean SAT scores in the 25 participants with IAD decreased with signi cance at week 1 (P = .0016), week 2 (P = .0023), week 3 (P = .0005), and week 4 (P disposable, high- uid capacity underpad improved SAT scores over time. IAD rates increased in each facility, but pressure

  6. Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol.

    Science.gov (United States)

    Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R

    2016-04-01

    The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662

  7. The use of the acute Pd/Pa drop after intracoronary nitroglycerin infusion to rule out significant FFR: CANICA (Can intracoronary nitroglycerin predict fractional flow reserve without adenosine?) multicenter study.

    Science.gov (United States)

    Martin-Reyes, R; de la Torre Hernandez, J M; Franco-Pelaez, J; Lopez-Palop, R; Telleria Arrieta, M; Amat Santos, I J; Carrillo Saez, P; Sanchez-Recalde, A; Sanmartin Pena, J C; Garcia Camarero, T; Brugaletta, S; Gimeno de Carlos, F; Pinero, A; Sorto Sanchez, D C; Frutos, A; Lasa Larraya, G; Navarro, F; Farre, J

    2016-02-01

    Functional assessment of coronary artery stenosis is performed by measuring the fractional flow reserve (FFR) under hyperemic conditions (Adenosine). However, the use of adenosine portends limitations. We sought to investigate the relationship and correlation between FFR and the Pd/Pa value obtained just after the intracoronary infusion (acute drop) of nitroglycerin (Pd/Pa-NTG) and if this parameter enhances diagnostic accuracy for FFR prediction compared to the resting baseline Pd/Pa. We conducted a multicenter study including prospectively patients presenting intermediate coronary artery stenosis (30-70%) evaluated with pressure wire. Resting baseline Pd/Pa, Pd/Pa-NTG and FFR were measured. 283 patients (335 lesions) were included. Resting baseline Pd/Pa value was 0.72 to 1.0 (0.93 ± 0.04), Pd/Pa-NTG was 0.60 to 1.0 (0.87 ± 0.07) and FFR 0.55 to 1.0 (0.83 ± 0.08). The ROC curves for resting baseline Pd/Pa and for Pd/Pa-NTG, using a FFR ≤ 0.80 showed an AUC of 0.88 (95% CI: 0.84-0.92, P values of resting baseline Pd/Pa and Pd/Pa-NTG for an FFR > 0.80, were >0.96 and >0.88, respectively. These values were present in a 29.8% (n = 100) and a 47.1% (n = 158), of the total lesions. Scatter plots showed a better correlation and agreement points with Pd/Pa-NTG than resting baseline Pd/Pa. The cutoff value of Pd/Pa-NTG > 0.88 showed an excellent NPV (96.2% for FFR > 0.8 and 100% for FFR > 0.75) and sensitivity (95% for FFR > 0.8 and 100% for FFR > 0.75) which were consistently high across all the subgroups analysis. The cutoff value of acute Pd/Pa-NTG > 0.88 has a high NPV meaning adenosine-FFR can be avoided in almost half of lesions. © 2015 Wiley Periodicals, Inc.

  8. Shared decision-making in end-stage renal disease: a protocol for a multi-center study of a communication intervention to improve end-of-life care for dialysis patients.

    Science.gov (United States)

    Eneanya, Nwamaka D; Goff, Sarah L; Martinez, Talaya; Gutierrez, Natalie; Klingensmith, Jamie; Griffith, John L; Garvey, Casey; Kitsen, Jenny; Germain, Michael J; Marr, Lisa; Berzoff, Joan; Unruh, Mark; Cohen, Lewis M

    2015-06-12

    End-stage renal disease carries a prognosis similar to cancer yet only 20 % of end-stage renal disease patients are referred to hospice. Furthermore, conversations between dialysis team members and patients about end-of-life planning are uncommon. Lack of provider training about how to communicate prognostic data may contribute to the limited number of end-of-life care discussions that take place with this chronically ill population. In this study, we will test the Shared Decision-Making Renal Supportive Care communication intervention to systematically elicit patient and caretaker preferences for end-of-life care so that care concordant with patients' goals can be provided. This multi-center study will deploy an intervention to improve end-of-life communication for hemodialysis patients who are at high risk of death in the ensuing six months. The intervention will be carried out as a prospective cohort with a retrospective cohort serving as the comparison group. Patients will be recruited from 16 dialysis units associated with two large academic centers in Springfield, Massachusetts and Albuquerque, New Mexico. Critical input from patient advisory boards, a stakeholder panel, and initial qualitative analysis of patient and caretaker experiences with advance care planning have informed the communication intervention. Rigorous communication training for hemodialysis social workers and providers will ensure that standardized study procedures are performed at each dialysis unit. Nephrologists and social workers will communicate prognosis and provide advance care planning in face-to-face encounters with patients and families using a social work-centered algorithm. Study outcomes including frequency and timing of hospice referrals, patient and caretaker satisfaction, quality of end-of-life discussions, and quality of death will be assessed over an 18 month period. The Shared Decision-Making Renal Supportive Care Communication intervention intends to improve discussions about prognosis and end-of-life care with end-stage renal disease patients. We anticipate that the intervention will help guide hemodialysis staff and providers to effectively participate in advance care planning for patients and caretakers to establish preferences and goals at the end of life. NCT02405312.

  9. Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study

    Science.gov (United States)

    O’Reilly, Ciara E.; Levine, Myron M.; Kotloff, Karen L.; Farag, Tamer H.; Nasrin, Dilruba; Alonso, Pedro L.; Breiman, Robert F.; Omore, Richard; Faruque, Abu S. G.; Das, Sumon Kumar; Ahmed, Shahnawaz; Saha, Debasish; Sow, Samba O.; Sur, Dipika; Zaidi, Anita K. M.; Quadri, Fahreen; Mintz, Eric D.

    2016-01-01

    Background Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age. Methods/Findings The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children sanitation facilities with 1–2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India. Conclusions This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of

  10. One-step transvaginal three-dimensional hysterosalpingo-foam sonography (3D-HyFoSy) confirmation test for Essure® follow-up: a multicenter study.

    Science.gov (United States)

    Zizolfi, B; Lazzeri, L; Franchini, M; Di Spiezio Sardo, A; Nappi, C; Piccione, E; Exacoustos, C

    2018-01-01

    To evaluate, in patients who underwent Fallopian-tube sterilization by hysteroscopic insertion of an Essure® device, the feasibility and accuracy of three-dimensional (3D) transvaginal sonography (TVS) to check the position of the device and 3D hysterosalpingo-foam sonography (3D-HyFoSy) using contrast-enhanced gel foam to assess consequent tubal occlusion. This was a prospective multicenter study conducted from June 2012 to July 2014 in four Italian centers, which included 50 women who underwent hysteroscopic Essure microinsert placement in a total of 95 Fallopian tubes. Placement of the microinserts was performed in an outpatient setting following standard procedure recommendations. All patients underwent transvaginal 3D-HyFoSy and hysterosalpingography (HSG) approximately 12-14 weeks after the procedure. The position of the devices was first checked on 3D-TVS and classified according to specific criteria (Positions A, B, C and D). Then, 3D-HyFoSy with ExEm® gel foam as the ultrasound contrast agent was performed to confirm tubal occlusion by the absence of contrast agent within the tubes and/or around the ovaries. To evaluate the feasibility of 3D-HyFoSy, consecutive volume acquisitions were performed while injecting the gel foam. After sonographic evaluation, women underwent HSG to assess the success of sterilization, as standard methodology. Side effects and pain evoked during and after 3D-HyFoSy and HSG were evaluated using a numeric pain rating scale. On 3D-TVS, 10 devices (10.5%) were in Position A, two (2.1%) in Position B, 59 (62.1%) in Position C and 24 (25.3%) in Position D. During 3D-HyFoSy, tubal occlusion was observed in 89 of 95 tubes (93.7%). In the six cases in which the passage of the contrast was observed, one device (16.7%) was in Position B, one device (16.7%) in Position D and four devices (66.7%) were found to lie in Position C. Tubal patency was confirmed at HSG with a concordance rate of 100%. The mean pain score associated with 3D

  11. [Cardiodoron® bei Patienten mit Schlafstörungen - Ergebnisse einer prospektiven Beobachtungsstudie].

    Science.gov (United States)

    Rother, Claudia; Schnelle, Martin

    Hintergrund: Schlafstörungen gehören zu den häufigsten gesundheitlichen Problemen der heutigen Zeit. Stress und die dadurch bedingte innere Anspannung sowie eine unrhythmische Lebensführung z.B. durch Schichtarbeit sind bekannte auslösende Faktoren. Weniger bekannt ist, dass auch funktionelle Herz-Kreislauf-Beschwerden zu Störungen des Schlafs führen können und dass deren Behandlung zu einer Verbesserung der Schlafqualität beiträgt. Ganzheitlich betrachtet geht es daher um die Wiederherstellung einer gesunden Rhythmik, insbesondere des Herz-/Atem- sowie des Schlaf-Wach-Rhythmus, die Cardiodoron®, eine Heilpflanzenkomposition aus Primula veris, Hyoscyamus niger und Onopordum acanthium, unterstützt. Patienten und Methoden: Mittels einer prospektiven, multizentrischen Beobachtungsstudie sollte ermittelt werden, wie sich funktionelle Herz-Kreislauf-Beschwerden und/oder Schlafstörungen unter der Behandlung mit Cardiodoron® (Dilution) über 3-6 Monate entwickeln. Im Zeitraum von September 2009 bis März 2012 dokumentierten 92 Ärzte 501 Patienten, von denen 380 über Schlafstörungen klagten und deren Daten in dieser Publikation näher betrachtet werden. Nach einer Aufnahmeuntersuchung erfolgte nach 90 Tagen eine Abschlussuntersuchung und bei Fortführung der Therapie nach nochmals 90 Tagen eine Follow-up-Untersuchung. Neben 30 ärztlicherseits bewerteten Symptomen beurteilten die Patienten ihr Befinden mittels Pittsburgh Sleep Quality Index (PSQI) nach Buysse und der Beschwerden-Liste nach von Zerssen (B-L und B-L'). Ergebnisse: Unter der Cardiodoron®-Therapie gingen bei guter Verträglichkeit sowohl die Ausprägung der Schlafstörungen (um 65% von 2,0 auf 0,7 Punkte) als auch die erfassten 30 Symptome (um 59% von 24,3 auf 9,9 Punkte) deutlich zurück (p mit Schlafstörungen (mit oder ohne funktionelle Herz-Kreislauf-Beschwerden) kann die Ausprägung der Beschwerden mit Cardiodoron® deutlich gesenkt werden. Cardiodoron® ist gut verträglich. © 2016 S

  12. Condensation energy of the Nambu-Jona-Lasinio vacuum and the MIT bag constant

    International Nuclear Information System (INIS)

    Li, S.; Bhalerao, R.S.; Bhaduri, R.K.

    1991-01-01

    In this paper the energy densities of the vacuum in the Wigner and the Goldstone modes of the Nambu- Jona-Lasinio Hamiltonian are calculated. The difference of these two quantities is analogous to the condensation energy of a BCS superconductor, and is used here to estimate the temperature dependence of the MIT bag constant. The formalism of da Providencia et al is generalized to finite temperatures, yielding the same gap equation as the finite- temperature field theory. The thermodynamics of the vacuum in the two phases is studied

  13. Tank für Überschusshefe versagt – mit katastrophalen Folgen

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess; Selig, Robert Simon

    2017-01-01

    Ein großer Tank für Überschusshefe flog in die Luft und nur noch die Bodenplatte und der Tankinhalt blieben zurück. Obwohl der Tank nicht für Überdruck ausgelegt war, wurde er auf ,"sehr geringem Überdruck" gehalten, um störende Schaumentwicklung zu verhindern. Der Brauerei waren die Gefahren dur...... Druckluft nicht bekannt. Der in diesem Artikel beschriebene Unfall soll aufzeigen, dass Vorsicht geboten ist, wenn ein ursprünglich für atmosphärischen Druck ausgelegter Tank auf Betrieb mit leichtem Überdruck abgeändert wird...

  14. Pembelajaran Embedded System Berbasis Arduino Mega 2560 dan MIT App Inventor

    OpenAIRE

    Tukadi, Tukadi

    2017-01-01

    This paper describes the learning process of the Embedded System course with a practical approach based on Arduino Mega 2560 and Android using MIT App inventor software. Learning materials include digital I / O and analog I / O access via android mobile phone. The method used in its implementation premises to provide tasks in the form of projects. The next step is to find the theories that can support in completing the project task. The project task is to control or read electronic devices co...

  15. Risikoabsicherung von Produkten/Prozessen mit der Fehlermöglichkeits- und Einflussanalyse (FMEA)

    OpenAIRE

    Schloske, Alexander

    2010-01-01

    Die FMEA stellt heutzutage eines der wichtigsten Werkzeuge des präventiven Risikomanagements dar. Die universell anwendbare Vorgehensweise des VDA hat sich dabei in der Industrie etabliert. Der Beitrag beschreibt aus der Sicht von 25 Jahren FMEA-Erfahrung, wie die FMEA zielführend erstellt wird und mit welchen Tipps und Tricks eine effiziente und effektive FMEA-Erstellung ermöglicht wird. Einen besonderen Schwerpunkt dabei bilden die präzise Bezeichnung von Funktion und Fehlfunktion, sowie di...

  16. New combined plant with integrated solar thermal energy; Neue Kombi-Anlage mit integrierter Solarwaerme

    Energy Technology Data Exchange (ETDEWEB)

    Leithner, R.; Dobrowolski, R.; Gresch, H. [Technische Univ. Braunschweig (Germany). Inst. fuer Waerme- und Brennstofftechnik

    1998-06-01

    In California there are already 350 MW{sub e} worth of solar thermal energy plants in operation on a more or less commercial basis. In these installations thermal oil in parabolic gutters is heated from 300 C to 400 C. The thermal oil passes its thermal energy on to a water vapour circuit via a heat exchanger. The water vapour circuit can also be heated with natural gas, for instance at night when solar energy is not available. However, as yet no existing plant fulfils all three of the following requirements: its construction should entail the lowest possible investment costs and it should be able to run without solar energy and without an expensive storage system; it should have the greatest possible efficiency, especially at times when solar energy is not available (e.g. at night); at the same time, the solar thermal energy should be harvested at the lowest possible temperature so as to make expensive concentrating equipment superfluous. These seemingly contradictory demands are now met by a new concept involving a combined gas and steam plant whose operation is based on the injection of water into the compressed air rather than on a high excess of air. This water is evaporated by solar thermal energy at temperatures below 170 C according to its partial pressure. [Deutsch] Es gibt bereits ueber 350 MWe solarthermische Anlagen in Kalifornien, die mehr oder weniger kommerziell betrieben werden. Bei diesen Anlagen wird Thermaloel von 300 C auf 400 C in Parabolrinnen erhitzt. In einem Waermetauscher gibt das Thermaloel die Waerme an einen Wasserdampfkreislauf ab, der auch mit Erdgas beheizt werden kann, wenn wie z.B. nachts keine Solarwaerme verfuegbar ist. In einem weiteren Schritt wurde vorgeschlagen, das Wasser direkt zu verdampfen. Keine dieser Anlagen genuegt jedoch gleichzeitig den folgenden drei Anforderungen: Die Anlage sollte mit moeglichst niedrigen Investitionskosten gebaut und auch ohne Solarwaerme bzw. ohne aufwendigen Speicher betrieben werden koennen

  17. Esclavos perfectos: historia breve de la ciberarquitectura en MIT (1959-1967

    Directory of Open Access Journals (Sweden)

    Daniel Cardoso Llach

    2012-07-01

    Full Text Available This paper addresses unexplored aspects of the relationship between military research at MIT, and the constitution, during the cold war years, of a techno-scientific discourse of architecture. Exploring primary sources from the "Computer-Aided Design Project" (1959-1967, this paper explains the emergence of a cybernetic understanding of design, and its transit into architectural culture. The article presents Nicholas Negroponte's use of the CAD project's technical and theoretical idioms to re-imagine architectural practice through a technocratic (and populist lens, and discusses aspects of its influence in contemporary techno-scientific design discourse.

  18. Von Donuts und Zucker: Mit Neutronen biologische Makromoleküle erforschen

    Science.gov (United States)

    May, Roland P.

    2003-05-01

    Für die Erforschung von Biomolekülen bieten Neutronen einzigartige Eigenschaften. Vor allem ihre unterschiedliche Wechselwirkung mit dem natürlichen Wasserstoff und seinem schweren Isotop Deuterium ermöglicht tiefe Einblicke in Struktur, Funktion und Dynamik von Proteinen, Nukleinsäuren und Biomembranen. Bei vielen Fragestellungen zur Strukturaufklärung gibt es kaum oder keine Alternative zum Neutron. Das Institut Laue-Langevin trägt Bahnbrechendes zum Erfolg der Neutronen-Methoden in der Biologie bei.

  19. Magnetic resonance imaging in the evaluation of pneumonia; Nachweis von pneumonischen Infiltraten mit der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Eibel, R.; Herzog, P.; Dietrich, O.; Reiser, M.; Schoenberg, S.O. [Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Rieger, C.; Ostermann, H. [Ludwig-Maximilians-Universitaet Muenchen (Germany). Abteilung fuer Haematologie/Onkologie, Klinikum Grosshadern

    2006-04-15

    Rundherde mit einem Durchmesser deutlich unterhalb der Schichtdicke nicht mehr zuverlaessig erfasst werden koennen. Auch Verkalkungen sind nicht mit der gleichen Sicherheit wie im CT zu identifizieren. Gleiches gilt fuer den Nachweis von Luftsicheln und -einschluessen in Laesionen. Mit Hilfe der parallelen Bildgebung koennen beide Lungenfluegel in 1-2 Atemstillstaenden mit einer Ortsaufloesung von 6 mm in der z-Achse und Submillimeteraufloesung in der x- und y-Ebene untersucht werden. Raumzeiten <10 min lassen sich so realisieren. Insbesondere fuer die Verlaufsbeurteilung von pneumonischen Infiltraten bei immunsupprimierten Patienten kann die MRT geeignet sein und zu einer geringeren Dosisexposition der Patienten beitragen. (orig.)

  20. MIT extraction method for measuring average subchannel axial velocities in reactor assemblies

    International Nuclear Information System (INIS)

    Hawley, J.T.; Chiu, C.; Todreas, N.E.

    1980-08-01

    The MIT extraction method for obtaining flow split data for individual subchannels is described in detail. An analysis of the method is presented which shows that isokinetic values of the subchannel flow rates are obtained directly even though the method is non-isokinetic. Time saving methods are discussed for obtaining the average value of the interior region flow split parameter. An analysis of the method at low bundle flow rates indicates that there is no inherent low flow rate limitation on the method and suggests a way to obtain laminar flow split data

  1. Recent results from the MIT in-core experiments on coolant chemistry

    International Nuclear Information System (INIS)

    Harling, O.K.; Kohse, G.E.; Cabello, E.C.; Bernard, J.A.

    1993-01-01

    This paper reports results from an ongoing series of in-core experiments that have been conducted at the 5-MW(thermal) MIT Research Reactor (MITR-II) for optimizing coolant chemistries in light water reactors. Four experiments are in progress, including a pressurized coolant chemistry loop (PCCL), a boiling coolant chemistry loop (BCCL), a facility for the study of irradiation-assisted stress-corrosion cracking, and one for the evaluation of in situ sensors for the monitoring of crack propagation in metal (SENSOR). The first two have now been fully operational for several years. The latter two are scheduled to begin regular operation later this year

  2. Summary and recommendations for the NASA/MIT workshop on short haul air transport

    Science.gov (United States)

    Simpson, R. W.

    1971-01-01

    The material is summarized that was covered by the MIT/NASA Waterville Valley workshop which dealt with the institutional, socio-economic, operational and technological problems associated with introducing new forms of short haul domestic air transportation. It was found that future air systems hold great potential in satisfying society's needs for a low noise, low landspace, high access, high speed, large network system for public travel over distances between 5 and 500 miles. It is concluded that quiet air systems are necessary for obtaining community approval, and is recommended that extremely high priority be assigned to the development of quiet aircraft for future short haul air systems.

  3. Aufgabenorientierung mit proaktiver Formfokussierung als didaktisches Konzept für den Deutschunterricht im Tourismus

    Directory of Open Access Journals (Sweden)

    Gloria Bosch Roig

    2012-04-01

    Full Text Available Der aufgabenoriente Unterricht Deutsch für den Tourismus stellt eine realitätsnähere Variante des kommunikativen Deutschunterrichts dar, die es ermöglicht, sinnvolle Inhalte mit der effizienten Bewältigung konkreter Interaktionssituationen des Berufslebens zu kombinieren. Dabei werden die formellen Aspekte der Sprache weder aus dem Unterricht ausgeklammert noch als reine Form-Funktionsbeziehungen eingeführt. Grammatik wird vielmehr als eine metasprachliche Aufgabe verstanden, die es kooperativ und interaktiv zu entschlüsseln und zu lösen gilt.

  4. Intraläsionale Therapie niedrig maligner primär kutaner B-Zell-Lymphome mit Anti-CD20-Antikörper: Nebenwirkungen korrelieren mit gutem klinischen Ansprechen.

    Science.gov (United States)

    Eberle, Franziska C; Holstein, Julia; Scheu, Alexander; Fend, Falko; Yazdi, Amir S

    2017-03-01

    Die intraläsionale Gabe von Anti-CD20-Antikörpern (Rituximab) wurde als effektive Therapieoption für Patienten mit niedrig malignen primär kutanen B-Zell-Lymphomen beschrieben. Bis heute wurden allerdings keine Parameter identifiziert, welche reproduzierbar ein gutes klinisches Ansprechen dieser Therapie vorhersagen. Ziel dieser Studie ist, sowohl das klinische Ansprechen und die unerwünschten Nebenwirkungen als auch die Patientenwahrnehmung hinsichtlich intraläsionaler Injektionen von anti-CD20-Antikörpern zur Behandlung indolenter primär kutaner B-Zell-Lymphome im Vergleich mit anderen Therapien zu evaluieren. Elf Patienten mit einem primär kutanen B-Zell-Lymphom, namentlich primär kutanes Keimzentrumslymphom (n = 9) und primär kutanes Marginalzonenlymphom (n = 2), welche mittels intraläsionalem Anti-CD20-Antikörper behandelt wurden, wurden retrospektiv evaluiert hinsichtlich der Ansprechrate und unerwünschter Nebenwirkungen sowie in Bezug auf deren Selbsteinschätzung dieser und anderer Therapien des primär kutanen B-Zell-Lymphoms. Patienten, deren primär kutanes B-Zell-Lymphom mittels intraläsionaler Gabe von Anti-CD20-Antikörper behandelt wurde, zeigten ein komplettes oder partielles Ansprechen in 45 % beziehungsweise 27 % aller Patienten. Speziell Patienten mit grippeähnlichen Symptomen nach erfolgter Injektion zeigten ein gutes Ansprechen. Die Mehrheit der Patienten empfand die Therapie mit Rituximab als die beste Therapie im Vergleich zu anderen Therapien wie beispielsweise chirurgische Exzision oder Radiotherapie. Intraläsionales Rituximab ist eine effektive Therapie mit hoher Patientenzufriedenheit. Starke therapiebedingte Nebenwirkungen wie Fieber, Schüttelfrost und Kopfschmerzen nach Gabe von Rituximab könnten als Indikator für gute Wirksamkeit dienen. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  5. Die Dramatikerin Theresia Walser spricht mit Maria Aparecida Barbosa über das Theaterstück »King Kongs Töchter«. Mit einer Einführung von Karina Schuller

    Directory of Open Access Journals (Sweden)

    Theresia Walser

    2012-11-01

    Full Text Available In ihrem Interview spricht die Literaturwissenschaftlerin Maria Aparecida Barbosa mit der Dramatikerin Theresia Walser. Am Beispiel des Theaterstücks King Kongs Töchter (1998, das sich auf groteske Art und Weise mit dem Alltag in einem Altenheim befasst, werden dabei verschiedene Themen angesprochen: Es geht um die Selbstreflexivität des Theaters, um Walsers Verständnis von poetischer Sprache und Realismus sowie um den kreativen Schreibprozess im Allgemeinen. Ergänzt wird das Interview durch eine Einführung von Karina Schuller.

  6. MRI for therapy planning in patients with atrial septum defects; MRT zur Therapieplanung bei Patienten mit Vorhofseptumdefekt

    Energy Technology Data Exchange (ETDEWEB)

    Huber, A.; Rummeny, E. [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institut fuer Radiologie, Muenchen (Germany); Prompona, M.; Reiser, M.; Theisen, D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Kozlik-Feldmann, R. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Kinderkardiologie, Muenchen (Germany); Muehling, O. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik I, Muenchen (Germany)

    2011-01-15

    The aim of this study was to determine the value of a combined magnetic resonance imaging (MRI) protocol including steady-state free precession (SSFP) imaging, phase-contrast measurements and contrast-enhanced MR angiography (CE-MRA) for presurgical or preinterventional diagnostic imaging in patients with suspected atrial septum defects. Out of 65 MRI studies of patients with suspected atrial septum defects, 56 patients were included in the study. The atrial septum defects were identified on cine images. Velocity encoded flow measurements were used to determine shunt volumes, which were compared with invasive oxymetry in 24 patients. Contrast-enhanced MRI was used to assess the thoracic vessels in order to detect vascular anomalies. The findings were compared with the intraoperative results. A total of 24 patients with high shunt volumes were treated either surgically (16 patients) or interventionally (8 patients) and 32 patients with low shunt volumes did not require surgical or interventional treatment. The vascular anomaly, which in all cases was anomalous pulmonary venous return, was confirmed by the intraoperative findings. The type and location of atrial septal defects which required treatment, were confirmed intraoperatively or during the intervention. The results of shunt quantification by MRI showed a good correlation with the results of invasive oximetry (r=0.91, p <0.0001). A combined MRI protocol including cine SSFP images, velocity-encoded flow measurements and CE-MRA is an accurate method for preoperative and preinterventional evaluation of atrial septum defects. (orig.) [German] Ziel war es, die Wertigkeit eines kombinierten MRT-Protokolls aus Funktionsuntersuchung, Flussmessung und MR-Angiographie zur praeoperativen oder -interventionellen Abklaerung bei Patienten mit Vorhofseptumdefekt zu evaluieren. Ingesamt wurden 56 Patienten mit Vorhofseptumdefekt aus einem Kollektiv von 65 Patienten mit Verdacht auf Vorhofseptumdefekt, die im MRT untersucht

  7. UBER DIE SCHREIBUNG UND RECHTSCHREIBUNG MIT BESONDERER RÜCKSICHT AUF DIE RECHTSCHREIBUNGSLÖSUNGEN IN "FLUMINENSIA" VON FRAN KURELAC

    Directory of Open Access Journals (Sweden)

    Lada Badurina

    1990-01-01

    Full Text Available Im Artikel sind zunächst Grundsetzen der Schreibung und der Rechtschreibung dargestellt, demnach die Schreibung und die Rechtschreibung in "Fluminensia" von Fran Kurelac. Die von Kurelac vorgeschlagenen Lösungen sind mit den Lösungen seiner unmittelbaren Vorgänger und Zeitgenossen vergleicht, sowie mit der heutigen Rechtschreibungspraxis. Für die von Kurelac vorgeschlagne Schreibung ist festgestellt, daß es sich um ein beständiges System handelt, das von der Tradition ausgeht und das sich nur in eingen Lösungen von heutigen unterscheidet. In der Rechtschreibung überwiegt der morphologische Grundsatz, was leicht in Verbindung mit den Grundgedanken der Philologischen Schule in Rijeka zu steilen ist.

  8. Umgang mit Antithrombotika bei Operationen an der Haut vor und nach Publikation der entsprechenden S3-Leitlinie.

    Science.gov (United States)

    Gaskins, Matthew; Dittmann, Martin; Eisert, Lisa; Werner, Ricardo Niklas; Dressler, Corinna; Löser, Christoph; Nast, Alexander

    2018-03-01

    Laut einer Befragung im Jahre 2012 war der Umgang mit Antithrombotika bei dermatochirurgischen Eingriffen in Deutschland sehr heterogen. 2014 wurde erstmals eine evidenzbasierte Leitlinie zu diesem Thema veröffentlicht. Es wurde eine anonyme Befragung derselben Stichprobe zum Umgang mit Antithrombotika sowie zu Kenntnissen der Leitlinie durchgeführt. Die Ergebnisse wurden als relative Häufigkeiten berichtet und denen aus 2012 gegenübergestellt. 208 Antwortbögen wurden ausgewertet (Rücklaufquote: 36,6 %). Die große Mehrheit der Dermatologen erklärte, kleinere Eingriffe unter Fortführung der Therapie mit Phenprocoumon, niedrig dosierter Acetylsalicylsäure (≤ 100 mg) und Clopidogrel sowie mit direkten oralen Antikoagulanzien durchzuführen. Bei größeren Eingriffen war der Umgang hingegen weiterhin heterogen, insbesondere unter niedergelassenen Dermatologen. Der Anteil der Dermatologen, die Phenprocoumon, Acetylsalicylsäure und Clopidogrel leitlinienkonform verwendeten, hat sich insgesamt vergrößert. Führten 2012 beispielsweise 53,8 % der Klinikärzte bzw. 36,3 % der niedergelassenen Dermatologen eine große Exzision unter Fortführung der Therapie mit niedrig dosierter Acetylsalicylsäure durch, taten dies 2017 90,2 % bzw. 57,8 % (Phenprocoumon: 33,8 % bzw. 11,9 % auf 63,9 % bzw. 29,9 %; Clopidogrel: 36,9 % bzw. 23,2 % auf 63,9 % bzw. 30,6 %). Unter den Klinikärzten war ein hoher Anteil mit der Leitlinie vertraut und fand diese hilfreich. Eine Zunahme des leitlinienkonformen Verhaltens war bei allen Eingriffen zu verzeichnen. Bei größeren Eingriffen zeigte sich trotz deutlicher Verbesserung die Notwendigkeit verstärkter Anstrengungen zur Leitlinienumsetzung bzw. zur Identifizierung von Implementierungsbarrieren. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  9. Computerunterstützte Sacherschließung mit dem Digitalen Assistenten (DA-2

    Directory of Open Access Journals (Sweden)

    Imma Hinrichs

    2016-12-01

    Full Text Available Wir beschreiben den Digitalen Assistenten DA-2, den wir zur Unterstützung der Sacherschliessung im IBS-Verbund implementiert haben. Diese webbasierte Anwendung ist eine vollständige Neuimplementierung, welche die Erkenntnisse des Vorgängersystems bei der Zentralbibliothek Zürich berücksichtigt. Wir stellen Überlegungen zur Zukunft der Sacherschliessung an und geben eine Übersicht über Projekte mit ähnlichen Zielsetzungen, die Sacherschließung mit Computerunterstützung effizienter und besser zu gestalten.   We describe the digital assistant DA-2 which we have implemented to support the subject indexing process in the IBS-Verbund. This web-based service is a new implementation from scratch based on the lessons learned with its predecessor used by the Zentralbibliothek Zürich. We also discuss the future of intellectual subject indexing and we give an overview on related projects also aiming at digitizing and economizing this challenging process.

  10. Distinct features of C/N balance regulation in Prochlorococcus sp. strain MIT9313.

    Science.gov (United States)

    Domínguez-Martín, María Agustina; López-Lozano, Antonio; Rangel-Zúñiga, Oriol Alberto; Díez, Jesús; García-Fernández, José Manuel

    2018-02-01

    The abundance and significant contribution to global primary production of the marine cyanobacterium Prochlorococcus have made it one of the main models in marine ecology. Several conditions known to cause strong effects on the regulation of N-related enzymes in other cyanobacteria lacked such effect in Prochlorococcus. Prochlorococcus sp. strain MIT9313 is one of the most early-branching strains among the members of this genus. In order to further understand the C/N control system in this cyanobacterium, we studied the effect of the absence of three key elements in the ocean, namely N, P and Fe, as well as the effect of inhibitors of the N assimilation or photosynthesis on the N metabolism of this strain. Furthermore, we focused our work in the effect of ageing, as the age of cultures has clear effects on the regulation of some enzymes in Prochlorococcus. To reach this goal, expression of the main three regulators involved in N assimilation in cyanobacteria, namely ntcA, glnB and pipX, as well as that of icd (encoding for isocitrate dehydrogenase) were analysed. Our results show that the control of the main proteins involved in the C/N balance in strain MIT9313 differs from other model Prochlorococcus strains. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Ustekinumab in der Therapie der Pustulosis palmoplantaris - Eine Fallserie mit neun Patienten.

    Science.gov (United States)

    Buder, Valeska; Herberger, Katharina; Jacobi, Arnd; Augustin, Matthias; Radtke, Marc Alexander

    2016-11-01

    Die Pustulosis palmoplantaris ist eine chronisch entzündliche Hauterkrankung, die mit bedeutenden Einschränkungen der Lebensqualität und der Belastbarkeit einhergeht. Aufgrund von Zulassungsbeschränkungen und einem häufig therapierefraktären Verlauf sind die Behandlungsmöglichkeiten limitiert. Nach zuvor frustranen Therapien erhielten 9 Patienten mit Pustulosis palmoplantaris nach Ausschluss einer latenten Tuberkulose Ustekinumab (45 mg Ustekinumab bei  100 kg KG) in Woche 0, 4, 12 und 24. Reguläre Visiten erfolgten nach 4 und 12 Wochen, im weiteren Verlauf alle 12 Wochen. Das Durchschnittsalter bei Therapiebeginn betrug 48 Jahre. Drei Patienten waren männlich. Bei n  =  4 Patienten (44,4 %) wurde eine Verbesserung um 75 % des Palmoplantar-Psoriasis-Area-Severity-Index (PPPASI) erreicht. Insgesamt verbesserte sich der PPPASI nach 24 Wochen durchschnittlich um 71,6 %. Eine komplette Abheilung zeigte sich bei n  =  2 Patienten nach 24 Wochen. Bis auf lokale Injektionsreaktionen und leichte Infekte wurden keine unerwünschten Wirkungen beobachtet. Die Fallserie ist ein weiterer Beleg für die Wirksamkeit und Verträglichkeit von Ustekinumab in der Therapie der Pustulosis palmoplantaris. Zur Beurteilung der Langzeitwirkung und -sicherheit sowie der Wirksamkeit einer intermittierenden Therapie sind kontrollierte Studiendaten sowie Beobachtungen im Rahmen von Patientenregistern notwendig. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  12. MIT-Skywalker: considerations on the Design of a Body Weight Support System.

    Science.gov (United States)

    Gonçalves, Rogério Sales; Krebs, Hermano Igo

    2017-09-06

    To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury. Here we will summarize our results with eight healthy subjects walking on the treadmill without any support, with 30% unloading supported by a harness hanging from an overhead system, and with a saddle/seat-like support system. We compared the center of mass as well as vertical and mediolateral trunk displacements across different walking speeds and support. The bicycle/saddle system had the highest values for the mediolateral inclination, while the overhead harness body weight support showed the lowest values at all speeds. The differences were statistically significant. We selected the bicycle/saddle system for the MIT-Skywalker. It allows faster don-and-doff, better centers the patient to the split treadmill, and allows all forms of training. The overhead harness body weight support might be adequate for rhythmic walking training but limits any potential for balance training.

  13. Berechnung des Hochfrequenzverhaltens komplexer Strukturen mit der Methode gekoppelter Streuparameter – CSC

    Directory of Open Access Journals (Sweden)

    H.-W. Glock

    2004-01-01

    Full Text Available Es wird eine Methode zur Berechnung der Hochfrequenz-Eigenschaften komplexer Strukturen vorgestellt. Das Verfahren beruht auf der Zerlegung der Gesamtstruktur in einzelne einfachere Segmente, deren breitbandige S-Matrizen mit kommerziellen Programmen berechnet werden. Das Gesamtsystem kann von beliebiger Topologie sein, und die Zahl der die Segmente verkoppelnden Hohlleiter- Moden ist nicht begrenzt. Als Ergebnis steht bei offenen Strukturen deren vollständige S-Matrix, bei abgeschlossenen deren Resonanzeigenschaften zur Verfügung. Die theoretischen Grundlagen werden beschrieben und die Anwendung mit Beispielen aus dem Gebiet der Teilchenbeschleuniger und zu Eigenschaften schwach elliptisch geformter Resonatoren illustriert. A method called Coupled S-Parameter Calculation – CSC is described which is used to calculate the rf properties of complex structures, i.e. either their scattering (devices with ports or their resonance properties. The method is based on the segmentation of the entire system into sections being less complex, the external calculation of the section’s broadband S-matrices, and a combination scheme, which is applicable to any topology and number of modes. The method’s principle is described. Examples from the field of particle accelerator cavities and about the properties of weakly elliptical resonators are given.

  14. Development of a Fissile Materials Irradiation Capability for Advanced Fuel Testing at the MIT Research Reactor

    International Nuclear Information System (INIS)

    Hu Linwen; Bernard, John A.; Hejzlar, Pavel; Kohse, Gordon

    2005-01-01

    A fissile materials irradiation capability has been developed at the Massachusetts Institute of Technology (MIT) Research Reactor (MITR) to support nuclear engineering studies in the area of advanced fuels. The focus of the expected research is to investigate the basic properties of advanced nuclear fuels using small aggregates of fissile material. As such, this program is intended to complement the ongoing fuel evaluation programs at test reactors. Candidates for study at the MITR include vibration-packed annular fuel for light water reactors and microparticle fuels for high-temperature gas reactors. Technical considerations that pertain to the design of the MITR facility are enumerated including those specified by 10 CFR 50 concerning the definition of a research reactor and those contained in a separate license amendment that was issued by the U.S. Nuclear Regulatory Commission to MIT for these types of experiments. The former includes limits on the cross-sectional area of the experiment, the physical form of the irradiated material, and the removal of heat. The latter addresses experiment reactivity worth, thermal-hydraulic considerations, avoidance of fission product release, and experiment specific temperature scrams

  15. Pump-turbines with constant flow direction; Pumpenturbinen mit gleicher Durchstroemrichtung

    Energy Technology Data Exchange (ETDEWEB)

    Mollenkopf, G. [Zentrale Forschung Engineering, KSB AG, Frankenthal (Germany)

    1997-12-31

    This research project was sponsored by the federal ministry of science and technology BMFT (product owner: New Materials and Chemical Technologies - NMT). Its aim was to develop a novel unit that can work both as a pump and a turbine with a constant flow direction through internal blade adjustment. This specifically high-speed pump-turbine is suited for plants where a liquid in one case needs to be hauled against a rising pressure and where, in another case, there is a pressure drop in the same direction. So far, either a separate pump and turbine each are used which are temporarily stopped, involving corresponding effort, or - almost as a rule - the turbine is dispensed with, so that the energy locked up in the pressure drop goes unused. (orig.) [Deutsch] Die Zielsetzung unseres Forschungsvorhabens, das vom BMFT (Produkttraeger: Neue Materialien und Chemische Technologien - NMT) gefoerdert wird, war die Entwicklung eines neuartigen Aggregats, das durch interne Schaufelverstellung in der Lage ist, sowohl als Pumpe als auch als Turbine mit gleichbleibender Durchstroemrichtung zu arbeiten. Diese spezifisch schnellaeufige Pumpturbine kommt fuer Anlagen in Frage, in denen eine Fluessigkeit im einen Fall gegen einen anstehenden Druck gefoerdert werden muss und im anderen Fall in gleicher Richtung ein Druckgefaelle zur Verfuegung steht. Entweder werden bisher getrennt aufgestellte Pumpen und Turbinen mit zeitweisem Stillstand und entsprechendem Aufwand eingesetzt oder es wird - fast in der Regel - auf die Turbine und damit auf die im Druckgefaelle enthaltene Energie verzichtet. (orig.)

  16. Identifikationsverfahren zur Analyse von EEG-Signalen bei Epilepsie mit Reaktions-Diffusions Netzwerken

    Science.gov (United States)

    Gollas, F.; Tetzlaff, R.

    2007-06-01

    Partielle Differentialgleichungen des Reaktions-Diffusions-Typs beschreiben Phänomene wie Musterbildung, nichtlineare Wellenausbreitung und deterministisches Chaos und werden oft zur Untersuchung komplexer Vorgänge auf den Gebieten der Biologie, Chemie und Physik herangezogen. Zellulare Nichtlineare Netzwerke (CNN) sind eine räumliche Anordnung vergleichsweise einfacher dynamischer Systeme, die eine lokale Kopplung untereinander aufweisen. Durch eine Diskretisierung der Ortsvariablen können Reaktions-Diffusions-Gleichungen häufig auf CNN mit nichtlinearen Gewichtsfunktionen abgebildet werden. Die resultierenden Reaktions-Diffusions-CNN (RD-CNN) weisen dann in ihrer Dynamik näherungsweise gleiches Verhalten wie die zugrunde gelegten Reaktions-Diffusions-Systeme auf. Werden RD-CNN zur Identifikation neuronaler Strukturen anhand von EEG-Signalen herangezogen, so besteht die Möglichkeit festzustellen, ob das gefundene Netzwerk lokale Aktivität aufweist. Die von Chua eingeführte Theorie der lokalen Aktivität Chua (1998); Dogaru und Chua (1998) liefert eine notwendige Bedingung für das Auftreten von emergentem Verhalten in zellularen Netzwerken. Änderungen in den Parametern bestimmter RD-CNN könnten auf bevorstehende epileptische Anfälle hinweisen. In diesem Beitrag steht die Identifikation neuronaler Strukturen anhand von EEG-Signalen durch Reaktions-Diffusions-Netzwerke im Vordergrund der dargestellten Untersuchungen. In der Ergebnisdiskussion wird insbesondere auch die Frage nach einer geeigneten Netzwerkstruktur mit minimaler Komplexität behandelt.

  17. Modern engine management using neuronal nets; Modernes Motormanagement mit Neuronalen Netzen

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, R O

    1998-07-01

    The author focuses on the theoretical analysis, description and extension of neuronal control technology and its applications in engine management. Definitions and methods are presented for forward and recurrent nets. The fundamentals of control technology are described, and neuronal methods for modelling and control are presented. The first part of the report ends with a stability calculation which leads to the extension of existing learning methods. The second part discusses neuronal methods in the control of an external combustion engine. The investigated engine system is described, the combustion process is analyzed, and the fundamentals of engine management are presented. Ignition point and momentum control are presented as examples to illustrate the applicability of neuronal methods. [German] Das Ziel der vorliegenden Arbeit war die theoretische Aufarbeitung, Darstellung und Erweiterung der neuronalen Regelungstechnik und ihre moegliche Anwendung im Motormanagement. Im grundlagenorientierten Teil wurden zuerst die wichtigsten Definitionen und Verfahren fuer vorwaertsgekoppelte und rekurrente Netze praesentiert. Anschliessend folgte eine kurze Einfuehrung in die Regelungstechnik, bevor ausfuehrlich verschiedene Methoden zur neuronalen Modellierung und Regelung vorgestellt wurden. Der erste Teil der Arbeit endete mit einer Stabilitaetsbetrachtung und einer darauf aufbauenden Erweiterung der bestehenden Lernverfahren. Der zweite Teil beschaeftigte sich mit der Anwendung der neuronalen Methoden in der Steuerung eines Verbrennungsmotors. Zur Motivation wurde das betrachtete System genau beschrieben, die Verbrennung analysiert und die Grundlagen des Motormanagements vorgestellt. Beispielhaft wurden im letzten Kapitel die Zuendzeitpunkt- und die Momentenregelung herausgegriffen und an ihnen die Anwendbarkeit der neuronalen Verfahren aufgezeigt. (orig.)

  18. The MIT HEDP Accelerator Facility for Diagnostic Development for OMEGA, Z, and the NIF

    Science.gov (United States)

    Sio, H.; Gatu Johnson, M.; Birkel, A.; Doeg, E.; Frankel, R.; Kabadi, N. V.; Lahmann, B.; Manzin, M.; Simpson, R. A.; Parker, C. E.; Sutcliffe, G. D.; Wink, C.; Frenje, J. A.; Li, C. K.; Seguin, F. H.; Petrasso, R. D.; Leeper, R.; Hahn, K.; Ruiz, C. L.; Sangster, T. C.; Hilsabeck, T.

    2017-10-01

    The MIT HEDP Accelerator Facility utilizes a 135-keV, linear electrostatic ion accelerator; DT and DD neutron sources; and two x-ray sources for development and characterization of nuclear diagnostics for OMEGA, Z, and the NIF. The accelerator generates DD and D3He fusion products through the acceleration of D+ ions onto a 3He-doped Erbium-Deuteride target. Accurately characterized fusion product rates of around 106 s- 1 are routinely achieved. The DT and DD neutron sources generate up to 6×108 and 1×107 neutrons/s, respectively. One x-ray generator is a thick-target W source with a peak energy of 225 keV and a maximum dose rate of 12 Gy/min; the other uses Cu, Mo, or Ti elemental tubes to generate x-rays with a maximum energy of 40 keV. Diagnostics developed and calibrated at this facility include CR-39-based charged-particle spectrometers, neutron detectors, and the particle Time-Of-Flight (pTOF) and Magnetic PTOF CVD-diamond-based bang time detectors. The accelerator is also a valuable hands-on tool for graduate and undergraduate education at MIT. This work was supported in part by the U.S. DoE, SNL, LLE and LLNL.

  19. Temperature measurement in practice with resistance thermometers and thermocouples; Temperaturmesspraxis mit Widerstandsthermometern und Thermoelementen

    Energy Technology Data Exchange (ETDEWEB)

    Irrgang, K.; Michalowsky, L (eds.)

    2004-07-01

    The book addresses students of science and engineering, engineers and practicians in research and industry who are interested in temperature measurements and thermal processes in the temperature range between a few K and over 3200 K. For the first time ever, temperature sensors are classified on the basis of heat transport and heat transfer to the sensor as related to the technological aspects of sensor stress. This includes physical and materials-related fundamentals, materials selection, sensor design and optimisation, error analysis, as well as the analysis of economically relevant applications of electrical temperature measurement in thermal processes. [German] Dieses Buch wendet sich an Studenten der Natur- und Technikwissenschaften, Ingenieure und Hochschulabsolventen in der Forschung und Industrie, die sich mit Temperaturmessungen und thermischen Prozessen im Temperaturbereich von wenigen Kelvin bis zu ueber 3200 K befassen. Der neue Titel wird sich gegenueber bekannten Standards auf diesem Gebiet dadurch auszeichnen, dass eine Klassifizierung der Temperaturfuehler abhaengig vom Waermetransport und den Waermeuebergaengen zum Sensor in Verbindung mit den technologischen Aspekten zu den konkreten Beanspruchungen der Fuehler in der Anwendung vorgenommen wird. Dieser hohe Anspruch schliesst physikalische und werkstoffwissenschaftliche Grundlagen zur Systemloesung, der Werkstoffauswahl, zur Auslegung und Optimierung des Fuehlerdesigns und der notwendigen Fehlerbetrachtung ebenso ein, wie die Analyse volkswirtschaftlich bedeutsamer Anwendungen der elektrischen Temperaturmesstechnik in thermischen Prozessen. (orig.)

  20. High-speed pyrolysis with circulating heat carriers; Schnell-Pyrolyse mit zirkulierenden Waermetraegern

    Energy Technology Data Exchange (ETDEWEB)

    Schmalfeld, J; Albrecht, J; Solmaz, S; Zentner, U [Lurgi Energie und Umwelt GmbH, Frankfurt am Main (Germany)

    1998-09-01

    Yields and product compositions of pyrolysis reactions depend on the mode of heat supply, the temperature level, and the time of residue at reaction temperature. Using hot circulating granular materials mixed with solid or liquid materials (e.g. biogenic or hydrocarbon-rich residues and waste materials or refinery residues), the following important processes can be investigated: Separation of pyrolysis reaction and heat supply - accurate, optimal temperature levels for pyrolysis, e.g. between 5000 and 850 degrees centigrade - undiluted, unmixed pyrolysis gas - short times of residue of the pyrolysis gas for suppression of secondary reactions. (orig.) [Deutsch] Ausbeuten und Produktzusammensetzung von Pyrolyse-Reaktionen werden weitestgehend durch die Art und Weise der Waermezufuhr, das Temperaturniveau und die Verweilzeit bei Reaktionstemperatur bestimmt. Mit Hilfe des Prinzips heisser, umlaufender, koerniger Waermetraeger in Vermischung - fuer die Pyrolyse-Reaktion - mit festen oder fluessigen Einsatzstoffen (z.B. biogene oder kohlenwasserstoffreiche Rest-/Abfallstoffe, Raffinerie-Rueckstaende) lassen sich folgende wichtige, haeufig gewuenschte Vorgaenge realisieren: - Trennung von Pyrolyse-Reaktion und Waermeversorgung - Temperaturgenaue Pyrolyse-Reaktion auf gewuenschtem, optimalem Niveau waehlbar zwischen z.B. 5000 C und 850 C - Erhalt eines unverduennten, unvermischten Pyrolysegases - Kurze Verweilzeiten des Pyrolysegases zur Unterdrueckung von Sekundaerreaktionen. (orig.)

  1. A MIT-Based Nonlinear Adaptive Set-Membership Filter for the Ellipsoidal Estimation of Mobile Robots' States

    Directory of Open Access Journals (Sweden)

    Dalei Song

    2012-10-01

    Full Text Available The adaptive extended set-membership filter (AESMF for nonlinear ellipsoidal estimation suffers a mismatch between real process noise and its set boundaries, which may result in unstable estimation. In this paper, a MIT method-based adaptive set-membership filter, for the optimization of the set boundaries of process noise, is developed and applied to the nonlinear joint estimation of both time-varying states and parameters. As a result of using the proposed MIT-AESMF, the estimation effectiveness and boundary accuracy of traditional AESMF are substantially improved. Simulation results have shown the efficiency and robustness of the proposed method.

  2. Mitä tänään on tarjolla?” : opiskelijaruokailu laadusta mielikuviin

    OpenAIRE

    Partanen, Elina

    2008-01-01

    Työn tavoitteena oli selvittää, mitä opiskelijat yleensä syövät lounaalla opiskelijaravintolassa ja mitä mieltä he olivat tarjotusta lounasruuasta. Jyväskylän ammattikorkeakoululla on viisi eri ruokapalveluiden tarjoajaa, ja jokaisella on hieman toisistaan poikkeava liikekonsepti. Tutkimus toteutettiin sähköpostikyselynä Digium-ohjelman avulla ammattikorkeakoulun eri alojen opiskelijoille. Kyselyyn oli mahdollista vastata 8.4.2008 – 22.4.2008 välisenä aikana. Kyselyyn vastasi 341. Kyselyn tul...

  3. Test calculations of physical parameters of the TRX,BETTIS and MIT critical assemblies according to the TRIFON program

    International Nuclear Information System (INIS)

    Kochurov, B.P.

    1980-01-01

    Results of calculations of physical parameters characterizing the TRX, MIT and BETTIS critical assemblies obtained according to the program TRIFON are presented. The program TRIFON permits to calculate the space-energy neutron distribution in the multigroup approximation in a multizone cylindrical cell. Results of comparison of the TRX, BETTIS and MIT crytical assembly parameters with experimental data and calculational results according to the Monte Carlo method are presented as well. Deviations of the parameters are in the range of 1.5-2 of experimental errors. Data on the interference of uranium 238 levels in the resonant neutron absorption in the cell are given [ru

  4. Distinct Mechanisms of Recognizing Endosomal Sorting Complex Required for Transport III (ESCRT-III) Protein IST1 by Different Microtubule Interacting and Trafficking (MIT) Domains*

    Science.gov (United States)

    Guo, Emily Z.; Xu, Zhaohui

    2015-01-01

    The endosomal sorting complex required for transport (ESCRT) machinery is responsible for membrane remodeling in a number of biological processes including multivesicular body biogenesis, cytokinesis, and enveloped virus budding. In mammalian cells, efficient abscission during cytokinesis requires proper function of the ESCRT-III protein IST1, which binds to the microtubule interacting and trafficking (MIT) domains of VPS4, LIP5, and Spartin via its C-terminal MIT-interacting motif (MIM). Here, we studied the molecular interactions between IST1 and the three MIT domain-containing proteins to understand the structural basis that governs pairwise MIT-MIM interaction. Crystal structures of the three molecular complexes revealed that IST1 binds to the MIT domains of VPS4, LIP5, and Spartin using two different mechanisms (MIM1 mode versus MIM3 mode). Structural comparison revealed that structural features in both MIT and MIM contribute to determine the specific binding mechanism. Within the IST1 MIM sequence, two phenylalanine residues were shown to be important in discriminating MIM1 versus MIM3 binding. These observations enabled us to deduce a preliminary binding code, which we applied to provide CHMP2A, a protein that normally only binds the MIT domain in the MIM1 mode, the additional ability to bind the MIT domain of Spartin in the MIM3 mode. PMID:25657007

  5. Distinct mechanisms of recognizing endosomal sorting complex required for transport III (ESCRT-III) protein IST1 by different microtubule interacting and trafficking (MIT) domains.

    Science.gov (United States)

    Guo, Emily Z; Xu, Zhaohui

    2015-03-27

    The endosomal sorting complex required for transport (ESCRT) machinery is responsible for membrane remodeling in a number of biological processes including multivesicular body biogenesis, cytokinesis, and enveloped virus budding. In mammalian cells, efficient abscission during cytokinesis requires proper function of the ESCRT-III protein IST1, which binds to the microtubule interacting and trafficking (MIT) domains of VPS4, LIP5, and Spartin via its C-terminal MIT-interacting motif (MIM). Here, we studied the molecular interactions between IST1 and the three MIT domain-containing proteins to understand the structural basis that governs pairwise MIT-MIM interaction. Crystal structures of the three molecular complexes revealed that IST1 binds to the MIT domains of VPS4, LIP5, and Spartin using two different mechanisms (MIM1 mode versus MIM3 mode). Structural comparison revealed that structural features in both MIT and MIM contribute to determine the specific binding mechanism. Within the IST1 MIM sequence, two phenylalanine residues were shown to be important in discriminating MIM1 versus MIM3 binding. These observations enabled us to deduce a preliminary binding code, which we applied to provide CHMP2A, a protein that normally only binds the MIT domain in the MIM1 mode, the additional ability to bind the MIT domain of Spartin in the MIM3 mode. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  6. PET-Studies in parkinson's disease; Untersuchungen mit der Positronen-Emissions-Tomographie (PET) bei Patienten mit Morbus Parkinson

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, J. [Klinik fuer Neurologie, Univ. Leipzig (Germany)

    2002-09-01

    Positron-emission-tomography (PET) has enabled to study the metabolism and blood flow in specific brain areas. Besides, there is a variety of radiotracers that allow quantification of the function of distinct molecules. In respect to Parkinson's disease, PET allowed for the first time to assess the number of dopaminergic neurons in vivo. Thus, helping confirming a dopaminergic deficit, measuring disease progression and also help to determine the function of dopaminergic grafts. Current research has shifted to determine the role of related neurotransmitter systems in the pathophysiology of Parkinson's disease. (orig.) [German] Die positronen-emissions-tomographie (PET) bietet neben der Messung von Metabolismus und Blutfluss die Moeglichkeit der Darstellung von einzelnen Molekuelen. Bei Patienten mit Morbus Parkinson hat es diese Technik erstmals erlaubt, die Anzahl der dopaminergen Neurone zu quantifizieren, wodurch die Diagnose gesichert, die Progression der Erkrankung beurteilt und auch das Anwachsen von Implantaten beurteilt werden kann. Die PET hat einen wesentlichen Beitrag zu unserem heutigen Wissen ueber die Pathophysiologie dieser Erkrankung beigetragen. (orig.)

  7. Inmunodiagnóstico de micosis endémicas y aspergilosis broncopulmonar: Estudio multicéntrico en la República Argentina Immunodiagnosis of endemic mycoses and bronchopulmonary aspergilosis: A multicenter study in Argentina

    Directory of Open Access Journals (Sweden)

    C.E. Canteros

    2004-06-01

    Full Text Available Se realizó entre 01-04-2000 y 30-03-2001, un estudio de corte transversal, para conocer la frecuencia relativa de las enfermedades por hongos dimorfos y Aspergillus spp. en la República Argentina y evaluar la certeza en el diagnóstico de los laboratorios de diferentes áreas geográficas. Participaron 25 centros de salud provenientes de 12 provincias y de la Ciudad Autónoma de Buenos Aires. Fueron analizados en el laboratorio de origen 965 sueros de pacientes con sospecha clínica de histoplasmosis (HP, paracoccidioidomicosis (PCM, coccidioidomicosis (CM y aspergilosis. Todos los sueros positivos y el 35% de los negativos fueron reevaluados en el laboratorio de referencia por inmunodifusión doble en agar. La concordancia entre los resultados obtenidos en los centros de origen y el de referencia fue de 98,8%. Se detectaron anticuerpos específicos en 120 sueros correspondientes a 98 pacientes. El 71,4% (70 casos de los diagnósticos correspondió a micosis endémicas (HP, PCM y CM y el resto a aspergilosis. PCM fue diagnosticada en 47,9% (47 casos, aspergilosis en 28,6% (28 casos, HP en13,3% (13 casos y CM en 10,2% (10 casos. La participación en este estudio fue voluntaria y no todos los centros del país estaban representados, sin embargo, las frecuencias de enfermedades fúngicas fueron las esperadas y coincidentes con estudios previos realizados a nivel nacional.In order to contribute to the knowledge of the relative frequency of chronic fungal diseases and assess the performance of diagnostic laboratories in Argentina, a multicenter study was performed with the participation of 25 medical centers located in 12 different provinces and Buenos Aires City. Between 04-01-2000 and 03-30-2001, 965 serum specimens from patients clinically suspected of having histoplasmosis (HP, paracoccidioidomycosis (PCM, coccidioidomycosis (CM or aspergilosis were analyzed. Agar immunodiffusion tests (IDD were done locally. All positive and 35% of negative

  8. Understanding the Self-Directed Online Learning Prefer