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Sample records for nonrandomized comparative feasibility

  1. Per-Oral Endoscopic Myotomy Versus Laparoscopic Heller Myotomy for Achalasia: A Meta-Analysis of Nonrandomized Comparative Studies.

    Science.gov (United States)

    Zhang, Yuan; Wang, Hongjuan; Chen, Xingdong; Liu, Lan; Wang, Hongbo; Liu, Bin; Guo, Jianqiang; Jia, Hongying

    2016-02-01

    We aimed to assess the short-term outcomes of per-oral endoscopic myotomy (POEM) compared with laparoscopic Heller myotomy (LHM) for achalasia through a meta-analysis of nonrandomized comparative studies.We searched PubMed, Embase, Medline, Cochrane Library, and Google Scholar for studies that compared POEM and LHM for achalasia and were published between January 1, 2008 and December 31, 2014. The Methodological Index for Nonrandomized Studies (MINORS) was used to evaluate the quality of the studies. Random- and fixed-effects meta-analytical models were used, and between-study heterogeneity was assessed.Four nonrandomized comparative studies that included 317 patients (125 in the POEM group and 192 in the LHM group) met our research criteria and were assessed. There were no differences between the POEM and LHM groups in terms of sex, preoperative Eckhart score, length of myotomy, operation time, length of hospital stay, and complications. The patients in the POEM group were older than those in the LHM group (MD =2.81, 95% CI 0.27-5.35; P = 0.03) with high between-study homogeneity (χ = 1.96, df = 2, I = 0%; P = 0.38). The patients in the POEM group had a lower Eckardt score after surgery compared with those in the LHM group (MD = -0.30, 95% CI -0.42 to -0.18; P < 0.001) with high between-study homogeneity (χ = 0.00, df = 1, I = 0%; P = 1.00).The efficacy and safety of POEM appear to be comparable to those of LHM. Multicenter and randomized trials with larger sample size are needed to further compare the efficacy and safety of POEM and LHM for the treatment of achalasia.

  2. Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities

    OpenAIRE

    Cameron, Chris; Fireman, Bruce; Hutton, Brian; Clifford, Tammy; Coyle, Doug; Wells, George; Dormuth, Colin R.; Platt, Robert; Toh, Sengwee

    2015-01-01

    Network meta-analysis is increasingly used to allow comparison of multiple treatment alternatives simultaneously, some of which may not have been compared directly in primary research studies. The majority of network meta-analyses published to date have incorporated data from randomized controlled trials (RCTs) only; however, inclusion of non-randomized studies may sometimes be considered. Non-randomized studies can complement RCTs or address some of their limitations, such as short follow-up...

  3. Additive Complex Ayurvedic Treatment in Patients with Fibromyalgia Syndrome Compared to Conventional Standard Care Alone: A Nonrandomized Controlled Clinical Pilot Study (KAFA Trial

    Directory of Open Access Journals (Sweden)

    Christian S. Kessler

    2013-01-01

    Full Text Available Background. Fibromyalgia (FMS is a challenging condition for health care systems worldwide. Only limited trial data is available for FMS for outcomes of complex treatment interventions of complementary and integrative (CIM approaches. Methods. We conducted a controlled, nonrandomized feasibility study that compared outcomes in 21 patients treated with Ayurveda with those of 11 patients treated with a conventional approach at the end of a two-week inpatient hospital stay. Primary outcome was the impact of fibromyalgia on patients as assessed by the FIQ. Secondary outcomes included scores of pain intensity, pain perception, depression, anxiety, and quality of sleep. Follow-up assessments were done after 6 months. Results. At 2 weeks, there were comparable and significant improvements in the FIQ and for most of secondary outcomes in both groups with no significant in-between-group differences. The beneficial effects for both treatment groups were partly maintained for the main outcome and a number of secondary outcomes at the 6-month followup, again with no significant in-between-group differences. Discussion. The findings of this feasibility study suggest that Ayurvedic therapy is noninferior to conventional treatment in patients with severe FMS. Since Ayurveda was only used as add-on treatment, RCTs on Ayurveda alone are warranted to increase model validity. This trial is registered with NCT01389336.

  4. Comparative Genomic Hybridization of Human Malignant Gliomas Reveals Multiple Amplification Sites and Nonrandom Chromosomal Gains and Losses

    Science.gov (United States)

    Schròck, Evelin; Thiel, Gundula; Lozanova, Tanka; du Manoir, Stanislas; Meffert, Marie-Christine; Jauch, Anna; Speicher, Michael R.; Nürnberg, Peter; Vogel, Siegfried; Janisch, Werner; Donis-Keller, Helen; Ried, Thomas; Witkowski, Regine; Cremer, Thomas

    1994-01-01

    Nine human malignant gliomas (2 astrocytomas grade III and 7 glioblastomas) were analyzed using comparative genomic hybridization (CGH). In addition to the amplification of the EGFR gene at 7p12 in 4 of 9 cases, six new amplification sites were mapped to 1q32, 4q12, 7q21.1, 7q21.2-3, 12p, and 22q12. Nonrandom chromosomal gains and losses were identified with overrepresentation of chromosome 7 and underrepresentation of chromosome 10 as the most frequent events (1 of 2 astrocytomas, 7 of 7 glioblastomas). Gain of a part or the whole chromosome 19 and losses of chromosome bands 9pter-23 and 22q13 were detected each in five cases. Loss of chromosome band 17p13 and gain of chromosome 20 were revealed each in three cases. The validity of the CGH data was confirmed using interphase cytogenetics with YAC clones, chromosome painting in tumor metaphase spreads, and DNA fingerprinting. A comparison of CGH data with the results of chromosome banding analyses indicates that metaphase spreads accessible in primary tumor cell cultures may not represent the clones predominant in the tumor tissue ImagesFigure 1Figure 4Figure 6 PMID:8203461

  5. Comparative Evaluation of Liposomal Albendazole and Tablet-Albendazole Against Hepatic Cystic Echinococcosis: A Non-Randomized Clinical Trial.

    Science.gov (United States)

    Li, Haitao; Song, Tao; Shao, Yingmei; Aili, Tuergan; Ahan, Ayifuhan; Wen, Hao

    2016-01-01

    In this study, we aimed to compare the clinical efficacy of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) for the treatment of human hepatic cystic echinococcosis (CE). Sixty patients with single cyst (CE1) or daughter cyst (CE2) were included in this study and were nonrandomly divided into the L-ABZ group (n = 30, 10  mg/kg per day, p.o., b.i.d.) and T-ABZ group (n = 30, 12-20 mg/kg per day, p.o., b.i.d.), respectively. The treatment duration lasted for 6 months, during which dynamic follow-up was carried out to evaluate the clinical efficacy through calculating the total effective rates (TERs). Measurement data and numerous data were analyzed by the chi-square test. Two-sided tests were performed for all the statistical tests. In our study, 2 patients were lost in the follow-up in the L-ABZ group. One patient was lost in the follow-up in the T-ABZ group, and 1 patient was withdrawal from the study due to receiving surgery. Significant difference was identified in the 3-month TERs of L-ABZ group and T-ABZ group (33.3% vs 76.7%, P  0.05). Based on our study, both T-ABZ and L-ABZ are effective for treating human CE. The TER in the L-ABZ group is superior to that of T-ABZ.

  6. Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team.

    Science.gov (United States)

    Nanton, Veronica; Appleton, Rebecca; Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

    2017-07-28

    The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to encourage engagement and uptake by

  7. Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team

    Science.gov (United States)

    Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

    2017-01-01

    Background The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Objective Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. Methods A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Results Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to

  8. Non-randomized clinical study comparing chemotherapy plus radiotherapy with radiotherapy alone in neoadjuvant therapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kayahara, Hiroaki; Okuda, Mamiko; Terakado, Nagaaki; Shintani, Satoru; Hamakawa, Hiroyuki [Ehime Univ., Shigenobu (Japan). School of Medicine

    2002-06-01

    Neoadjuvant therapy plays an important role for organ preservation and survival rate in the treatment of oral cancer. We clinically compared the effect of neoadjuvant radiotherapy and chemoradiotherapy in patients with oral cancer. We retrospectively examined 47 patients diagnosed with oral squamous cell carcinoma who underwent neoadjuvant therapy followed by curative surgery in the oral and maxillofacial surgery department of Ehime University Hospital. We divided them into two groups: radiotherapy alone (24 cases) and chemoradiotherapy (23 cases). The patients in the radiotherapy group underwent irradiation of 32.6{+-}5.0 Gy (mean {+-}SD). The patients in the chemoradiotherapy group received a low-dose fraction of cisplatin (8 mg/mm{sup 2}/day, 5 days a week; total dose: 139.4{+-}67.1 mg) and 5-fluorouracil (300 mg/mm{sup 2}/day, 5 days a week; total dose: 5,900{+-}1,839.8 mg) combined with simultaneous irradiation of 31.0{+-}3.2 Gy. None of the 24 patients had a complete response to radiotherapy alone and 12 (50%) had a partial response. Six (26%) of the 23 patients had a complete response to chemoradiotherapy and 12 (52%) had a partial response. The primary control rate (82.6%) to chemoradiotherapy was higher than that (67.5%) to radiotherapy alone although no significant difference was found. The 5-year survival rate was 64.3% in the radiotherapy group and 62.8% in the chemoradiotherapy group. The findings of the present study suggest that while the combination of radiation and cisplatin/5-fluorouracil in neoadjuvant therapy for oral cancer may not bring a significant benefit to improve survival rate, the primary local control rate is improved in comparison with radiotherapy alone. (author)

  9. An open, nonrandomized, comparative study of imiquimod 5% cream versus 10% potassium hydroxide solution in the treatment of molluscum contagiosum.

    Science.gov (United States)

    Metkar, Amol; Pande, Sushil; Khopkar, Uday

    2008-01-01

    There are numerous therapeutic modalities available for treatment of molluscum contagiosum. However, the ablative modalities are painful and not suitable for children. We aimed to evaluate and compare the safety and efficacy of 2 of the painless modalities, viz., 5% imiquimod cream and 10% potassium hydroxide (KOH) solution, in the treatment of molluscum contagiosum. Out of a total of 40 patients of molluscum contagiosum in the study, 18 patients in the imiquimod group and 19 patients in the KOH group completed the study. The given medication was applied by the patient or a parent to mollusca at night, 3 days per week. Imiquimod was continued till clinical cure; and 10% KOH, till lesions showed signs of inflammation. Assessments of response and side effects were performed at the end of week 4, week 8, and week 12. Significance was tested by Student's t test and Mann-Whitney test. The mean lesion count decreased from 22.39 to 10.75 with imiquimod and from 20.79 to 4.31 with KOH at the end of 12 weeks. We found complete clearance of lesions in 8 (44%) patients with imiquimod and in 8 (42.1%) patients with 10% KOH. Minor side effects were seen in 15 (78.9%) patients on KOH and 10 (55.5%) patients on imiquimod. The results of this study suggest that both 5% imiquimod cream and 10% KOH solution are equally effective in molluscum contagiosum though KOH has a faster onset of action. However, KOH solution is associated with a higher incidence of side effects.

  10. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

    Directory of Open Access Journals (Sweden)

    Tahsin Gorgulu

    2016-02-01

    Full Text Available ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33% occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9 minutes. The conventional guillotine group comprised one hematoma (1.3%, two wound dehiscences (2.6%, and two hemorrhages (2.6%, and the median operating time was 22 (range 20–26 minutes. The difference in surgical time was significant (p<0.001, with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

  11. A tool for assessing the feasibility of comparative effectiveness research

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    Walker AM

    2013-01-01

    Full Text Available Alexander M Walker,1 Amanda R Patrick,2 Michael S Lauer,3 Mark C Hornbrook,4 Matthew G Marin,5 Richard Platt,6 Véronique L Roger,7 Paul Stang,8 Sebastian Schneeweiss21World Health Information Science Consultants, Newton, MA; 2Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA; 3National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; 4The Center for Health Research, Kaiser Permanente Northwest, Portland, OR; 5Department of Medicine, New Jersey Medical School, Newark, NJ; 6Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA; 7Department of Health Sciences Research, Mayo Clinic, Rochester, MN; 8Johnson and Johnson Pharmaceutical Research and Development, Titusville, NJ, USABackground: Comparative effectiveness research (CER provides actionable information for health care decision-making. Randomized clinical trials cannot provide the patients, time horizons, or practice settings needed for all required CER. The need for comparative assessments and the infeasibility of conducting randomized clinical trials in all relevant areas is leading researchers and policy makers to non-randomized, retrospective CER. Such studies are possible when rich data exist on large populations receiving alternative therapies that are used as-if interchangeably in clinical practice. This setting we call “empirical equipoise.”Objectives: This study sought to provide a method for the systematic identification of settings it in which it is empirical equipoise that offers promised non-randomized CER.Methods: We used a standardizing transformation of the propensity score called “preference” to assess pairs of common treatments for uncomplicated community-acquired pneumonia and new-onset heart failure in a population of low-income elderly people in Pennsylvania, for whom we had access to de-identified insurance records. Treatment

  12. Is the alpha-beta ratio of prostate cancer really low? A prospective, non-randomized trial comparing standard and hyperfractionated conformal radiation therapy

    International Nuclear Information System (INIS)

    Valdagni, Riccardo; Italia, Corrado; Montanaro, Paolo; Lanceni, Angelo; Lattuada, Paola; Magnani, Tiziana; Fiorino, Claudio; Nahum, Alan

    2005-01-01

    Background and purpose: The objectives of the current study were to compare genito-urinary (GU) and gastro-intestinal (GI) toxicities as well as biochemical control (bRFS) in prostate cancer, utilizing conventional (2.0 Gy daily) (STD) or hyperfractionated (HFX) conformal irradiation (CRT). HFX (1.2 Gy BID) was chosen as a radiobiological method to try to reduce long term sequelae without compromising local control. Patients and methods: Three-hundred-and-seventy consecutive patients (pts) entered this prospective, non-randomized trial in the period January 1993-January 2003; 209 were treated with STD and 161 with HFX CRT. All were evaluable for acute toxicity analysis, 179 (STD) and 151 pts (HFX) being evaluable for late sequelae and bRFS analyses. Pt characteristics were not statistically different in the two groups. CRT consisted of a 4-field technique for prostate and/or pelvic nodes and a 5-field boost with rectal shielding. Median doses were 74 and 79.2 Gy for STD and HFX patients respectively, the latter dose being isoeffective for tumour control assuming α/β=10 (EQD 2 =73.9 Gy). Median follow-up was 29.4 months (25.2 mos for STD; 37.7 mos for HFX; P<0.01). The two regimens were compared in terms of acute and late GU and GI toxicities and 5-year bRFS by univariate and multivariate analyses. Results: Acute grade≥2 GU toxicity was higher in the STD group (48.6% versus 37.3% in HFX, P=0.03), while no significant difference was found for acute GI toxicity. Late grade≥2 GU and GI toxicities were lower in the HFX group (5-year actuarial rate: GU: 10.1% versus 20.3%, P=0.05; GI: 6.0% versus 10.6%, P=0.18). Five-year bRFS were 70% (±13.8%, 95% CI) and 82.6% (±7.2%) for STD and HFX, respectively (P=0.44); a trend favouring HFX was found in the subgroup of pts who did not receive hormonal therapy (5-year bRFS: 85.9%±12.4% versus 63.9%±23.8%, P=0.15). Multivariate analysis revealed only risk groups and age statistically related to bRFS but not fractionation

  13. A systematic review and meta-analysis of randomized and non-randomized studies comparing laparoscopic and open abdominoperineal resection for rectal cancer.

    LENUS (Irish Health Repository)

    Ahmad, N Z

    2013-03-01

    Evidence supporting the role of laparoscopy in abdominoperineal resection (APR) is limited. This study compared the short-term and long-term outcomes and complications associated with open and laparoscopic APR.

  14. COMPLETE SUBRETINAL FLUID DRAINAGE IS NOT NECESSARY DURING VITRECTOMY SURGERY FOR MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT WITH PERIPHERAL BREAKS: A Prospective, Nonrandomized Comparative Interventional Study.

    Science.gov (United States)

    Chen, Xiao; Zhang, Yong; Yan, Ying; Hong, Ling; Zhu, Li; Deng, Jun; Din, Qin; Huang, Zhijian; Zhou, Hezhen

    2017-03-01

    To compare clinical outcomes in eyes with macula-off rhegmatogenous retinal detachments managed by surgical protocols, the result in either complete (CSFD) or partial subretinal fluid drainage (PSFD). Fifty-four eyes with macula-off rhegmatogenous retinal detachments with peripheral retinal breaks of 54 patients were assigned prospectively to one of the two surgical designs (PSFD or CSFD, 2:1) in a sequence. Patients were treated with 25-gauge plus vitrectomy, either CSFD (n = 18) or PSFD (n = 36), and 14% C3F8 was used for intraocular tamponade. Anatomical and visual outcomes as well as intraoperative and postoperative complications of the two groups were compared. The single-operation success rates were 16/18 (88.9%) and 33/36 (91.6%), respectively, for the CSFD and the PSFD groups (P = 1.00). The mean BCVA improvement (Early Treatment Diabetic Retinopathy Study letters) at the 6-month postoperative was not significantly different between the two groups (26.50 ± 15.43 in CSFD group vs. 22.64 ± 15.43 in PSFD group, P = 0.43). Partial subretinal fluid drainage procedure during vitrectomy for the repair of macula-off rhegmatogenous retinal detachments revealed comparable results with CSFD in terms of anatomical and visual outcomes. Complete subretinal fluid drainage during vitrectomy seems to be unnecessary for all RRD reattachment surgical procedures.

  15. Nonrandomized study comparing the effects of preoperative radiotherapy and daily administration of low-dose cisplatin with those radiotherapy alone for oral cancer

    International Nuclear Information System (INIS)

    Kurita, Hiroshi; Azegami, Takuya; Kobayashi, Hirokazu; Kurashina, Kenji; Tanaka, Kouichi; Kotani, Akira; Oguchi, Masahiko; Tamura, Minoru.

    1997-01-01

    The purpose of this study was to compare the effect of preoperative radiotherapy and daily administration of low-dose cisplatin with those of radiotherapy alone for oral cancer. Ten patients underwent preoperative radiotherapy of 30 to 40 Gy with concomitant daily administration of low-dose cisplatin (5 mg/body or 5 mg/m 2 ). Ten patients received external radiotherapy alone. The locoregional response rates (complete response and partial response) did not differ significantly between the two groups (80% for combined therapy and 60% for radiotherapy alone). On histopathologic evaluation of surgical specimens, however, the combined-therapy group (80%) had a higher response rate than did the radiotherapy-alone group (10%; p<0.01). We conclude that daily administration of low-dose cisplatin enhances the efficacy of radiotherapy against primary tumors. We also suggested that combined therapy may be beneficial as an initial treatment for oral cancer before a planned operation. (author)

  16. A sexy spin on nonrandom chromosome segregation.

    Science.gov (United States)

    Charville, Gregory W; Rando, Thomas A

    2013-06-06

    Nonrandom chromosome segregation is an intriguing phenomenon linked to certain asymmetric stem cell divisions. In a recent report in Nature, Yadlapalli and Yamashita (2013) observe nonrandom segregation of X and Y chromosomes in Drosophila germline stem cells and shed light on the complex mechanisms of this fascinating process. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. A 4-year non-randomized comparative phase-IV study of early rheumatoid arthritis: integrative anthroposophic medicine for patients with preference against DMARDs versus conventional therapy including DMARDs for patients without preference

    Directory of Open Access Journals (Sweden)

    Hamre HJ

    2018-03-01

    Full Text Available Harald J Hamre,1 Van N Pham,2 Christian Kern,3 Rolf Rau,4 Jörn Klasen,3 Ute Schendel,5 Lars Gerlach,6 Attyla Drabik,2 Ludger Simon6,† 1Institute for Applied Epistemology and Medical Methodology at the Witten/Herdecke University, Freiburg, Germany; 2Institute of Statistics in Medicine, Universitätsklinikum Düsseldorf, Düsseldorf, Germany; 3Department of Integrative Medicine, Asklepios Westklinikum, Hamburg, Germany; 4Department of Rheumatology, Evangelisches Fachkrankenhaus Ratingen, Ratingen, Germany; 5Department of Rheumatology, m&i-Fachklinik Bad Pyrmont, Bad Pyrmont, Germany; 6Department of Internal Medicine and Gastroenterology, Filderklinik, Filderstadt, Germany †Dr Ludger Simon passed away on June 10, 2016 Background: While disease-modifying antirheumatic drugs (DMARDs are a mainstay of therapy for rheumatoid arthritis (RA, some patients with early RA refuse DMARDs. In anthroposophic medicine (AM, a treatment strategy for early RA without DMARDs has been developed. Preliminary data suggest that RA symptoms and inflammatory markers can be reduced under AM, without DMARDs. Patients and methods: Two hundred and fifty-one self-selected patients aged 16–70 years, starting treatment for RA of <3 years duration, without prior DMARD therapy, participated in a prospective, non-randomized, comparative Phase IV study. C-patients were treated in clinics offering conventional therapy including DMARDs, while A-patients had chosen treatment in anthroposophic clinics, without DMARDs. Both groups received corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs. Primary outcomes were intensity of RA symptoms measured by self-rating on visual analog scales, C-reactive protein, radiological progression, study withdrawals, serious adverse events (SAE, and adverse drug reactions in months 0–48. Results: The groups were similar in most baseline characteristics, while A-patients had longer disease duration (mean 15.1 vs 10.8 months, p<0

  18. Feasible sets, comparative risk aversion, and comparative uncertainty aversion in bargaining

    NARCIS (Netherlands)

    Driesen, B.W.I.; Lombardi, M.; Peters, H.J.M.

    2015-01-01

    We study feasible sets of the bargaining problem under two different assumptions: the players are subjective expected utility maximizers or the players are Choquet expected utility maximizers. For the latter case, we consider the effects on bargaining solutions when players become more risk averse

  19. Tests for nonrandomness in quantum jumps

    International Nuclear Information System (INIS)

    Berkeland, D.J.; Raymondson, D.A.; Tassin, V.M.

    2004-01-01

    In a fundamental test of quantum mechanics, we have observed 228 000 quantum jumps of a single trapped and laser cooled 88 Sr + ion. This represents a statistical increase of two orders of magnitude over previous similar analyses of quantum jumps. Compared to other searches for nonrandomness in quantum-mechanical processes, using quantum jumps simplifies the interpretation of data by eliminated multiparticle effects and providing near-unit detection efficiency of transitions. We measure the fractional reduction in the entropy of information to be -4 when the value of any interval between quantum jumps is known. We also find that the number of runs of successively increasing or decreasing interval times agrees with the theoretically expected values. Furthermore, we analyze 238 000 quantum jumps from two simultaneously confined ions and find that the number of apparently coincidental transitions is as expected. Finally, we observe 8400 spontaneous decays of two simultaneously trapped ions and find that the number of apparently coincidental decays from the metastable state agrees with the expected value. We find no evidence for short- or long-term correlations in the intervals of the quantum jumps or in the decay of the quantum states, in agreement with quantum theory

  20. Nonrandom network connectivity comes in pairs

    Directory of Open Access Journals (Sweden)

    Felix Z. Hoffmann

    2017-02-01

    Full Text Available Overrepresentation of bidirectional connections in local cortical networks has been repeatedly reported and is a focus of the ongoing discussion of nonrandom connectivity. Here we show in a brief mathematical analysis that in a network in which connection probabilities are symmetric in pairs, Pij = Pji, the occurrences of bidirectional connections and nonrandom structures are inherently linked; an overabundance of reciprocally connected pairs emerges necessarily when some pairs of neurons are more likely to be connected than others. Our numerical results imply that such overrepresentation can also be sustained when connection probabilities are only approximately symmetric.

  1. Comparative analysis of public's perception of economic feasibility and reality for selected energy sources in Korea

    International Nuclear Information System (INIS)

    Roh, Seungkook; Jeong, Ik; Lee, Kibog; Kim, Dongwook; Kim, Hyunjin

    2016-01-01

    Controversy on nuclear energy has persisted ever since, but nuclear energy has maintained around 30% of electricity generation in Korea. This is because Korean wants to secure energy security and diversity of energy sources, but the most rational driver behind nuclear energy is the economic feasibility. Looking at the actual prices of electricity traded in the Korean Power Exchange, the price of electricity generated by nuclear energy is 39.1 Korean won per kWh, which is lower than that of other sources: 58.9 (bituminous coal), 221.8 (oil), 158.6 (gas), 170.9 (hydropower), 162.8 (wind) and 463.1 (photovoltaic). However only experts, regulators and people from electricity generation industry are aware of this fact and the public does not seem to be perceiving this correctly. This research, therefore, will compare the economic feasibility of energy sources and how it is perceived by the public in general. This research was able to identify the large gap between public's perception on and reality of economic feasibility of energy sources. There are two possible reasons for the gap. Firstly, the electricity price paid by the public is agnostic of energy sources. Therefore, it is difficult for the public to be aware that the electricity from nuclear energy is benefiting them and hence the public would be indifferent to the real economic feasibility. Secondly, public's awareness of nuclear reactor decommissioning and spent fuel processing along with easier access to relevant information the media would have played a role. In fact, number of press and media has questioned the economic feasibility of nuclear energy. However, the price of electricity generated by nuclear energy includes costs for future activities such as decommissioning, radioactive waste disposal and spent fuel disposal. The public seems to be not aware of such fact and therefore favoring the media. Such analysis leads to two major policy implications. Most importantly, the government should emphasize the

  2. Comparability and feasibility of wrist- and hip-worn accelerometers in free-living adolescents.

    Science.gov (United States)

    Scott, Joseph J; Rowlands, Alex V; Cliff, Dylan P; Morgan, Philip J; Plotnikoff, Ronald C; Lubans, David R

    2017-12-01

    To determine the comparability and feasibility of wrist- and hip-worn accelerometers among free-living adolescents. 89 adolescents (age=13-14years old) from eight secondary schools in New South Wales (NSW), Australia wore wrist-worn GENEActiv and hip-worn ActiGraph (GT3X+) accelerometers simultaneously for seven days and completed an accelerometry behavior questionnaire. Bivariate correlations between the wrist- and hip-worn out-put were used to determine concurrent validity. Paired samples t-test were used to compare minutes per day in moderate-to-vigorous physical activity (MVPA). Group means and paired sample t-tests were used to analyze participants' perceptions of the wrist- and hip-worn monitoring protocols to assist with determining the feasibility. Wrist-worn accelerometry compared favorably with the hip-worn in average activity (r=0.88, phip-worn accelerometer (n=152, 24.4%). Participants reported they liked to wear the device on the wrist (phip (phip-worn accelerometer out-put among adolescents in free-living conditions. Adolescent compliance was significantly higher with wrist placement, with participants reporting that it was more comfortable and less embarrassing to wear on the wrist. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Random Versus Nonrandom Peer Review: A Case for More Meaningful Peer Review.

    Science.gov (United States)

    Itri, Jason N; Donithan, Adam; Patel, Sohil H

    2018-05-10

    Random peer review programs are not optimized to discover cases with diagnostic error and thus have inherent limitations with respect to educational and quality improvement value. Nonrandom peer review offers an alternative approach in which diagnostic error cases are targeted for collection during routine clinical practice. The objective of this study was to compare error cases identified through random and nonrandom peer review approaches at an academic center. During the 1-year study period, the number of discrepancy cases and score of discrepancy were determined from each approach. The nonrandom peer review process collected 190 cases, of which 60 were scored as 2 (minor discrepancy), 94 as 3 (significant discrepancy), and 36 as 4 (major discrepancy). In the random peer review process, 1,690 cases were reviewed, of which 1,646 were scored as 1 (no discrepancy), 44 were scored as 2 (minor discrepancy), and none were scored as 3 or 4. Several teaching lessons and quality improvement measures were developed as a result of analysis of error cases collected through the nonrandom peer review process. Our experience supports the implementation of nonrandom peer review as a replacement to random peer review, with nonrandom peer review serving as a more effective method for collecting diagnostic error cases with educational and quality improvement value. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. COMPARATIVE FEASIBILITY ANALYSIS OF MODERN AND TRADITIONAL SYSTEM OF BROILER CHICKEN FARM BUSINESS

    Directory of Open Access Journals (Sweden)

    Firda Rachma Amalia

    2015-05-01

    Full Text Available Feasibility study is a study assessing a project to be undertaken in the future. This research aimed to analyze whether the broiler business by partnership pattern at Prospek Mitra Lestari (PML was feasible to be continued. This research analyzed two models of cage that is traditional cage (open with a scale of 10,000  and modern cage (close with a scale 14.500 and decided whether they were financially feasible or not. In addition, this research aimed to compare between traditional cage and modern cage with estimation for one year (six harvest times and to analyze which cage had better feasibility in order to provide recommendations or suggestions to the breeders or young breeders. Sensitivity analysis was based on current input and output data from breeder in 2012. The feasibility study of chicken broiler farm cage partnership with traditional and modern cage with the next ten year estimation showed that the modern cage was better than the traditional cage. It can be seen from the values of NPV, IRR, PP, B/C, GPM and ROI. Sensitivity analysis shows that traditional cage is more sensitive to price changes than modern cage. It is shown in the traditional cage with the capacity of 10,000 produces smaller values, indicating that is it is sensitive to cost increase by 2% and to selling price decline of chicken by 1,7%. The recommendations from this study include inputs to farmers in selecting a modern cage since it is more feasible than the traditional cage for long periods of time, while the traditional cage is more viable than the modern cage if the farmer wants a shorter investment timeKeywords: Feasibility studies, Broiler, modern and Traditional cageABSTRAKKelayakan merupakan studi  menilai proyek yang akan dikerjakan di masa mendatang. Penelitian ini bertujuan untuk menganalisisis apakah usaha ayam broiler dengan pola kemitraan pada Prospek Mitra Lestari (PML layak untuk diteruskan. Penelitian ini menganalisisis dua model kandang tradisional

  5. Does an Otolaryngology-Specific Database Have Added Value? A Comparative Feasibility Analysis.

    Science.gov (United States)

    Bellmunt, Angela M; Roberts, Rhonda; Lee, Walter T; Schulz, Kris; Pynnonen, Melissa A; Crowson, Matthew G; Witsell, David; Parham, Kourosh; Langman, Alan; Vambutas, Andrea; Ryan, Sheila E; Shin, Jennifer J

    2016-07-01

    There are multiple nationally representative databases that support epidemiologic and outcomes research, and it is unknown whether an otolaryngology-specific resource would prove indispensable or superfluous. Therefore, our objective was to determine the feasibility of analyses in the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases as compared with the otolaryngology-specific Creating Healthcare Excellence through Education and Research (CHEER) database. Parallel analyses in 2 data sets. Ambulatory visits in the United States. To test a fixed hypothesis that could be directly compared between data sets, we focused on a condition with expected prevalence high enough to substantiate availability in both. This query also encompassed a broad span of diagnoses to sample the breadth of available information. Specifically, we compared an assessment of suspected risk factors for sensorineural hearing loss in subjects 0 to 21 years of age, according to a predetermined protocol. We also assessed the feasibility of 6 additional diagnostic queries among all age groups. In the NAMCS/NHAMCS data set, the number of measured observations was not sufficient to support reliable numeric conclusions (percentage standard error among risk factors: 38.6-92.1). Analysis of the CHEER database demonstrated that age, sex, meningitis, and cytomegalovirus were statistically significant factors associated with pediatric sensorineural hearing loss (P < .01). Among the 6 additional diagnostic queries assessed, NAMCS/NHAMCS usage was also infeasible; the CHEER database contained 1585 to 212,521 more observations per annum. An otolaryngology-specific database has added utility when compared with already available national ambulatory databases. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  6. The feasibility of single-port laparoscopic appendectomy using a solo approach: a comparative study.

    Science.gov (United States)

    Kim, Say-June; Choi, Byung-Jo; Jeong, Wonjun; Lee, Sang Chul

    2016-03-01

    To investigate the feasibility and safety of solo surgery with single-port laparoscopic appendectomy, which is termed herein solo-SPLA (solo-single-port laparoscopic appendectomy). This study prospectively collected and retrospectively analyzed data from patients who had undergone either non-solo-SPLA (n = 150) or solo-SPLA (n = 150). Several devices were utilized for complete, skin-to-skin solo-SPSA, including a Lone Star Retractor System and an adjustable mechanical camera holder. Operating times were not significantly different between solo- and non-solo-SPLA (45.0 ± 21.0 minutes vs. 46.7 ± 26.1 minutes, P = 0.646). Most postoperative variables were also comparable between groups, including the necessity for intravenous analgesics (0.7 ± 1.2 ampules [solo-SPLA] vs. 0.9 ± 1.5 ampules [non-solo-SPLA], P = 0.092), time interval to gas passing (1.3 ± 1.0 days vs. 1.4 ± 1.0 days, P = 0.182), and the incidence of postoperative complications (4.0% vs. 8.7%, P = 0.153). Moreover, solo-SPLA effectively lowered the operating cost by reducing surgical personnel expenses. Solo-SPLA economized staff numbers and thus lowered hospital costs without lengthening of operating time. Therefore, solo-SPLA could be considered a safe and feasible alternative to non-solo-SPLA.

  7. Feasibility testing of smart tablet questionnaires compared to paper questionnaires in an amputee rehabilitation clinic.

    Science.gov (United States)

    Payne, Michael; Janzen, Shannon; Earl, Eric; Deathe, Barry; Viana, Ricardo

    2017-08-01

    Capturing the variability that exists among patients attending an amputee clinic using standardized paper-based questionnaires is time-consuming and may not be practical for routine clinical use. Electronic questionnaires are a potential solution; however, the benefits are dependent on the feasibility and acceptance of this mode of data collection among patients. To determine the feasibility and patient preference/comfort in using a tablet-based questionnaire for data collection in an outpatient amputee rehabilitation clinic compared to a traditional paper-based questionnaire. Observational study. In all, 48 patients with major extremity amputations completed both tablet and paper questionnaires related to their amputation and prosthetic use. Both trials were timed; patients then completed a semi-structured questionnaire about their experience. In all, 20.5% of patients needed hands-on assistance completing the paper questionnaire compared to 20.8% for the tablet. The majority of participants (52.1%) indicated a preference for the tablet questionnaire; 64.6% of patients felt the tablet collected a more complete and accurate representation of their status and needs. In all, 70.8% of participants described themselves as comfortable using the tablet. Despite comorbidities, patients with amputations demonstrated excellent acceptance of the electronic tablet-based questionnaire. Tablet questionnaires have significant potential advantages over paper questionnaires and should be further explored. Clinical relevance A custom electronic questionnaire was found to be beneficial for routine clinic use and was well received by patients in an amputee rehabilitation clinic. Development of such questionnaires can provide an efficient mechanism to collect meaningful data that can be used for individual patient care and program quality improvement initiatives.

  8. Feasibility of extracting data from electronic medical records for research: an international comparative study.

    Science.gov (United States)

    van Velthoven, Michelle Helena; Mastellos, Nikolaos; Majeed, Azeem; O'Donoghue, John; Car, Josip

    2016-07-13

    Electronic medical records (EMR) offer a major potential for secondary use of data for research which can improve the safety, quality and efficiency of healthcare. They also enable the measurement of disease burden at the population level. However, the extent to which this is feasible in different countries is not well known. This study aimed to: 1) assess information governance procedures for extracting data from EMR in 16 countries; and 2) explore the extent of EMR adoption and the quality and consistency of EMR data in 7 countries, using management of diabetes type 2 patients as an exemplar. We included 16 countries from Australia, Asia, the Middle East, and Europe to the Americas. We undertook a multi-method approach including both an online literature review and structured interviews with 59 stakeholders, including 25 physicians, 23 academics, 7 EMR providers, and 4 information commissioners. Data were analysed and synthesised thematically considering the most relevant issues. We found that procedures for information governance, levels of adoption and data quality varied across the countries studied. The required time and ease of obtaining approval also varies widely. While some countries seem ready for secondary uses of data from EMR, in other countries several barriers were found, including limited experience with using EMR data for research, lack of standard policies and procedures, bureaucracy, confidentiality, data security concerns, technical issues and costs. This is the first international comparative study to shed light on the feasibility of extracting EMR data across a number of countries. The study will inform future discussions and development of policies that aim to accelerate the adoption of EMR systems in high and middle income countries and seize the rich potential for secondary use of data arising from the use of EMR solutions.

  9. Feasibility Exploration of Electrodermal Response to Food in Children with ASD Compared to Typically Developing Children

    Directory of Open Access Journals (Sweden)

    Michelle A. Suarez

    2018-01-01

    Full Text Available Background: Children with Autism Spectrum Disorder (ASD frequently have food selectivity that causes additional health and quality of life stressors for the child and the family. The causes of food selectivity are currently unknown but may be linked, at least in part, to sensory processing problems. Method: The purpose of this study was to test the feasibility of using electrodermal activity (EDA measurement in response to food to gain insight into the physiological processes associated with eating for children with ASD compared to typically developing children. In addition, differences in food acceptance and the relationship between food acceptance and sensory over-responsivity were explored. Results: Children with ASD had significantly different EDA during food presentation compared to typically developing controls. In addition, children with ASD accepted significantly fewer foods as part of their regular diet, and the number of foods accepts was significantly related to a measure of SOR. Discussion: This information has the potential to inform research and treatment for food selectivity

  10. Improving Sleep for Hospitalized Antepartum Patients: A Non-Randomized Controlled Pilot Study.

    Science.gov (United States)

    Lee, Kathryn A; Gay, Caryl L

    2017-12-15

    To evaluate feasibility and efficacy of a hospital-based protocol for improving sleep in high- risk antepartum patients. Sleep measures were compared during 1 week of hospitalization before and after implementing a Sleep Improvement Protocol for Antepartum Patients (SIP-AP). A non-randomized convenience sample of usual care controls was compared to a subsequent intervention sample after the protocol was implemented. Women were eligible if they spoke English, were medically stable, pregnant for at least 20 weeks, and hospitalized at least 24 hours; 25 pregnant women had sufficient data for analyses (11 controls, 14 intervention). Sleep was assessed in 3 ways: the Pittsburgh Sleep Quality Index was completed after obtaining consent to estimate sleep quality prior to hospital admission; sleep diary completed each hospital day; and General Sleep Disturbance Scale completed at 7 days or prior to hospital discharge. Symptoms that could affect sleep were assessed with the Memorial Symptom Assessment Scale. Both groups recorded similar sleep duration (7 hours) but the intervention group had fewer symptoms and significantly ( P = .015) lower sleep disturbance scores (53.1 ± 14.5) than controls (71.9 ± 18.8). Participant feedback about the intervention was positive, although adherence to components of the intervention protocol was variable. This pilot study provides evidence of the feasibility and preliminary efficacy of the SIP-AP intervention for reducing symptoms and improving sleep of antepartum patients during hospitalization. Further detailed evaluation of specific components of this protocol is warranted, and other types of hospitalized patients may benefit from unit-based modifications to this SIP-AP protocol. © 2017 American Academy of Sleep Medicine

  11. Random assay in radioimmunoassay: Feasibility and application compared with batch assay

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Min; Lee, Hwan Hee; Park, Sohyun; Kim, Tae Sung; Kim, Seok Ki [Dept. of Nuclear MedicineNational Cancer Center, Goyang (Korea, Republic of)

    2016-12-15

    The batch assay has been conventionally used for radioimmunoassay (RIA) because of its technical robustness and practical convenience. However, it has limitations in terms of the relative lag of report time due to the necessity of multiple assays in a small number of samples compared with the random assay technique. In this study, we aimed to verify whether the random assay technique can be applied in RIA and is feasible in daily practice. The coefficients of variation (CVs) of eight standard curves within a single kit were calculated in a CA-125 immunoradiometric assay (IRMA) for the reference of the practically ideal CV of the CA-125 kit. Ten standard curves of 10 kits from 2 prospectively collected lots (pLot) and 85 standard curves of 85 kits from 3 retrospectively collected lots (Lot) were obtained. Additionally, the raw measurement data of both 170 control references and 1123 patients' sera were collected retrospectively between December 2015 and January 2016. A standard curve of the first kit of each lot was used as a master standard curve for a random assay. The CVs of inter-kits were analyzed in each lot, respectively. All raw measurements were normalized by decay and radioactivity. The CA-125 values from control samples and patients' sera were compared using the original batch assay and random assay. In standard curve analysis, the CVs of inter-kits in pLots and Lots were comparable to those within a single kit. The CVs from the random assay with normalization were similar to those from the batch assay in the control samples (CVs % of low/high concentration; Lot1 2.71/1.91, Lot2 2.35/1.83, Lot3 2.83/2.08 vs. Lot1 2.05/1.21, Lot2 1.66/1.48, Lot3 2.41/2.14). The ICCs between the batch assay and random assay using patients' sera were satisfactory (Lot1 1.00, Lot2 0.999, Lot3 1.00). The random assay technique could be successfully applied to the conventional CA-125 IRMA kits. The random assay showed strong agreement with the batch assay. The

  12. Quantitative assessment of unobserved confounding is mandatory in nonrandomized intervention studies

    NARCIS (Netherlands)

    Groenwold, R H H; Hak, E; Hoes, A W

    OBJECTIVE: In nonrandomized intervention studies unequal distribution of patient characteristics in the groups under study may hinder comparability of prognosis and therefore lead to confounding bias. Our objective was to review methods to control for observed confounding, as well as unobserved

  13. Good research practices for comparative effectiveness research: approaches to mitigate bias and confounding in the design of nonrandomized studies of treatment effects using secondary data sources: the International Society for Pharmacoeconomics and Outcomes Research Good Research Practices for Retrospective Database Analysis Task Force Report--Part II.

    Science.gov (United States)

    Cox, Emily; Martin, Bradley C; Van Staa, Tjeerd; Garbe, Edeltraut; Siebert, Uwe; Johnson, Michael L

    2009-01-01

    The goal of comparative effectiveness analysis is to examine the relationship between two variables, treatment, or exposure and effectiveness or outcome. Unlike data obtained through randomized controlled trials, researchers face greater challenges with causal inference with observational studies. Recognizing these challenges, a task force was formed to develop a guidance document on methodological approaches to addresses these biases. The task force was commissioned and a Chair was selected by the International Society for Pharmacoeconomics and Outcomes Research Board of Directors in October 2007. This report, the second of three reported in this issue of the Journal, discusses the inherent biases when using secondary data sources for comparative effectiveness analysis and provides methodological recommendations to help mitigate these biases. The task force report provides recommendations and tools for researchers to mitigate threats to validity from bias and confounding in measurement of exposure and outcome. Recommendations on design of study included: the need for data analysis plan with causal diagrams; detailed attention to classification bias in definition of exposure and clinical outcome; careful and appropriate use of restriction; extreme care to identify and control for confounding factors, including time-dependent confounding. Design of nonrandomized studies of comparative effectiveness face several daunting issues, including measurement of exposure and outcome challenged by misclassification and confounding. Use of causal diagrams and restriction are two techniques that can improve the theoretical basis for analyzing treatment effects in study populations of more homogeneity, with reduced loss of generalizability.

  14. Feasibility and Accuracy of Digitizing Edentulous Maxillectomy Defects: A Comparative Study.

    Science.gov (United States)

    Elbashti, Mahmoud E; Hattori, Mariko; Patzelt, Sebastian Bm; Schulze, Dirk; Sumita, Yuka I; Taniguchi, Hisashi

    The aim of this study was to evaluate the feasibility and accuracy of using an intraoral scanner to digitize edentulous maxillectomy defects. A total of 20 maxillectomy models with two defect types were digitized using cone beam computed tomography. Conventional and digital impressions were made using silicone impression material and a laboratory optical scanner as well as a chairside intraoral scanner. The 3D datasets were analyzed using 3D evaluation software. Two-way analysis of variance revealed no interaction between defect types and impression methods, and the accuracy of the impression methods was significantly different (P = .0374). Digitizing edentulous maxillectomy defect models using a chairside intraoral scanner appears to be feasible and accurate.

  15. Feasibility study of offshore wind turbine installation in Iran compared with the world

    Energy Technology Data Exchange (ETDEWEB)

    Mostafaeipour, Ali [Industrial Engineering Department, Yazd University, Yazd (Iran)

    2010-09-15

    Renewable energies have potential for supplying of relatively clean and mostly local energy. Wind energy generation is expected to increase in the near future and has experienced dramatic growth over the past decade in many countries. Offshore winds are generally stronger and more constant than onshore winds in many areas. The economic feasibility for utilization of offshore wind energy depends on the favorable wind conditions in the area. The present paper analyses offshore wind speed in global scale and also studies feasibility of introducing this technology for harnessing wind in Persian Gulf, Caspian Sea, Urmia Lake and Gulf of Oman. Wind speed data were collected from different sources. The ocean surface winds at a 10 m height from satellite passes as processed by NOAA/NESDIS, from near real-time data collected by NASA/JPL's Sea Winds Scatterometer aboard the QuikSCAT. Development of renewable energy is one of priority research goals in Iran. There are many installed wind turbines in suitable regions like Manjil and Binalood, but there has not been any offshore wind installation yet in Iran. It is suggested that policy makers to invest and pay more attentions toward harnessing renewable energy sources like offshore wind in Persian Gulf and Gulf of Oman in southern parts of Iran. (author)

  16. Epidemic spreading in networks with nonrandom long-range interactions

    Science.gov (United States)

    Estrada, Ernesto; Kalala-Mutombo, Franck; Valverde-Colmeiro, Alba

    2011-09-01

    An “infection,” understood here in a very broad sense, can be propagated through the network of social contacts among individuals. These social contacts include both “close” contacts and “casual” encounters among individuals in transport, leisure, shopping, etc. Knowing the first through the study of the social networks is not a difficult task, but having a clear picture of the network of casual contacts is a very hard problem in a society of increasing mobility. Here we assume, on the basis of several pieces of empirical evidence, that the casual contacts between two individuals are a function of their social distance in the network of close contacts. Then, we assume that we know the network of close contacts and infer the casual encounters by means of nonrandom long-range (LR) interactions determined by the social proximity of the two individuals. This approach is then implemented in a susceptible-infected-susceptible (SIS) model accounting for the spread of infections in complex networks. A parameter called “conductance” controls the feasibility of those casual encounters. In a zero conductance network only contagion through close contacts is allowed. As the conductance increases the probability of having casual encounters also increases. We show here that as the conductance parameter increases, the rate of propagation increases dramatically and the infection is less likely to die out. This increment is particularly marked in networks with scale-free degree distributions, where infections easily become epidemics. Our model provides a general framework for studying epidemic spreading in networks with arbitrary topology with and without casual contacts accounted for by means of LR interactions.

  17. Epidemic spreading in networks with nonrandom long-range interactions.

    Science.gov (United States)

    Estrada, Ernesto; Kalala-Mutombo, Franck; Valverde-Colmeiro, Alba

    2011-09-01

    An "infection," understood here in a very broad sense, can be propagated through the network of social contacts among individuals. These social contacts include both "close" contacts and "casual" encounters among individuals in transport, leisure, shopping, etc. Knowing the first through the study of the social networks is not a difficult task, but having a clear picture of the network of casual contacts is a very hard problem in a society of increasing mobility. Here we assume, on the basis of several pieces of empirical evidence, that the casual contacts between two individuals are a function of their social distance in the network of close contacts. Then, we assume that we know the network of close contacts and infer the casual encounters by means of nonrandom long-range (LR) interactions determined by the social proximity of the two individuals. This approach is then implemented in a susceptible-infected-susceptible (SIS) model accounting for the spread of infections in complex networks. A parameter called "conductance" controls the feasibility of those casual encounters. In a zero conductance network only contagion through close contacts is allowed. As the conductance increases the probability of having casual encounters also increases. We show here that as the conductance parameter increases, the rate of propagation increases dramatically and the infection is less likely to die out. This increment is particularly marked in networks with scale-free degree distributions, where infections easily become epidemics. Our model provides a general framework for studying epidemic spreading in networks with arbitrary topology with and without casual contacts accounted for by means of LR interactions.

  18. Feasibility evaluation of two solar cooling systems applied to a cuban hotel. Comparative analysis

    International Nuclear Information System (INIS)

    Díaz Torres, Yamile; Valdivia Nodal, Yarelis; Monteagudo Yanes, José Pedro; Miranda Torres, Yudit

    2016-01-01

    The article presents an analysis of technical and economic feasibility of using two configurations of solar cooling in a Cuban hotel. HVAC hybrid schemes are: a cooler of ice water vapor compression (chiller) interconnected in parallel with a smaller capacity chiller, first with a solar-powered absorption cooling system (SACS), and then with a photovoltaic cooling system(PSC). Both were simulated taking into account the weather conditions in the region, thermodynamic calculation methodologies and principles that govern these technologies. The results show that the use of these alternatives contributes to reducing energy consumption and the environmental impact of heating, ventilation and air conditioning systems (HVAC). Economic analysis highlights that PCS is more favorable than the SACS taking into account the cooling cost generation (CCG) but energy assessment indicates that SACS has higher thermal performance for the case study to which it is applied. (author)

  19. Comparative feasibility study on retrofitting ballast water treatment system for a bulk carrier.

    Science.gov (United States)

    Jee, Jaehoon; Lee, Sangick

    2017-06-30

    Use of ballast water in ships causes harmful effects on marine environment accompanied by economic loss and negative impact on ecosystem and human health. To solve these problems, the international convention on ballast water management will take into force in September 2017. In this study, a comprehensive feasibility of retrofitting the ballast water treatment system for an ocean-going bulk carrier was conducted. The technologies involved, installation and operational aspects of direct flow and side stream electrolysis, UV, and ozone type BWTS are described in detail. The principal concept of each BWTS is explained and probable arrangements of retrofitting in engine room are suggested. The cost analysis is carried out for retrofitting 4 types of BWTS onboard the target ship by examining each processes of installation and operation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Financial Feasibility and Merits of the Small Lightweight Tactical Intelligence. Surveillance, and Reconnaisacce Satellite Compared to National Systems

    National Research Council Canada - National Science Library

    Hodge, Donald

    1999-01-01

    This study examines the financial feasibility, technological improvements, and construction procedures that are occurring in the space industry with respect to the feasibility of developing a small...

  1. Two-port cholecystectomy maintains safety and feasibility in benign gallbladder diseases: a comparative study.

    Science.gov (United States)

    Lee, Sang Chul; Choi, Byeong-Jo; Kim, Say-June

    2014-01-01

    In an effort to overcome the limitations of single-port laparoscopic cholecystectomy (LC) while preserving the cosmetic benefits of reduced ports cholecystectomy, we have developed a 2-port LC that allows for the full, unrestricted use of 4 laparoscopic instruments. We retrospectively analyzed data of patients who had undergone either 4-port LC or 2-port LC for benign gallbladder diseases between March 2007 and March 2013. Two incisions of 2-port LC were composed of an umbilical incision as the manner of single-port laparoscopic surgery and a 5-mm epigastric incision. These two incisions were utilized for comfortable bimanual manipulation under the liver-elevated vision provided by a liver retractor. During the study period, 766 patients underwent LC; 263 (34.3%) started with 4-port LC, and 503 (65.7%) started with 2-port LC. Of patients started with 2-port LC, 486 patients (96.6%) was ended up with 2-port without open conversion or addition of port(s). The two groups had similar operative time, open conversion rate, incidence of complications, analgesic requirement, and length of postoperative hospital stay. Multivariate analyses revealed that the independent factors related to prolonged operative time (≥ 90 th percentile) in 2-port LC were the presence of cholecystitis (odds ratio [OR] 2.412, 95% CI 1.246-4.668, p = 0.009) and admission through the emergency department (OR 2.132, 95% CI 1.135-4.004, p = 0.019). This study suggests that 2-port LC for benign gallbladder diseases is as safe and feasible as 4-port LC when it is performed by surgeons trained in conventional laparoscopic techniques. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Interactive video gaming compared with health education in older adults with mild cognitive impairment: a feasibility study.

    Science.gov (United States)

    Hughes, Tiffany F; Flatt, Jason D; Fu, Bo; Butters, Meryl A; Chang, Chung-Chou H; Ganguli, Mary

    2014-09-01

    We evaluated the feasibility of a trial of Wii interactive video gaming, and its potential efficacy at improving cognitive functioning compared with health education, in a community sample of older adults with neuropsychologically defined mild cognitive impairment. Twenty older adults were equally randomized to either group-based interactive video gaming or health education for 90 min each week for 24 weeks. Although the primary outcomes were related to study feasibility, we also explored the effect of the intervention on neuropsychological performance and other secondary outcomes. All 20 participants completed the intervention, and 18 attended at least 80% of the sessions. The majority (80%) of participants were "very much" satisfied with the intervention. Bowling was enjoyed by the most participants and was also rated the highest among the games for mental, social, and physical stimulation. We observed medium effect sizes for cognitive and physical functioning in favor of the interactive video gaming condition, but these effects were not statistically significant in this small sample. Interactive video gaming is feasible for older adults with mild cognitive impairment, and medium effect sizes in favor of the Wii group warrant a larger efficacy trial. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Comparative analysis of public's perception of economic feasibility and reality for selected energy sources in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Seungkook; Jeong, Ik; Lee, Kibog [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Dongwook [KAIST, Daejeon (Korea, Republic of); Kim, Hyunjin [Korea Nuclear Energy Agency, Seoul (Korea, Republic of)

    2016-10-15

    Controversy on nuclear energy has persisted ever since, but nuclear energy has maintained around 30% of electricity generation in Korea. This is because Korean wants to secure energy security and diversity of energy sources, but the most rational driver behind nuclear energy is the economic feasibility. Looking at the actual prices of electricity traded in the Korean Power Exchange, the price of electricity generated by nuclear energy is 39.1 Korean won per kWh, which is lower than that of other sources: 58.9 (bituminous coal), 221.8 (oil), 158.6 (gas), 170.9 (hydropower), 162.8 (wind) and 463.1 (photovoltaic). However only experts, regulators and people from electricity generation industry are aware of this fact and the public does not seem to be perceiving this correctly. This research, therefore, will compare the economic feasibility of energy sources and how it is perceived by the public in general. This research was able to identify the large gap between public's perception on and reality of economic feasibility of energy sources. There are two possible reasons for the gap. Firstly, the electricity price paid by the public is agnostic of energy sources. Therefore, it is difficult for the public to be aware that the electricity from nuclear energy is benefiting them and hence the public would be indifferent to the real economic feasibility. Secondly, public's awareness of nuclear reactor decommissioning and spent fuel processing along with easier access to relevant information the media would have played a role. In fact, number of press and media has questioned the economic feasibility of nuclear energy. However, the price of electricity generated by nuclear energy includes costs for future activities such as decommissioning, radioactive waste disposal and spent fuel disposal. The public seems to be not aware of such fact and therefore favoring the media. Such analysis leads to two major policy implications. Most importantly, the government should

  4. Feasibility of CBCT-based dose calculation: Comparative analysis of HU adjustment techniques

    International Nuclear Information System (INIS)

    Fotina, Irina; Hopfgartner, Johannes; Stock, Markus; Steininger, Thomas; Lütgendorf-Caucig, Carola; Georg, Dietmar

    2012-01-01

    Background and purpose: The aim of this work was to compare the accuracy of different HU adjustments for CBCT-based dose calculation. Methods and materials: Dose calculation was performed on CBCT images of 30 patients. In the first two approaches phantom-based (Pha-CC) and population-based (Pop-CC) conversion curves were used. The third method (WAB) represents override of the structures with standard densities for water, air and bone. In ROI mapping approach all structures were overridden with average HUs from planning CT. All techniques were benchmarked to the Pop-CC and CT-based plans by DVH comparison and γ-index analysis. Results: For prostate plans, WAB and ROI mapping compared to Pop-CC showed differences in PTV D median below 2%. The WAB and Pha-CC methods underestimated the bladder dose in IMRT plans. In lung cases PTV coverage was underestimated by Pha-CC method by 2.3% and slightly overestimated by the WAB and ROI techniques. The use of the Pha-CC method for head–neck IMRT plans resulted in difference in PTV coverage up to 5%. Dose calculation with WAB and ROI techniques showed better agreement with pCT than conversion curve-based approaches. Conclusions: Density override techniques provide an accurate alternative to the conversion curve-based methods for dose calculation on CBCT images.

  5. Nonrandom Intrafraction Target Motions and General Strategy for Correction of Spine Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Ma Lijun; Sahgal, Arjun; Hossain, Sabbir; Chuang, Cynthia; Descovich, Martina; Huang, Kim; Gottschalk, Alex; Larson, David A.

    2009-01-01

    Purpose: To characterize nonrandom intrafraction target motions for spine stereotactic body radiotherapy and to develop a method of correction via image guidance. The dependence of target motions, as well as the effectiveness of the correction strategy for lesions of different locations within the spine, was analyzed. Methods and Materials: Intrafraction target motions for 64 targets in 64 patients treated with a total of 233 fractions were analyzed. Based on the target location, the cases were divided into three groups, i.e., cervical (n = 20 patients), thoracic (n = 20 patients), or lumbar-sacrum (n = 24 patients) lesions. For each case, time-lag autocorrelation analysis was performed for each degree of freedom of motion that included both translations (x, y, and z shifts) and rotations (roll, yaw, and pitch). A general correction strategy based on periodic interventions was derived to determine the time interval required between two adjacent interventions, to overcome the patient-specific target motions. Results: Nonrandom target motions were detected for 100% of cases regardless of target locations. Cervical spine targets were found to possess the highest incidence of nonrandom target motion compared with thoracic and lumbar-sacral lesions (p < 0.001). The average time needed to maintain the target motion to within 1 mm of translation or 1 deg. of rotational deviation was 5.5 min, 5.9 min, and 7.1 min for cervical, thoracic, and lumbar-sacrum locations, respectively (at 95% confidence level). Conclusions: A high incidence of nonrandom intrafraction target motions was found for spine stereotactic body radiotherapy treatments. Periodic interventions at approximately every 5 minutes or less were needed to overcome such motions.

  6. A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise

    Directory of Open Access Journals (Sweden)

    Kamioka H

    2011-03-01

    showed a remarkable lack of description in the studies. Furthermore, there was the problem of heterogeneity, and we were therefore not able to perform a meta-analysis.Conclusion: Because there was insufficient evidence on aquatic exercise due to poor methodological and reporting quality and heterogeneity of nRCTs, we were unable to offer any conclusions about the effects of this intervention. However, we were able to identify problems with current nRCTs of aquatic exercise, and propose a strategy of strengthening study quality, stressing the importance of study feasibility as a future research agenda objective.Keywords: aquatic exercise, systematic review, nonrandomized controlled trials 

  7. Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations.

    Science.gov (United States)

    Müller, Kai Ivar; Alstadhaug, Karl Bjørnar; Bekkelund, Svein Ivar

    2016-05-30

    The feasibility of telemedicine in diagnosing and treating nonacute headaches, such as primary headaches (migraine and tension-type) and medication-overuse headaches has not been previously investigated. By eliminating the need of travel to specialists, telemedicine may offer significant time and money savings. Our objective was to estimate the acceptance of telemedicine and investigate the feasibility and cost savings of telemedicine consultations in diagnosing and treating nonacute headaches. From September 2012 to March 2015, nonacute headache patients from Northern Norway who were referred to neurologists through an electronic application system were consecutively screened and randomized to participate in either telemedicine or traditional specialist visits. All patients were consulted by two neurologists at the neurological department in Tromsø University Hospital. Feasibility outcomes were compared between telemedicine and traditional groups. Baseline characteristics and costs were then compared between rural and urban patients. Travel costs were calculated by using the probabilistic method of the Norwegian traveling agency: the cheapest means of public transport for each study participant. Loss of pay was calculated based on the Norwegian full-time employee's average salary: 3.5 hours spent on travel and consultation=one day's salary. Distance and time spent on travel were estimated by using Google Maps. Of 557 headache patients screened, 479 were found eligible and 402 accepted telemedicine participation (83.9%, 402/479) and were included in the final analyses. Of these, 202 received traditional specialist consultations and 200 received telemedicine. All patients in the telemedicine group were satisfied with the video quality, and 198 (99%, 198/200) were satisfied with the sound quality. The baseline characteristics as well as headache diagnostics and follow-up appointments, and the investigation, advice, and prescription practices were not statistically

  8. Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures.

    Science.gov (United States)

    Reynolds, Stacy L; Bryant, Kathleen K; Studnek, Jonathan R; Hogg, Melanie; Dunn, Connell; Templin, Megan A; Moore, Charity G; Young, James R; Walker, Katherine Rivera; Runyon, Michael S

    2017-12-01

    We compared the tolerability and efficacy of intranasal subdissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger noninferiority trial that could investigate the potential opioid-sparing effects of intranasal ketamine. This randomized controlled trial compared 1 mg/kg intranasal ketamine to 1.5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016. Patients, parents, treating physicians, and outcome assessors were blinded to group allocation. The primary outcome, a tolerability measure, was the frequency of cumulative side effects and adverse events within 60 minutes of drug administration. The secondary outcomes included the difference in mean pain score reduction at 20 minutes, the proportion of patients achieving a clinically significant reduction in pain in 20 minutes, total dose of opioid pain medication in morphine equivalents/kg/hour (excluding study drug) required during the emergency department (ED) stay, and the feasibility of enrolling children presenting to the ED in acute pain into a randomized trial conducted under U.S. regulations. All patients were monitored until 6 hours after their last dose of study drug or until admission to the hospital ward or operating room. Of 629 patients screened, 87 received the study drug and 82 had complete data for the primary outcome (41 patients in each group). The median (interquartile range) age was 8 (6-11) years and 62% were male. Baseline pain scores were similar among patients randomized to receive ketamine (73 ± 26) and fentanyl (69 ± 26; mean difference [95% CI] = 4 [-7 to 15]). The cumulative number of side effects was 2.2 times higher in the ketamine group, but there were no serious adverse events and no patients in either group required intervention. The most

  9. Comparative analysis of diagnostic performance, feasibility and cost of different test-methods for thyroid nodules with indeterminate cytology.

    Science.gov (United States)

    Sciacchitano, Salvatore; Lavra, Luca; Ulivieri, Alessandra; Magi, Fiorenza; De Francesco, Gian Paolo; Bellotti, Carlo; Salehi, Leila B; Trovato, Maria; Drago, Carlo; Bartolazzi, Armando

    2017-07-25

    Since it is impossible to recognize malignancy at fine needle aspiration (FNA) cytology in indeterminate thyroid nodules, surgery is recommended for all of them. However, cancer rate at final histology is blood assay.We performed systematic reviews and meta-analyses to compare their features, feasibility, diagnostic performance and cost. GEC, GEC+BRAF, M/F panel+miRNA GEC and M/F panel by NGS were the best in ruling-out malignancy (sensitivity = 90%, 89%, 89% and 90% respectively). BRAF and M/F panel alone and by NGS were the best in ruling-in malignancy (specificity = 100%, 93% and 93%). The M/F by NGS showed the highest accuracy (92%) and BRAF the highest diagnostic odds ratio (DOR) (247). GAL-3-ICC performed well as rule-out (sensitivity = 83%) and rule-in test (specificity = 85%), with good accuracy (84%) and high DOR (27) and is one of the cheapest (113 USD) and easiest one to be performed in different clinical settings.In conclusion, the more accurate molecular-based test-methods are still expensive and restricted to few, highly specialized and centralized laboratories. GAL-3-ICC, although limited by some false negatives, represents the most suitable screening test-method to be applied on a large-scale basis in the diagnostic algorithm of indeterminate thyroid lesions.

  10. The feasibility of using UML to compare the impact of different brands of computer system on the clinical consultation.

    Science.gov (United States)

    Kumarapeli, Pushpa; de Lusignan, Simon; Koczan, Phil; Jones, Beryl; Sheeler, Ian

    2007-01-01

    UK general practice is universally computerised, with computers used in the consulting room at the point of care. Practices use a range of different brands of computer system, which have developed organically to meet the needs of general practitioners and health service managers. Unified Modelling Language (UML) is a standard modelling and specification notation widely used in software engineering. To examine the feasibility of UML notation to compare the impact of different brands of general practice computer system on the clinical consultation. Multi-channel video recordings of simulated consultation sessions were recorded on three different clinical computer systems in common use (EMIS, iSOFT Synergy and IPS Vision). User action recorder software recorded time logs of keyboard and mouse use, and pattern recognition software captured non-verbal communication. The outputs of these were used to create UML class and sequence diagrams for each consultation. We compared 'definition of the presenting problem' and 'prescribing', as these tasks were present in all the consultations analysed. Class diagrams identified the entities involved in the clinical consultation. Sequence diagrams identified common elements of the consultation (such as prescribing) and enabled comparisons to be made between the different brands of computer system. The clinician and computer system interaction varied greatly between the different brands. UML sequence diagrams are useful in identifying common tasks in the clinical consultation, and for contrasting the impact of the different brands of computer system on the clinical consultation. Further research is needed to see if patterns demonstrated in this pilot study are consistently displayed.

  11. Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

    International Nuclear Information System (INIS)

    Leborgne, Felix; Fowler, Jack

    2009-01-01

    Purpose: To study retrospectively late complications and biochemical control in patients treated with three-dimensional conformal external-beam radiotherapy for localized prostate cancer administered using hypofractionation vs. a standard fractionation regimen. The hypofractionation regimen (Hypo) was designed to avoid more late rectal reactions and to be done in half as many treatment sessions. Methods and Materials: Eighty-nine nonrandomized patients chose Hypo delivered in 20 fractions of 3 Gy (n = 52) or 3.15 Gy (n = 37) for a median overall treatment time of 33 days. One hundred thirty comparable patients were contemporaneously treated with standard fractionation to a median dose of 78 Gy delivered over 55 days. The median follow-up time was 49 months (range, 24-73 months). Results: The 5-year actuarial biochemical control rates were 96%, 84%, and 85% for low-, medium-, and high-risk disease in the Hypo group, respectively. The respective rates in the standard fractionation group were 98%, 84%, and 87%, with no statistical difference between the two groups. The rate of rectal Grade 2-4 complications was 5.5% in both treatment groups and of urinary Grade 2-4 complications was 5.6% in the Hypo and 3% in the standard group (p = 0.36). Similarly, there were no statistical differences in the rate of late complications between patients treated with 3 Gy/fraction vs. 3.15 Gy/fraction. Conclusions: Our preliminary results showed that the Hypo regimen is feasible and does not reduce biochemical control compared with standard fractionation. The incidence of late complications was not increased when the tumor normalized total doses at 2Gy/fraction was increased from 77.1 to 83.7 Gy in patients treated with either 3 or 3.15 Gy/fraction in the Hypo group, respectively.

  12. Correction of confounding bias in non-randomized studies by appropriate weighting.

    Science.gov (United States)

    Schmoor, Claudia; Gall, Christine; Stampf, Susanne; Graf, Erika

    2011-03-01

    In non-randomized studies, the assessment of a causal effect of treatment or exposure on outcome is hampered by possible confounding. Applying multiple regression models including the effects of treatment and covariates on outcome is the well-known classical approach to adjust for confounding. In recent years other approaches have been promoted. One of them is based on the propensity score and considers the effect of possible confounders on treatment as a relevant criterion for adjustment. Another proposal is based on using an instrumental variable. Here inference relies on a factor, the instrument, which affects treatment but is thought to be otherwise unrelated to outcome, so that it mimics randomization. Each of these approaches can basically be interpreted as a simple reweighting scheme, designed to address confounding. The procedures will be compared with respect to their fundamental properties, namely, which bias they aim to eliminate, which effect they aim to estimate, and which parameter is modelled. We will expand our overview of methods for analysis of non-randomized studies to methods for analysis of randomized controlled trials and show that analyses of both study types may target different effects and different parameters. The considerations will be illustrated using a breast cancer study with a so-called Comprehensive Cohort Study design, including a randomized controlled trial and a non-randomized study in the same patient population as sub-cohorts. This design offers ideal opportunities to discuss and illustrate the properties of the different approaches. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding: its feasibility compared with transjugular intrahepatic portosystemic shunt

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Yoon, Chang Jin; Park, Jae Hyung; Chung, Jin Wook; Kwon, Jong Won [Seoul Natioonal University College of Medicine, Seoul (Korea, Republic of); Choi, Guk Myung [Cheju National University College of Medicine, Jeju (Korea, Republic of)

    2003-06-01

    To assess the feasibility of balloon-occluded retrograde transvenous obliteration (BRTO) in active gastric variceal bleeding, and to compare the findings with those of transjugular intrahepatic portosystemic shunt (TIPS). Twenty-one patients with active gastric variceal bleeding due to liver cirrhosis were referred for radiological intervention. In 15 patients, contrast-enhanced CT scans demonstrated gastrorenal shunt, and the remaining six (Group 1) underwent TIPS. Seven of the 15 with gastrorenal shunt (Group 2) were also treated with TIPS, and the other eight (Group 3) underwent BRTO. All patients were followed up for 6 to 21 (mean, 14.4) months. For statistical inter-group comparison of immediate hemostasis, rebleeding and encephalopathy, Fisher's exact test was used. Changes in the Child-Pugh score before and after each procedure in each group were statistically analyzed by means of Wilcoxon's signed rank test. One patient in Group 1 died of sepsis, acute respiratory distress syndrome, and persistent bleeding three days after TIPS, while the remaining 20 survived the procedure with immediate hemostasis. Hepatic encephalopathy developed in four patients (one in Group 1, three in Group 2, and none in Group 3); one, in Group 2, died while in an hepatic coma 19 months after TIPS. Rebleeding occurred in one patient, also in Group 2. Except for transient fever in two Group-3 patients, no procedure-related complication occurred. In terms of immediate hemostasis, rebleeding and encephalopathy, there were no statistically significant differences between the groups (p > 0.05). In Group 3, the Child-Pugh score showed a significant decrease after the procedure (p = 0.02). BRTO can effectively control active gastric variceal bleeding, and because of immediate hemostasis, the absence of rebleeding, and improved liver function, is a good alternative to TIPS in patients in whom such bleeding, accompanied by gastrorenal shunt, occurs.

  14. Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding: its feasibility compared with transjugular intrahepatic portosystemic shunt

    International Nuclear Information System (INIS)

    Choi, Young Ho; Yoon, Chang Jin; Park, Jae Hyung; Chung, Jin Wook; Kwon, Jong Won; Choi, Guk Myung

    2003-01-01

    To assess the feasibility of balloon-occluded retrograde transvenous obliteration (BRTO) in active gastric variceal bleeding, and to compare the findings with those of transjugular intrahepatic portosystemic shunt (TIPS). Twenty-one patients with active gastric variceal bleeding due to liver cirrhosis were referred for radiological intervention. In 15 patients, contrast-enhanced CT scans demonstrated gastrorenal shunt, and the remaining six (Group 1) underwent TIPS. Seven of the 15 with gastrorenal shunt (Group 2) were also treated with TIPS, and the other eight (Group 3) underwent BRTO. All patients were followed up for 6 to 21 (mean, 14.4) months. For statistical inter-group comparison of immediate hemostasis, rebleeding and encephalopathy, Fisher's exact test was used. Changes in the Child-Pugh score before and after each procedure in each group were statistically analyzed by means of Wilcoxon's signed rank test. One patient in Group 1 died of sepsis, acute respiratory distress syndrome, and persistent bleeding three days after TIPS, while the remaining 20 survived the procedure with immediate hemostasis. Hepatic encephalopathy developed in four patients (one in Group 1, three in Group 2, and none in Group 3); one, in Group 2, died while in an hepatic coma 19 months after TIPS. Rebleeding occurred in one patient, also in Group 2. Except for transient fever in two Group-3 patients, no procedure-related complication occurred. In terms of immediate hemostasis, rebleeding and encephalopathy, there were no statistically significant differences between the groups (p > 0.05). In Group 3, the Child-Pugh score showed a significant decrease after the procedure (p = 0.02). BRTO can effectively control active gastric variceal bleeding, and because of immediate hemostasis, the absence of rebleeding, and improved liver function, is a good alternative to TIPS in patients in whom such bleeding, accompanied by gastrorenal shunt, occurs

  15. Classroom-based narrative and vocabulary instruction: results of an early-stage, nonrandomized comparison study.

    Science.gov (United States)

    Gillam, Sandra Laing; Olszewski, Abbie; Fargo, Jamison; Gillam, Ronald B

    2014-07-01

    This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.

  16. A nonrandomized trial of vitamin D supplementation for Barrett's esophagus.

    Directory of Open Access Journals (Sweden)

    Linda C Cummings

    Full Text Available Vitamin D deficiency may increase esophageal cancer risk. Vitamin D affects genes regulating proliferation, apoptosis, and differentiation and induces the tumor suppressor 15-hydroxyprostaglandin dehydrogenase (PGDH in other cancers. This nonrandomized interventional study assessed effects of vitamin D supplementation in Barrett's esophagus (BE. We hypothesized that vitamin D supplementation may have beneficial effects on gene expression including 15-PGDH in BE.BE subjects with low grade or no dysplasia received vitamin D3 (cholecalciferol 50,000 international units weekly plus a proton pump inhibitor for 12 weeks. Esophageal biopsies from normal plus metaplastic BE epithelium and blood samples were obtained before and after vitamin D supplementation. Serum 25-hydroxyvitamin D was measured to characterize vitamin D status. Esophageal gene expression was assessed using microarrays.18 study subjects were evaluated. The baseline mean serum 25-hydroxyvitamin D level was 27 ng/mL (normal ≥30 ng/mL. After vitamin D supplementation, 25-hydroxyvitamin D levels rose significantly (median increase of 31.6 ng/mL, p<0.001. There were no significant changes in gene expression from esophageal squamous or Barrett's epithelium including 15-PGDH after supplementation.BE subjects were vitamin D insufficient. Despite improved vitamin D status with supplementation, no significant alterations in gene expression profiles were noted. If vitamin D supplementation benefits BE, a longer duration or higher dose of supplementation may be needed.

  17. The use of a European coinage alloy to compare the detection limits of mobile XRF systems. A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Cesareo, R. [Struttura Dipartimentale di Matematica e Fisica, Universita di Sassari, Sassari (Italy); Ferretti, M. [CNR-Istituto per le Tecnologie Applicate ai Beni Culturali, Rome (Italy); Gigante, G.E. [Dipartimento di Fisica, Universita di Roma ' La Sapienza' , Rome (Italy); Guida, G. [Laboratorio di Chimica, Istituto Centrale per il Restauro, Rome (Italy); Moioli, P. [Unita Tecnico-Scientifica Materiali e Nuove Tecnologie, ENEA, Rome (Italy); Ridolfi, S. [Ars Mensurae, Rome (Italy); Roldan Garcia, C. [Unidad de Arqueometria, Instituto de Ciencia de Materiales, Universidad de Valencia, Valencia (Spain)

    2007-05-15

    The investigation of archaeological and historical materials makes use of techniques that, though borrowed from other fields of research and industrial production, frequently have to be 're-invented' because of peculiar characteristics of the analysed objects. Artistic relevance, limited movability, compositional and structural heterogeneity radically change the experimental approach and often require ad hoc designed equipment. These considerations also apply to x-ray fluorescence, especially regarding mobile systems. The extensive development and use of mobile spectrometers has produced an extremely diversified context and created the need for common criteria to evaluate their performances as well as the advisability of a survey on the existing equipment. This paper shows the feasibility of such an idea through a demonstrative survey that was carried out among users of different mobile x-ray fluorescence spectrometry (XRF) systems in the areas of Rome, Italy and Valencia, Spain. The experimental protocol was based on measuring spectrometer detection limits with the single standard method. The standard was the 50 Euro-cent coin, whose alloy is made of 89% Cu, 5% Al, 5% Zn, 1% Sn; the large spread of the European currency guarantees maximum availability. The experimental data show that the use of different x-ray tubes and detectors results in detection limits that may differ from each other by a factor of 6 for Zn and almost 100 for Sn; despite the large number of variables that in principle affect the performance, it was observed that the high voltage of the x-ray tube is the most important parameter. (authors)

  18. Nonrandomized studies are not always found even when selection criteria for health systems intervention reviews include them: a methodological study.

    Science.gov (United States)

    Glenton, Claire; Lewin, Simon; Mayhew, Alain; Scheel, Inger; Odgaard-Jensen, Jan

    2013-04-01

    Systematic reviews within the Cochrane Effective Practice and Organisation of Care Group (EPOC) can include both randomized and nonrandomized study designs. We explored how many EPOC reviews consider and identify nonrandomized studies, and whether the proportion of nonrandomized studies identified is linked to the review topic. We recorded the study designs considered in 65 EPOC reviews. For reviews that considered nonrandomized studies, we calculated the proportion of identified studies that were nonrandomized and explored whether there were differences in the proportion of nonrandomized studies according to the review topic. Fifty-one (78.5%) reviews considered nonrandomized studies. Forty-six of these reviews found nonrandomized studies, but the proportion varied a great deal (median, 33%; interquartile range, 25--50%). Reviews of health care delivery interventions had lower proportions of nonrandomized studies than those of financial and governance interventions. Most EPOC reviews consider nonrandomized studies, but the degree to which they find them varies. As nonrandomized studies are believed to be at higher risk of bias and their inclusion entails a considerable effort, review authors should consider whether the benefits justify the inclusion of these designs. Research should explore whether it is more useful to consider nonrandomized studies in reviews of some intervention types than others. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study

    International Nuclear Information System (INIS)

    Lutterbey, G.; Behrends, K.; Falkenhausen, M.V.; Wattjes, M.P.; Morakkabati, N.; Schild, H.; Gieseke, J.

    2007-01-01

    The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained. (orig.)

  20. Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study.

    Science.gov (United States)

    Lutterbey, G; Behrends, K; Falkenhausen, M V; Wattjes, M P; Morakkabati, N; Gieseke, J; Schild, H

    2007-02-01

    The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained.

  1. Microstructural descriptors and cellular automata simulation of the effects of non-random nuclei location on recrystallization in two dimensions

    Directory of Open Access Journals (Sweden)

    Paulo Rangel Rios

    2006-06-01

    Full Text Available The effect of non-random nuclei location and the efficiency of microstructural descriptors in assessing such a situation are studied. Cellular automata simulation of recrystallization in two dimensions is carried out to simulate microstrutural evolution for nuclei distribution ranging from a periodic arrangement to clusters of nuclei. The simulation results are compared in detail with microstrutural descriptors normally used to follow transformation evolution. It is shown that the contiguity is particularly relevant to detect microstructural deviations from randomness. This work focuses on recrystallization but its results are applicable to any nucleation and growth transformation.

  2. Randomised feasibility study of a more liberal haemoglobin trigger for red blood cell transfusion compared to standard practice in anaemic cancer patients treated with chemotherapy

    DEFF Research Database (Denmark)

    Yakymenko, D.; Frandsen, K. B.; Christensen, I. J.

    2017-01-01

    Objectives: The primary objective of this feasibility study was to identify quality of life (QoL) scores and symptom scales as tools for measuring patient-reported outcomes (PRO) associated with haemoglobin level in chemotherapy-treated cancer patients. Secondary objectives included comparing QoL......-An, FACT-An TOI, fatigue and dyspnoea. Conclusions: QoL scores of physical and functional domains as well as self-reported anaemia-related symptoms correlated well with haemoglobin level in chemotherapy-treated cancer patients.......Objectives: The primary objective of this feasibility study was to identify quality of life (QoL) scores and symptom scales as tools for measuring patient-reported outcomes (PRO) associated with haemoglobin level in chemotherapy-treated cancer patients. Secondary objectives included comparing Qo......L and symptoms between randomisation arms. Background: Anaemia in cancer patients undergoing chemotherapy is associated with decreased QoL. One treatment option is red blood cell transfusion (RBCT). However, the optimal haemoglobin trigger for transfusion is unknown. Methods: Patients were randomised...

  3. Comparing open and minimally invasive surgical procedures for oesophagectomy in the treatment of cancer: the ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) feasibility study and pilot trial.

    Science.gov (United States)

    Metcalfe, Chris; Avery, Kerry; Berrisford, Richard; Barham, Paul; Noble, Sian M; Fernandez, Aida Moure; Hanna, George; Goldin, Robert; Elliott, Jackie; Wheatley, Timothy; Sanders, Grant; Hollowood, Andrew; Falk, Stephen; Titcomb, Dan; Streets, Christopher; Donovan, Jenny L; Blazeby, Jane M

    2016-06-01

    Localised oesophageal cancer can be curatively treated with surgery (oesophagectomy) but the procedure is complex with a risk of complications, negative effects on quality of life and a recovery period of 6-9 months. Minimal-access surgery may accelerate recovery. The ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) study aimed to establish the feasibility of, and methodology for, a definitive trial comparing minimally invasive and open surgery for oesophagectomy. Objectives were to quantify the number of eligible patients in a pilot trial; develop surgical manuals as the basis for quality assurance; standardise pathological processing; establish a method to blind patients to their allocation in the first week post surgery; identify measures of postsurgical outcome of importance to patients and clinicians; and establish the main cost differences between the surgical approaches. Pilot parallel three-arm randomised controlled trial nested within feasibility work. Two UK NHS departments of upper gastrointestinal surgery. Patients aged ≥ 18 years with histopathological evidence of oesophageal or oesophagogastric junctional adenocarcinoma, squamous cell cancer or high-grade dysplasia, referred for oesophagectomy or oesophagectomy following neoadjuvant chemo(radio)therapy. Oesophagectomy, with patients randomised to open surgery, a hybrid open chest and minimally invasive abdomen or totally minimally invasive access. The primary outcome measure for the pilot trial was the number of patients recruited per month, with the main trial considered feasible if at least 2.5 patients per month were recruited. During 21 months of recruitment, 263 patients were assessed for eligibility; of these, 135 (51%) were found to be eligible and 104 (77%) agreed to participate, an average of five patients per month. In total, 41 patients were allocated to open surgery, 43 to the hybrid procedure and 20 to totally minimally invasive surgery. Recruitment is continuing

  4. The Comparative Reliability and Feasibility of the Past-Year Canadian Diet History Questionnaire II: Comparison of the Paper and Web Versions.

    Science.gov (United States)

    Lo Siou, Geraldine; Csizmadi, Ilona; Boucher, Beatrice A; Akawung, Alianu K; Whelan, Heather K; Sharma, Michelle; Al Rajabi, Ala; Vena, Jennifer E; Kirkpatrick, Sharon I; Koushik, Anita; Massarelli, Isabelle; Rondeau, Isabelle; Robson, Paula J

    2017-02-13

    Advances in technology-enabled dietary assessment include the advent of web-based food frequency questionnaires, which may reduce costs and researcher burden but may introduce new challenges related to internet connectivity and computer literacy. The purpose of this study was to evaluate the intra- and inter-version reliability, feasibility and acceptability of the paper and web Canadian Diet History Questionnaire II (CDHQ-II) in a sub-sample of 648 adults (aged 39-81 years) recruited from Alberta's Tomorrow Project. Participants were randomly assigned to one of two groups: (1) paper, web, paper; or (2) web, paper, web over a six-week period. With few exceptions, no statistically significant differences in mean nutrient intake were found in the intra- and inter-version reliability analyses. The majority of participants indicated future willingness to complete the CDHQ-II online, and 59% indicated a preference for the web over the paper version. Findings indicate that, in this population of adults drawn from an existing cohort, the CDHQ-II may be administered in paper or web modalities (increasing flexibility for questionnaire delivery), and the nutrient estimates obtained with either version are comparable. We recommend that other studies explore the feasibility and reliability of different modes of administration of dietary assessment instruments prior to widespread implementation.

  5. The Comparative Reliability and Feasibility of the Past-Year Canadian Diet History Questionnaire II: Comparison of the Paper and Web Versions

    Science.gov (United States)

    Lo Siou, Geraldine; Csizmadi, Ilona; Boucher, Beatrice A.; Akawung, Alianu K.; Whelan, Heather K.; Sharma, Michelle; Al Rajabi, Ala; Vena, Jennifer E.; Kirkpatrick, Sharon I.; Koushik, Anita; Massarelli, Isabelle; Rondeau, Isabelle; Robson, Paula J.

    2017-01-01

    Advances in technology-enabled dietary assessment include the advent of web-based food frequency questionnaires, which may reduce costs and researcher burden but may introduce new challenges related to internet connectivity and computer literacy. The purpose of this study was to evaluate the intra- and inter-version reliability, feasibility and acceptability of the paper and web Canadian Diet History Questionnaire II (CDHQ-II) in a sub-sample of 648 adults (aged 39–81 years) recruited from Alberta’s Tomorrow Project. Participants were randomly assigned to one of two groups: (1) paper, web, paper; or (2) web, paper, web over a six-week period. With few exceptions, no statistically significant differences in mean nutrient intake were found in the intra- and inter-version reliability analyses. The majority of participants indicated future willingness to complete the CDHQ-II online, and 59% indicated a preference for the web over the paper version. Findings indicate that, in this population of adults drawn from an existing cohort, the CDHQ-II may be administered in paper or web modalities (increasing flexibility for questionnaire delivery), and the nutrient estimates obtained with either version are comparable. We recommend that other studies explore the feasibility and reliability of different modes of administration of dietary assessment instruments prior to widespread implementation. PMID:28208819

  6. Comparative feasibility of gamma, electron beam and x-rays facilities at the Kuala Lumpur International airport (KLIA), Sepang, Malaysia

    International Nuclear Information System (INIS)

    Muhamad Lebai Juri; Sidek Othman; Wan Mashol Wan Zain; Ridzuan Ismail

    1997-01-01

    Malaysia is one of the world's leading producers of rubber, palm oil and cocoa beans. There is a great concern within the commodity industries of the possible outbreak of plant diseases yet to be detected in the country but endemic in the South American tropics and Africa. The risk of transferring the diseases to Malaysia are high because of increasing contacts between Malaysia and the South American countries and Africa through trades, tourism and the South-South cooperation. Diseases of particular importance are the South American leaf blight (SALB) of rubber, vascular wilts of oil palm and witches'broom of cocoa caused by Microcyclus ulei, Fusarium oxysporum f sp. elaeidies and Crinipellis pemiciosa (Stahel) Singer respectively. Recent estimates by the Agriculture Department of Malaysia indicated in the event of large scale attack by SALB on rubber would result in revenue loss of a staggering RM 3-3.5 billion per annum, an equivalent of 70% loss in rubber acreage. This excludes massive unemployment in the rubber industry and cost of cleaning up activities to eradicate and free plantations of SALB. Recurring attacks of the diseases cannot be discounted given the fact that spores of fungi can remain dormant for years but still viable. Stringent control and quarantine steps are presently being exercised by the authorities to intercept at airports and hence prevent entry of infectious plant diseases in Malaysia. Many of the measures using chemicals, ultra violet light (UV), steam sterilization, air blowers etc. are not sufficiently effective in killing fungi especially when spores are carried in the personal belongings of air-passengers. There was suggestion that ionizing radiation offers alternative to the present methods for intercepting pathogens at the port of entry. This paper will firstly, discuss results on the investigations carried out to compare the effectiveness of various ionizing radiation sources, i.e., gamma, electron beam and x-rays; chemicals and UV

  7. Treatment of benign esophageal stricture by Eder-Puestow or balloon dilators: a comparison between randomized and prospective nonrandomized trials.

    Science.gov (United States)

    Yamamoto, H; Hughes, R W; Schroeder, K W; Viggiano, T R; DiMagno, E P

    1992-03-01

    To determine whether the natural history of strictures is affected by the type of dilator used to treat newly diagnosed peptic strictures, we designed a prospective randomized trial to compare the results after Eder-Puestow or Medi-Tech balloon dilation. We entered 31 patients into the trial. We also prospectively followed up all 92 nonrandomized patients who underwent their first dilation for a benign stricture during the same period as the prospective randomized trial. The nonrandomized patients also underwent dilation with either the Eder-Puestow or the balloon technique at the discretion of the gastroenterologist performing the endoscopy. We found no statistically significant differences in the immediate or long-term results of the two methods among the randomized, nonrandomized, and overall combined groups. All but 1 of the 123 patients had immediate relief of dysphagia. Within each group of patients, the probability of remaining free of dysphagia 1 year after the initial dilation was approximately 20%, and the probability of not requiring a second dilation was approximately 65% with either technique. Major (esophageal rupture) and minor (bleeding or chest pain) complications occurred in 1% and 5% of the patients and 0.4% and 3% of the total dilation procedures, respectively. The esophageal rupture and four of six minor complications occurred after repeated dilations. Five of the six minor complications occurred with use of the Eder-Puestow dilators. We conclude that Eder-Puestow and balloon dilations of benign esophageal strictures are associated with similar outcomes, but repeated dilations and the Eder-Puestow technique may be associated with an increased risk of complications.

  8. Safety and feasibility of minimally invasive gastrectomy during the early introduction in the Netherlands: short-term oncological outcomes comparable to open gastrectomy.

    Science.gov (United States)

    Brenkman, H J F; Ruurda, J P; Verhoeven, R H A; van Hillegersberg, R

    2017-09-01

    Minimally invasive techniques for gastric cancer surgery have recently been introduced in the Netherlands, based on a proctoring program. The aim of this population-based cohort study was to evaluate the short-term oncological outcomes of minimally invasive gastrectomy (MIG) during its introduction in the Netherlands. The Netherlands Cancer Registry identified all patients with gastric adenocarcinoma who underwent gastrectomy with curative intent between 2010 and 2014. Multivariable analysis was performed to compare MIG and open gastrectomy (OG) on lymph node yield (≥15), R0 resection rate, and 1-year overall survival. The pooled learning curve per center of MIG was evaluated by groups of five subsequent procedures. Between 2010 and 2014, a total of 277 (14%) patients underwent MIG and 1633 (86%) patients underwent OG. During this period, the use of MIG and neoadjuvant chemotherapy increased from 4% to 39% (p introduction of minimally invasive gastrectomy in Western countries is feasible and can be performed safely.

  9. Towards a five-minute comprehensive cardiac MR examination using highly accelerated parallel imaging with a 32-element coil array: feasibility and initial comparative evaluation.

    Science.gov (United States)

    Xu, Jian; Kim, Daniel; Otazo, Ricardo; Srichai, Monvadi B; Lim, Ruth P; Axel, Leon; Mcgorty, Kelly Anne; Niendorf, Thoralf; Sodickson, Daniel K

    2013-07-01

    To evaluate the feasibility and perform initial comparative evaluations of a 5-minute comprehensive whole-heart magnetic resonance imaging (MRI) protocol with four image acquisition types: perfusion (PERF), function (CINE), coronary artery imaging (CAI), and late gadolinium enhancement (LGE). This study protocol was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board-approved. A 5-minute comprehensive whole-heart MRI examination protocol (Accelerated) using 6-8-fold-accelerated volumetric parallel imaging was incorporated into and compared with a standard 2D clinical routine protocol (Standard). Following informed consent, 20 patients were imaged with both protocols. Datasets were reviewed for image quality using a 5-point Likert scale (0 = non-diagnostic, 4 = excellent) in blinded fashion by two readers. Good image quality with full whole-heart coverage was achieved using the accelerated protocol, particularly for CAI, although significant degradations in quality, as compared with traditional lengthy examinations, were observed for the other image types. Mean total scan time was significantly lower for the Accelerated as compared to Standard protocols (28.99 ± 4.59 min vs. 1.82 ± 0.05 min, P simplified scan prescription and high spatial and temporal resolution enabled by highly parallel imaging technology. The study also highlights technical hurdles that remain to be addressed. Although image quality remained diagnostic for most scan types, the reduced image quality of PERF, CINE, and LGE scans in the Accelerated protocol remain a concern. Copyright © 2012 Wiley Periodicals, Inc.

  10. Para-aortic lymphadenectomy in advanced stage cervical cancer, a protocol for comparing safety, feasibility and diagnostic accuracy of surgical staging versus PET-CT; PALDISC trial.

    Science.gov (United States)

    Tax, Casper; Abbink, Karin; Rovers, Maroeska M; Bekkers, Ruud L M; Zusterzeel, Petra L M

    2018-01-01

    Currently, a PET-CT is used to assess the need for extended field radiotherapy of para-aortic lymph nodes (PALN) in International Federation of Gynaecology and Obstetrics (FIGO) stage IB2, IIA2-IVA (locally advanced stage) cervical cancer. A small study established a sensitivity and specificity estimate for PALN metastases of 50% (95% CI; 7-93%) and 83% (95% CI; 52-98%), respectively. Surgical staging of PALN may lead to a higher diagnostic accuracy. However, surgical staging of para-aortic lymph nodes in locally advanced stage cervical cancer is not common practice. Therefore, a phase 2 randomised controlled trial is needed to assess its safety and feasibility. In addition to standard imaging (MRI or CT scan) with PET-CT, 30 adult women with FIGO stage IB2, IIA2-IVA cervical cancer will be randomised to receive either surgical staging or usual PET-CT staging. Administering extended field radiotherapy will be based on lymphadenectomy results for the intervention group and on the PET-CT results for the control group. Follow-up visits at 0, 3, 6, 9 and 12 months will assess health-related quality of life and progression-free survival.Primary safety and feasibility outcomes of surgical staging will be assessed by calculating means with 95% confidence intervals for duration of surgery, number of complications, blood loss, nodal yield after para-aortic lymphadenectomy and treatment delay due to surgical staging. Secondary patient-centred outcomes on quality of life and first year survival will be documented and compared between the two groups. Estimates of sensitivity, specificity and negative and positive predictive values of MRI, PET-CT and surgical staging will be presented with 95% CI.. All analysis will be performed according to the intention to treat principle. This study will assess safety and feasibility, expressed as the number and severity of complications, effect on quality of life and the treatment delay due to surgically staging para-aortic lymph nodes in

  11. The feasibility of a pragmatic randomised controlled trial to compare usual care with usual care plus individualised homeopathy, in children requiring secondary care for asthma.

    Science.gov (United States)

    Thompson, E A; Shaw, A; Nichol, J; Hollinghurst, S; Henderson, A J; Thompson, T; Sharp, D

    2011-07-01

    To test the feasibility of a pragmatic trial design with economic evaluation and nested qualitative study, comparing usual care (UC) with UC plus individualised homeopathy, in children requiring secondary care for asthma. This included recruitment and retention, acceptability of outcome measures patients' and health professionals' views and experiences and a power calculation for a definitive trial. In a pragmatic parallel group randomised controlled trial (RCT) design, children on step 2 or above of the British Thoracic Society Asthma Guidelines (BTG) were randomly allocated to UC or UC plus a five visit package of homeopathic care (HC). Outcome measures included the Juniper Asthma Control Questionnaire, Quality of Life Questionnaire and a resource use questionnaire. Qualitative interviews were used to gain families' and health professionals' views and experiences. 226 children were identified from hospital clinics and related patient databases. 67 showed an interest in participating, 39 children were randomised, 18 to HC and 21 to UC. Evidence in favour of adjunctive homeopathic treatment was lacking. Economic evaluation suggests that the cost of additional consultations was not offset by the reduced cost of homeopathic remedies and the lower use of primary care by children in the homeopathic group. Qualitative data gave insights into the differing perspectives of families and health care professionals within the research process. A future study using this design is not feasible, further investigation of a potential role for homeopathy in asthma management might be better conducted in primary care with children with less severe asthma. Copyright © 2011 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  12. Colonic stem cell data are consistent with the immortal model of stem cell division under non-random strand segregation.

    Science.gov (United States)

    Walters, K

    2009-06-01

    Colonic stem cells are thought to reside towards the base of crypts of the colon, but their numbers and proliferation mechanisms are not well characterized. A defining property of stem cells is that they are able to divide asymmetrically, but it is not known whether they always divide asymmetrically (immortal model) or whether there are occasional symmetrical divisions (stochastic model). By measuring diversity of methylation patterns in colon crypt samples, a recent study found evidence in favour of the stochastic model, assuming random segregation of stem cell DNA strands during cell division. Here, the effect of preferential segregation of the template strand is considered to be consistent with the 'immortal strand hypothesis', and explore the effect on conclusions of previously published results. For a sample of crypts, it is shown how, under the immortal model, to calculate mean and variance of the number of unique methylation patterns allowing for non-random strand segregation and compare them with those observed. The calculated mean and variance are consistent with an immortal model that incorporates non-random strand segregation for a range of stem cell numbers and levels of preferential strand segregation. Allowing for preferential strand segregation considerably alters previously published conclusions relating to stem cell numbers and turnover mechanisms. Evidence in favour of the stochastic model may not be as strong as previously thought.

  13. NEOCENT: a randomised feasibility and translational study comparing neoadjuvant endocrine therapy with chemotherapy in ER-rich postmenopausal primary breast cancer.

    Science.gov (United States)

    Palmieri, C; Cleator, S; Kilburn, L S; Kim, S B; Ahn, S-H; Beresford, M; Gong, G; Mansi, J; Mallon, E; Reed, S; Mousa, K; Fallowfield, L; Cheang, M; Morden, J; Page, K; Guttery, D S; Rghebi, B; Primrose, L; Shaw, J A; Thompson, A M; Bliss, J M; Coombes, R C

    2014-12-01

    Neoadjuvant endocrine therapy is an alternative to chemotherapy for women with oestrogen receptor (ER)-positive early breast cancer (BC). We aimed to assess feasibility of recruiting patients to a study comparing chemotherapy versus endocrine therapy in postmenopausal women with ER-rich primary BC, and response as well as translational endpoints were assessed. Patients requiring neoadjuvant therapy were randomised to chemotherapy: 6 × 3-weekly cycles FE₁₀₀C or endocrine therapy: letrozole 2.5 mg, daily for 18-23 weeks. Primary endpoints were recruitment feasibility and tissue collection. Secondary endpoints included clinical, radiological and pathological response rates, quality of life and translational endpoints. 63/80 patients approached were eligible, of those 44 (70, 95% CI 57-81) were randomised. 12 (54.5, 95% CI 32.2-75.6) chemotherapy patients showed radiological objective response compared with 13 (59.1, 95% CI 36.4-79.3) letrozole patients. Compared with baseline, mean Ki-67 levels fell in both groups at days 2-4 and at surgery [fold change: 0.24 (95% CI 0.12-0.51) and 0.24; (95% CI 0.15-0.37), respectively]. Plasma total cfDNA levels rose from baseline to week 8 [fold change: chemotherapy 2.10 (95% CI 1.47-3.00), letrozole 1.47(95% CI 0.98-2.20)], and were maintained at surgery in the chemotherapy group [chemotherapy 2.63; 95% CI 1.56-4.41), letrozole 0.95 (95% CI 0.71-1.26)]. An increase in plasma let-7a miRNA was seen at surgery for patients with objective radiological response to chemotherapy. Recruitment and tissue collection endpoints were met; however, a larger trial was deemed unfeasible due to slow accrual. Both regimens were equally efficacious. Dynamic changes were seen in Ki-67 and circulating biomarkers in both groups with increases in cfDNA and let-7a miRNA persisting until surgery for chemotherapy patients.

  14. Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery.

    Science.gov (United States)

    Edwards, Janet P; Kelly, Elizabeth J; Lin, Yongtao; Lenders, Taryn; Ghali, William A; Graham, Andrew J

    2012-06-01

    Randomized controlled trials (RCTs) are thought to provide the most accurate estimation of "true" treatment effect. The relative quality of effect estimates derived from nonrandomized studies (nRCTs) remains unclear, particularly in surgery, where the obstacles to performing high-quality RCTs are compounded. We performed a meta-analysis of effect estimates of RCTs comparing surgical procedures for breast cancer relative to those of corresponding nRCTs. English-language RCTs of breast cancer treatment in human patients published from 2003 to 2008 were identified in MEDLINE, EMBASE and Cochrane databases. We identified nRCTs using the National Library of Medicine's "related articles" function and reference lists. Two reviewers conducted all steps of study selection. We included studies comparing 2 surgical arms for the treatment of breast cancer. Information on treatment efficacy estimates, expressed as relative risk (RR) for outcomes of interest in both the RCTs and nRCTs was extracted. We identified 12 RCTs representing 10 topic/outcome combinations with comparable nRCTs. On visual inspection, 4 of 10 outcomes showed substantial differences in summary RR. The pooled RR estimates for RCTs versus nRCTs differed more than 2-fold in 2 of 10 outcomes and failed to demonstrate consistency of statistical differences in 3 of 10 cases. A statistically significant difference, as assessed by the z score, was not detected for any of the outcomes. Randomized controlled trials comparing surgical procedures for breast cancer may demonstrate clinically relevant differences in effect estimates in 20%-40% of cases relative to those generated by nRCTs, depending on which metric is used.

  15. Quantitative right and left ventricular functional analysis during gated whole-chest MDCT: A feasibility study comparing automatic segmentation to semi-manual contouring

    International Nuclear Information System (INIS)

    Coche, Emmanuel; Walker, Matthew J.; Zech, Francis; Crombrugghe, Rodolphe de; Vlassenbroek, Alain

    2010-01-01

    Purpose: To evaluate the feasibility of an automatic, whole-heart segmentation algorithm for measuring global heart function from gated, whole-chest MDCT images. Material and methods: 15 patients with suspicion of PE underwent whole-chest contrast-enhanced MDCT with retrospective ECG synchronization. Two observers computed right and left ventricular functional indices using a semi-manual and an automatic whole-heart segmentation algorithm. The two techniques were compared using Bland-Altman analysis and paired Student's t-test. Measurement reproducibility was calculated using intraclass correlation coefficient. Results: Ventricular analysis with automatic segmentation was successful in 13/15 (86%) and in 15/15 (100%) patients for the right ventricle and left ventricle, respectively. Reproducibility of measurements for both ventricles was perfect (ICC: 1.00) and very good for automatic and semi-manual measurements, respectively. Ventricular volumes and functional indices except right ventricular ejection fraction obtained from the automatic method were significantly higher for the RV compared to the semi-manual methods. Conclusions: The automatic, whole-heart segmentation algorithm enabled highly reproducible global heart function to be rapidly obtained in patients undergoing gated whole-chest MDCT for assessment of acute chest pain with suspicion of pulmonary embolism.

  16. Real-time definition of non-randomness in the distribution of genomic events.

    Directory of Open Access Journals (Sweden)

    Ulrich Abel

    Full Text Available Features such as mutations or structural characteristics can be non-randomly or non-uniformly distributed within a genome. So far, computer simulations were required for statistical inferences on the distribution of sequence motifs. Here, we show that these analyses are possible using an analytical, mathematical approach. For the assessment of non-randomness, our calculations only require information including genome size, number of (sampled sequence motifs and distance parameters. We have developed computer programs evaluating our analytical formulas for the real-time determination of expected values and p-values. This approach permits a flexible cluster definition that can be applied to most effectively identify non-random or non-uniform sequence motif distribution. As an example, we show the effectivity and reliability of our mathematical approach in clinical retroviral vector integration site distribution.

  17. Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial.

    Science.gov (United States)

    Raurell-Torredà, Marta; Olivet-Pujol, Josep; Romero-Collado, Àngel; Malagon-Aguilera, Maria Carmen; Patiño-Masó, Josefina; Baltasar-Bagué, Alícia

    2015-01-01

    To compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE). In a nonrandomized clinical trial, 101 undergraduates enrolled in the "Adult Patients 1" course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes. Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test). Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more "rules-based errors" than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1). The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols. Case-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice. © 2014 Sigma Theta Tau International.

  18. A Non-randomized Controlled Trial of EMDR on Affective Symptoms in Patients With Glioblastoma Multiforme

    Directory of Open Access Journals (Sweden)

    Monika Szpringer

    2018-05-01

    Full Text Available Glioblastoma multiforme (GBM is a highly aggressive brain cancer and its survival after diagnosis is less than 2 years. Therefore, GBM patients are especially prone to co-occurring psychological conditions such as anxiety and depressive disorders. Furthermore, aggressive medical therapies affect patients’ lives, undermining their sense of meaning and coherence. The main aim of this study was to determine the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR therapy on anxiety, depression and sense of coherence in patients with GBM. Thirty-seven GBM-diagnosed women were included in this trial and received standard medical care. Of those, 18 patients were treated during 4 months with 10–12 individual EMDR sessions (60–90 minutes each. Nineteen GBM patients were used as a non-randomized control group as they consented to psychological evaluations but not to a psychotherapeutic intervention. The groups were homogeneous in terms of gender, age, educational level and treatment, but not in anxiety and depressive levels at baseline. All patients were evaluated at baseline, after treatment (4 months and at follow-up (further 4 months by the Hospital Anxiety and Depression Scale (HADS-M and the Sense of Coherence Scale (SOC-29. Caregivers in both groups were interviewed by the Patient Caregiver Questionnaire after 4 months follow-up. Statistical analyses were conducted using ANOVA statistics, correlation and regression analysis. Results showed a statistically significant decrease in the EMDR group in anxiety, depression and anger, when compared to the experimental group. EMDR therapy also had a positive impact upon the sense of coherence level in the experimental group, whereas in the control group this declined. Finally, the caregivers reported beneficial outcomes of the EMDR therapy with less anxiety- and anger-related behaviors in patients in the experimental group compared to the control group. This study is the first to show

  19. Triacylglycerol Profile of Summer and Winter Bovine Milk Fat and the Feasibility of Triacylglycerol Fragmentation

    NARCIS (Netherlands)

    Tzompa-Sosa, Daylan A.; Meurs, Pim P.; Valenberg, van Hein J.F.

    2018-01-01

    Bovine milk fat (MF) is considered to be one of the most complex fats, as it can consist of 400 FA which are non-randomly esterified into the TAG molecule. This study aims to determine specific differences on MF TAG profile between summer and winter cow's milk, and to study the feasibility of TAG

  20. Translating cognitive behavioral interventions from bench to bedside: The feasibility and acceptability of cognitive remediation in research as compared to clinical settings.

    Science.gov (United States)

    Medalia, Alice; Erlich, Matthew D; Soumet-Leman, Charlotte; Saperstein, Alice M

    2017-07-30

    Cognitive remediation (CR) research typically addresses internal validity, and few studies consider CR in a real-world context. This study evaluated the fit between the program conditions and treatment model in research and clinical settings, with the goal of informing future research on the contextual challenges associated with the implementation of CR. Data was drawn from an initiative by New York State's Office of Mental Health (OMH), to implement CR programs for adults with Serious Mental Illness (SMI) in 16 state operated outpatient clinics. One of these clinics first became a research site for a CR randomized clinical trial, which allowed for a comparison of the feasibility and acceptability of CR in a research as compared to a clinical setting. The research site averaged almost triple the number of referrals as the clinical sites. Over nine months 46.51% of clinic referrals were enrolled in the CR program whereas 64.29% of research referrals were enrolled. Clinical site utilization averaged 70.53% while research site utilization averaged 90.47%. At the clinical sites, 97% of respondents reported CR was an excellent or good experience. There was high treatment fidelity for program structure and content across sites. This comparison of CR in clinical and research sites highlights the decrease in referrals, enrollment and utilization that occurs when a program moves from a highly controlled setting to the real world. Still, the acceptability, fill rates and utilization indicated that CR can be successfully implemented in large scale, geographically diverse, publically funded clinic settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. How a dependent's variable non-randomness affects taper equation ...

    African Journals Online (AJOL)

    In order to apply the least squares method in regression analysis, the values of the dependent variable Y should be random. In an example of regression analysis linear and nonlinear taper equations, which estimate the diameter of the tree dhi at any height of the tree hi, were compared. For each tree the diameter at the ...

  2. 14-plex Feasibility Report

    Energy Technology Data Exchange (ETDEWEB)

    Kotongan, Victoria Hazel [Native Village of Unalakleet

    2013-06-21

    The Native Village of Unalakleet project was a feasibility study for a retrofit of a “tribally owned” three story, 14 apartment complex located in Unalakleet, Alaska. The program objective and overall goal was to create a plan for retrofitting to include current appraised value and comparable costs of new construction to determine genuine feasibility as low-income multi-family housing for tribal members.

  3. Feasibility study

    International Nuclear Information System (INIS)

    Gibbs, P.; Kalas, P.

    1975-01-01

    The feasibility study itself examines the technical, economic and financial implications of a nuclear power station in depth so as to make sure that nuclear power is the right course to take. This means that it is quite an expensive operation and it is to avoid wasting this money that a pre-feasibility study is carried out. This preliminary study should eliminate cases where the electrical system cannot absorb the capacity of a nuclear station of commercial size, where other sources of power such as hydro-electricity, gas or cheap coal would make nuclear obviously uneconomic or where no suitable sites exist. If this first rather simple survey shows that nuclear power is a credible solution to a utilities need for electricity or heat production plant, then the next stage is a full feasibility study. (orig./TK) [de

  4. Initial Report of a Prospective Dosimetric and Clinical Feasibility Trial Demonstrates the Potential of Protons to Increase the Therapeutic Ratio in Breast Cancer Compared With Photons

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Julie A., E-mail: jbradley@floridaproton.org; Dagan, Roi; Ho, Meng Wei; Rutenberg, Michael; Morris, Christopher G.; Li, Zuofeng; Mendenhall, Nancy P.

    2016-05-01

    Purpose: To compare dosimetric endpoints between proton therapy (PT) and conventional radiation and determine the feasibility of PT for regional nodal irradiation (RNI) in women with breast cancer. Methods and Materials: From 2012 to 2014, 18 women (stage IIA-IIIB) requiring RNI prospectively enrolled on a pilot study. Median age was 51.8 years (range, 42-73 years). The cohort included breast-conserving therapy (BCT) and mastectomy patients and right- and left-sided cancers. Treatment targets and organs at risk were delineated on computed tomography scans, and PT and conventional plans were developed. Toxicity was prospectively recorded using Common Terminology Criteria for Adverse Events version 4.0. A Wilcoxon signed-rank sum test compared the dose-volume parameters. The primary endpoint was a reduction in cardiac V5. Results: Median follow-up was 20 months (range, 2-31 months). For all patients, the PT plan better met the dosimetric goals and was used for treatment. Proton therapy alone was used for 10 patients (9 postmastectomy, 1 after BCT) and combined proton–photon in 8 (6 BCT, 2 postmastectomy with immediate expander reconstruction). Proton therapy improved coverage of level 2 axilla (P=.0005). Adequate coverage of internal mammary nodes was consistently achieved with PT (median D95, 50.3 Gy; range, 46.6-52.1 Gy) but not with conventional radiation therapy (median D95, 48.2 Gy; range, 40.8-55 Gy; P=.0005). Median cardiac V5 was 0.6% with PT and 16.3% with conventional radiation (P<.0001). Median ipsilateral lung V5 and V20 were improved with PT (median V5 35.3% vs 60.5% [P<.0001]; and median V20, 21.6% vs 35.5% [P<.0001]). Grade 3 dermatitis developed in 4 patients (22%), which was the only grade 3 toxicity. No grade 4+ toxicities developed. Conclusion: Proton therapy for RNI after mastectomy or BCT significantly improves cardiac dose, especially for left-sided patients, and lung V5 and V20 in all patients without excessive acute toxicity

  5. Excess Gibbs Energy for Ternary Lattice Solutions of Nonrandom Mixing

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hae Young [DukSung Womens University, Seoul (Korea, Republic of)

    2008-12-15

    It is assumed for three components lattice solution that the number of ways of arranging particles randomly on the lattice follows a normal distribution of a linear combination of N{sub 12}, N{sub 23}, N{sub 13} which are the number of the nearest neighbor interactions between different molecules. It is shown by random number simulations that this assumption is reasonable. From this distribution, an approximate equation for the excess Gibbs energy of three components lattice solution is derived. Using this equation, several liquid-vapor equilibria are calculated and compared with the results from other equations.

  6. Early assessment of feasibility and technical specificities of transoral robotic surgery using the da Vinci Xi.

    Science.gov (United States)

    Gorphe, Philippe; Von Tan, Jean; El Bedoui, Sophie; Hartl, Dana M; Auperin, Anne; Qassemyar, Quentin; Moya-Plana, Antoine; Janot, François; Julieron, Morbize; Temam, Stephane

    2017-12-01

    The latest generation Da Vinci ® Xi™ Surgical System Robot released has not been evaluated to date in transoral surgery for head and neck cancers. We report here the 1-year results of a non-randomized phase II multicentric prospective trial aimed at assessing its feasibility and technical specificities. Our primary objective was to evaluate the feasibility of transoral robotic surgery using the da Vinci ® Xi™ Surgical System Robot. The secondary objective was to assess peroperative outcomes. Twenty-seven patients, mean age 62.7 years, were included between May 2015 and June 2016 with tumors affecting the following sites: oropharynx (n = 21), larynx (n = 4), hypopharynx (n = 1), parapharyngeal space (n = 1). Eighteen patients were included for primary treatment, three for a local recurrence, and six for cancer in a previously irradiated field. Three were reconstructed with a FAMM flap and 6 with a free ALT flap. The mean docking time was 12 min. "Chopsticking" of surgical instruments was very rare. During hospitalization following surgery, 3 patients experienced significant bleeding between day 8 and 9 that required surgical transoral hemostasis (n = 1) or endovascular embolization (n = 2). Transoral robotic surgery using the da Vinci ® Xi™ Surgical System Robot proved feasible with technological improvements compared to previous generation surgical system robots and with a similar postoperative course. Further technological progress is expected to be of significant benefit to the patients.

  7. Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study

    Directory of Open Access Journals (Sweden)

    Torisson G

    2013-09-01

    Full Text Available Gustav Torisson,1 Lennart Minthon,1 Lars Stavenow,2 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 2Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann–Whitney U test, P = 0.02. For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009. Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002 and decreased from 75 to 58 in the intervention group (P = 0.25. From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann–Whitney test, P = 0.054. Conclusion: A multidisciplinary approach

  8. The effects of a life goal-setting technique in a preventive care program for frail community-dwelling older people: a cluster nonrandomized controlled trial.

    Science.gov (United States)

    Yuri, Yoshimi; Takabatake, Shinichi; Nishikawa, Tomoko; Oka, Mari; Fujiwara, Taro

    2016-05-12

    Frailty among older people is associated with an increased risk of needing care. There have been many reports on preventive care programs for frail older people, but few have shown positive effects on disability prevention. Physical exercise programs for frail older people affect elements such as physical fitness and balance, but are less effective for disability outcomes and are not followed up in the longer term. We developed a life goal-setting technique (LGST). Our objective was to determine the effect of a LGST plus standard preventive care program for community-dwelling frail older people. We used a cluster nonrandomized controlled trial with seven intervention and nine matched control groups, with baseline assessment and follow-up at 3, 6, and 9 months. Participants were 176 frail older people, aged 65 years or over, living in the community in Izumi, Osaka, Japan. All participants attended regular 120 min preventive care exercise classes each week, over 3 months. They also received oral care and nutrition education. The intervention groups alone received life goal-setting support. We assessed outcomes longitudinally, comparing pre-intervention with follow-up. The primary outcome measure was health improvement according to the Japanese Ministry of Health, Labour and Welfare's "Kihon Checklist" for assessment of frailty and quality of life (QOL), analyzed with a two-way ANOVA and post-test comparison. Secondary outcomes included physical functions and assessment of life goals. The improvement on the Kihon Checklist for the intervention group was approximately 60 % from baseline to 9-months follow-up; the control group improved by approximately 40 %. The difference between groups was significant at 3-month (p = 0.043) and 6-month (p = 0.015) follow-ups but not at 9-month (p = 0.098) follow-up. Analysis of QOL yielded a significant time × group interaction effect (p = 0.022). The effect was significant at 3 months in the intervention

  9. COMPAR

    International Nuclear Information System (INIS)

    Kuefner, K.

    1976-01-01

    COMPAR works on FORTRAN arrays with four indices: A = A(i,j,k,l) where, for each fixed k 0 ,l 0 , only the 'plane' [A(i,j,k 0 ,l 0 ), i = 1, isub(max), j = 1, jsub(max)] is held in fast memory. Given two arrays A, B of this type COMPAR has the capability to 1) re-norm A and B ind different ways; 2) calculate the deviations epsilon defined as epsilon(i,j,k,l): =[A(i,j,k,l) - B(i,j,k,l)] / GEW(i,j,k,l) where GEW (i,j,k,l) may be chosen in three different ways; 3) calculate mean, standard deviation and maximum in the array epsilon (by several intermediate stages); 4) determine traverses in the array epsilon; 5) plot these traverses by a printer; 6) simplify plots of these traverses by the PLOTEASY-system by creating input data blocks for this system. The main application of COMPAR is given (so far) by the comparison of two- and three-dimensional multigroup neutron flux-fields. (orig.) [de

  10. Prospective Nonrandomized Trial of Manual Compression and Angio-Seal and Starclose Arterial Closure Devices in Common Femoral Punctures

    International Nuclear Information System (INIS)

    Ratnam, Lakshmi A.; Raja, Jowad; Munneke, Graham J.; Morgan, Robert A.; Belli, Anna-Maria

    2007-01-01

    We compared the use of manual compression and Angio-Seal and Starclose arterial closure devices to achieve hemostasis following common femoral artery (CFA) punctures in order to evaluate safety and efficacy. A prospective nonrandomized, single-center study was carried out on all patients undergoing CFA punctures over 1 year. Hemostasis was achieved using manual compression in 108 cases, Angio-Seal in 167 cases, and Starclose in 151 cases. Device-failure rates were low and not significantly different in the two groups (manual compression and closure devices; p = 0.8). There were significantly more Starclose (11.9%) patients compared to Angio-Seal (2.4%), with successful initial deployment subsequently requiring additional manual compression to achieve hemostasis (p < 0.0001). A significant number of very thin patients failed to achieve hemostasis (p = 0.014). Major complications were seen in 2.9% of Angio-Seal, 1.9% of Starclose, and 3.7% of manual compression patients, with no significant difference demonstrated; 4.7% of the major complications were seen in female patients compared to 1.3% in males (p = 0.0415). All three methods showed comparable safety and efficacy. Very thin patients are more likely to have failed hemostasis with the Starclose device, although this did not translate into an increased complication rate. There is a significant increased risk of major puncture-site complications in women with peripheral vascular disease

  11. In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

    Directory of Open Access Journals (Sweden)

    Andreas Michalsen

    2013-01-01

    Full Text Available Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM. We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014 and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

  12. Non-random distribution of instability-associated chromosomal rearrangement breakpoints in human lymphoblastoid cells

    International Nuclear Information System (INIS)

    Moore, Stephen R.; Papworth, David; Grosovsky, Andrew J.

    2006-01-01

    Genomic instability is observed in tumors and in a large fraction of the progeny surviving irradiation. One of the best-characterized phenotypic manifestations of genomic instability is delayed chromosome aberrations. Our working hypothesis for the current study was that if genomic instability is in part attributable to cis mechanisms, we should observe a non-random distribution of chromosomes or sites involved in instability-associated rearrangements, regardless of radiation quality, dose, or trans factor expression. We report here the karyotypic examination of 296 instability-associated chromosomal rearrangement breaksites (IACRB) from 118 unstable TK6 human B lymphoblast, and isogenic derivative, clones. When we tested whether IACRB were distributed across the chromosomes based on target size, a significant non-random distribution was evident (p < 0.00001), and three IACRB hotspots (chromosomes 11, 12, and 22) and one IACRB coldspot (chromosome 2) were identified. Statistical analysis at the chromosomal band-level identified four IACRB hotspots accounting for 20% of all instability-associated breaks, two of which account for over 14% of all IACRB. Further, analysis of independent clones provided evidence within 14 individual clones of IACRB clustering at the chromosomal band level, suggesting a predisposition for further breaks after an initial break at some chromosomal bands. All of these events, independently, or when taken together, were highly unlikely to have occurred by chance (p < 0.000001). These IACRB band-level cluster hotspots were observed independent of radiation quality, dose, or cellular p53 status. The non-random distribution of instability-associated chromosomal rearrangements described here significantly differs from the distribution that was observed in a first-division post-irradiation metaphase analysis (p = 0.0004). Taken together, these results suggest that genomic instability may be in part driven by chromosomal cis mechanisms

  13. Frugivores bias seed-adult tree associations through nonrandom seed dispersal: a phylogenetic approach.

    Science.gov (United States)

    Razafindratsima, Onja H; Dunham, Amy E

    2016-08-01

    Frugivores are the main seed dispersers in many ecosystems, such that behaviorally driven, nonrandom patterns of seed dispersal are a common process; but patterns are poorly understood. Characterizing these patterns may be essential for understanding spatial organization of fruiting trees and drivers of seed-dispersal limitation in biodiverse forests. To address this, we studied resulting spatial associations between dispersed seeds and adult tree neighbors in a diverse rainforest in Madagascar, using a temporal and phylogenetic approach. Data show that by using fruiting trees as seed-dispersal foci, frugivores bias seed dispersal under conspecific adults and under heterospecific trees that share dispersers and fruiting time with the dispersed species. Frugivore-mediated seed dispersal also resulted in nonrandom phylogenetic associations of dispersed seeds with their nearest adult neighbors, in nine out of the 16 months of our study. However, these nonrandom phylogenetic associations fluctuated unpredictably over time, ranging from clustered to overdispersed. The spatial and phylogenetic template of seed dispersal did not translate to similar patterns of association in adult tree neighborhoods, suggesting the importance of post-dispersal processes in structuring plant communities. Results suggest that frugivore-mediated seed dispersal is important for structuring early stages of plant-plant associations, setting the template for post-dispersal processes that influence ultimate patterns of plant recruitment. Importantly, if biased patterns of dispersal are common in other systems, frugivores may promote tree coexistence in biodiverse forests by limiting the frequency and diversity of heterospecific interactions of seeds they disperse. © 2016 by the Ecological Society of America.

  14. Osteitis: a retrospective feasibility study comparing single-source dual-energy CT to MRI in selected patients with suspected acute gout

    Energy Technology Data Exchange (ETDEWEB)

    Diekhoff, Torsten [Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Department of Radiology (CCM), Berlin (Germany); Scheel, Michael; Hamm, Bernd; Hermann, Kay-Geert A. [Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Berlin (Germany); Hermann, Sandra [Charite - Universitaetsmedizin Berlin Campus Mitte, Department of Rheumatology and Clinical Immunology, Berlin (Germany); Mews, Juergen [Toshiba Medical Systems Europe, BV, Zoetermeer (Netherlands)

    2017-02-15

    Dual-energy computed tomography detects tophi in patients with chronic gout. However, other information that can be obtained from the same scan is not the focus of the current research, e.g., the detection of bone marrow edema (BME) using virtual bone marrow imaging (VBMI). The aim of this study was to evaluate if BME in patients with acute arthritis can be detected with VBMI using magnetic resonance imaging (MRI) as the standard of reference. This retrospective study included 11 patients who underwent both MRI and dual-energy computed tomography (mean interval of 40 days). BME in MRI (standard of reference) and VBMI was judged independently by two different blinded readers. φ-correlation coefficient and Cohen's κ were performed for statistical analysis. Approval was waived by the IRB. Two patients with a final diagnosis of RA and one with septic arthritis showed osteitis on MRI and VBMI. However, in each case, there were individual bones identified with osteitis on MRI but not VBMI. Three additional patients with the final diagnosis of RA were identified correctly as negative for BME. There was a good correlation between both modalities (φ = 0.8; κ = 0.8). Inter-rater reliability was excellent for both modalities (κ = 0.9). We have shown that detecting osteitis using VBMI is feasible in patients with inflammatory arthritis. Further studies are needed on larger, more-targeted populations to better define the indications, accuracy, and added value of this technique. (orig.)

  15. Osteitis: a retrospective feasibility study comparing single-source dual-energy CT to MRI in selected patients with suspected acute gout

    International Nuclear Information System (INIS)

    Diekhoff, Torsten; Scheel, Michael; Hamm, Bernd; Hermann, Kay-Geert A.; Hermann, Sandra; Mews, Juergen

    2017-01-01

    Dual-energy computed tomography detects tophi in patients with chronic gout. However, other information that can be obtained from the same scan is not the focus of the current research, e.g., the detection of bone marrow edema (BME) using virtual bone marrow imaging (VBMI). The aim of this study was to evaluate if BME in patients with acute arthritis can be detected with VBMI using magnetic resonance imaging (MRI) as the standard of reference. This retrospective study included 11 patients who underwent both MRI and dual-energy computed tomography (mean interval of 40 days). BME in MRI (standard of reference) and VBMI was judged independently by two different blinded readers. φ-correlation coefficient and Cohen's κ were performed for statistical analysis. Approval was waived by the IRB. Two patients with a final diagnosis of RA and one with septic arthritis showed osteitis on MRI and VBMI. However, in each case, there were individual bones identified with osteitis on MRI but not VBMI. Three additional patients with the final diagnosis of RA were identified correctly as negative for BME. There was a good correlation between both modalities (φ = 0.8; κ = 0.8). Inter-rater reliability was excellent for both modalities (κ = 0.9). We have shown that detecting osteitis using VBMI is feasible in patients with inflammatory arthritis. Further studies are needed on larger, more-targeted populations to better define the indications, accuracy, and added value of this technique. (orig.)

  16. Reassessing the forest impacts of protection: the challenge of nonrandom location and a corrective method.

    Science.gov (United States)

    Joppa, Lucas; Pfaff, Alexander

    2010-01-01

    Protected areas are leading tools in efforts to slow global species loss and appear also to have a role in climate change policy. Understanding their impacts on deforestation informs environmental policies. We review several approaches to evaluating protection's impact on deforestation, given three hurdles to empirical evaluation, and note that "matching" techniques from economic impact evaluation address those hurdles. The central hurdle derives from the fact that protected areas are distributed nonrandomly across landscapes. Nonrandom location can be intentional, and for good reasons, including biological and political ones. Yet even so, when protected areas are biased in their locations toward less-threatened areas, many methods for impact evaluation will overestimate protection's effect. The use of matching techniques allows one to control for known landscape biases when inferring the impact of protection. Applications of matching have revealed considerably lower impact estimates of forest protection than produced by other methods. A reduction in the estimated impact from existing parks does not suggest, however, that protection is unable to lower clearing. Rather, it indicates the importance of variation across locations in how much impact protection could possibly have on rates of deforestation. Matching, then, bundles improved estimates of the average impact of protection with guidance on where new parks' impacts will be highest. While many factors will determine where new protected areas will be sited in the future, we claim that the variation across space in protection's impact on deforestation rates should inform site choice.

  17. Statistical method on nonrandom clustering with application to somatic mutations in cancer

    Directory of Open Access Journals (Sweden)

    Rejto Paul A

    2010-01-01

    Full Text Available Abstract Background Human cancer is caused by the accumulation of tumor-specific mutations in oncogenes and tumor suppressors that confer a selective growth advantage to cells. As a consequence of genomic instability and high levels of proliferation, many passenger mutations that do not contribute to the cancer phenotype arise alongside mutations that drive oncogenesis. While several approaches have been developed to separate driver mutations from passengers, few approaches can specifically identify activating driver mutations in oncogenes, which are more amenable for pharmacological intervention. Results We propose a new statistical method for detecting activating mutations in cancer by identifying nonrandom clusters of amino acid mutations in protein sequences. A probability model is derived using order statistics assuming that the location of amino acid mutations on a protein follows a uniform distribution. Our statistical measure is the differences between pair-wise order statistics, which is equivalent to the size of an amino acid mutation cluster, and the probabilities are derived from exact and approximate distributions of the statistical measure. Using data in the Catalog of Somatic Mutations in Cancer (COSMIC database, we have demonstrated that our method detects well-known clusters of activating mutations in KRAS, BRAF, PI3K, and β-catenin. The method can also identify new cancer targets as well as gain-of-function mutations in tumor suppressors. Conclusions Our proposed method is useful to discover activating driver mutations in cancer by identifying nonrandom clusters of somatic amino acid mutations in protein sequences.

  18. Randomly and Non-Randomly Missing Renal Function Data in the Strong Heart Study: A Comparison of Imputation Methods.

    Directory of Open Access Journals (Sweden)

    Nawar Shara

    Full Text Available Kidney and cardiovascular disease are widespread among populations with high prevalence of diabetes, such as American Indians participating in the Strong Heart Study (SHS. Studying these conditions simultaneously in longitudinal studies is challenging, because the morbidity and mortality associated with these diseases result in missing data, and these data are likely not missing at random. When such data are merely excluded, study findings may be compromised. In this article, a subset of 2264 participants with complete renal function data from Strong Heart Exams 1 (1989-1991, 2 (1993-1995, and 3 (1998-1999 was used to examine the performance of five methods used to impute missing data: listwise deletion, mean of serial measures, adjacent value, multiple imputation, and pattern-mixture. Three missing at random models and one non-missing at random model were used to compare the performance of the imputation techniques on randomly and non-randomly missing data. The pattern-mixture method was found to perform best for imputing renal function data that were not missing at random. Determining whether data are missing at random or not can help in choosing the imputation method that will provide the most accurate results.

  19. Promoting motor skills in low-income, ethnic children: The Physical Activity in Linguistically Diverse Communities (PALDC) nonrandomized trial.

    Science.gov (United States)

    Okely, Anthony D; Hardy, Louise L; Batterham, Marijka; Pearson, Phillip; McKeen, Kim; Puglisi, Lauren

    2017-11-01

    This study reports the long-term effects of a professional learning program for classroom teachers on fundamental motor skill (FMS) proficiency of primary school students from ethnically diverse backgrounds. A cluster non-randomized trial using a nested cross-sectional design. The study was conducted in 8 primary schools located in disadvantaged and culturally diverse areas in Sydney, Australia. The intervention used an action learning framework, with each school developing and implementing an action plan for enhancing the teaching of FMS in their school. School teams comprised 4-5 teachers and were supported by a member of the research team. The primary outcome was total proficiency score for 7 FMS (run, jump, catch, throw, kick, leap, side gallop). Outcome data were analyzed using mixed effects models. Eight-hundred and sixty-two students (82% response rate) were assessed at baseline in 2006 and 830 (82%) at follow-up in 2010. Compared with students in the control schools, there was a significantly greater increase in total motor skill proficiency among children in the intervention schools at follow-up (adjusted difference=5.2 components, 95%CI [1.65, 8.75]; p=0.01) and in four of the seven motor skills. Training classroom teachers to develop and implement units of work based around individual FMS is a promising strategy for increasing FMS among ethnically diverse children over an extended period of time. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Lateral cephalometric analysis for treatment planning in orthodontics based on MRI compared with radiographs: A feasibility study in children and adolescents.

    Science.gov (United States)

    Heil, Alexander; Lazo Gonzalez, Eduardo; Hilgenfeld, Tim; Kickingereder, Philipp; Bendszus, Martin; Heiland, Sabine; Ozga, Ann-Kathrin; Sommer, Andreas; Lux, Christopher J; Zingler, Sebastian

    2017-01-01

    The objective of this prospective study was to evaluate whether magnetic resonance imaging (MRI) is equivalent to lateral cephalometric radiographs (LCR, "gold standard") in cephalometric analysis. The applied MRI technique was optimized for short scanning time, high resolution, high contrast and geometric accuracy. Prior to orthodontic treatment, 20 patients (mean age ± SD, 13.95 years ± 5.34) received MRI and LCR. MRI datasets were postprocessed into lateral cephalograms. Cephalometric analysis was performed twice by two independent observers for both modalities with an interval of 4 weeks. Eight bilateral and 10 midsagittal landmarks were identified, and 24 widely used measurements (14 angles, 10 distances) were calculated. Statistical analysis was performed by using intraclass correlation coefficient (ICC), Bland-Altman analysis and two one-sided tests (TOST) within the predefined equivalence margin of ± 2°/mm. Geometric accuracy of the MRI technique was confirmed by phantom measurements. Mean intraobserver ICC were 0.977/0.975 for MRI and 0.975/0.961 for LCR. Average interobserver ICC were 0.980 for MRI and 0.929 for LCR. Bland-Altman analysis showed high levels of agreement between the two modalities, bias range (mean ± SD) was -0.66 to 0.61 mm (0.06 ± 0.44) for distances and -1.33 to 1.14° (0.06 ± 0.71) for angles. Except for the interincisal angle (p = 0.17) all measurements were statistically equivalent (p feasibility of orthodontic treatment planning without radiation exposure based on MRI. High-resolution isotropic MRI datasets can be transformed into lateral cephalograms allowing reliable measurements as applied in orthodontic routine with high concordance to the corresponding measurements on LCR.

  1. Application of a nonrandomized stepped wedge design to evaluate an evidence-based quality improvement intervention: a proof of concept using simulated data on patient-centered medical homes.

    Science.gov (United States)

    Huynh, Alexis K; Lee, Martin L; Farmer, Melissa M; Rubenstein, Lisa V

    2016-10-21

    Stepped wedge designs have gained recognition as a method for rigorously assessing implementation of evidence-based quality improvement interventions (QIIs) across multiple healthcare sites. In theory, this design uses random assignment of sites to successive QII implementation start dates based on a timeline determined by evaluators. However, in practice, QII timing is often controlled more by site readiness. We propose an alternate version of the stepped wedge design that does not assume the randomized timing of implementation while retaining the method's analytic advantages and applying to a broader set of evaluations. To test the feasibility of a nonrandomized stepped wedge design, we developed simulated data on patient care experiences and on QII implementation that had the structures and features of the expected data from a planned QII. We then applied the design in anticipation of performing an actual QII evaluation. We used simulated data on 108,000 patients to model nonrandomized stepped wedge results from QII implementation across nine primary care sites over 12 quarters. The outcome we simulated was change in a single self-administered question on access to care used by Veterans Health Administration (VA), based in the United States, as part of its quarterly patient ratings of quality of care. Our main predictors were QII exposure and time. Based on study hypotheses, we assigned values of 4 to 11 % for improvement in access when sites were first exposed to implementation and 1 to 3 % improvement in each ensuing time period thereafter when sites continued with implementation. We included site-level (practice size) and respondent-level (gender, race/ethnicity) characteristics that might account for nonrandomized timing in site implementation of the QII. We analyzed the resulting data as a repeated cross-sectional model using HLM 7 with a three-level hierarchical data structure and an ordinal outcome. Levels in the data structure included patient ratings

  2. Non-random intrachromosomal distribution of radiation-induced chromatid aberrations in Vicia faba. [Aberration clustering

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, I; Rieger, R [Akademie der Wissenschaften der DDR, Gatersleben. Zentralinst. fuer Genetik und Kulturpflanzenforschung

    1976-04-01

    A reconstructed karyotype of Vicia faba, with all chromosomes individually distinguishable, was treated with X-rays, fast neutrons, (/sup 3/H) uridine (/sup 3/HU). The distribution within metaphase chromosomes of induced chromatid aberrations was non-random for all agents used. Aberration clustering, in part agent specific, occurred in chromosome segments containing heterochromatin as defined by the presence of G bands. The pattern of aberration clustering found after treatment with /sup 3/HU did not allow the recognition of chromosome regions active in transcription during treatment. Furthermore, it was impossible to obtain unambiguous indications of the presence of AT- and GC-base clusters from the patterns of /sup 3/HT- and /sup 3/HC-induced chromatid aberrations, respectively. Possible reasons underlying these observations are discussed.

  3. GreenLight laser vs diode laser vaporization of the prostate: 3-year results of a prospective nonrandomized study.

    Science.gov (United States)

    Guo, Sanwei; Müller, Georg; Bonkat, Gernot; Püschel, Heike; Gasser, Thomas; Bachmann, Alexander; Rieken, Malte

    2015-04-01

    Laser vaporization of the prostate is one of the alternatives to transurethral resection of the prostate. Short-term studies report a comparable outcome after laser vaporization with the 532 nm 120-W GreenLight high-performance system (HPS) laser and the 980 nm 200 W high-intensity diode (diode) laser. In this study, we analyzed the intermediate-term results of both techniques. From January 2007 to January 2008, 112 consecutive patients with symptomatic benign prostate enlargement were nonrandomly assigned to treatment with the GreenLight laser or the diode laser. Perioperative parameters, postoperative functional outcome, complications, and the reoperation rate at 3 years were analyzed. Improvement of voiding symptoms (International Prostate Symptom Score, quality-of-life) and micturition parameters (maximum flow rate, postvoid residual volume) showed no significant difference between the HPS group and the diode group. A significantly higher reoperation rate was observed in the diode group in comparison to the HPS group (37.5% vs 8.9%, p=0.0003) due to obstructive necrotic tissue (16.1% vs 0%, p=0.0018), bladder neck stricture (16.1% vs 1.8%, p=0.008), and persisting or recurrent adenoma (5.4% vs 7.1%, p=0.70), respectively. Both lasers lead to comparable improvement of voiding parameters and micturition symptoms. Treatment with the 200 W diode laser led to a significantly higher reoperation rate, which might be attributed to a higher degree of coagulation necrosis. Thus, a careful clinical application of this diode laser type is warranted.

  4. Comparative Evaluation of Phase 1 Results from the Energy Conversion Alternatives Study (ECAS). [coal utilization for electric power plants feasibility analysis

    Science.gov (United States)

    1976-01-01

    Ten advanced energy conversion systems for central-station, based-load electric power generation using coal and coal-derived fuels which were studied by NASA are presented. Various contractors were selected by competitive bidding to study these systems. A comparative evaluation is provided of the contractor results on both a system-by-system and an overall basis. Ground rules specified by NASA, such as coal specifications, fuel costs, labor costs, method of cost comparison, escalation and interest during construction, fixed charges, emission standards, and environmental conditions, are presented. Each system discussion includes the potential advantages of the system, the scope of each contractor's analysis, typical schematics of systems, comparison of cost of electricity and efficiency for each contractor, identification and reconciliation of differences, identification of future improvements, and discussion of outside comments. Considerations common to all systems, such as materials and furnaces, are also discussed. Results of selected in-house analyses are presented, in addition to contractor data. The results for all systems are then compared.

  5. The HAQ compared with the MDHAQ: "keep it simple, stupid" (KISS), with feasibility and clinical value as primary criteria for patient questionnaires in usual clinical care.

    Science.gov (United States)

    Pincus, Theodore; Swearingen, Christopher J

    2009-11-01

    The health assessment questionnaire (HAQ) is the questionnaire most widely used to assess and monitor patients with rheumatic diseases. The HAQ includes 20 activities grouped into 8 categories of 2 or 3 (and queries the use of "aids and devices" and "help from another person" to perform these activities), and visual analog scales (VAS) for pain and patient global estimate of status. Use of the HAQ in usual care over the years has led to several modifications to develop a multidimensional HAQ (MDHAQ). The MDHAQ includes 10 activities, one from each category of the HAQ plus 2 complex activities-walk 2 miles or 3 km-all on one side of a page for easy "eyeball" review by a clinician; pain, global and fatigue VAS with 21 circles rather than 10-cm lines for ease of scoring; recent medical history; review of systems; a query about exercise; and scoring templates for the 3 rheumatoid arthritis (RA) Core Data Set patient-reported measures-physical function, pain, and global estimate-for a routine assessment of patient index data (RAPID3) composite score. Both the HAQ and MDHAQ involve 2 sides of one sheet of paper, and are completed by patients in 5 to 10 minutes. The HAQ requires 42 seconds to score, compared with 5 to 10 seconds for RAPID3 on the MDHAQ.

  6. Feasibility of deep-inspiration breath-hold PET/CT with short-time acquisition. Detectability for pulmonary lesions compared with respiratory-gated PET/CT

    International Nuclear Information System (INIS)

    Yamashita, Shozo; Yamamoto, Haruki; Hiko, Shigeaki; Horita, Akihiro; Yokoyama, Kunihiko; Onoguchi, Masahisa; Nakajima, Kenichi

    2014-01-01

    Deep-inspiration breath-hold (DIBH) positron emission tomography (PET)/CT with short-time acquisition and respiratory-gated (RG) PET/CT are performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used. (author)

  7. Accuracy and feasibility of frameless stereotactic and robot-assisted CT-based puncture in interventional radiology. A comparative phantom study

    International Nuclear Information System (INIS)

    Stoffner, R.; Widmann, G.; Bale, R.; Augschoell, C.; Boehler, D.

    2009-01-01

    Purpose: To compare the accuracy of frameless stereotactic and robot-assisted puncture in vitro based on computed tomography (CT) imaging with a slice thickness of 1, 3, and 5 mm. Materials and Methods: 300 punctures were carried out with help of the Atlas aiming device guided by the optical navigation system Stealth Station TREONplus and 150 punctures were guided by the robotic assistance system Innomotion. Conically shaped rods were punctured with Kirschner wires. The accuracy was evaluated on the basis of control CTs by measuring the Euclidean distance between the wire tip and target and the normal distance between the target and wire. Results: With the Stealth Station a mean Euclidean distance of 1.94±0.912, 2.2±1.136, and 2.74±1.166 mm at a slice thickness of 1, 3 and 5 mm, respectively, was reached. The mean normal distance was 1.64±0.919, 1.84±1.189, and 2.48±1.196 mm, respectively. The Innomotion system resulted in a mean Euclidean distance of 1.69±0.772, 1.91±0.673, and 2.30±0.881 mm, respectively, while the mean normal distance was (1.42±0.78), 1.60±0.733, and 1.98±1.002 mm, respectively. A statistical significance between accuracies with both systems with 1 mm and 3 mm slices could not be detected (p > 0.05). At a slice thickness of 5 mm, the robot was significantly more accurate, but not as accurate as when using thinner slices (p < 0.05). The procedure time is longer for the Innomotion system (∝30 vs. ∝18 min), and the practicability is higher with the Stealth Station. (orig.)

  8. Comparative study of Contour Transtar and STARR procedure for the treatment of obstructed defecation syndrome (ODS)--feasibility, morbidity and early functional results.

    Science.gov (United States)

    Isbert, C; Reibetanz, J; Jayne, D G; Kim, M; Germer, C-T; Boenicke, L

    2010-09-01

    Stapled transanal rectal resection (STARR) is a promising new treatment for obstructed defecation syndrome (ODS). It may be performed using either a double-stapling technique (PPH-STARR) or with the new Contour Transtar (CT) device. The aim of this study was to evaluate the two techniques with respect to morbidity and functional outcomes. Patients presenting with ODS were evaluated using standardized clinical and radiological investigations and prospectively entered into a database. A total of 150 Patients were treated with either PPH-STARR (n = 68) or CT (n = 82) and further evaluated at 12 month postoperatively. The mean size of the resected specimen was 27 cm(2) (SD +/-4.86 cm(2)) in the PPH-STARR group and 46 cm(2) (SD +/-10.6 cm(2)) in the CT group [P < 0.001]. Morbidity was 7.3% (n = 5) in the PPH-STARR group and 7.5% (n = 6) in the CT group. The most common complication was minor postoperative bleeding in both groups (PPH-STARR: n = 2, 2.9%; CT: n = 2, 2.4%) Overall there were no septic complications and no surgical re-interventions. There was a tendency for more postoperative pain following CT (n = 3, 3.6%) as compared with PPH-STARR (n = 1, 1.4%). Constipation Scores (CCS) were 15.50 +/- 5.71 in the PPH-STARR group and 15.70 +/- 5.84 in the CT group preoperatively and decreased significantly to 8.25 (SD +/-1.45) and 8.01 (SD +/-2.31) 12-months after surgery. Values did not differ significantly between the two groups. Contour Transtar is as safe and effective as PPH-STARR and provides a true circumferential resection of rectal intussusception. This may benefit selected patients and result in improved long-term durability of the technique.

  9. Telomere disruption results in non-random formation of de novo dicentric chromosomes involving acrocentric human chromosomes.

    Directory of Open Access Journals (Sweden)

    Kaitlin M Stimpson

    2010-08-01

    Full Text Available Genome rearrangement often produces chromosomes with two centromeres (dicentrics that are inherently unstable because of bridge formation and breakage during cell division. However, mammalian dicentrics, and particularly those in humans, can be quite stable, usually because one centromere is functionally silenced. Molecular mechanisms of centromere inactivation are poorly understood since there are few systems to experimentally create dicentric human chromosomes. Here, we describe a human cell culture model that enriches for de novo dicentrics. We demonstrate that transient disruption of human telomere structure non-randomly produces dicentric fusions involving acrocentric chromosomes. The induced dicentrics vary in structure near fusion breakpoints and like naturally-occurring dicentrics, exhibit various inter-centromeric distances. Many functional dicentrics persist for months after formation. Even those with distantly spaced centromeres remain functionally dicentric for 20 cell generations. Other dicentrics within the population reflect centromere inactivation. In some cases, centromere inactivation occurs by an apparently epigenetic mechanism. In other dicentrics, the size of the alpha-satellite DNA array associated with CENP-A is reduced compared to the same array before dicentric formation. Extra-chromosomal fragments that contained CENP-A often appear in the same cells as dicentrics. Some of these fragments are derived from the same alpha-satellite DNA array as inactivated centromeres. Our results indicate that dicentric human chromosomes undergo alternative fates after formation. Many retain two active centromeres and are stable through multiple cell divisions. Others undergo centromere inactivation. This event occurs within a broad temporal window and can involve deletion of chromatin that marks the locus as a site for CENP-A maintenance/replenishment.

  10. The feasibility of 11C-methionine-PET in diagnosis of solitary lung nodules/masses when compared with 18F-FDG-PET

    International Nuclear Information System (INIS)

    Hsieh Hungjen; Lin Shenghsiang; Lin Kohan; Lee Chienying; Chang Chengpei; Wang Shyhjen

    2008-01-01

    The objective of this study was to differentiate between benign and malignant lesions of the lung, 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) has limitations such as a lower specificity in cases of non-specific inflammation. The positive predictive value is unsatisfactory in countries where inflammatory lung disorders are prevalent. We present the preliminary results of the usefulness of combining 11 C-methionine-PET and 18 F-FDG-PET in this context. Fifteen patients with indeterminate solitary pulmonary nodules/masses (10 men, 5 women; average age 64.7±14.0 years, ranging from 25 to 87 years) were studied using 11 C-methionine- and 18 F-FDG-PET. Interpretations were primarily made on visual analysis with five-point scale and a consensus of two nuclear medicine physicians, using standardized uptake value as an accessory reference. Foci of abnormal radiotracer uptake were subsequently correlated with clinical follow-up, imaging modalities such as chest radiography, chest computed tomography (CT), serial PET studies, and pathology results from bronchoscopic biopsy and/or surgical specimen. Diagnoses were established in 14 patients. The 11 C-methionine-PET and 18 F-FDG-PET studies were both true positive in two cases of adenocarcinoma and true negative in two cases of clinical benign nodules. In one case of lymphoid hyperplasia both 11 C-methionine-PET and 18 F-FDG-PET showed false-positive findings. Discordant results were obtained in nine cases. In spite of the false-positive results of 18 F-FDG-PET, 11 C-methionine-PET was true negative in four cases with chronic inflammatory nodules and three cases of pulmonary tuberculosis. Furthermore, 11 C-methionine-PET was true positive in one case of lung metastasis of thyroid cancer, and in another with recurrence of gastric cancer, respectively, for which 18 F-FDG-PET imaging was false negative. Our experience indicates that 11 C-methionine-PET seems more specific and sensitive when compared with

  11. Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Violante Francesco S

    2010-12-01

    Full Text Available Abstract Background The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR program as compared to a Stabilization Exercise (SE program in subjects with persistent low back pain (LBP at short- and mid-term follow-up (ie. 3 and 6 months. Methods According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ and Oswestry Disability Index (ODI. Secondary outcome measures were lumbar Visual Analogue Scale (VAS and Fingertip-to-floor test (FFT. Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7. Conclusions Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. Trial

  12. Non-random alkylation of DNA sequences induced in vivo by chemical mutagens

    Energy Technology Data Exchange (ETDEWEB)

    Durante, M.; Geri, C.; Bonatti, S.; Parenti, R. (Universita di Pisa (Italy))

    1989-08-01

    Previous studies of the interaction of alkylating agents on the eukaryotic genome support the idea that induction of DNA adducts is at specific genomic sites. Here we show molecular and cytological evidence that alkylation is rather specific. Mammalian cell cultures were exposed to different doses of mutagens and the DNA was analyzed by density gradient ultracentrifugation, hydroxylapatite fractionation, and by restriction enzyme analysis. Studies with the labelled mutagens N-ethyl-N-nitrosourea and N-methyl-N'-nitro-N-nitrosoguanidine show that there is a non-random distribution of the adducts. The adducts are found more frequently in A-T, G-C rich satellite DNA and highly repetitive sequences. Analysis with restriction enzymes shows that both methyl and ethyl groups influence the restriction patterns of the enzymes HpaII and MspI that recognize specific endogenous DNA methylation. These data suggest, as a subsequent mechanism, a modification in the pattern of the normal endogenous methylation of 5-methylcytosine.

  13. Translocation 1;7 in dyshematopoiesis: possibly induced with a nonrandom geographic distribution

    International Nuclear Information System (INIS)

    Scheres, J.M.; Hustinx, T.W.; Holdrinet, R.S.; Geraedts, J.P.; Hagemeijer, A.; van der Blij-Philipsen, M.

    1984-01-01

    Eight patients with various hematologic disorders had an identical chromosomal aberration in their bone marrow or unstimulated peripheral blood, a translocation t(1;7) interpreted as t(1;7)(p11;p11). The translocation chromosome replaced one normal chromosome number7; therefore, the karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Including four cases from the literature, a total of 12 patients (4 women, 8 men) with this translocation are known at the moment. The translocation does not seem to be associated with a specific disorder, but almost all patients had a preleukemic syndrome during some stage of their disease. It is very remarkable that 11 of the 12 patients lived in the Netherlands, and 7 patients had a history of iatrogenic exposure to alkylating agents or irradiation; one patient was a radiation worker and another one had a history of toxic exposure to chloramphenicol. It is suggested, therefore, that the t(1;7) is a possibly induced chromosomal aberration with a clearly nonrandom geographic distribution

  14. Random and non-random mating populations: Evolutionary dynamics in meiotic drive.

    Science.gov (United States)

    Sarkar, Bijan

    2016-01-01

    Game theoretic tools are utilized to analyze a one-locus continuous selection model of sex-specific meiotic drive by considering nonequivalence of the viabilities of reciprocal heterozygotes that might be noticed at an imprinted locus. The model draws attention to the role of viability selections of different types to examine the stable nature of polymorphic equilibrium. A bridge between population genetics and evolutionary game theory has been built up by applying the concept of the Fundamental Theorem of Natural Selection. In addition to pointing out the influences of male and female segregation ratios on selection, configuration structure reveals some noted results, e.g., Hardy-Weinberg frequencies hold in replicator dynamics, occurrence of faster evolution at the maximized variance fitness, existence of mixed Evolutionarily Stable Strategy (ESS) in asymmetric games, the tending evolution to follow not only a 1:1 sex ratio but also a 1:1 different alleles ratio at particular gene locus. Through construction of replicator dynamics in the group selection framework, our selection model introduces a redefining bases of game theory to incorporate non-random mating where a mating parameter associated with population structure is dependent on the social structure. Also, the model exposes the fact that the number of polymorphic equilibria will depend on the algebraic expression of population structure. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Offender and offense characteristics of a nonrandom sample of mass murderers.

    Science.gov (United States)

    Hempel, A G; Meloy, J R; Richards, T C

    1999-01-01

    A nonrandom sample (N = 30) of mass murderers in the United States and Canada during the past 50 years was studied. Data suggest that such individuals are single or divorced males in their fourth decade of life with various Axis I paranoid and/or depressive conditions and Axis II personality traits and disorders, usually Clusters A and B. The mass murder is precipitated by a major loss related to employment or relationship. A warrior mentality suffuses the planning and attack behavior of the subject, and greater deaths and higher casualty rates are significantly more likely if the perpetrator is psychotic at the time of the offense. Alcohol plays a very minor role. A large proportion of subjects will convey their central motivation in a psychological abstract, a phrase or sentence yelled with great emotion at the beginning of the mass murder; but in our study sample, only 20 percent directly threatened their victims before the offense. Death by suicide or at the hands of others is the usual outcome for the mass murderer.

  16. Offender and offense characteristics of a nonrandom sample of adolescent mass murderers.

    Science.gov (United States)

    Meloy, J R; Hempel, A G; Mohandie, K; Shiva, A A; Gray, B T

    2001-06-01

    The authors conducted a descriptive, archival study of adolescent (murderers-subjects who intentionally killed three or more victims in one event-to identify demographic, clinical, and forensic characteristics. A nonrandom sample of convenience of adolescent mass murderers was utilized. Thirty-four subjects, acting alone or in pairs, committed 27 mass murders between 1958 and 1999. The sample consisted of males with a median age of 17. A majority were described as "loners" and abused alcohol or drugs; almost half were bullied by others, preoccupied with violent fantasy, and violent by history. Although 23% had a documented psychiatric history, only 6% were judged to have been psychotic at the time of the mass murder. Depressive symptoms and historical antisocial behaviors were predominant. There was a precipitating event in most cases--usually a perceived failure in love or school--and most subjects made threatening statements regarding the mass murder to third parties. The majority of the sample clustered into three types: the family annihilator, the classroom avenger, and the criminal opportunist. The adolescent mass murderer is often predatorily rather than affectively violent and typically does not show any sudden or highly emotional warning signs. Although the act of mass murder is virtually impossible to predict because of its extremely low frequency, certain clinical and forensic findings can alert the clinician to the need for further, intensified primary care, including family, school, community, law enforcement, and mental health intervention.

  17. Selecting for extinction: nonrandom disease-associated extinction homogenizes amphibian biotas.

    Science.gov (United States)

    Smith, Kevin G; Lips, Karen R; Chase, Jonathan M

    2009-10-01

    Studying the patterns in which local extinctions occur is critical to understanding how extinctions affect biodiversity at local, regional and global spatial scales. To understand the importance of patterns of extinction at a regional spatial scale, we use data from extirpations associated with a widespread pathogenic agent of amphibian decline, Batrachochytrium dendrobatidis (Bd) as a model system. We apply novel null model analyses to these data to determine whether recent extirpations associated with Bd have resulted in selective extinction and homogenization of diverse tropical American amphibian biotas. We find that Bd-associated extinctions in this region were nonrandom and disproportionately, but not exclusively, affected low-occupancy and endemic species, resulting in homogenization of the remnant amphibian fauna. The pattern of extirpations also resulted in phylogenetic homogenization at the family level and ecological homogenization of reproductive mode and habitat association. Additionally, many more species were extirpated from the region than would be expected if extirpations occurred randomly. Our results indicate that amphibian declines in this region are an extinction filter, reducing regional amphibian biodiversity to highly similar relict assemblages and ultimately causing amplified biodiversity loss at regional and global scales.

  18. Prevalence of burnout in Polish anesthesiologists and anesthetist nursing professionals: A comparative non-randomized cross-sectional study.

    Science.gov (United States)

    Misiołek, Aleksandra; Gil-Monte, Pedro R; Misiołek, Hanna

    2017-03-01

    The purpose of the study was to assess the burnout levels in nurses ( N = 161) versus physicians ( N = 373). The levels of burnout were evaluated by the Polish adaptation of the Spanish Burnout Inventory (Cronbach's alpha > .70). High burnout level was found in 18.63 percent nurses and 12.06 percent anesthesiologists, and critical level in 3.74 percent nurses and 5.90 percent anesthetists. There were statistically significant differences in Burnout global score, Enthusiasm toward the job, Psychological exhaustion, and Indolence subscales between nurses and physicians. No significant differences were found between sexes in any variable.

  19. Intramyocardial injection of autologous bone marrow-derived ex vivo expanded mesenchymal stem cells in acute myocardial infarction patients is feasible and safe up to 5 years of follow-up.

    Science.gov (United States)

    Rodrigo, Sander F; van Ramshorst, Jan; Hoogslag, Georgette E; Boden, Helèn; Velders, Matthijs A; Cannegieter, Suzanne C; Roelofs, Helene; Al Younis, Imad; Dibbets-Schneider, Petra; Fibbe, Willem E; Zwaginga, Jaap Jan; Bax, Jeroen J; Schalij, Martin J; Beeres, Saskia L; Atsma, Douwe E

    2013-10-01

    In experimental studies, mesenchymal stem cell (MSC) transplantation in acute myocardial infarction (AMI) models has been associated with enhanced neovascularization and myogenesis. Clinical data however, are scarce. Therefore, the present study evaluates the safety and feasibility of intramyocardial MSC injection in nine patients, shortly after AMI during short-term and 5-year follow-up. Periprocedural safety analysis demonstrated one transient ischemic attack. No other adverse events related to MSC treatment were observed during 5-year follow-up. Clinical events were compared to a nonrandomized control group comprising 45 matched controls. A 5-year event-free survival after MSC-treatment was comparable to controls (89 vs. 91 %, P = 0.87). Echocardiographic imaging for evaluation of left ventricular function demonstrated improvements up to 5 years after MSC treatment. These findings were not significantly different when compared to controls. The present safety and feasibility study suggest that intramyocardial injection of MSC in patients shortly after AMI is feasible and safe up to 5-year follow-up.

  20. Home-based hand rehabilitation with a robotic glove in hemiplegic patients after stroke: a pilot feasibility study.

    Science.gov (United States)

    Bernocchi, Palmira; Mulè, Chiara; Vanoglio, Fabio; Taveggia, Giovanni; Luisa, Alberto; Scalvini, Simonetta

    2018-03-01

    To evaluate the feasibility and safety of home rehabilitation of the hand using a robotic glove, and, in addition, its effectiveness, in hemiplegic patients after stroke. In this non-randomized pilot study, 21 hemiplegic stroke patients (Ashworth spasticity index ≤ 3) were prescribed, after in-hospital rehabilitation, a 2-month home-program of intensive hand training using the Gloreha Lite glove that provides computer-controlled passive mobilization of the fingers. Feasibility was measured by: number of patients who completed the home-program, minutes of exercise and number of sessions/patient performed. Safety was assessed by: hand pain with a visual analog scale (VAS), Ashworth spasticity index for finger flexors, opponents of the thumb and wrist flexors, and hand edema (circumference of forearm, wrist and fingers), measured at start (T0) and end (T1) of rehabilitation. Hand motor function (Motricity Index, MI), fine manual dexterity (Nine Hole Peg Test, NHPT) and strength (Grip test) were also measured at T0 and T1. Patients performed, over a mean period 56 (49-63) days, a total of 1699 (1353-2045) min/patient of exercise with Gloreha Lite, 5.1 (4.3-5.8) days/week. Seventeen patients (81%) completed the full program. The mean VAS score of hand pain, Ashworth spasticity index and hand edema did not change significantly at T1 compared to T0. The MI, NHPT and Grip test improved significantly (p = 0.0020, 0.0156 and 0.0024, respectively) compared to baseline. Gloreha Lite is feasible and safe for use in home rehabilitation. The efficacy data show a therapeutic effect which need to be confirmed by a randomized controlled study.

  1. Variation of mutational burden in healthy human tissues suggests non-random strand segregation and allows measuring somatic mutation rates.

    Science.gov (United States)

    Werner, Benjamin; Sottoriva, Andrea

    2018-06-01

    The immortal strand hypothesis poses that stem cells could produce differentiated progeny while conserving the original template strand, thus avoiding accumulating somatic mutations. However, quantitating the extent of non-random DNA strand segregation in human stem cells remains difficult in vivo. Here we show that the change of the mean and variance of the mutational burden with age in healthy human tissues allows estimating strand segregation probabilities and somatic mutation rates. We analysed deep sequencing data from healthy human colon, small intestine, liver, skin and brain. We found highly effective non-random DNA strand segregation in all adult tissues (mean strand segregation probability: 0.98, standard error bounds (0.97,0.99)). In contrast, non-random strand segregation efficiency is reduced to 0.87 (0.78,0.88) in neural tissue during early development, suggesting stem cell pool expansions due to symmetric self-renewal. Healthy somatic mutation rates differed across tissue types, ranging from 3.5 × 10-9/bp/division in small intestine to 1.6 × 10-7/bp/division in skin.

  2. Variation of mutational burden in healthy human tissues suggests non-random strand segregation and allows measuring somatic mutation rates.

    Directory of Open Access Journals (Sweden)

    Benjamin Werner

    2018-06-01

    Full Text Available The immortal strand hypothesis poses that stem cells could produce differentiated progeny while conserving the original template strand, thus avoiding accumulating somatic mutations. However, quantitating the extent of non-random DNA strand segregation in human stem cells remains difficult in vivo. Here we show that the change of the mean and variance of the mutational burden with age in healthy human tissues allows estimating strand segregation probabilities and somatic mutation rates. We analysed deep sequencing data from healthy human colon, small intestine, liver, skin and brain. We found highly effective non-random DNA strand segregation in all adult tissues (mean strand segregation probability: 0.98, standard error bounds (0.97,0.99. In contrast, non-random strand segregation efficiency is reduced to 0.87 (0.78,0.88 in neural tissue during early development, suggesting stem cell pool expansions due to symmetric self-renewal. Healthy somatic mutation rates differed across tissue types, ranging from 3.5 × 10-9/bp/division in small intestine to 1.6 × 10-7/bp/division in skin.

  3. Discrimination of benign and malignant lymph nodes at 7.0T compared to 1.5T magnetic resonance imaging using ultrasmall particles of iron oxide: a feasibility preclinical study.

    Science.gov (United States)

    Kinner, Sonja; Maderwald, Stefan; Albert, Juliane; Parohl, Nina; Corot, Claire; Robert, Philippe; Baba, Hideo A; Barkhausen, Jörg

    2013-12-01

    To investigate the feasibility and performance of 7T magnetic resonance imaging compared to 1.5T imaging to discriminate benign (normal and inflammatory changed) from tumor-bearing lymph nodes in rabbits using ultrasmall particles of iron oxide (USPIO)-based contrast agents. Six New Zealand White rabbits were inoculated with either complete Freund's adjuvant cell suspension (n = 3) to induce reactively enlarged lymph nodes or with VX2 tumor cells to produce metastatic lymph nodes (n = 3). Image acquisition was performed before and 24 hours after bolus injection of an USPIO contrast agent at 1.5T and afterward at 7T using T1-weighted and T2*-weighted sequences. Sensitivities, specificities, and negative and positive predictive values for the detection of lymph node metastases were calculated for both field strengths with histopathology serving as reference standard. Sizes of lymph nodes with no, inflammatory, and malignant changes were compared using a Mann-Whitney U-test. All 24 lymph nodes were detected at 1.5T as well as at 7T. At 1.5T, sensitivity amounted to 0.67, while specificity reached a value of 1. At the higher field strength (7T), imaging was able to reach sensitivity and specificity values of 1. No statistical differences were detected concerning lymph node sizes. Magnetic resonance lymphography with USPIO contrast agents allows for differentiation of normal and reactively enlarged lymph nodes compared to metastatic nodes. First experiments at 7T show promising results compared to 1.5T, which have to be evaluated in further trials. Copyright © 2013. Published by Elsevier Inc.

  4. Nonrandom γ-TuNA-dependent spatial pattern of microtubule nucleation at the Golgi.

    Science.gov (United States)

    Sanders, Anna A W M; Chang, Kevin; Zhu, Xiaodong; Thoppil, Roslin J; Holmes, William R; Kaverina, Irina

    2017-11-07

    Noncentrosomal microtubule (MT) nucleation at the Golgi generates MT network asymmetry in motile vertebrate cells. Investigating the Golgi-derived MT (GDMT) distribution, we find that MT asymmetry arises from nonrandom nucleation sites at the Golgi (hotspots). Using computational simulations, we propose two plausible mechanistic models of GDMT nucleation leading to this phenotype. In the "cooperativity" model, formation of a single GDMT promotes further nucleation at the same site. In the "heterogeneous Golgi" model, MT nucleation is dramatically up-regulated at discrete and sparse locations within the Golgi. While MT clustering in hotspots is equally well described by both models, simulating MT length distributions within the cooperativity model fits the data better. Investigating the molecular mechanism underlying hotspot formation, we have found that hotspots are significantly smaller than a Golgi subdomain positive for scaffolding protein AKAP450, which is thought to recruit GDMT nucleation factors. We have further probed potential roles of known GDMT-promoting molecules, including γ-TuRC-mediated nucleation activator (γ-TuNA) domain-containing proteins and MT stabilizer CLASPs. While both γ-TuNA inhibition and lack of CLASPs resulted in drastically decreased GDMT nucleation, computational modeling revealed that only γ-TuNA inhibition suppressed hotspot formation. We conclude that hotspots require γ-TuNA activity, which facilitates clustered GDMT nucleation at distinct Golgi sites. © 2017 Sanders et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  5. The nucleoid protein Dps binds genomic DNA of Escherichia coli in a non-random manner

    Science.gov (United States)

    Kondrashov, F. A.; Toshchakov, S. V.; Dominova, I.; Shvyreva, U. S.; Vrublevskaya, V. V.; Morenkov, O. S.; Panyukov, V. V.

    2017-01-01

    Dps is a multifunctional homododecameric protein that oxidizes Fe2+ ions accumulating them in the form of Fe2O3 within its protein cavity, interacts with DNA tightly condensing bacterial nucleoid upon starvation and performs some other functions. During the last two decades from discovery of this protein, its ferroxidase activity became rather well studied, but the mechanism of Dps interaction with DNA still remains enigmatic. The crucial role of lysine residues in the unstructured N-terminal tails led to the conventional point of view that Dps binds DNA without sequence or structural specificity. However, deletion of dps changed the profile of proteins in starved cells, SELEX screen revealed genomic regions preferentially bound in vitro and certain affinity of Dps for artificial branched molecules was detected by atomic force microscopy. Here we report a non-random distribution of Dps binding sites across the bacterial chromosome in exponentially growing cells and show their enrichment with inverted repeats prone to form secondary structures. We found that the Dps-bound regions overlap with sites occupied by other nucleoid proteins, and contain overrepresented motifs typical for their consensus sequences. Of the two types of genomic domains with extensive protein occupancy, which can be highly expressed or transcriptionally silent only those that are enriched with RNA polymerase molecules were preferentially occupied by Dps. In the dps-null mutant we, therefore, observed a differentially altered expression of several targeted genes and found suppressed transcription from the dps promoter. In most cases this can be explained by the relieved interference with Dps for nucleoid proteins exploiting sequence-specific modes of DNA binding. Thus, protecting bacterial cells from different stresses during exponential growth, Dps can modulate transcriptional integrity of the bacterial chromosome hampering RNA biosynthesis from some genes via competition with RNA polymerase

  6. Human heavy-chain variable region gene family nonrandomly rearranged in familial chronic lymphocytic leukemia

    International Nuclear Information System (INIS)

    Shen, A.; Humphries, C.; Tucker, P.; Blattner, F.

    1987-01-01

    The authors have identified a family of human immunoglobulin heavy-chain variable-region (V/sub H/) genes, one member of which is rearranged in two affected members of a family in which the father and four of five siblings developed chronic lymphocytic leukemia. Cloning and sequencing of the rearranged V/sub H/ genes from leukemic lymphocytes of three affected siblings showed that two siblings had rearranged V/sub H/ genes (V/sub H/TS1 and V/sub H/WS1) that were 90% homologous. The corresponding germ-line gene, V/sub H/251, was found to part of a small (four gene) V/sub H/ gene family, which they term V/sub H/V. The DNA sequence homology to V/sub H/WS1 (95%) and V/sub H/TS1 (88%) and identical restriction sites on the 5' side of V/sub H/ confirm that rearrangement of V/sub H/251 followed by somatic mutation produced the identical V/sub H/ gene rearrangements in the two siblings. V/sub H/TS1 is not a functional V/sub H/ gene; a functional V/sub H/ rearrangement was found on the other chromosome of this patient. The other two siblings had different V/sub H/ gene rearrangements. All used different diversity genes. Mechanisms proposed for nonrandom selection of a single V/sub H/ gene include developmental regulation of this V/sub H/ gene rearrangement or selection of a subpopulation of B cells in which this V/sub H/ has been rearranged

  7. Critical appraisal of nonrandomized studies-A review of recommended and commonly used tools.

    Science.gov (United States)

    Quigley, Joan M; Thompson, Juliette C; Halfpenny, Nicholas J; Scott, David A

    2018-02-27

    When randomized controlled trial data are limited or unavailable, or to supplement randomized controlled trial evidence, health technology assessment (HTA) agencies may rely on systematic reviews of nonrandomized studies (NRSs) for evidence of the effectiveness of health care interventions. NRS designs may introduce considerable bias into systematic reviews, and several methodologies by which to evaluate this risk of bias are available. This study aimed to identify tools commonly used to assess bias in NRS and determine those recommended by HTA bodies. Appraisal tools used in NRS were identified through a targeted search of systematic reviews (January 2013-March 2017; MEDLINE and EMBASE [OVID SP]). Recommendations for the critical appraisal of NRS by expert review groups and HTA bodies were reviewed. From the 686 studies included in the narrative synthesis, 48 critical appraisal tools were identified. Commonly used tools included the Newcastle-Ottawa Scale, the methodological index for NRS, and bespoke appraisal tools. Neither the Cochrane Handbook nor the Centre for Reviews and Dissemination recommends a particular instrument for the assessment of risk of bias in NRS, although Cochrane has recently developed their own NRS critical appraisal tool. Among HTA bodies, only the Canadian Agency for Drugs and Technologies in Health recommends use of a specific critical appraisal tool-SIGN 50 (for cohort or case-control studies). Several criteria including reporting, external validity, confounding, and power were examined. There is no consensus between HTA groups on the preferred appraisal tool. Reviewers should select from a suite of tools on the basis of the design of studies included in their review. © 2018 John Wiley & Sons, Ltd.

  8. Functional redundancy patterns reveal non-random assembly rules in a species-rich marine assemblage.

    Directory of Open Access Journals (Sweden)

    Nicolas Guillemot

    Full Text Available The relationship between species and the functional diversity of assemblages is fundamental in ecology because it contains key information on functional redundancy, and functionally redundant ecosystems are thought to be more resilient, resistant and stable. However, this relationship is poorly understood and undocumented for species-rich coastal marine ecosystems. Here, we used underwater visual censuses to examine the patterns of functional redundancy for one of the most diverse vertebrate assemblages, the coral reef fishes of New Caledonia, South Pacific. First, we found that the relationship between functional and species diversity displayed a non-asymptotic power-shaped curve, implying that rare functions and species mainly occur in highly diverse assemblages. Second, we showed that the distribution of species amongst possible functions was significantly different from a random distribution up to a threshold of ∼90 species/transect. Redundancy patterns for each function further revealed that some functions displayed fast rates of increase in redundancy at low species diversity, whereas others were only becoming redundant past a certain threshold. This suggested non-random assembly rules and the existence of some primordial functions that would need to be fulfilled in priority so that coral reef fish assemblages can gain a basic ecological structure. Last, we found little effect of habitat on the shape of the functional-species diversity relationship and on the redundancy of functions, although habitat is known to largely determine assemblage characteristics such as species composition, biomass, and abundance. Our study shows that low functional redundancy is characteristic of this highly diverse fish assemblage, and, therefore, that even species-rich ecosystems such as coral reefs may be vulnerable to the removal of a few keystone species.

  9. High-resolution characterization of sequence signatures due to non-random cleavage of cell-free DNA.

    Science.gov (United States)

    Chandrananda, Dineika; Thorne, Natalie P; Bahlo, Melanie

    2015-06-17

    High-throughput sequencing of cell-free DNA fragments found in human plasma has been used to non-invasively detect fetal aneuploidy, monitor organ transplants and investigate tumor DNA. However, many biological properties of this extracellular genetic material remain unknown. Research that further characterizes circulating DNA could substantially increase its diagnostic value by allowing the application of more sophisticated bioinformatics tools that lead to an improved signal to noise ratio in the sequencing data. In this study, we investigate various features of cell-free DNA in plasma using deep-sequencing data from two pregnant women (>70X, >50X) and compare them with matched cellular DNA. We utilize a descriptive approach to examine how the biological cleavage of cell-free DNA affects different sequence signatures such as fragment lengths, sequence motifs at fragment ends and the distribution of cleavage sites along the genome. We show that the size distributions of these cell-free DNA molecules are dependent on their autosomal and mitochondrial origin as well as the genomic location within chromosomes. DNA mapping to particular microsatellites and alpha repeat elements display unique size signatures. We show how cell-free fragments occur in clusters along the genome, localizing to nucleosomal arrays and are preferentially cleaved at linker regions by correlating the mapping locations of these fragments with ENCODE annotation of chromatin organization. Our work further demonstrates that cell-free autosomal DNA cleavage is sequence dependent. The region spanning up to 10 positions on either side of the DNA cleavage site show a consistent pattern of preference for specific nucleotides. This sequence motif is present in cleavage sites localized to nucleosomal cores and linker regions but is absent in nucleosome-free mitochondrial DNA. These background signals in cell-free DNA sequencing data stem from the non-random biological cleavage of these fragments. This

  10. A Place-Based Community Health Worker Program: Feasibility and Early Outcomes, New York City, 2015

    Science.gov (United States)

    Lopez, Priscilla M.; Islam, Nadia; Feinberg, Alexis; Myers, Christa; Seidl, Lois; Drackett, Elizabeth; Riley, Lindsey; Mata, Andrea; Pinzon, Juan; Benjamin, Elisabeth; Wyka, Katarzyna; Dannefer, Rachel; Lopez, Javier; Trinh-Shevrin, Chau; Maybank, Karen Aletha; Thorpe, Lorna E.

    2017-01-01

    Introduction This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes. Methods This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity). Results At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90%) and HA (76%). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up. Conclusions Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are

  11. The Nonrandom Distribution of Interior Landforms for 100-km Diameter Craters on Mercury Suggests Regional Variations in Near-Surface Mechanical Properties

    Science.gov (United States)

    Herrick, R. R.

    2018-05-01

    There is great diversity of appearance in the interiors of 100-km diameter craters. The spatial distribution of interior landforms is clustered and nonrandom, but does not clearly correlate with Mercury's surface geology patterns.

  12. Assessment of early treatment response to neoadjuvant chemotherapy in breast cancer using non-mono-exponential diffusion models: a feasibility study comparing the baseline and mid-treatment MRI examinations

    Energy Technology Data Exchange (ETDEWEB)

    Bedair, Reem; Manavaki, Roido; Gill, Andrew B.; Abeyakoon, Oshaani; Gilbert, Fiona J. [University of Cambridge, Department of Radiology, School of Clinical Medicine, Cambridge (United Kingdom); Priest, Andrew N.; Patterson, Andrew J. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Addenbrookes Hospital, Cambridge (United Kingdom); McLean, Mary A. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Addenbrookes Hospital, Cambridge (United Kingdom); University of Cambridge, Li Ka Shing Centre, Cancer Research UK Cambridge Institute, Cambridge (United Kingdom); Graves, Martin J. [University of Cambridge, Department of Radiology, School of Clinical Medicine, Cambridge (United Kingdom); Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Addenbrookes Hospital, Cambridge (United Kingdom); Griffiths, John R. [University of Cambridge, Li Ka Shing Centre, Cancer Research UK Cambridge Institute, Cambridge (United Kingdom)

    2017-07-15

    To assess the feasibility of the mono-exponential, bi-exponential and stretched-exponential models in evaluating response of breast tumours to neoadjuvant chemotherapy (NACT) at 3 T. Thirty-six female patients (median age 53, range 32-75 years) with invasive breast cancer undergoing NACT were enrolled for diffusion-weighted MRI (DW-MRI) prior to the start of treatment. For assessment of early response, changes in parameters were evaluated on mid-treatment MRI in 22 patients. DW-MRI was performed using eight b values (0, 30, 60, 90, 120, 300, 600, 900 s/mm{sup 2}). Apparent diffusion coefficient (ADC), tissue diffusion coefficient (D{sub t}), vascular fraction (Florin), distributed diffusion coefficient (DDC) and alpha (α) parameters were derived. Then t tests compared the baseline and changes in parameters between response groups. Repeatability was assessed at inter- and intraobserver levels. All patients underwent baseline MRI whereas 22 lesions were available at mid-treatment. At pretreatment, mean diffusion coefficients demonstrated significant differences between groups (p < 0.05). At mid-treatment, percentage increase in ADC and DDC showed significant differences between responders (49 % and 43 %) and non-responders (21 % and 32 %) (p = 0.03, p = 0.04). Overall, stretched-exponential parameters showed excellent repeatability. DW-MRI is sensitive to baseline and early treatment changes in breast cancer using non-mono-exponential models, and the stretched-exponential model can potentially monitor such changes. (orig.)

  13. Assessment of early treatment response to neoadjuvant chemotherapy in breast cancer using non-mono-exponential diffusion models: a feasibility study comparing the baseline and mid-treatment MRI examinations

    International Nuclear Information System (INIS)

    Bedair, Reem; Manavaki, Roido; Gill, Andrew B.; Abeyakoon, Oshaani; Gilbert, Fiona J.; Priest, Andrew N.; Patterson, Andrew J.; McLean, Mary A.; Graves, Martin J.; Griffiths, John R.

    2017-01-01

    To assess the feasibility of the mono-exponential, bi-exponential and stretched-exponential models in evaluating response of breast tumours to neoadjuvant chemotherapy (NACT) at 3 T. Thirty-six female patients (median age 53, range 32-75 years) with invasive breast cancer undergoing NACT were enrolled for diffusion-weighted MRI (DW-MRI) prior to the start of treatment. For assessment of early response, changes in parameters were evaluated on mid-treatment MRI in 22 patients. DW-MRI was performed using eight b values (0, 30, 60, 90, 120, 300, 600, 900 s/mm"2). Apparent diffusion coefficient (ADC), tissue diffusion coefficient (D_t), vascular fraction (Florin), distributed diffusion coefficient (DDC) and alpha (α) parameters were derived. Then t tests compared the baseline and changes in parameters between response groups. Repeatability was assessed at inter- and intraobserver levels. All patients underwent baseline MRI whereas 22 lesions were available at mid-treatment. At pretreatment, mean diffusion coefficients demonstrated significant differences between groups (p < 0.05). At mid-treatment, percentage increase in ADC and DDC showed significant differences between responders (49 % and 43 %) and non-responders (21 % and 32 %) (p = 0.03, p = 0.04). Overall, stretched-exponential parameters showed excellent repeatability. DW-MRI is sensitive to baseline and early treatment changes in breast cancer using non-mono-exponential models, and the stretched-exponential model can potentially monitor such changes. (orig.)

  14. Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care

    Directory of Open Access Journals (Sweden)

    Weiderpass Elisabete

    2008-08-01

    Full Text Available Abstract Background Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study. Methods A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1 recruitment and participation, 2 completion of data collection, 3 realization of the intervention and 4 the public health nurses' experiences. Results 1 The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrolment was 77% and the drop-out rate 15%. 2 In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3 In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4 The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study. Conclusion The study protocol was mostly feasible to implement, which

  15. A Novel Therapy for Chronic Sleep-Onset Insomnia: A Retrospective, Nonrandomized Controlled Study of Auto-Adjusting, Dual-Level, Positive Airway Pressure Technology.

    Science.gov (United States)

    Krakow, Barry; Ulibarri, Victor A; McIver, Natalia D; Nadorff, Michael R

    2016-09-29

    Evidence indicates that behavioral or drug therapy may not target underlying pathophysiologic mechanisms for chronic insomnia, possibly due to previously unrecognized high rates (30%-90%) of sleep apnea in chronic insomnia patients. Although treatment studies with positive airway pressure (PAP) demonstrate decreased severity of chronic sleep maintenance insomnia in patients with co-occurring sleep apnea, sleep-onset insomnia has not shown similar results. We hypothesized advanced PAP technology would be associated with decreased sleep-onset insomnia severity in a sample of predominantly psychiatric patients with comorbid sleep apnea. We reviewed charts of 74 severe sleep-onset insomnia patients seen from March 2011 to August 2015, all meeting American Academy of Sleep Medicine Work Group criteria for a chronic insomnia disorder and all affirming behavioral and psychological origins for insomnia (averaging 10 of 18 indicators/patient), as well as averaging 2 or more psychiatric symptoms or conditions: depression (65.2%), anxiety (41.9%), traumatic exposure (35.1%), claustrophobia (29.7%), panic attacks (28.4%), and posttraumatic stress disorder (20.3%). All patients failed continuous or bilevel PAP and were manually titrated with auto-adjusting PAP modes (auto-bilevel and adaptive-servo ventilation). At 1-year follow-up, patients were compared through nonrandom assignment on the basis of a PAP compliance metric of > 20 h/wk (56 PAP users) versus insomnia severity (Hedges' g = 1.72) and sleep-onset insomnia (g = 2.07) compared to partial users (g = 1.04 and 0.91, respectively). Both global and sleep-onset insomnia severity decreased below moderate levels in PAP users compared to partial users whose outcomes persisted at moderately severe levels. In a nonrandomized controlled retrospective study, advanced PAP technology (both auto-bilevel and adaptive servo-ventilation) were associated with large decreases in insomnia severity for sleep-onset insomnia patients who

  16. Telepsychiatry: effectiveness and feasibility

    Directory of Open Access Journals (Sweden)

    Gajaria A

    2015-04-01

    Full Text Available Amy Gajaria,1 David K Conn,1,2 Robert Madan1,2 1Department of Psychiatry, University of Toronto, Toronto, ON, Canada; 2Department of Psychiatry, Baycrest Health Sciences, Toronto, ON, Canada Abstract: Providing psychiatric services by real-time videoconferencing has been increasingly adopted as a method of reaching hard-to-serve populations since the early 1990s. As the field has expanded, a growing body of research has developed investigating both how telepsychiatry compares to in-person psychiatric care and how effectively telepsychiatry can be implemented in routine clinical care. A narrative review was performed to consider the evidence that telepsychiatry is feasible and effective across a variety of patient populations and clinical settings. There is a growing body of evidence investigating the efficacy of telepsychiatry when used for psychiatric assessment and treatment in the adult, child, and geriatric populations. Though studies vary in quality, they generally demonstrate that telepsychiatry is effective across multiple age groups and clinical settings. Telepsychiatry is generally well accepted by patients and clinicians and is feasible to implement, with the suggestion that some patients may actually prefer telepsychiatry to in-person treatment. Issues to consider in the implementation of telepsychiatry services include funding and reimbursement, medico-legal issues when provision crosses legislative boundaries, incorporation into existing health systems, and crosscultural considerations. Future directions for research and practice include a need for higher-quality efficacy studies, consideration of data security, increased attention to low- and middle-income countries, and the introduction of novel technological approaches. Keywords: efficacy, service delivery, telemental health, videoconferencing 

  17. A phase I/II, non-randomized, feasibility/safety and efficacy study of the combination of everolimus, cetuximab and capecitabine in patients with advanced pancreatic cancer

    NARCIS (Netherlands)

    Kordes, Sil; Richel, Dick J.; Klümpen, Heinz-Josef; Weterman, Mariëtte J.; Stevens, Arnoldus J. W. M.; Wilmink, Johanna W.

    2013-01-01

    Improvements in knowledge of molecular mechanisms in cancer are the basis for new studies combining chemotherapy with targeted drugs. Inhibition of the epidermal growth factor receptor (EGFR) by erlotinib or cetuximab has limited or no activity, respectively, in pancreatic cancer. The crosstalk

  18. An intervention to reduce HIV risk behavior of substance-using men who have sex with men: a two-group randomized trial with a nonrandomized third group.

    Directory of Open Access Journals (Sweden)

    Gordon Mansergh

    2010-08-01

    Full Text Available Substance use during sex is associated with sexual risk behavior among men who have sex with men (MSM, and MSM continue to be the group at highest risk for incident HIV in the United States. The objective of this study is to test the efficacy of a group-based, cognitive-behavioral intervention to reduce risk behavior of substance-using MSM, compared to a randomized attention-control group and a nonrandomized standard HIV-testing group.Participants (n = 1,686 were enrolled in Chicago, Los Angeles, New York City, and San Francisco and randomized to a cognitive-behavioral intervention or attention-control comparison. The nonrandomized group received standard HIV counseling and testing. Intervention group participants received six 2-h group sessions focused on reducing substance use and sexual risk behavior. Attention-control group participants received six 2-h group sessions of videos and discussion of MSM community issues unrelated to substance use, sexual risk, and HIV/AIDS. All three groups received HIV counseling and testing at baseline. The sample reported high-risk behavior during the past 3 mo prior to their baseline visit: 67% reported unprotected anal sex, and 77% reported substance use during their most recent anal sex encounter with a nonprimary partner. The three groups significantly (p0.05 from each other at 3-, 6-, and 12-mo follow-up. Outcomes for the 2-arm comparisons were not significantly different at 12-mo follow-up (e.g., unprotected anal sex, odds ratio = 1.14, confidence interval = 0.86-1.51, nor at earlier time points. Similar results were found for each outcome variable in both 2- and 3-arm comparisons.These results for reducing sexual risk behavior of substance-using MSM are consistent with results of intervention trials for other populations, which collectively suggest critical challenges for the field of HIV behavioral interventions. Several mechanisms may contribute to statistically indistinguishable reductions in risk

  19. p15PAF is an intrinsically disordered protein with nonrandom structural preferences at sites of interaction with other proteins.

    Science.gov (United States)

    De Biasio, Alfredo; Ibáñez de Opakua, Alain; Cordeiro, Tiago N; Villate, Maider; Merino, Nekane; Sibille, Nathalie; Lelli, Moreno; Diercks, Tammo; Bernadó, Pau; Blanco, Francisco J

    2014-02-18

    We present to our knowledge the first structural characterization of the proliferating-cell-nuclear-antigen-associated factor p15(PAF), showing that it is monomeric and intrinsically disordered in solution but has nonrandom conformational preferences at sites of protein-protein interactions. p15(PAF) is a 12 kDa nuclear protein that acts as a regulator of DNA repair during DNA replication. The p15(PAF) gene is overexpressed in several types of human cancer. The nearly complete NMR backbone assignment of p15(PAF) allowed us to measure 86 N-H(N) residual dipolar couplings. Our residual dipolar coupling analysis reveals nonrandom conformational preferences in distinct regions, including the proliferating-cell-nuclear-antigen-interacting protein motif (PIP-box) and the KEN-box (recognized by the ubiquitin ligase that targets p15(PAF) for degradation). In accordance with these findings, analysis of the (15)N R2 relaxation rates shows a relatively reduced mobility for the residues in these regions. The agreement between the experimental small angle x-ray scattering curve of p15(PAF) and that computed from a statistical coil ensemble corrected for the presence of local secondary structural elements further validates our structural model for p15(PAF). The coincidence of these transiently structured regions with protein-protein interaction and posttranslational modification sites suggests a possible role for these structures as molecular recognition elements for p15(PAF). Copyright © 2014 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  20. Discovering non-random segregation of sister chromatids: The naïve treatment of a premature discovery

    Directory of Open Access Journals (Sweden)

    Karl G. Lark

    2013-02-01

    Full Text Available The discovery of non-random chromosome segregation is discussed from the perspective of what was known in1965 and1966. The distinction between daughter, parent or grandparent strands of DNA was developed in a bacterial system and led to the discovery that multiple copies of DNA elements of bacteria are not distributed randomly with respect to the age of the template strand. Experiments with higher eukaryotic cells demonstrated that during mitosis Mendel’s laws were violated; and the initial serendipitous choice of eukaryotic cell system led to the striking example of non-random segregation of parent and grand-parent DNA template strands in primary cultures of cells derived from mouse embryos. Attempts to extrapolate these findings to established TC lines demonstrated that the property could be lost. Experiments using plant root tips demonstrated that the phenomenon exists in plants and that it was, at some level, under genetic control. Despite publication in major journals and symposia (Lark et al. (1966a; Lark (1967a; 1967b; 1969, 1969a; 1969b the potential implications of these findings were ignored for several decades. Here we explore possible reasons for the pre-maturity (Stent, 1972 of this discovery.

  1. An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy

    Directory of Open Access Journals (Sweden)

    William Eardley

    2010-04-01

    Full Text Available William Eardley, Cory TothDepartment of Clinical Neurosciences and the University of Calgary, Calgary, AB, CanadaAbstract: Although many therapies are used in the management of neuropathic pain (NeP due to polyneuropathy (PN, few comparison studies exist. We performed a prospective, non-randomized, unblended, efficacy comparison of the serotonin-norepinephrine reuptake inhibitor venlafaxine, as either monotherapy or adjuvant therapy, with a first-line medication for NeP, gabapentin, in patients with PN-related NeP. VAS pain scores were assessed after 3 and 6 months in intervention groups and in a cohort of patients receiving no pharmacotherapy. In a total of 223 patients, we analyzed pain quantity and quality (visual analogue scale [VAS] score, Brief Pain Inventory [BPI], quality of life and health status measures [EuroQol 5 Domains, EQ-5D], Medical Outcomes Sleep Study Scale [MOSSS], Hospital Anxiety and Depression Scale [HADS] and Short Form 36 Health Survey [SF-36] after 6 months of therapy. Significant improvements in VAS pain scores occurred for all treatment groups after 6 months. Improvements in aspects of daily life and anxiety were identified in all treatment groups. Our data suggest that monotherapy or adjuvant therapy with venlafaxine is comparable to gabapentin for NeP management. We advocate for head-to-head, randomized, double-blinded studies of current NeP therapies.Keywords: peripheral neuropathy, neuropathic pain, pharmacotherapy, venlafaxine, gabapentin

  2. Estimating the treatment effect from non-randomized studies: The example of reduced intensity conditioning allogeneic stem cell transplantation in hematological diseases

    Directory of Open Access Journals (Sweden)

    Resche-Rigon Matthieu

    2012-08-01

    Full Text Available Abstract Background In some clinical situations, for which RCT are rare or impossible, the majority of the evidence comes from observational studies, but standard estimations could be biased because they ignore covariates that confound treatment decisions and outcomes. Methods Three observational studies were conducted to assess the benefit of Allo-SCT in hematological malignancies of multiple myeloma, follicular lymphoma and Hodgkin’s disease. Two statistical analyses were performed: the propensity score (PS matching approach and the inverse probability weighting (IPW approach. Results Based on PS-matched samples, a survival benefit in MM patients treated by Allo-SCT, as compared to similar non-allo treated patients, was observed with an HR of death at 0.35 (95%CI: 0.14-0.88. Similar results were observed in HD, 0.23 (0.07-0.80 but not in FL, 1.28 (0.43-3.77. Estimated benefits of Allo-SCT for the original population using IPW were erased in HR for death at 0.72 (0.37-1.39 for MM patients, 0.60 (0.19-1.89 for HD patients, and 2.02 (0.88-4.66 for FL patients. Conclusion Differences in estimated benefits rely on whether the underlying population to which they apply is an ideal randomized experimental population (PS or the original population (IPW. These useful methods should be employed when assessing the effects of innovative treatment in non-randomized experiments.

  3. Laparoscopic Complete Mesocolic Excision versus Open Complete Mesocolic Excision for Transverse Colon Cancer: Long-Term Survival Results of a Prospective Single Centre Non-Randomized Study.

    Science.gov (United States)

    Storli, Kristian Eeg; Eide, Geir Egil

    2016-01-01

    Laparoscopic complete mesocolic excision (CME) used in the treatment of transverse colon cancer has been questioned on the basis of the technical challenges. The aim of this study was to evaluate the medium- and long-term clinical and survival outcomes after laparoscopic and open CME for transverse colon cancer and to compare the 2 approaches. This study was a retrospective non-randomized study of patients with prospectively registered data on open and laparoscopic CME for transverse colon cancer tumour-node-metastasis stages I-III operated on between 2007 and 2014. This was a single-centre study in a community teaching hospital. A total of 56 patients with transverse colon cancer were included, excluding those with tumours in the colonic flexures. The outcome aims were 4-year time to recurrence (TTR) and cancer-specific survival (CSS). Morbidity was also measured. The 4-year TTR was 93.9% in the laparoscopic group and 91.3% in the open group (p = 0.71). The 4-year CSS was 97.0% in the laparoscopic group and 91.3% in the open group (p = 0.42). This was a prospective single-institution study with a small sample size. Results of the study suggest that the laparoscopic CME approach might be the preferred approach for transverse colon cancer, especially regarding its benefits in terms of short-term morbidity, length of stay and oncological outcome. © 2016 S. Karger AG, Basel.

  4. Evaluation of an educational "toolbox" for improving nursing staff competence and psychosocial work environment in elderly care: results of a prospective, non-randomized controlled intervention.

    Science.gov (United States)

    Arnetz, J E; Hasson, H

    2007-07-01

    Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction. The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction. The study was a prospective, non-randomized, controlled intervention. Nursing staff in two municipal elderly care organizations in western Sweden. In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced. Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality. Compared to a reference municipality, nursing staff ratings of their competence and the

  5. Feasible Histories, Maximum Entropy

    International Nuclear Information System (INIS)

    Pitowsky, I.

    1999-01-01

    We consider the broadest possible consistency condition for a family of histories, which extends all previous proposals. A family that satisfies this condition is called feasible. On each feasible family of histories we choose a probability measure by maximizing entropy, while keeping the probabilities of commuting histories to their quantum mechanical values. This procedure is justified by the assumption that decoherence increases entropy. Finally, a criterion for identifying the nearly classical families is proposed

  6. Feasibility and safety of treating non-unions in tibia, femur and humerus with autologous, expanded, bone marrow-derived mesenchymal stromal cells associated with biphasic calcium phosphate biomaterials in a multicentric, non-comparative trial.

    Science.gov (United States)

    Gómez-Barrena, Enrique; Rosset, Philippe; Gebhard, Florian; Hernigou, Philippe; Baldini, Nicola; Rouard, Helène; Sensebé, Luc; Gonzalo-Daganzo, Rosa M; Giordano, Rosaria; Padilla-Eguiluz, Norma; García-Rey, Eduardo; Cordero-Ampuero, José; Rubio-Suárez, Juan Carlos; Stanovici, Julien; Ehrnthaller, Christian; Huber-Lang, Markus; Flouzat-Lachaniette, Charles Henri; Chevallier, Nathalie; Donati, Davide Maria; Ciapetti, Gabriela; Fleury, Sandrine; Fernandez, Manuel-Nicolás; Cabrera, José-Rafael; Avendaño-Solá, Cristina; Montemurro, Tiziana; Panaitescu, Carmen; Veronesi, Elena; Rojewski, Markus Thomas; Lotfi, Ramin; Dominici, Massimo; Schrezenmeier, Hubert; Layrolle, Pierre

    2018-03-19

    ORTHO-1 is a European, multicentric, first in human clinical trial to prove safety and feasibility after surgical implantation of commercially available biphasic calcium phosphate bioceramic granules associated during surgery with autologous mesenchymal stromal cells expanded from bone marrow (BM-hMSC) under good manufacturing practices, in patients with long bone pseudarthrosis. Twenty-eight patients with femur, tibia or humerus diaphyseal or metaphyso-diaphyseal non-unions were recruited and surgically treated in France, Germany, Italy and Spain with 100 or 200 million BM-hMSC/mL associated with 5-10 cc of bioceramic granules. Patients were followed up during one year. The investigational advanced therapy medicinal product (ATMP) was expanded under the same protocol in all four countries, and approved by each National Competent Authority. With safety as primary end-point, no severe adverse event was reported as related to the BM-hMSC. With feasibility as secondary end-point, the participating production centres manufactured the BM-hMSC as planned. The ATMP combined to the bioceramic was surgically delivered to the non-unions, and 26/28 treated patients were found radiologically healed at one year (3 out of 4 cortices with bone bridging). Safety and feasibility were clinically proven for surgical implantation of expanded autologous BM-hMSC with bioceramic. EU-FP7-HEALTH-2009, REBORNE Project (GA: 241876). Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

    Science.gov (United States)

    Logie, Carmen H; Daniel, CarolAnn; Newman, Peter A; Weaver, James; Loutfy, Mona R

    2014-01-01

    Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI) prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo) (Women Taking Action For Their Health) study examined the effectiveness of a peer health worker (PHW) delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti. This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829). Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88%) completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26), STI knowledge (β = 0.84; 95% CI 0.70-0.99), condom use (AOR = 4.05, 95% CI 1.86-8.83), and depression (β = -0.63, 95% CI -0.88--0.39) scores showed statistically significant change post-intervention (pHaiti. Pilot studies are an important approach to understand feasibility and scientific impacts of HIV prevention strategies in disaster contexts. Study results may inform HIV prevention interventions among internally displaced women in

  8. A nonrandomized controlled clinical pilot trial on 8 wk of intermittent fasting (24 h/wk).

    Science.gov (United States)

    Kessler, Christian S; Stange, Rainer; Schlenkermann, Maike; Jeitler, Michael; Michalsen, Andreas; Selle, Antonia; Raucci, Franca; Steckhan, Nico

    2018-02-01

    The aim of the study was to evaluate whether intermittent fasting (IF) is an effective preventive measure, and whether it is feasible for healthy volunteers under every day conditions. A nonrandomized controlled clinical trial on IF was performed with healthy volunteers over a period of 8 wk, and a subsequent 4-mo follow-up. Outcomes were assessed at baseline, after 8 wk, and after 6 mo. Volunteers who were not interested in fasting served as a control group. Participants in the fasting group were asked to continue their regular nutritional habits on the nonfasting days, whereas the control group maintained their habitual nutrition throughout the whole period. Outcomes included changes of metabolic parameters (insulin, glucose, insulin resistance, insulin-like growth factor-1, brain-derived neurotropic factor, lipids, liver enzymes, hemoglobin A1c) and coagulation markers; bioelectrical impedance analysis; body mass index; abdominal girth; blood pressure; general quality of life (five-item World Health Organization Well-Being Index [WHO-5] questionnaire), as well as mood and anxiety (Hospital Anxiety and Depression Scale [HADS], Profile of Mood States, Flourishing-Scale, visual analog scale, Likert scales). The intervention consisted of a fasting day, which was repeated every week for 8 wk, with abstinence from solid food between 00:00 and 23:59 at minimum and a maximum caloric intake of 300 kcal on each fasting day. A per-protocol analysis was performed. P < 0.05 was considered significant. Thirty-six volunteers were included; 22 allocated themselves to the fasting group, and 14 to the control group. Thirty-three data sets were included in the final analysis. Although significant in-group changes were observed in both groups for a number of outcomes after 8 wk and 6 mo, no significant between-group differences were observed for any outcome other than overall body fat mass after 8 wk as well as for the HADS total score and the WHO-5 total score after 6

  9. A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

    Directory of Open Access Journals (Sweden)

    Carmen H Logie

    Full Text Available Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo (Women Taking Action For Their Health study examined the effectiveness of a peer health worker (PHW delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti.This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829.Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88% completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26, STI knowledge (β = 0.84; 95% CI 0.70-0.99, condom use (AOR = 4.05, 95% CI 1.86-8.83, and depression (β = -0.63, 95% CI -0.88--0.39 scores showed statistically significant change post-intervention (p<0.05.This pilot study evaluated a PHW psycho-educational HIV/STI prevention intervention among internally displaced women in post-earthquake Haiti. Pilot studies are an important approach to understand feasibility and scientific

  10. Sucralfate gel as a radioprotector against radiation induced dermatitis in a hypo-fractionated schedule: a non-randomized study.

    Science.gov (United States)

    Kouloulias, V; Asimakopoulos, C; Tolia, M; Filippou, G; Platoni, K; Dilvoi, M; Beli, I; Georgakopoulos, J; Patatoukas, G; Kelekis, N

    2013-04-01

    External beam radiotherapy with high doses provokes many acute skin reactions, such as erythema and moist desquamation. Many topical preparations are used in radiation oncology departments in the skin care. Sucralfate humid gel, a colloidal physical form of the anti-ulcer drug sucralfate, promotes epithelial regeneration and activates cell proliferation. Based on this knowledge, we performed a non-randomized clinical trial to evaluate the efficacy of topical sucralfate gel in 30 breast cancer patients receiving postoperative accelerated hypofractionated photon beam therapy. The comparison was performed with 30 patients as historical controls. The acute reaction of the skin was significantly lower in the group receiving the sucralfate gel (p<0.05, Mann Whitney test), while 90% of the patients had no evidence of radiation induced skin toxicity. There was no sucralfate gel related toxicity reported by any patient in this study. More patients in a randomized way are needed for more definite results.

  11. Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center.

    Science.gov (United States)

    Palanivelu, C; Shetty, R; Jani, K; Sendhilkumar, K; Rajan, P S; Maheshkumar, G S

    2007-03-01

    Though laparoscopic distal pancreatectomy for benign conditions was first described in the early 1990s, it has not become as popular as other laparoscopic surgeries. Published literature on this topic consists of several case reports and a handful of small series. We present our experience, which, to the best of our knowledge, is the largest series reported to date. Since 1998, 22 patients have undergone distal pancreatectomy at our institute. The technique of distal pancreatosplenectomy, as well as spleen-preserving distal pancreatectomy, is described. Four males and 18 females in the age range of 12-69 years underwent operation. Splenic preservation was possible in 7 patients. The tumor diameter ranged from 2.1 cm to 7.4 cm. The mean operating time was 215 min. The mean length of incision required for specimen retrieval was 3.4 cm. All patients were started on a liquid diet on the first postoperative day. The median hospital stay was 4 days. One patient developed a pancreatic fistula that was managed conservatively. At the end of an average follow-up of 4.6 years, no recurrence has been reported. Laparoscopic distal pancreatectomy is a safe procedure, with minimal morbidity, rapid recovery, and short hospital stay. In appropriate cases, splenic preservation is feasible.

  12. Feasibility of Economic Analysis of Radiation Therapy Oncology Group (RTOG) 91-11 Using Medicare Data

    International Nuclear Information System (INIS)

    Konski, Andre; Bhargavan, Mythreyi; Owen, Jean; Paulus, Rebecca; Cooper, Jay; Forastiere, Arlene; Ang, K. Kian; Watkins-Bruner, Deborah

    2011-01-01

    Purpose: The specific aim of this analysis was to evaluate the feasibility of performing a cost-effectiveness analysis using Medicare data from patients treated on a randomized Phase III clinical trial. Methods and Materials: Cost data included Medicare Part A and Part B costs from all providers-inpatient, outpatient, skilled nursing facility, home health, hospice, and physicians-and were obtained from the Centers for Medicare and Medicaid Services for patients eligible for Medicare, treated on Radiation Therapy Oncology Group (RTOG) 9111 between 1992 and 1996. The 47-month expected discounted (annual discount rate of 3%) cost for each arm of the trial was calculated in 1996 dollars, with Kaplan-Meier sampling average estimates of survival probabilities for each month and mean monthly costs. Overall and disease-free survival was also discounted 3%/year. The analysis was performed from a payer's perspective. Incremental cost-effectiveness ratios were calculated comparing the chemotherapy arms to the radiation alone arm. Results: Of the 547 patients entered, Medicare cost data and clinical outcomes were available for 66 patients. Reasons for exclusion included no RTOG follow-up, Medicare HMO enrollment, no Medicare claims since trial entry, and trial entry after 1996. Differences existed between groups in tumor characteristics, toxicity, and survival, all which could affect resource utilization. Conclusions: Although we were able to test the methodology of economic analysis alongside a clinical trial using Medicare data, the results may be difficult to translate to the entire trial population because of non-random missing data. Methods to improve Medicare data capture and matching to clinical trial samples are required.

  13. Feasibility and impact study of a reward-based mobile application to improve adolescents' snacking habits.

    Science.gov (United States)

    De Cock, Nathalie; Van Lippevelde, Wendy; Vangeel, Jolien; Notebaert, Melissa; Beullens, Kathleen; Eggermont, Steven; Deforche, Benedicte; Maes, Lea; Goossens, Lien; Verbeken, Sandra; Moens, Ellen; Vervoort, Leentje; Braet, Caroline; Huybregts, Lieven; Kolsteren, Patrick; Van Camp, John; Lachat, Carl

    2018-04-02

    Adolescents' snacking habits are driven by both explicit reflective and implicit hedonic processes. Hedonic pathways and differences in sensitivity to food rewards in addition to reflective determinants should be considered. The present study evaluated the feasibility and impact of a mobile phone-delivered intervention, incorporating explicit reflective and implicit rewarding strategies, on adolescents' snack intake. Adolescents (n 988; mean age 14·9 (sd 0·70) years, 59·4 % boys) completed a non-randomized clustered controlled trial. Adolescents (n 416) in the intervention schools (n 3) were provided with the intervention application for four weeks, while adolescents (n 572) in the control schools (n 3) followed the regular curriculum. Outcomes were differences in healthy snacking ratio and key determinants (awareness, intention, attitude, self-efficacy, habits and knowledge). Process evaluation data were collected via questionnaires and through log data of the app. No significant positive intervention effects on the healthy snack ratio (b=-3·52 (se 1·82), P>0·05) or targeted determinants were observed. Only 268 adolescents started using the app, of whom only fifty-five (20·5 %) still logged in after four weeks. Within the group of users, higher exposure to the app was not significantly associated with positive intervention effects. App satisfaction ratings were low in both high and low user groups. Moderation analyses revealed small positive intervention effects on the healthy snack ratio in high compared with low reward-sensitive boys (b=1·38 (se 0·59), P<0·05). The intervention was not able to improve adolescents' snack choices, due to low reach and exposure. Future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.

  14. Feasible mathematics II

    CERN Document Server

    Remmel, Jeffrey

    1995-01-01

    Perspicuity is part of proof. If the process by means of which I get a result were not surveyable, I might indeed make a note that this number is what comes out - but what fact is this supposed to confirm for me? I don't know 'what is supposed to come out' . . . . 1 -L. Wittgenstein A feasible computation uses small resources on an abstract computa­ tion device, such as a 'lUring machine or boolean circuit. Feasible math­ ematics concerns the study of feasible computations, using combinatorics and logic, as well as the study of feasibly presented mathematical structures such as groups, algebras, and so on. This volume contains contributions to feasible mathematics in three areas: computational complexity theory, proof theory and algebra, with substantial overlap between different fields. In computational complexity theory, the polynomial time hierarchy is characterized without the introduction of runtime bounds by the closure of certain initial functions under safe composition, predicative recursion on nota...

  15. Lifetime health effects and medical costs of integrated stroke services - a non-randomized controlled cluster-trial based life table approach

    Directory of Open Access Journals (Sweden)

    Dirks Maaike

    2010-11-01

    Full Text Available Abstract Background Economic evaluation of stroke services indicates that such services may lead to improved quality of life at affordable cost. The present study assesses lifetime health impact and cost consequences of stroke in an integrated service setting. Methods The EDISSE study is a prospective non-randomized controlled cluster trial that compared stroke services (n = 151 patients to usual care (n = 187 patients. Health status and cost trial-data were entered in multi-dimensional stroke life-tables. The tables distinguish four levels of disability which are defined by the modified Rankin scale. Quality-of-life scores (EuroQoL-5D, transition and survival probabilities are based on concurrent Dutch follow-up studies. Outcomes are quality-adjusted life years lived and lifetime medical cost by disability category. An economic analysis compares outcomes from a successful stroke service to usual care, by bootstrapping individual costs and effects data from patients in each arm. Results Lifetime costs and QALYs after stroke depend on age-of-onset of first-ever stroke. Lifetime QALYs after stroke are 2.42 (90% CI - 0.49 - 2.75 for male patients in usual care and 2.75 (-0.61; 6.26 for females. Lifetime costs for men in the usual care setting are €39,335 (15,951; 79,837 and €42,944 (14,081; 95,944 for women. A comparison with the stroke service results in an ICER of €11,685 saved per QALY gained (€14,211 and €7,745 for men and women respectively. This stroke service is with 90% certainty cost-effective. Conclusions Our analysis shows the potential of large health benefits and cost savings of stroke services, taking a lifetime perspective, also in other European settings.

  16. A multicenter randomized clinical trial of etonogestrel- and levonorgestrel- contraceptive implants with nonrandomized copper-IUD controls: effect on weight variations up to three years after placement.

    Science.gov (United States)

    Bahamondes, Luis; Brache, Vivian; Ali, Moazzam; Habib, Ndema

    2018-05-16

    To evaluate weight changes in women randomized to either the etonogestrel (ENG)- or the levonorgestrel (LNG)-releasing contraceptive implants and to compare with users of the TCu380A intrauterine device (IUD). A multi-center randomized trial with 1:1 allocation ratio of the ENG- and the LNG- implants with non-randomized, age-matched control group of women choosing TCu380A IUD. The primary objective was to assess contraceptive efficacy and method continuation rates, and secondarily the incidence of common complaints and side effects (including weight changes) associated with use of the three contraceptives. All women were enrolled in nine centers at seven countries. Weight change was evaluated from time at device(s) placement. Confounders were socio-demographic, baseline weight and body mass index, center, and time from insertion. We used a linear mixed effects regression modeling with random intercept and slope. Weight was compared between the two implants groups and between the implants and the IUD-groups, through linear mixed multivariable regression model. A total of 995, 997 and 971 users in the ENG-, LNG-implant and IUD-groups respectively, were included. At 36months of use, ENG- and LNG-implants users had similar significant mean weight increase of 3.0 kg (95% CI 2.5-3.5) and 2.9 kg (95% CI 2.4-3.4), respectively (p than 50 kg. These findings must be useful for clinicians to counsel implant-users which could improve method continuation. Copyright © 2018. Published by Elsevier Inc.

  17. A prospective nonrandomized comparison of laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication in Indian population using detailed objective and subjective criteria

    Directory of Open Access Journals (Sweden)

    Pawanindra Lal

    2012-01-01

    Full Text Available Background: Laparoscopic Nissen fundoplication (LNF is a commonly performed procedure for the treatment of gastro esophageal reflux disease (GERD worldwide. However, unfavourable postoperative sequel, including gas bloat and dysphagia, has encouraged surgeons to perform alternative procedures such as laparoscopic Toupet fundoplication (LTF. This prospective nonrandomized study was designed to compare LNF with LTF in patients with GERD. Materials and Methods: Hundred and ten patients symptomatic for GERD were included in the study after having received intensive acid suppression therapy for a minimum of 8 weeks. A 24-hour pH metry was done on all patients. Fifty patients having reflux on 24-hour pH metry were taken up for the surgery. Patients were further divided into group-A (LNF and group-B (LTF. Results: The median percentage time with esophageal pH < 4 decreased from 10.18% and 12.31% preoperatively to 0.85% and 1.94% postoperatively in LNF and LTF-groups, respectively. There was a significant and comparable increase in length of lower esophageal sphincter (LES, length of intraabdominal part of LES and LES pressure at respiratory inversion point in both the groups. In LNF-group, five patients had early dysphagia that improved afterwards. There were no significant postoperative complications. Conclusion: LNF and LTF are highly effective in the management of GERD with significant improvement in symptoms and objective parameters. LNF may be associated with significantly higher incidence of short onset transient dysphagia that improves with time. Patients in both the groups showed excellent symptom and objective control on 24-hour pH metry on short term follow-up.

  18. Evaluation of the Prevention and Reactivation Care Program (PReCaP for the hospitalized elderly: a prospective nonrandomized controlled trial

    Directory of Open Access Journals (Sweden)

    Asmus-Szepesi KJ

    2015-03-01

    Full Text Available Kirsten J Asmus-Szepesi,1 Linda E Flinterman,1 Marc A Koopmanschap,2 Anna P Nieboer,2 Ton J Bakker,3 Johan P Mackenbach,1 Ewout W Steyerberg1 1Department of Public Health, Erasmus University Medical Center, 2Institute of Health Policy and Management, Erasmus University, 3Stichting Wetenschap Balans, Rotterdam, the Netherlands Background: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP, while two other hospitals providing usual care served as control settings. Within the PReCaP hospital we compared patients pre-implementation with patients post-implementation of the PReCaP (“within-hospital analysis”, while our nonrandomized controlled trial compared patients of the PReCaP hospital post-implementation with patients from the two control hospitals providing usual care (“between-hospital analysis”. Hospitalized patients 65 years or older and at risk of functional decline were interviewed at baseline and at 3 and 12 months using validated questionnaires to score functioning, depression, and health-related quality of life (HRQoL. We estimated costs per unit of care from hospital information systems and national data sources. We used adjusted general linear mixed models to analyze functioning and HRQoL.Results: Between-hospital analysis showed no difference in activities of daily living (ADL or instrumental activities of daily living (IADL between PReCaP patients and control groups. PReCaP patients did have slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI 0.2–0.6], lower depression (Geriatric Depression Scale 15; -0

  19. The feasibility of a randomised controlled trial to compare the cost-effectiveness of palliative cardiology or usual care in people with advanced heart failure: Two exploratory prospective cohorts.

    Science.gov (United States)

    Johnson, Miriam J; McSkimming, Paula; McConnachie, Alex; Geue, Claudia; Millerick, Yvonne; Briggs, Andrew; Hogg, Karen

    2018-06-01

    The effectiveness of cardiology-led palliative care is unknown; we have insufficient information to conduct a full trial. To assess the feasibility (recruitment/retention, data quality, variability/sample size estimation, safety) of a clinical trial of palliative cardiology effectiveness. Non-randomised feasibility. Unmatched symptomatic heart failure patients on optimal cardiac treatment from (1) cardiology-led palliative service (caring together group) and (2) heart failure liaison service (usual care group). Outcomes/safety: Symptoms (Edmonton Symptom Assessment Scale), Kansas City Cardiomyopathy Questionnaire, performance, understanding of disease, anticipatory care planning, cost-effectiveness, survival and carer burden. A total of 77 participants (caring together group = 43; usual care group = 34) were enrolled (53% men; mean age 77 years (33-100)). The caring together group scored worse in Edmonton Symptom Assessment Scale (43.5 vs 35.2) and Kansas City Cardiomyopathy Questionnaire (35.4 vs 39.9). The caring together group had a lower consent/screen ratio (1:1.7 vs 1: 2.8) and few died before approach (0.08% vs 16%) or declined invitation (17% vs 37%). Data quality: At 4 months, 74% in the caring together group and 71% in the usual care group provided data. Most attrition was due to death or deterioration. Data quality in self-report measures was otherwise good. There was no difference in survival. Symptoms and quality of life improved in both groups. A future trial requires 141 (202 allowing 30% attrition) to detect a minimal clinical difference (1 point) in Edmonton Symptom Assessment Scale score for breathlessness (80% power). More participants (176; 252 allowing 30% attrition) are needed to detect a 10.5 change in Kansas City Cardiomyopathy Questionnaire score (80% power; minimum clinical difference = 5). A trial to test the clinical effectiveness (improvement in breathlessness) of cardiology-led palliative care is feasible.

  20. Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

    NARCIS (Netherlands)

    K.J.E. Asmus-Szepesi (Kirsten); L.E. Flinterman (Linda); M.A. Koopmanschap (Marc); A.P. Nieboer (Anna); T.J.E.M. Bakker (Ton); J.P. Mackenbach (Johan); E.W. Steyerberg (Ewout)

    2015-01-01

    textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled

  1. An open-label, non-randomized study of the pharmacokinetics of the nutritional supplement nicotinamide riboside (NR and its effects on blood NAD+ levels in healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Sophia E Airhart

    Full Text Available The co-primary objectives of this study were to determine the human pharmacokinetics (PK of oral NR and the effect of NR on whole blood nicotinamide adenine dinucleotide (NAD+ levels.Though mitochondrial dysfunction plays a critical role in the development and progression of heart failure, no mitochondria-targeted therapies have been translated into clinical practice. Recent murine studies have reported associations between imbalances in the NADH/NAD+ ratio with mitochondrial dysfunction in multiple tissues, including myocardium. Moreover, an NAD+ precursor, nicotinamide mononucleotide, improved cardiac function, while another NAD+ precursor, nicotinamide riboside (NR, improved mitochondrial function in muscle, liver and brown adipose. Thus, PK studies of NR in humans is critical for future clinical trials.In this non-randomized, open-label PK study of 8 healthy volunteers, 250 mg NR was orally administered on Days 1 and 2, then uptitrated to peak dose of 1000 mg twice daily on Days 7 and 8. On the morning of Day 9, subjects completed a 24-hour PK study after receiving 1000 mg NR at t = 0. Whole-blood levels of NR, clinical blood chemistry, and NAD+ levels were analyzed.Oral NR was well tolerated with no adverse events. Significant increases comparing baseline to mean concentrations at steady state (Cave,ss were observed for both NR (p = 0.03 and NAD+ (p = 0.001; the latter increased by 100%. Absolute changes from baseline to Day 9 in NR and NAD+ levels correlated highly (R2 = 0.72, p = 0.008.Because NR increases circulating NAD+ in humans, NR may have potential as a therapy in patients with mitochondrial dysfunction due to genetic and/or acquired diseases.

  2. An open-label, non-randomized study of the pharmacokinetics of the nutritional supplement nicotinamide riboside (NR) and its effects on blood NAD+ levels in healthy volunteers.

    Science.gov (United States)

    Airhart, Sophia E; Shireman, Laura M; Risler, Linda J; Anderson, Gail D; Nagana Gowda, G A; Raftery, Daniel; Tian, Rong; Shen, Danny D; O'Brien, Kevin D

    2017-01-01

    The co-primary objectives of this study were to determine the human pharmacokinetics (PK) of oral NR and the effect of NR on whole blood nicotinamide adenine dinucleotide (NAD+) levels. Though mitochondrial dysfunction plays a critical role in the development and progression of heart failure, no mitochondria-targeted therapies have been translated into clinical practice. Recent murine studies have reported associations between imbalances in the NADH/NAD+ ratio with mitochondrial dysfunction in multiple tissues, including myocardium. Moreover, an NAD+ precursor, nicotinamide mononucleotide, improved cardiac function, while another NAD+ precursor, nicotinamide riboside (NR), improved mitochondrial function in muscle, liver and brown adipose. Thus, PK studies of NR in humans is critical for future clinical trials. In this non-randomized, open-label PK study of 8 healthy volunteers, 250 mg NR was orally administered on Days 1 and 2, then uptitrated to peak dose of 1000 mg twice daily on Days 7 and 8. On the morning of Day 9, subjects completed a 24-hour PK study after receiving 1000 mg NR at t = 0. Whole-blood levels of NR, clinical blood chemistry, and NAD+ levels were analyzed. Oral NR was well tolerated with no adverse events. Significant increases comparing baseline to mean concentrations at steady state (Cave,ss) were observed for both NR (p = 0.03) and NAD+ (p = 0.001); the latter increased by 100%. Absolute changes from baseline to Day 9 in NR and NAD+ levels correlated highly (R2 = 0.72, p = 0.008). Because NR increases circulating NAD+ in humans, NR may have potential as a therapy in patients with mitochondrial dysfunction due to genetic and/or acquired diseases.

  3. Non-random mating for selection with restricted rates of inbreeding and overlapping generations

    NARCIS (Netherlands)

    Sonesson, A.K.; Meuwissen, T.H.E.

    2002-01-01

    Minimum coancestry mating with a maximum of one offspring per mating pair (MC1) is compared with random mating schemes for populations with overlapping generations. Optimum contribution selection is used, whereby $\\\\\\\\Delta F$ is restricted. For schemes with $\\\\\\\\Delta F$ restricted to 0.25% per

  4. Intensive Versus Distributed Aphasia Therapy: A Nonrandomized, Parallel-Group, Dosage-Controlled Study.

    Science.gov (United States)

    Dignam, Jade; Copland, David; McKinnon, Eril; Burfein, Penni; O'Brien, Kate; Farrell, Anna; Rodriguez, Amy D

    2015-08-01

    Most studies comparing different levels of aphasia treatment intensity have not controlled the dosage of therapy provided. Consequently, the true effect of treatment intensity in aphasia rehabilitation remains unknown. Aphasia Language Impairment and Functioning Therapy is an intensive, comprehensive aphasia program. We investigated the efficacy of a dosage-controlled trial of Aphasia Language Impairment and Functioning Therapy, when delivered in an intensive versus distributed therapy schedule, on communication outcomes in participants with chronic aphasia. Thirty-four adults with chronic, poststroke aphasia were recruited to participate in an intensive (n=16; 16 hours per week; 3 weeks) versus distributed (n=18; 6 hours per week; 8 weeks) therapy program. Treatment included 48 hours of impairment, functional, computer, and group-based aphasia therapy. Distributed therapy resulted in significantly greater improvements on the Boston Naming Test when compared with intensive therapy immediately post therapy (P=0.04) and at 1-month follow-up (P=0.002). We found comparable gains on measures of participants' communicative effectiveness, communication confidence, and communication-related quality of life for the intensive and distributed treatment conditions at post-therapy and 1-month follow-up. Aphasia Language Impairment and Functioning Therapy resulted in superior clinical outcomes on measures of language impairment when delivered in a distributed versus intensive schedule. The therapy progam had a positive effect on participants' functional communication and communication-related quality of life, regardless of treatment intensity. These findings contribute to our understanding of the effect of treatment intensity in aphasia rehabilitation and have important clinical implications for service delivery models. © 2015 American Heart Association, Inc.

  5. Spatially nonrandom tree mortality and ingrowth maintain equilibrium pattern in an old-growth Pseudotsuga-Tsuga forest.

    Science.gov (United States)

    Lutz, James A; Larson, Andrew J; Furniss, Tucker J; Donato, Daniel C; Freund, James A; Swanson, Mark E; Bible, Kenneth J; Chen, Jiquan; Franklin, Jerry F

    2014-08-01

    Mortality processes in old-growth forests are generally assumed to be driven by gap-scale disturbance, with only a limited role ascribed to density-dependent mortality, but these assumptions are rarely tested with data sets incorporating repeated measurements. Using a 12-ha spatially explicit plot censused 13 years apart in an approximately 500-year-old Pseudotsuga-Tsuga forest, we demonstrate significant density-dependent mortality and spatially aggregated tree recruitment. However, the combined effect of these strongly nonrandom demographic processes was to maintain tree patterns in a state of dynamic equilibrium. Density-dependent mortality was most pronounced for the dominant late-successional species, Tsuga heterophylla. The long-lived, early-seral Pseudotsuga menziesii experienced an annual stem mortality rate of 0.84% and no new recruitment. Late-seral species Tsuga and Abies amabilis had nearly balanced demographic rates of ingrowth and mortality. The 2.34% mortality rate for Taxus brevifolia was higher than expected, notably less than ingrowth, and strongly affected by proximity to Tsuga. Large-diameter Tsuga structured both the regenerating conspecific and heterospecific cohorts with recruitment of Tsuga and Abies unlikely in neighborhoods crowded with large-diameter competitors (P old-growth forests.

  6. Does balneotherapy with low radon concentration in water influence the endocrine system? A controlled non-randomized pilot study.

    Science.gov (United States)

    Nagy, Katalin; Berhés, István; Kovács, Tibor; Kávási, Norbert; Somlai, János; Bender, Tamás

    2009-08-01

    Radon bath is a well-established modality of balneotherapy for the management of degenerative musculoskeletal disorders. The present study was conducted to ascertain whether baths of relatively low (80 Bq/l) radon concentration have any influence on the functioning of the endocrine system. In the study, a non-randomized pilot study, 27 patients with degenerative musculoskeletal disorders received 30-min radon baths (of 31-32 degrees C temperature and 80 Bq/l average radon concentration) daily, for 15 days. Twenty-five patients with matching pathologies were subjected to balneotherapy according to the same protocol, using thermal water with negligible radon content (6 Bq/l). Serum thyroid stimulating hormone, prolactin, cortisol, adrenocorticotropic hormone, and dehydroepiandrosterone levels were measured before and after a balneotherapy course of 15 sessions. Comparison of the accumulated data using the Wilcoxon test did not reveal any significant difference between pre- and post-treatment values or between the two patient groups. It is noted that while the beneficial effects of balneotherapy with radon-containing water on degenerative disorders is widely known, only few data have been published in the literature on its effect on endocrine functions. The present study failed to demonstrate any substantial effect of thermal water with relatively low radon content on the functioning of the endocrine system.

  7. Aneuploidy in immortalized human mesenchymal stem cells with non-random loss of chromosome 13 in culture.

    Science.gov (United States)

    Takeuchi, Masao; Takeuchi, Kikuko; Ozawa, Yutaka; Kohara, Akihiro; Mizusawa, Hiroshi

    2009-01-01

    Aneuploidy (an abnormal number of chromosomes) is commonly observed in most human cancer cells, highlighting the need to examine chromosomal instability in tumorigenesis. Previously, the immortalized human mesenchymal stem cell line UE6E7T-3 was shown to undergo a preferential loss of one copy of chromosome 13 after prolonged culture. Here, the loss of chromosome 13 was found to be caused by chromosome missegregation during mitosis, which involved unequal segregation, exclusion of the misaligned chromosome 13 on the metaphase plate, and trapping of chromosome 13 in the midbody region, as observed by fluorescence in situ hybridization. Near-diploid aneuploidy, not tetraploidy, was the direct result. The loss of chromosome 13 was non-random, and was detected by analysis of microsatellites and single nucleotide polymorphism-based loss of heterozygosity (LOH). Of the five microsatellite loci on chromosome 13, four loci showed microsatellite instability at an early stage in culture, and LOH was apparent at a late stage in culture. These results suggest that the microsatellite mutations cause changes in centromere integrity provoking loss of this chromosome in the UE6E7T-3 cell line. Thus, these results support the use of this cell line as a useful model for understanding the mechanism of aneuploid formation in cell cultures.

  8. Treatment of age-related subfoveal neovascular membranes by teletherapy. Results of a non-randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Subasi, M.; Akmansu, M.; Or, M. [Gazi Univ., Ankara (Turkey). Medical Faculty

    1999-03-01

    This investigation was designed to determine whether low-dose radiation to the macular region could influence the natural course of age-related subfoveal neovascularization. Thirty-one patients with subfoveal membranes due to age-related macular degeneration (ARMD) were treated with 12 Gy of 6 MV X-rays, and 72 patients who were untreated served as a control group. Both groups were followed-up. At six months of follow-up visual acuity was maintained in 54.8% and improved 25.8% of patients treated by radiotherapy. In the control group, visual acuity showed deterioration in 55.5%. There was a significant difference between the treated and untreated groups (p<0.01). Significant neovascular membrane regression or stabilization was recorded in 61.3% of treated patients at six months post-radiation, whereas the membranes in all. 72 control patients showed progressive enlargement. This non-randomized study suggested that low doses of radiation may be an alternative treatment for ARMD without an immediate drop in visual acuity or significant radiation morbidity. (author)

  9. Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial

    International Nuclear Information System (INIS)

    Mara, Michal; Kubinova, Kristyna; Maskova, Jana; Horak, Petr; Belsan, Tomas; Kuzel, David

    2012-01-01

    Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

  10. Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Mara, Michal; Kubinova, Kristyna, E-mail: kristyna.kubinova@gmail.com [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Maskova, Jana [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Horak, Petr [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Belsan, Tomas [Central Military Hospital, Department of Radiology (Czech Republic); Kuzel, David [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic)

    2012-10-15

    Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

  11. Non-Random Inversion Landscapes in Prokaryotic Genomes Are Shaped by Heterogeneous Selection Pressures.

    Science.gov (United States)

    Repar, Jelena; Warnecke, Tobias

    2017-08-01

    Inversions are a major contributor to structural genome evolution in prokaryotes. Here, using a novel alignment-based method, we systematically compare 1,651 bacterial and 98 archaeal genomes to show that inversion landscapes are frequently biased toward (symmetric) inversions around the origin-terminus axis. However, symmetric inversion bias is not a universal feature of prokaryotic genome evolution but varies considerably across clades. At the extremes, inversion landscapes in Bacillus-Clostridium and Actinobacteria are dominated by symmetric inversions, while there is little or no systematic bias favoring symmetric rearrangements in archaea with a single origin of replication. Within clades, we find strong but clade-specific relationships between symmetric inversion bias and different features of adaptive genome architecture, including the distance of essential genes to the origin of replication and the preferential localization of genes on the leading strand. We suggest that heterogeneous selection pressures have converged to produce similar patterns of structural genome evolution across prokaryotes. © The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  12. Workplace hazards and prevention options from a nonrandom sample of retail trade businesses.

    Science.gov (United States)

    Anderson, Vern Putz; Chun, Heekyoung

    2014-01-01

    Employer commitment is a key factor in an effective safety program, yet limited research has focused on the safety priorities of retail store managers. To address this, the U.S. National Institute for Occupational Safety and Health recruited 4 experienced ergonomists, who met and interviewed 9 retailers in different parts of the eastern USA. The reports from the 9 interviews were used to document the hazards facing retailers and the interventions they attempted. Those interviewed were managers/owners of establishments that ranged from a small bakery with 11 employees to a supermarket with 85 or more employees. The main hazards across all establishments included overexertion, contact-with-objects, and falls-to-the-same-level. We also compared the retailers' perceptions of safety hazards with injuries from actual hazards as supplied by the U.S. Bureau of Labor Statistics. This report provides insight into the retailers' perceptions of safety hazards as well as their commitment to the prevention of workplace injuries.

  13. Testing for nonrandom shape similarity between sister cells using automated shape comparison

    Science.gov (United States)

    Guo, Monica; Marshall, Wallace F.

    2009-02-01

    Several reports in the biological literature have indicated that when a living cell divides, the two daughter cells have a tendency to be mirror images of each other in terms of their overall cell shape. This phenomenon would be consistent with inheritance of spatial organization from mother cell to daughters. However the published data rely on a small number of examples that were visually chosen, raising potential concerns about inadvertent selection bias. We propose to revisit this issue using automated quantitative shape comparison methods which would have no contribution from the observer and which would allow statistical testing of similarity in large numbers of cells. In this report we describe a first order approach to the problem using rigid curve matching. Using test images, we compare a pointwise correspondence based distance metric with a chamfer matching strategy and find that the latter provides better correspondence and smaller distances between aligned curves, especially when we allow nonrigid deformation of the outlines in addition to rotation.

  14. Feasibility studies and technological innovation

    DEFF Research Database (Denmark)

    Hvelplund, Frede Kloster; Lund, Henrik; Sukkumnoed, Decharut

    2004-01-01

    The chapter offers a tool to conduct feasibility studies and focuses on how to make feasibility studies in a situation with environmental concerns, in which technological innovation and institutional chnages are among the objectives.......The chapter offers a tool to conduct feasibility studies and focuses on how to make feasibility studies in a situation with environmental concerns, in which technological innovation and institutional chnages are among the objectives....

  15. Non-random co-occurrence of native and exotic plant species in Mediterranean grasslands

    Science.gov (United States)

    de Miguel, José M.; Martín-Forés, Irene; Acosta-Gallo, Belén; del Pozo, Alejandro; Ovalle, Carlos; Sánchez-Jardón, Laura; Castro, Isabel; Casado, Miguel A.

    2016-11-01

    Invasion by exotic species in Mediterranean grasslands has determined assembly patterns of native and introduced species, knowledge of which provides information on the ecological processes underlying these novel communities. We considered grasslands from Spain and Chile. For each country we considered the whole grassland community and we split species into two subsets: in Chile, species were classified as natives or colonizers (i.e. exotics); in Spain, species were classified as exclusives (present in Spain but not in Chile) or colonizers (Spanish natives and exotics into Chile). We used null models and co-occurrence indices calculated in each country for each one of 15 sites distributed along a precipitation gradient and subjected to similar silvopastoral exploitation. We compared values of species co-occurrence between countries and between species subsets (natives/colonizers in Chile; exclusives/colonizers in Spain) within each country and we characterised them according to climatic variables. We hypothesized that: a) the different coexistence time of the species in both regions should give rise to communities presenting a spatial pattern further from random in Spain than in Chile, b) the co-occurrence patterns in the grasslands are affected by mesoclimatic factors in both regions. The patterns of co-occurrence are similar in Spain and Chile, mostly showing a spatial pattern more segregated than expected by random. The colonizer species are more segregated in Spain than in Chile, possibly determined by the longer residence time of the species in the source area than in the invaded one. The segregation of species in Chile is related to water availability, being species less segregated in habitat with greater water deficit; in Spain no relationship with climatic variables was found. After an invasion process, our results suggest that the possible process of alteration of the original Chilean communities has not prevented the assembly between the native and

  16. The non-random clustering of non-synonymous substitutions and its relationship to evolutionary rate

    Directory of Open Access Journals (Sweden)

    Stone Eric A

    2011-08-01

    Full Text Available Abstract Background Protein sequences are subject to a mosaic of constraint. Changes to functional domains and buried residues, for example, are more apt to disrupt protein structure and function than are changes to residues participating in loops or exposed to solvent. Regions of constraint on the tertiary structure of a protein often result in loose segmentation of its primary structure into stretches of slowly- and rapidly-evolving amino acids. This clustering can be exploited, and existing methods have done so by relying on local sequence conservation as a signature of selection to help identify functionally important regions within proteins. We invert this paradigm by leveraging the regional nature of protein structure and function to both illuminate and make use of genome-wide patterns of local sequence conservation. Results Our hypothesis is that the regional nature of structural and functional constraints will assert a positive autocorrelation on the evolutionary rates of neighboring sites, which, in a pairwise comparison of orthologous proteins, will manifest itself as the clustering of non-synonymous changes across the amino acid sequence. We introduce a dispersion ratio statistic to test this and related hypotheses. Using genome-wide interspecific comparisons of orthologous protein pairs, we reveal a strong log-linear relationship between the degree of clustering and the intensity of constraint. We further demonstrate how this relationship varies with the evolutionary distance between the species being compared. We provide some evidence that proteins with a history of positive selection deviate from genome-wide trends. Conclusions We find a significant association between the evolutionary rate of a protein and the degree to which non-synonymous changes cluster along its primary sequence. We show that clustering is a non-redundant predictor of evolutionary rate, and we speculate that conflicting signals of clustering and constraint may

  17. Statistical grand rounds: understanding the mechanism: mediation analysis in randomized and nonrandomized studies.

    Science.gov (United States)

    Mascha, Edward J; Dalton, Jarrod E; Kurz, Andrea; Saager, Leif

    2013-10-01

    In comparative clinical studies, a common goal is to assess whether an exposure, or intervention, affects the outcome of interest. However, just as important is to understand the mechanism(s) for how the intervention affects outcome. For example, if preoperative anemia was shown to increase the risk of postoperative complications by 15%, it would be important to quantify how much of that effect was due to patients receiving intraoperative transfusions. Mediation analysis attempts to quantify how much, if any, of the effect of an intervention on outcome goes though prespecified mediator, or "mechanism" variable(s), that is, variables sitting on the causal pathway between exposure and outcome. Effects of an exposure on outcome can thus be divided into direct and indirect, or mediated, effects. Mediation is claimed when 2 conditions are true: the exposure affects the mediator and the mediator (adjusting for the exposure) affects the outcome. Understanding how an intervention affects outcome can validate or invalidate one's original hypothesis and also facilitate further research to modify the responsible factors, and thus improve patient outcome. We discuss the proper design and analysis of studies investigating mediation, including the importance of distinguishing mediator variables from confounding variables, the challenge of identifying potential mediators when the exposure is chronic versus acute, and the requirements for claiming mediation. Simple designs are considered, as well as those containing multiple mediators, multiple outcomes, and mixed data types. Methods are illustrated with data collected by the National Surgical Quality Improvement Project (NSQIP) and utilized in a companion paper which assessed the effects of preoperative anemic status on postoperative outcomes.

  18. The NARCONON™ drug education curriculum for high school students: A non-randomized, controlled prevention trial

    Directory of Open Access Journals (Sweden)

    Cecchini Marie A

    2008-03-01

    Full Text Available Abstract Background An estimated 13 million youths aged 12 to 17 become involved with alcohol, tobacco and other drugs annually. The number of 12- to 17-year olds abusing controlled prescription drugs increased an alarming 212 percent between 1992 and 2003. For many youths, substance abuse precedes academic and health problems including lower grades, higher truancy, drop out decisions, delayed or damaged physical, cognitive, and emotional development, or a variety of other costly consequences. For thirty years the Narconon program has worked with schools and community groups providing single educational modules aimed at supplementing existing classroom-based prevention activities. In 2004, Narconon International developed a multi-module, universal prevention curriculum for high school ages based on drug abuse etiology, program quality management data, prevention theory and best practices. We review the curriculum and its rationale and test its ability to change drug use behavior, perceptions of risk/benefits, and general knowledge. Methods After informed parental consent, approximately 1000 Oklahoma and Hawai'i high school students completed a modified Center for Substance Abuse Prevention (CSAP Participant Outcome Measures for Discretionary Programs survey at three testing points: baseline, one month later, and six month follow-up. Schools assigned to experimental conditions scheduled the Narconon curriculum between the baseline and one-month follow-up test; schools in control conditions received drug education after the six-month follow-up. Student responses were analyzed controlling for baseline differences using analysis of covariance. Results At six month follow-up, youths who received the Narconon drug education curriculum showed reduced drug use compared with controls across all drug categories tested. The strongest effects were seen in all tobacco products and cigarette frequency followed by marijuana. There were also significant

  19. PWR decontamination feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Silliman, P.L.

    1978-12-18

    The decontamination work which has been accomplished is reviewed and it is concluded that it is worthwhile to investigate further four methods for decontamination for future demonstration. These are: dilute chemical; single stage strong chemical; redox processes; and redox/chemical in combination. Laboratory work is recommended to define the agents and processes for demonstration and to determine the effect of the solvents on PWR materials. The feasibility of Indian Point 1 for decontamination demonstrations is discussed, and it is shown that the system components of Indian Point 1 are well suited for use in demonstrations.

  20. PWR decontamination feasibility study

    International Nuclear Information System (INIS)

    Silliman, P.L.

    1978-01-01

    The decontamination work which has been accomplished is reviewed and it is concluded that it is worthwhile to investigate further four methods for decontamination for future demonstration. These are: dilute chemical; single stage strong chemical; redox processes; and redox/chemical in combination. Laboratory work is recommended to define the agents and processes for demonstration and to determine the effect of the solvents on PWR materials. The feasibility of Indian Point 1 for decontamination demonstrations is discussed, and it is shown that the system components of Indian Point 1 are well suited for use in demonstrations

  1. Run charts revisited: a simulation study of run chart rules for detection of non-random variation in health care processes.

    Science.gov (United States)

    Anhøj, Jacob; Olesen, Anne Vingaard

    2014-01-01

    A run chart is a line graph of a measure plotted over time with the median as a horizontal line. The main purpose of the run chart is to identify process improvement or degradation, which may be detected by statistical tests for non-random patterns in the data sequence. We studied the sensitivity to shifts and linear drifts in simulated processes using the shift, crossings and trend rules for detecting non-random variation in run charts. The shift and crossings rules are effective in detecting shifts and drifts in process centre over time while keeping the false signal rate constant around 5% and independent of the number of data points in the chart. The trend rule is virtually useless for detection of linear drift over time, the purpose it was intended for.

  2. Design and Baseline Findings of a Multi-site Non-randomized Evaluation of the Effect of a Health Programme on Microfinance Clients in India

    OpenAIRE

    Saha, Somen

    2013-01-01

    Microfinance is the provision of financial services for the poor. Health program through microfinance has the potential to address several access barriers to health. We report the design and baseline findings of a multi-site non-randomized evaluation of the effect of a health program on the members of two microfinance organizations from Karnataka and Gujarat states of India. Villages identified for roll-out of health services with microfinance were pair-matched with microfinance only villages...

  3. Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

    OpenAIRE

    Asmus-Szepesi, Kirsten; Flinterman, Linda; Koopmanschap, Marc; Nieboer, Anna; Bakker, Ton; Mackenbach, Johan; Steyerberg, Ewout

    2015-01-01

    textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP), while two other hospitals providing usual car...

  4. Feasibility of evacuation

    International Nuclear Information System (INIS)

    1988-01-01

    The main question is whether evacuation of people is feasible in case of accidents with a nuclear power plant. The limiting conditions of this question are extracted from other studies. This study is therefore focused on a postulated accident in a newly built nuclear power plant with an electric capacity of 1000 Megawatt and a source term of one percent. In this particular case an evacuation should take place within the period between the accident and the emission of nuclear materials. Initial focus is on the administrative-organizational aspects of evacuation. Then bottlenecks in the technical implementation of evacuation are determined. An analysis is made for each potential Dutch location (Borssele, Eemshaven, Maasvlakte, Moerdijk and Westelijke Noordoostpolderdijk) of a nuclear power plant. By means of a model the following question is examined: can the population leave the danger area or be evacuated on time, under certain circumstances. It is concluded that preventive evacuation of the population from the planned locations is feasible, but at Moerdijk complications may occur because of the presence of some homes for the elderly and a nursing home. 18 refs.; 7 figs.; 2 tabs

  5. Non-random mating and convergence over time for alcohol consumption, smoking, and exercise: the Nord-Trøndelag Health Study.

    Science.gov (United States)

    Ask, Helga; Rognmo, Kamilla; Torvik, Fartein Ask; Røysamb, Espen; Tambs, Kristian

    2012-05-01

    Spouses tend to have similar lifestyles. We explored the degree to which spouse similarity in alcohol use, smoking, and physical exercise is caused by non-random mating or convergence. We used data collected for the Nord-Trøndelag Health Study from 1984 to 1986 and prospective registry information about when and with whom people entered marriage/cohabitation between 1970 and 2000. Our sample included 19,599 married/cohabitating couples and 1,551 future couples that were to marry/cohabitate in the 14-16 years following data collection. All couples were grouped according to the duration between data collection and entering into marriage/cohabitation. Age-adjusted polychoric spouse correlations were used as the dependent variables in non-linear segmented regression analysis; the independent variable was time. The results indicate that spouse concordance in lifestyle is due to both non-random mating and convergence. Non-random mating appeared to be strongest for smoking. Convergence in alcohol use and smoking was evident during the period prior to marriage/cohabitation, whereas convergence in exercise was evident throughout life. Reduced spouse similarity in smoking with relationship duration may reflect secular trends.

  6. An Approach to Distinguish between Plasticity and Non-random Distributions of Behavioral Types Along Urban Gradients in a Wild Passerine Bird

    Directory of Open Access Journals (Sweden)

    Philipp Sprau

    2017-08-01

    Full Text Available The impact of urbanization has been widely studied in the context of species diversity and life history evolution. Behavioral adaptation, by contrast, remains poorly understood because empirical studies rarely investigate the relative importance of two key mechanisms: plastic responses vs. non-random distributions of behavioral types. We propose here an approach that enables the simultaneous estimation of the respective roles of these distinct mechanisms. We investigated why risky behaviors are often associated with urbanization, using an urban nest box population of great tits (Parus major as a study system. We simultaneously and repeatedly quantified individual behavior (aggression and flight initiation distance as well as environmental factors characterizing level of urbanization (numbers of pedestrians, cars and cyclists. This enabled us to statistically distinguish plastic responses from patterns of non-random distributions of behavioral types. Data analyses revealed that individuals did not plastically adjust their behavior to the level of urbanization. Behavioral types were instead non-randomly distributed: bold birds occurred more frequently in areas with more cars and fewer pedestrians while shy individuals were predominantly found in areas with fewer cars and more pedestrians. These novel findings imply a major role for behavioral types in the evolutionary ecology of urban environments and call for the full integration of among- and within-individual variation in urban ecological studies.

  7. Personalised long-term follow-up of cochlear implant patients using remote care, compared with those on the standard care pathway: study protocol for a feasibility randomised controlled trial.

    Science.gov (United States)

    Cullington, Helen; Kitterick, Padraig; DeBold, Lisa; Weal, Mark; Clarke, Nicholas; Newberry, Eva; Aubert, Lisa

    2016-05-13

    Many resources are required to provide postoperative care to patients who receive a cochlear implant. The implant service commits to lifetime follow-up. The patient commits to regular adjustment and rehabilitation appointments in the first year and annual follow-up appointments thereafter. Offering remote follow-up may result in more stable hearing, reduced patient travel expense, time and disruption, more empowered patients, greater equality in service delivery and more freedom to optimise the allocation of clinic resources. This will be a two-arm feasibility randomised controlled trial (RCT) involving 60 adults using cochlear implants with at least 6 months device experience in a 6-month clinical trial of remote care. This project will design, implement and evaluate a person-centred long-term follow-up pathway for people using cochlear implants offering a triple approach of remote and self-monitoring, self-adjustment of device and a personalised online support tool for home speech recognition testing, information, self-rehabilitation, advice, equipment training and troubleshooting. The main outcome measure is patient activation. Secondary outcomes are stability and quality of hearing, stability of quality of life, clinic resources, patient and clinician experience, and any adverse events associated with remote care. We will examine the acceptability of remote care to service users and clinicians, the willingness of participants to be randomised, and attrition rates. We will estimate numbers required to plan a fully powered RCT. Ethical approval was received from North West-Greater Manchester South Research Ethics Committee (15/NW/0860) and the University of Southampton Research Governance Office (ERGO 15329). Results will be disseminated in the clinical and scientific communities and also to the patient population via peer-reviewed research publications both online and in print, conference and meeting presentations, posters, newsletter articles, website reports

  8. Feasibility evaluation of two solar cooling systems applied to a cuban hotel. Comparative analysis; Evaluación de factibilidad del uso dos sistemas climatización solar aplicado a un hotel cubano. Análisis comparativo

    Directory of Open Access Journals (Sweden)

    Yamile Díaz Torres

    2015-12-01

    Full Text Available The article presents an analysis of technical and economic feasibility of using two configurations of solar cooling in a Cuban hotel. HVAC hybrid schemes are: a cooler of ice water vapor compression (chiller interconnected in parallel with a smaller capacity chiller, first with a solar-powered absorption cooling system (SACS, and then with a photovoltaic cooling system(PSC. Both were simulated taking into account the weather conditions in the region, thermodynamic calculation methodologies and principles that govern thesetechnologies. The results show that the use of these alternatives contributes to reducing energy consumption and the environmental impact of heating, ventilation and air conditioning systems (HVAC. Economic analysishighlights that PCS is more favorable than the SACS taking into account the cooling cost generation (CCG but energy assessment indicates that SACS has higher thermal performance for the case study to which it isapplied.El artículo presenta un análisis de factibilidad técnica y económica de uso de dos configuraciones de climatización solar en un hotel cubano. Los esquemas de climatización híbridas son: una enfriadora de agua helada de compresión de vapor (chiller interconectada en paralelo con una enfriadora de absorción asistida con energía solar térmica (SACS, siglas en inglés, y posteriormente con un chiller asistido por un sistema solar fotovoltaico (PSC, siglas en ingles. Ambos fueron simulados teniendo en cuenta las condiciones meteorológicas de la región, metodologías de cálculo y principios termodinámicos que gobiernan estossistemas. Los resultados muestran que el uso de estas alternativas contribuye a la reducción del consumo energético y el impacto ambiental de los sistemas calefacción, ventilación y aire acondicionado (HVAC, siglas en inglés. El análisis económico resalta que PCS es más favorable que el SACS, teniendo en cuenta el costo de generación de frío (CCG, siglas en ingl

  9. Can teaching research methodology influence students' attitude toward science? Cohort study and nonrandomized trial in a single medical school.

    Science.gov (United States)

    Vujaklija, Ana; Hren, Darko; Sambunjak, Dario; Vodopivec, Ivana; Ivanis, Ana; Marusić, Ana; Marusić, Matko

    2010-02-01

    Medical teaching aims to develop attitudes and behaviors underlying professional competence of future physicians. We investigated whether a mandatory course on scientific methodology in the second study year could affect students' attitudes toward science in medicine. In a longitudinal study, students (n = 241) enrolling in 2001-2002 academic year at a single medical school were followed up until graduation in 2006-2007. Each year, they filled out a Likert-type questionnaire of 18 statements evaluating attitude toward science. Direct influence of the course on students' attitudes was tested in a nonrandomized controlled trial with the 2006-2007 second year student cohort. Positive students' attitudes toward science increased during study years (mean [SD] score of the maximum score of 90): from 57.6 (6.0) in the first to 69.8 (10.4) in the sixth year. There was a significant trend of increase in attitudes with the years of study (cubic trend by polynomial contrasts analysis, P = 0.011). Attendance of a course on research methodology significantly increased positive attitudes (score, 67.0 [7.0] before and 70.8 [7.5] after course, P = 0.032 vs control group), regardless of grade point average. The intervention had an effect even when the influence of the initial attitude was accounted for (F1,140 = 9.25, P = 0.003; analysis of covariance). The attitude changes after the course was greatest in students with low initial attitude scores (Spearman rinitial score, score difference, -0.44). Medical students have positive attitudes toward science and scientific method in medicine. Attendance of a course on research methodology had positive short-term effect on students' attitudes toward science. This positive effect should be maintained by vertical integration of the course in the medical curriculum.

  10. A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial

    Science.gov (United States)

    2013-01-01

    Background “Mental health for everyone” is a school program for mental health literacy and prevention aimed at secondary schools (13–15 yrs). The main aim was to investigate whether mental health literacy, could be improved by a 3-days universal education programme by: a) improving naming of symptom profiles of mental disorder, b) reducing prejudiced beliefs, and c) improving knowledge about where to seek help for mental health problems. A secondary aim was to investigate whether adolescent sex and age influenced the above mentioned variables. A third aim was to investigate whether prejudiced beliefs influenced knowledge about available help. Method This non-randomized cluster controlled trial included 1070 adolescents (53.9% boys, M age14 yrs) from three schools in a Norwegian town. One school (n = 520) received the intervention, and two schools (n = 550) formed the control group. Pre-test and follow-up were three months apart. Linear mixed models and generalized estimating equations models were employed for analysis. Results Mental health literacy improved contingent on the intervention, and there was a shift towards suggesting primary health care as a place to seek help. Those with more prejudiced beleifs did not suggest places to seek help for mental health problems. Generally, girls and older adolescents recognized symptom profiles better and had lower levels of prejudiced beliefs. Conclusions A low cost general school program may improve mental health literacy in adolescents. Gender specific programs and attention to the age and maturity of the students should be considered when mental health literacy programmes are designed and tried out. Prejudice should be addressed before imparting information about mental health issues. PMID:24053381

  11. Exceptional diversity, non-random distribution, and rapid evolution of retroelements in the B73 maize genome.

    Directory of Open Access Journals (Sweden)

    Regina S Baucom

    2009-11-01

    Full Text Available Recent comprehensive sequence analysis of the maize genome now permits detailed discovery and description of all transposable elements (TEs in this complex nuclear environment. Reiteratively optimized structural and homology criteria were used in the computer-assisted search for retroelements, TEs that transpose by reverse transcription of an RNA intermediate, with the final results verified by manual inspection. Retroelements were found to occupy the majority (>75% of the nuclear genome in maize inbred B73. Unprecedented genetic diversity was discovered in the long terminal repeat (LTR retrotransposon class of retroelements, with >400 families (>350 newly discovered contributing >31,000 intact elements. The two other classes of retroelements, SINEs (four families and LINEs (at least 30 families, were observed to contribute 1,991 and approximately 35,000 copies, respectively, or a combined approximately 1% of the B73 nuclear genome. With regard to fully intact elements, median copy numbers for all retroelement families in maize was 2 because >250 LTR retrotransposon families contained only one or two intact members that could be detected in the B73 draft sequence. The majority, perhaps all, of the investigated retroelement families exhibited non-random dispersal across the maize genome, with LINEs, SINEs, and many low-copy-number LTR retrotransposons exhibiting a bias for accumulation in gene-rich regions. In contrast, most (but not all medium- and high-copy-number LTR retrotransposons were found to preferentially accumulate in gene-poor regions like pericentromeric heterochromatin, while a few high-copy-number families exhibited the opposite bias. Regions of the genome with the highest LTR retrotransposon density contained the lowest LTR retrotransposon diversity. These results indicate that the maize genome provides a great number of different niches for the survival and procreation of a great variety of retroelements that have evolved to

  12. Large-area imaging reveals biologically driven non-random spatial patterns of corals at a remote reef

    Science.gov (United States)

    Edwards, Clinton B.; Eynaud, Yoan; Williams, Gareth J.; Pedersen, Nicole E.; Zgliczynski, Brian J.; Gleason, Arthur C. R.; Smith, Jennifer E.; Sandin, Stuart A.

    2017-12-01

    For sessile organisms such as reef-building corals, differences in the degree of dispersion of individuals across a landscape may result from important differences in life-history strategies or may reflect patterns of habitat availability. Descriptions of spatial patterns can thus be useful not only for the identification of key biological and physical mechanisms structuring an ecosystem, but also by providing the data necessary to generate and test ecological theory. Here, we used an in situ imaging technique to create large-area photomosaics of 16 plots at Palmyra Atoll, central Pacific, each covering 100 m2 of benthic habitat. We mapped the location of 44,008 coral colonies and identified each to the lowest taxonomic level possible. Using metrics of spatial dispersion, we tested for departures from spatial randomness. We also used targeted model fitting to explore candidate processes leading to differences in spatial patterns among taxa. Most taxa were clustered and the degree of clustering varied by taxon. A small number of taxa did not significantly depart from randomness and none revealed evidence of spatial uniformity. Importantly, taxa that readily fragment or tolerate stress through partial mortality were more clustered. With little exception, clustering patterns were consistent with models of fragmentation and dispersal limitation. In some taxa, dispersion was linearly related to abundance, suggesting density dependence of spatial patterning. The spatial patterns of stony corals are non-random and reflect fundamental life-history characteristics of the taxa, suggesting that the reef landscape may, in many cases, have important elements of spatial predictability.

  13. Endoscopy/EUS-guided fiducial marker placement in patients with esophageal cancer: a comparative analysis of 3 types of markers.

    Science.gov (United States)

    Machiels, Melanie; van Hooft, Jeanin; Jin, Peng; van Berge Henegouwen, Mark I; van Laarhoven, Hanneke M; Alderliesten, Tanja; Hulshof, Maarten C

    2015-10-01

    Markers placed at the borders of esophageal tumors are potentially useful to facilitate radiotherapy (RT) target delineation, which offers the possibility of image-guided RT. To evaluate and compare the feasibility and technical benefit of endoscopy/EUS-guided marker placement of 3 different types of markers in patients with esophageal cancer referred for RT. Prospective, single-center, feasibility and comparative study. Tertiary-care medical center. Thirty patients with esophageal cancer who were referred for RT. Patients underwent endoscopy/EUS-guided implantation of 1 type of marker. A solid gold marker (SM) with fixed dimensions, a flexible coil-shaped gold marker (FM) with hand-cut length (2-10 mm), and a radiopaque hydrogel marker (HG) were used. Technical feasibility and adverse events were registered. CT scans and cone-beam CT scans (CBCT) acquired during RT were analyzed to determine and compare the visibility and continuous clear visibility of the implanted markers. Technical feasibility, technical benefit, and adverse events of 3 types of markers. A total of 101 markers were placed in 30 patients. Implantation was technically feasible in all patients without grade 3 to 4 adverse events. Two patients with asymptomatic mediastinitis and one with asymptomatic pneumothorax were seen. Visibility on CT scan of all 3 types of implanted markers was adequate for target delineation. Eighty percent of FMs remained continuously visible over the treatment period on CBCT, significantly better than SMs (63%) and HGs (11%) (P = .015). When we selected FMs ≥5 mm, 90.5% remained visible on CBCT between implantation and the end of RT. Single-center, nonrandomized design. Endoscopy/EUS-guided fiducial marker placement for esophageal cancer is both safe and feasible and can be used for target volume delineation purposes on CT. Our results imply a significant advantage of FMs over SMs and HGs, regarding visibility and continuous clear visibility over the treatment period

  14. TP53 status and taxane-platinum versus platinum-based therapy in ovarian cancer patients: A non-randomized retrospective study

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    Markowska Janina

    2008-01-01

    Full Text Available Abstract Background Taxane-platinum therapy (TP has replaced platinum-based therapy (PC or PAC, DNA damaging chemotherapy in the postoperative treatment of ovarian cancer patients; however, it is not always effective. TP53 protein plays a differential role in response to DNA-damaging agents and taxanes. We sought to define profiles of patients who benefit the most from TP and also of those who can be treated with PC. Methods We compared the effectiveness of PC/PAC (n = 253 and TP (n = 199 with respect to tumor TP53 accumulation in ovarian cancer patients with FIGO stage IIB-IV disease; this was a non-randomized retrospective study. Immunohistochemical analysis was performed on 452 archival tumors; univariate and multivariate analysis by the Cox's and logistic regression models was performed in all patients and in subgroups with [TP53(+] and without TP53 accumulation [TP53(-]. Results The advantage of taxane-platinum therapy over platinum-based therapy was seen in the TP53(+, and not in the TP53(- group. In the TP53(+ group taxane-platinum therapy enhanced the probability of complete remission (p = .018, platinum sensitivity (p = .014, platinum highly sensitive response (p = .038 and longer survival (OS, p = .008. Poor tumor differentiation diminished the advantage from taxane-platinum therapy in the TP53(+ group. In the TP53(- group PC/PAC was at least equally efficient as taxane-platinum therapy and it enhanced the chance of platinum highly sensitive response (p = .010. However, in the TP53(- group taxane-platinum therapy possibly diminished the risk of death in patients over 53 yrs (p = .077. Among factors that positively interacted with taxane-platinum therapy in some analyses were endometrioid and clear cell type, FIGO III stage, bulky residual tumor, more advanced age of patient and moderate tumor differentiation. Conclusion Our results suggest that taxane-platinum therapy is particularly justified in patients with TP53(+ tumors or older

  15. Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

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    Kaitani T

    2015-02-01

    Full Text Available Toshiko Kaitani,1 Gojiro Nakagami,2 Junko Sugama,3 Masahiro Tachi,4 Yutaka Matsuyama,5 Yoshiki Miyachi,6 Takashi Nagase,2 Yukie Takemura,7 Hiromi Sanada2 1School of Nursing, Sapporo City University, Hokkaido, Japan; 2Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; 4Department of Plastic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan; 5Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 6Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; 7Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan Aims and objectives: We investigated the effectiveness and safety of an advanced pressure ulcer (PU management protocol comprising 1 ultrasonography to assess the deep tissue, 2 use of a non-contact thermometer to detect critical colonization, 3 conservative sharp debridement, 4 dressing selection, 5 negative pressure wound therapy, and 6 vibration therapy in comparison with those of a conventional approach. Each protocol was followed by trained wound, ostomy, and continence nurses (WOCNs. Background: At present, there is no systematic PU management protocol for nurses that includes appropriate assessment and intervention techniques for deep tissue injury and critical colonization. In Japan, there is no such protocol that the nurses can follow without a physician’s orders. Design and methods: This was a prospective non-randomized controlled trial. Over a 3-week period, we evaluated the effectiveness of an advanced protocol by comparing the PU severity and healing on the basis of the DESIGN-R scale and presence of patients' discomfort. We recruited ten WOCNs to follow

  16. Safety and feasibility of chronic transvenous phrenic nerve stimulation for treatment of central sleep apnea in heart failure patients.

    Science.gov (United States)

    Zhang, Xilong; Ding, Ning; Ni, Buqing; Yang, Bing; Wang, Hong; Zhang, Shi-Jiang

    2017-03-01

    Central sleep apnea (CSA) is common in patients with heart failure (HF) and is associated with poor quality of life and prognosis. Early acute studies using transvenous phrenic nerve stimulation (PNS) to treat CSA in HF have shown a significantly reduction of CSA and improvement of key polysomnographic parameters. In this study, we evaluated the safety of and efficiency chronic transvenous PNS with an implanted neurostimulator in HF patients with CSA. This study was a prospective, nonrandomized evaluation of unilateral transvenous PNS in eight HF patients with CSA. The stimulation lead, which connected to a proprietary neurostimulator, was positioned in either the left pericardiophrenic or right brachiocephalic vein. Monitoring during implantation and 6-monthly follow-ups were performed. Six of the implanted eight patients completed the study (one was lost to follow-up; one died from pneumonia). Neither side effects nor adverse events related to stimulation occurred. During the 6-monthly follow-ups, one patient had a lead dislodgement in the first month and the lead was subsequently repositioned. No additional lead dislodgements occurred. There were no significant changes in sleep habits, appetite, bleeding or infections. Compared with the parameters before stimulator implantation, there were significant improvement in apnea-hypopnea index, central apnea index, left ventricular ejection fraction and 6-min walk distance (all P < 0.01). Use of chronic transvenous PNS appears to be safe and feasible in HF patients with CSA. Large multicenter studies are needed to confirm safety and efficacy in this population. © 2015 John Wiley & Sons Ltd.

  17. The feasibility of images reconstructed with the method of sieves

    International Nuclear Information System (INIS)

    Veklerov, E.; Llacer, J.

    1990-01-01

    The concept of sieves has been applied with the maximum likelihood estimator (MLE) to image reconstruction. While it makes it possible to recover smooth images consistent with the data, the degree of smoothness provided by it is arbitrary. It is shown that the concept of feasibility is able to resolve this arbitrariness. By varying the values of parameters determining the degree of smoothness, one can generate images on both sides of the feasibility region, as well as within the region. Feasible images recovered by using different sieve parameters are compared with feasible results of other procedures. One- and two-dimensional examples using both simulated and real data sets are considered

  18. Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

    Science.gov (United States)

    Badar, Ahmed; Kaatabi, Huda; Bamosa, Abdullah; Al-Elq, Abdulmohsen; Abou-Hozaifa, Bodour; Lebda, Fatma; Alkhadra, Akram; Al-Almaie, Sameeh

    2017-01-01

    Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). Single-blind, nonrandomized. Diabetes clinic of a university hospital in Saudi Arabia. Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. Lipid and cardiovascular parameters, and BMI. Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. There were 9 subjects in each group lost to follow up

  19. Tribal Utility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Engel, R. A.; Zoellick, J. J.

    2007-06-30

    The Schatz Energy Research Center (SERC) assisted the Yurok Tribe in investigating the feasibility of creating a permanent energy services program for the Tribe. The original purpose of the DOE grant that funded this project was to determine the feasibility of creating a full-blown Yurok Tribal electric utility to buy and sell electric power and own and maintain all electric power infrastructure on the Reservation. The original project consultant found this opportunity to be infeasible for the Tribe. When SERC took over as project consultant, we took a different approach. We explored opportunities for the Tribe to develop its own renewable energy resources for use on the Reservation and/or off-Reservation sales as a means of generating revenue for the Tribe. We also looked at ways the Tribe can provide energy services to its members and how to fund such efforts. We identified opportunities for the development of renewable energy resources and energy services on the Yurok Reservation that fall into five basic categories: • Demand-side management – This refers to efforts to reduce energy use through energy efficiency and conservation measures. • Off-grid, facility and household scale renewable energy systems – These systems can provide electricity to individual homes and Tribal facilities in areas of the Reservation that do not currently have access to the electric utility grid. • Village scale, micro-grid renewable energy systems - These are larger scale systems that can provide electricity to interconnected groups of homes and Tribal facilities in areas of the Reservation that do not have access to the conventional electric grid. This will require the development of miniature electric grids to serve these interconnected facilities. • Medium to large scale renewable energy development for sale to the grid – In areas where viable renewable energy resources exist and there is access to the conventional electric utility grid, these resources can be

  20. Overweight and obesity in Slovak high school students and body composition indicators: a non-randomized cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bibiana Vadasova

    2016-08-01

    Full Text Available Abstract Background Physical development can be considered as an indicator of the overall health status of the youth population. Currently, it appears that the increasing trend of the prevalence of obesity among children and youths has stopped in a number of countries worldwide. Studies point to the fact that adolescence is a critical period for the development of obesity. Body mass index (BMI seems to be an orientation parameter in the assessment of prevalence of obesity which is not sufficient for more accurate identification of at risk individuals. The purpose of this study was to evaluate association between BMI percentile zones as health-risk for being overweight and obese and body composition indicators in high-school students from the Prešov (Slovakia region. Methods A non-randomized cross-sectional study in high school students from the Prešov (Slovakia region was conducted. The research sample consisted of 1014 participants (boys n = 466, girls n = 549. Body composition was measured using direct segmental multi-frequency bioelectrical impedance analysis (DSM-BIA. To examine the association between obesity and selected body composition indicators, Kruskal-Wallis ANOVA and Eta2 were used. The relationship between selected body composition indicators and percentile BMI zones was determined using the Kendall tau correlation. Results In groups with different BMI percentile zones (normal weight, overweight, obese, ANOVA showed significant differences for girls and boys (p ˂.05 with high effect size (η2 ˂.26 in body weight, body fat mass index, body fat percentage, fat free mass index, fat-free mass percentage, visceral fat area, waist-to-hip ratio, waist circumference, protein mass and mineral mass. The highest degree of correlation among boys was between BMI values indicating overweight and obesity and fat free mass index and waist circumference, respectively (τ = .71, τ = .70, respectively. In girls, the highest

  1. Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study

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    Oriol Cunillera

    2015-07-01

    Full Text Available Introduction: Kiwifruit consumption has shown to improve functional constipation in healthy elderly population, according to studies in New Zealand and China. The aim of this study was to evaluate the effect of kiwifruit intake on functional constipation in a Mediterranean patient population characterized by its distinctive nutritional habits.Material and Methods: An open, non-controlled and non-randomized longitudinal study was conducted in 46 patients with constipation (Rome III criteria. Patients monitored for five weeks: weeks 1 and 2 no kiwifruit and weeks 3-5 three kiwifruit per day (Green kiwifruit, Actinidia deliciosa var Hayward. Bristol Scale, volume of stools, and ease of defecation was self- reported daily. The evolution of the categorical variables was tested using the Bhapkar test; functional data methodology was used for continuous variables, and Generalized Estimating Equation (GEE models were adjusted.Results: The percentage of patients with ≥3 stools per week increased from 82.61% (95% CI: 69–91.2 at week 1 to 97.78% (95% CI: 87.4–99.9 at week 2 of kiwifruit intake, with 76.09% (95% CI: 61.9–86.2 responding during the first week. The reporting of stable ideal stools increased from 17.39% (95% CI: 8.8–31 at week 2 to 33.33% (95% CI: 21.3–48 at week 5. According to GEE models, the number of depositions increased significantly (p-values<0.001 in 0.398 daily units at week 1 the first week of intake, up to 0.593 daily units at week 5; significant improvements on facility in evacuation and volume of evacuation were found from the firstweek of intake (all p-values<0.001.Conclusions: The intake of three kiwifruits per day significantly improves the quality of evacuation (number of depositions, volume, consistency and ease in a Mediterranean patient population suffering from functional constipation.

  2. Feasibility studies for decommissioning

    International Nuclear Information System (INIS)

    Hladky, E.

    2000-01-01

    In this presentation author deals with planning of decommission of the NPPs A1, V1 and V2 Bohunice and Mochovce. It was concluded that: Used model for decommissioning parameters assessment has been suitable for elaboration of initial decommissioning plans (feasibility studies); Basic assessment of main decommissioning parameters and basic comparison of various decommissioning options have been possible; Improvement of the model and corresponding software is desirable and works on software improvement began one year ago; V1-NPP initial decommissioning plan should be actualized, because initial decommissioning plan does not correspond by its content and structure to requirements of Act No. 130/98 and Nuclear Regulatory Authority Degree No. 246/99; Strategy of radioactive wastes treatment and conditioning together with technical provisions at Jaslovske Bohunice site was changed in comparison with the assumptions in 1991-92; Considered V1 NPP decommissioning options are necessary to be re-evaluated in accordance with latest development of knowledge and approaches to NPP decommissioning in the world; Specific unit costs are substantially and differentially changed in comparison with the assumptions in 1991-92; Necessity to take into account technical changes resulted from V1 NPP reconstruction. (author)

  3. Comparative anatomy of the human APRT gene and enzyme: nucleotide sequence divergence and conservation of a nonrandom CpG dinucleotide arrangement

    International Nuclear Information System (INIS)

    Broderick, T.P.; Schaff, D.A.; Bertino, A.M.; Dush, M.K.; Tischfield, J.A.; Stambrook, P.J.

    1987-01-01

    The functional human adenine phosphoribosyltransferase (APRT) gene is <2.6 kilobases in length and contains five exons. The amino acid sequences of APRTs have been highly conserved throughout evolution. The human enzyme is 82%, 90%, and 40% identical to the mouse, hamster, and Escherichia coli enzymes, respectively. The promoter region of the human APRT gene, like that of several other housekeeping genes, lacks TATA and CCAAT boxes but contains five GC boxes that are potential binding sites for the Sp1 transcription factor. The distal three, however, are dispensable for gene expression. Comparison between human and mouse APRT gene nucleotide sequences reveals a high degree of homology within protein coding regions but an absence of significant homology in 5' flanking, 3' untranslated, and intron sequences, except for similarly positioned GC boxes in the promoter region and a 26-base-pair region in intron 3. This 26-base-pair sequence is 92% identical with a similarly positioned sequence in the mouse gene and is also found in intron 3 of the hamster gene, suggesting that its retention may be a consequence of stringent selection. The positions of all introns have been precisely retained in the human and both rodent genes. Retention of an elevated CpG dinucleotide content, despite loss of sequence homology, suggests that there may be selection for CpG dinucleotides in these regions and that their maintenance may be important for APRT gene function

  4. EFFECT OF FUROSEMIDE AND TORASEMIDE ON HEART RATE VARIABILITY AND VENTRICULAR RHYTHM DISORDERS IN PATIENTS WITH CHRONIC HEART FAILURE COMPLICATING ISCHEMIC HEART DISEASE: COMPARATIVE NONRANDOMIZED STUDY

    Directory of Open Access Journals (Sweden)

    H. H. Shugushev

    2010-01-01

    Full Text Available Aim. To study effect of diuretic therapy with furosemide and torasemide on heart rate variability (HRV and frequency of ventriclar rhythm disorders in patients with chronic heart failure (CHF complicating ischemic heart disease (IHD.Material and methods. Patients (n=107 with CHF III-IV functional class (NYHA complicating IHD were examined. The first group of patients received furosemide, 20-60 mg QD (n=52, the second group received torasemide, 5-20 mg QD (n=55. Analysis of heart rhythm disorders and the basic HRV indicators was performed by ECG 10-minute recordings initially and after 10 days of therapy.Results. Decrease in time and spectral HRV parameters and increase in daily number of ventricular extrasystoles was found in furosemide treated patients. Improvement of HRV parameters and reduction of daily number of ventricular rhythm disorders was found torasemide treated patients.Conclusion. Torasemide therapy improves an autonomic regulation of heart rhythm and leads to the reduction of ventricular heart rhythm disorders in patients with CHF complicating IHD.

  5. Management of adenocarcinoma of the esophagus with chemoradiation alone or chemoradiation followed by esophagectomy: results of sequential nonrandomized phase II studies

    Energy Technology Data Exchange (ETDEWEB)

    Algan, Oezer; Coia, Lawrence R; Keller, Steven M; Engstrom, Paul F; Weiner, Louis M; Schultheiss, Timothy E; Hanks, Gerald E

    1995-06-15

    Purpose: The incidence of adenocarcinoma of the esophagus is increasing, but the optimal treatment for this disease is unknown. We evaluated the efficacy of chemoradiation and chemoradiation followed by esophagectomy as treatment for adenocarcinoma of the esophagus in sequential prospective nonrandomized phase II studies. Methods and Materials: Between May 1981 and June 1992, all previously untreated patients (N = 35) with potentially resectable adenocarcinoma of the esophagus (clinical Stage I or II) were treated with curative intent in sequential prospective Phase II studies. From May 1981 to August 1987, 11 patients (median age 66) were treated with concurrent chemotherapy [mitomycin C, and 5-fluorouracil (5-FU)] and radiotherapy to a median dose of 60 Gy (CRT group). From September 1987 to June 1992, 24 patients (median age 65) were treated with the same regimen of chemoradiation followed by planned esophagectomy (CRT + PE group). Of these, 12 patients (median age 62) actually underwent esophagectomy (CRT + E subgroup). Results: The median overall survival was 19 months for the CRT group and 15 months for the CRT + PE group. For the CRT + E subgroup, the median overall survival was 33 months. The 3-year actuarial overall survival for the CRT and the CRT + PE groups were 36 and 28% (p = 0.949). The subset of patients treated with chemoradiation followed by esophagectomy had a 3-year actuarial overall survival of 33% (p = 0.274). The 3-year actuarial freedom from local failure rates were similar: 62% in the CRT group vs. 58% in the CRT + PE group. Of the 12 patients who underwent esophagectomy (CRT + E group), 9 (75%) were free of local failure. Four of 12 (33%) patients had no pathologic evidence of malignancy in their surgical specimen. Six of 11 patients (55%) in the CRT group were free of local failure at the time of analysis. Two of five patients in this group who had local recurrence at 2 and 10 months underwent surgical salvage with subsequent survivals of

  6. GINGER: A feasibility study

    Science.gov (United States)

    Di Virgilio, Angela D. V.; Belfi, Jacopo; Ni, Wei-Tou; Beverini, Nicolo; Carelli, Giorgio; Maccioni, Enrico; Porzio, Alberto

    2017-04-01

    GINGER (Gyroscopes IN General Relativity) is a proposal for an Earth-based experiment to measure the Lense-Thirring (LT) and de Sitter effects. GINGER is based on ring lasers, which are the most sensitive inertial sensors to measure the rotation rate of the Earth. We show that two ring lasers, one at maximum signal and the other horizontal, would be the simplest configuration able to retrieve the GR effects. Here, we discuss this configuration in detail showing that it would have the capability to test LT effect at 1%, provided the accuracy of the scale factor of the instrument at the level of 1 part in 1012 is reached. In principle, one single ring laser could do the test, but the combination of the two ring lasers gives the necessary redundancy and the possibility to verify that the systematics of the lasers are sufficiently small. The discussion can be generalised to seismology and geodesy and it is possible to say that signals 10-12 orders of magnitude below the Earth rotation rate can be studied; the proposed array can be seen as the basic element of multi-axial systems, and the generalisation to three dimensions is feasible adding one or two devices and monitoring the relative angles between different ring lasers. This simple array can be used to measure with very high precision the amplitude of angular rotation rate (the length of the day, LOD), its short term variations, and the angle between the angular rotation vector and the horizontal ring laser. Finally this experiment could be useful to probe gravity at fundamental level giving indications on violations of Einstein Equivalence Principle and Lorenz Invariance and possible chiral effects in the gravitational field.

  7. Growth-induced strong pinning sites in laser ablated YBa2Cu3O7-δ films with a non-random distribution

    International Nuclear Information System (INIS)

    Huijbregtse, J.M.; Klaassen, F.C.; Geest, R.C.F. van der; Dam, B.; Griessen, R.

    1999-01-01

    Recently, the authors showed that natural linear defects are the origin of the high critical currents in laser ablated YGBa 2 Cu 3 O 7-δ films. Combining wet-chemical etching and Atomic Force Microscopy, they find that these dislocations are created by island coalescence during growth. Consequently, the defect density can be reproducibly varied by manipulating the density of growth islands, which in turn depends on the substrate temperature. Interestingly, the radial defect distribution function approaches zero at small distances, indicating short range order. Therefore, they are now able to study vortex matter in films with a tailored non-random distribution of natural strong pinning sites

  8. Feasible Path Planning for Autonomous Vehicles

    Directory of Open Access Journals (Sweden)

    Vu Trieu Minh

    2014-01-01

    Full Text Available The objective of this paper is to find feasible path planning algorithms for nonholonomic vehicles including flatness, polynomial, and symmetric polynomial trajectories subject to the real vehicle dynamical constraints. Performances of these path planning methods are simulated and compared to evaluate the more realistic and smoother generated trajectories. Results show that the symmetric polynomial algorithm provides the smoothest trajectory. Therefore, this algorithm is recommended for the development of an automatic control for autonomous vehicles.

  9. EFFICACY AND SAFETY OF INHALED NITRIC OXIDE USE IN PATIENTS WITH PULMONARY HYPERTENSION AND CHRONIC HEART FAILURE III-IV FUNCTIONAL CLASS, SURVIVED LEFT VENTRICULAR MYOCARDIAL INFARCTION: RESULTS OF NON-RANDOMIZED COMAPARIVE STUDY

    Directory of Open Access Journals (Sweden)

    P. N. Pavlenko

    2011-01-01

    Full Text Available Aim – assessment of the influence of inhaled nitric oxide (NO on the course of pulmonary hypertension (PH in patients with chronic heartfailure (CHF III–IV functional class (FC, myocardial infarction (MI.Materials and methods. Results of comparative non-randomized study that included 45 patients (26 men and 19 women aged 51 to 98 years with PH III–IV functional class, left ventricular myocardial infarction. In the study, patients underwent physical examination and Doppler echocardiography, and assessed FC LH (carried out with six-minute walking test, to determine the degree of dyspnea by Borg.Results. Symptoms of CHF and PH regressed in both groups of patients against the background of the therapy. Conclusion. It is established that the use of inhaled NO is a safe therapy and helps to reduce mean pulmonary arterial pressure (PAPmean in patients with PH and CHF III–IV FC, myocardial infarction. The method of inhaled NO is simple and easy to use.

  10. EFFICACY AND SAFETY OF INHALED NITRIC OXIDE USE IN PATIENTS WITH PULMONARY HYPERTENSION AND CHRONIC HEART FAILURE III-IV FUNCTIONAL CLASS, SURVIVED LEFT VENTRICULAR MYOCARDIAL INFARCTION: RESULTS OF NON-RANDOMIZED COMAPARIVE STUDY

    Directory of Open Access Journals (Sweden)

    P. N. Pavlenko

    2014-07-01

    Full Text Available Aim – assessment of the influence of inhaled nitric oxide (NO on the course of pulmonary hypertension (PH in patients with chronic heartfailure (CHF III–IV functional class (FC, myocardial infarction (MI.Materials and methods. Results of comparative non-randomized study that included 45 patients (26 men and 19 women aged 51 to 98 years with PH III–IV functional class, left ventricular myocardial infarction. In the study, patients underwent physical examination and Doppler echocardiography, and assessed FC LH (carried out with six-minute walking test, to determine the degree of dyspnea by Borg.Results. Symptoms of CHF and PH regressed in both groups of patients against the background of the therapy. Conclusion. It is established that the use of inhaled NO is a safe therapy and helps to reduce mean pulmonary arterial pressure (PAPmean in patients with PH and CHF III–IV FC, myocardial infarction. The method of inhaled NO is simple and easy to use.

  11. The study protocol for a non-randomized controlled clinical trial using a genotype-guided strategy in a dataset of patients who undergone percutaneous coronary intervention with stent

    Directory of Open Access Journals (Sweden)

    Cristina Lucía Dávila-Fajardo

    2017-02-01

    Full Text Available This article contains data related to the research article entitled “Results of genotype–guided antiplatelet therapy in patients undergone percutaneous coronary intervention with stent” (J. Sánchez-Ramos, C.L. Dávila-Fajardo, P. Toledo Frías, X. Díaz Villamarín, L.J. Martínez-González, S. Martínez Huertas, F. Burillo Gómez, J. Caballero Borrego, A. Bautista Pavés, M.C. Marín Guzmán, J.A. Ramirez Hernández, C. Correa Vilches, J. Cabeza Barrera, 2016 (1. This data article reports, for the first time, about the non-randomized clinical trial protocol that check if CYP2C19/ABCB1 genotype–guided strategy in which the choice of antiplatelet therapy is based on the genetic test, reduces the rates of cardiovascular events and bleeding compared to a non-tailored strategy in patients undergone percutaneous coronary intervention (PCI with stent. The data included in this article are: design and setting of the study, study population, inclusion and exclusion criteria, definition of the intervention, objectives, variables (baseline characteristics and during the follow-up, study procedures, collection and treatment of the biological sample, genotyping, withdrawal criteria, sample size, statistic analysis, ethical aspects, information sheet and consent form. The authors confirm that this study has been registered in Eudra CT (Eudra CT: 2016-001294-33.

  12. Standalone Effects of a Cognitive Behavioral Intervention Using a Mobile Phone App on Psychological Distress and Alcohol Consumption Among Japanese Workers: Pilot Nonrandomized Controlled Trial.

    Science.gov (United States)

    Hamamura, Toshitaka; Suganuma, Shinichiro; Ueda, Mami; Mearns, Jack; Shimoyama, Haruhiko

    2018-03-22

    Research that investigates standalone effects of a mobile phone-based cognitive behavioral therapy without any human contact for reducing both psychological distress and risky drinking has been advancing; however, the number of studies is still limited. A mobile phone app called Self Record that facilitates cognitive restructuring through self-monitoring of daily thoughts and activities was developed in Japan. This study conducted a nonrandomized controlled pilot trial of the Self Record app to investigate standalone effects of the intervention on psychological distress and alcohol consumption among Japanese workers. Additionally, we examined moderating effects of negative mood regulation expectancies, which are beliefs about one's ability to control one's negative mood. A quasi-experimental design with a 1-month follow-up was conducted online in Japan from February 2016 to March 2016. A research marketing company recruited participants. The selection criteria were being a Japanese full-time worker (age 20-59 years), experiencing mild to moderate psychological distress, and having some interest in self-record apps. Assignment to group was based on participants' willingness to use the app in the study. All participants completed outcome measures of negative mood regulation expectancies, positive well-being, general distress, depression, anxiety, and typical/most weekly alcohol consumption. From the recruitment, 15.65% (1083/6921) of participants met the inclusion criteria. Of these, 51.43% (557/1083) enrolled in the study: 54.9% (306/557) in the intervention group and 45.1% (251/557) in the control group. At the 1-month follow-up, 15.3% (85/557) of participants had dropped out. Intention-to-treat analyses revealed that participants in the intervention group reported increased typical drinking (η2=.009) and heavy drinking (η2=.001). Adherence to using the app was low; 64.8% (199/306) of participants in the intervention group discontinued using the app on the first

  13. Base compaction specification feasibility analysis.

    Science.gov (United States)

    2012-12-01

    The objective of this research is to establish the technical engineering and cost : analysis concepts that will enable WisDOT management to objectively evaluate the : feasibility of switching construction specification philosophies for aggregate base...

  14. Per-oral endoscopic myotomy for achalasia. Are results comparable to laparoscopic Heller myotomy?

    Science.gov (United States)

    Kumagai, Koshi; Tsai, Jon A; Thorell, Anders; Lundell, Lars; Håkanson, Bengt

    2015-05-01

    Per-oral endoscopic myotomy (POEM) has recently been introduced as a minimal invasive alternative to conventional treatment for achalasia. This study aimed to clarify the feasibility and the short-term clinical efficacy of POEM as compared to laparoscopic Heller myotomy (LHM). Treatment outcomes were prospectively recorded and compared between the procedures in a nonrandomized fashion. Reduction rate (RR) in timed barium esophagogram (TBE) was calculated at 1, 2 and 5 min after barium ingestion as: RR = 1- postoperative barium height/preoperative barium height. Risk factors for treatment failure defined as the proportion of patients with RR <0.5 (1 min) and gastroesophageal reflux (GER) after POEM were analyzed. Forty-two consecutive patients who underwent POEM were compared to 41 patients who had a LHM during the immediate time period prior to the introduction of POEM. Ninety percent of the cases reported complete symptom relief after POEM. The percentage of esophageal emptying and RR in TBE improved dramatically by both procedures without significant difference. A longer operation time (odds ratio [OR] 32.80, 95%CI 2.99-359.82, p = 0.004) and younger age (OR 26.81, 95%CI 2.09-344.03, p = 0.012) were the independent predictors of treatment failure after POEM. GER was observed in seven patients where previous dilatation (OR 8.59, 95%CI 1.16-63.45, p = 0.035) and higher body mass index (OR 8.69, 95%CI 1.13-66.63, p = 0.037) were the independent predictors for symptomatic GER after POEM. POEM seems to be a safe and effective treatment option for achalasia in the short-term perspective; an effect well comparable to LHM.

  15. Feasibility of selected private money

    Directory of Open Access Journals (Sweden)

    Lukáš Nevěděl

    2012-01-01

    Full Text Available The goal of the entry: “Feasibility of selected private money” is the assessment of practicability of selected private money types as future currency especially in terms of attributes that the currency should meet to fulfil all claims required by its users. In the first step the features that the widely used currency has to have will be described and it will be analysed which of these features are characteristic for nowadays currencies (Czech crown and Euro too. In the second step private (unnationalized money will be described as well as several concepts derived from it. The paper will concern mainly on Hayek’s concept of private money and on particular variations of Local exchange trading systems. In the next part there will be pointed out good and bad features of these types of money, mainly from the view of characteristics that the proper currency should have. At the end it will be carried out the comparison of bad and good effects resulting from using of particular currencies types and I will decide about the applicability of analysed private money types. The paper uses the standard methods of scientific work. Firstly, the method of description is used to describe the development of private money concepts and characteristic features that the currency should have. Then, a comparative analysis is used to discuss the differences between contemporary currencies and unnationalized currencies as well as between required and real features of particular private money. At the end the method of synthesis, deduction and induction is used.

  16. Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial.

    Science.gov (United States)

    Kattakuzhy, Sarah; Gross, Chloe; Emmanuel, Benjamin; Teferi, Gebeyehu; Jenkins, Veronica; Silk, Rachel; Akoth, Elizabeth; Thomas, Aurielle; Ahmed, Charisse; Espinosa, Michelle; Price, Angie; Rosenthal, Elana; Tang, Lydia; Wilson, Eleanor; Bentzen, Soren; Masur, Henry; Kottilil, Shyam

    2017-09-05

    Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has resulted in high rates of disease cure; however, not enough specialists currently are available to provide care. To determine the efficacy of HCV treatment independently provided by nurse practitioners (NPs), primary care physicians (PCPs), or specialist physicians using DAA therapy. Nonrandomized, open-label clinical trial initiated in 2015. (ClinicalTrials.gov: NCT02339038). 13 urban, federally qualified health centers (FQHCs) in the District of Columbia. A referred sample of 600 patients, of whom 96% were black, 69% were male, 82% were treatment naive, and 20% had cirrhosis. Seventy-two percent of the patients had HCV genotype 1a infection. The baseline characteristics of patients seen by each provider type were similar. Patients were assigned in a nonrandomized but specified manner to receive treatment from 1 of 5 NPs, 5 PCPs, or 6 specialists. All providers underwent an identical 3-hour training session based on guidelines. Patients received treatment with ledipasvir-sofosbuvir, which was provided on site, according to U.S. Food and Drug Administration labeling requirements. Sustained virologic response (SVR). 516 patients achieved SVR, a response rate of 86% (95% CI, 83.0% to 88.7%), with no major safety signals. Response rates were consistent across the 3 provider types: NPs, 89.3% (CI, 83.3% to 93.8%); PCPs, 86.9% (CI, 80.6% to 91.7%); and specialists, 83.8% (CI, 79.0% to 87.8%). Patient loss to follow-up was the major cause of non-SVR. Nonrandomized patient distribution; possible referral bias. In a real-world cohort of patients at urban FQHCs, HCV treatment administered by nonspecialist providers was as safe and effective as that provided by specialists. Nurse practitioners and PCPs with compact didactic training could substantially expand the availability of community-based providers to escalate HCV therapy, bridging existing gaps in the continuum of care for patients with

  17. The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy.

    Science.gov (United States)

    Wu, Rui-Yi; Wang, Guo-Min; Xu, Lei; Zhang, Bo-Heng; Xu, Ye-Qing; Zeng, Zhao-Chong; Chen, Bing

    2011-05-01

    The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU+LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU+LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P = 0.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU+LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU+LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU+LRT and CRT were independently associated with DSS (P = 0.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU+LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade ≥ II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU+LRT showed good efficacy and better safety.

  18. The feasibility of ecological taxation

    International Nuclear Information System (INIS)

    Paulus, A.T.G.

    1995-01-01

    The feasibility of ecological taxation in general and for the Netherlands in specific was analyzed within the context of one of the NRP research projects. The analysis shows that the feasibility of ecological taxes is generally determined by the tax design, the taxing authority by which these taxes are imposed and by the constitutional, institutional and fiscal structures into which they are embedded. In order to be feasible, the analysis shows that ecologically relevant taxes have to be imposed by a taxing authority which is clearly related to relevant ecological circumstances. Since normal taxing authorities tend to be political units which most of the times do not fit this description, institutional and constitutional changes are necessary to introduce and impose (additional) feasible types of ecological taxes in practice. Within the context of the Netherlands, the analysis shows that the currently changing intergovernmental and financial relationships in this country provide important starting points for municipalities, water authorities and provinces to introduce feasible types of such taxes. 225 refs

  19. Cogeneration: Key feasibility analysis parameters

    International Nuclear Information System (INIS)

    Coslovi, S.; Zulian, A.

    1992-01-01

    This paper first reviews the essential requirements, in terms of scope, objectives and methods, of technical/economic feasibility analyses applied to cogeneration systems proposed for industrial plants in Italy. Attention is given to the influence on overall feasibility of the following factors: electric power and fuel costs, equipment coefficients of performance, operating schedules, maintenance costs, Italian Government taxes and financial and legal incentives. Through an examination of several feasibility studies that were done on cogeneration proposals relative to different industrial sectors, a sensitivity analysis is performed on the effects of varying the weights of different cost benefit analysis parameters. With the use of statistical analyses, standard deviations are then determined for key analysis parameters, and guidelines are suggested for analysis simplifications

  20. Probability calculus of fractional order and fractional Taylor's series application to Fokker-Planck equation and information of non-random functions

    International Nuclear Information System (INIS)

    Jumarie, Guy

    2009-01-01

    A probability distribution of fractional (or fractal) order is defined by the measure μ{dx} = p(x)(dx) α , 0 α (D x α h α )f(x) provided by the modified Riemann Liouville definition, one can expand a probability calculus parallel to the standard one. A Fourier's transform of fractional order using the Mittag-Leffler function is introduced, together with its inversion formula; and it provides a suitable generalization of the characteristic function of fractal random variables. It appears that the state moments of fractional order are more especially relevant. The main properties of this fractional probability calculus are outlined, it is shown that it provides a sound approach to Fokker-Planck equation which are fractional in both space and time, and it provides new results in the information theory of non-random functions.

  1. Feasibility Study on HYSOL CSP

    DEFF Research Database (Denmark)

    Nielsen, Lars Henrik; Baldini, Mattia; Skytte, Klaus

    2016-01-01

    integrated HYSOL concept, therefore, becomes a fully dispatchable (offering firm power) and fully renewable energy source (RES) based power supply alternative, offering CO2-free electricity in regions with sufficient solar resources. The economic feasibility of HYSOL configurations is addressed in this paper....... The CO2 free HYSOL alternative is discussed relative to conventional reference firm power generation technologies. In particular the HYSOL performance relative to new power plants based on natural gas (NG) such as open cycle or combined cycle gas turbines (OCGT or CCGT) are in focus. The feasibility...

  2. Lower Sioux Wind Feasibility & Development

    Energy Technology Data Exchange (ETDEWEB)

    Minkel, Darin

    2012-04-01

    This report describes the process and findings of a Wind Energy Feasibility Study (Study) conducted by the Lower Sioux Indian Community (Community). The Community is evaluating the development of a wind energy project located on tribal land. The project scope was to analyze the critical issues in determining advantages and disadvantages of wind development within the Community. This analysis addresses both of the Community's wind energy development objectives: the single turbine project and the Commerical-scale multiple turbine project. The main tasks of the feasibility study are: land use and contraint analysis; wind resource evaluation; utility interconnection analysis; and project structure and economics.

  3. General discussion of feasibility study

    International Nuclear Information System (INIS)

    Calori, F.

    1976-01-01

    Fundamentals, objectives and parameters of feasibility studies in the field of nuclear power project planning are discussed in a general way. Technical and economic problems to be considered are pointed out. In special cases, IAEA offers its aid and support. (UA) [de

  4. The feasibility of ecological taxation

    International Nuclear Information System (INIS)

    Paulus, A.T.G.

    1995-01-01

    From an analysis of the possibilities and complexities of ecological taxation, conducted within the context of the first NRP (research project 851051E), it follows that the feasibility of ecological taxes is determined by their design, the level at which they are implemented, the taxing authority by which they are imposed and by the constitutional, institutional and fiscal framework in which they are embedded

  5. Mindfulness Training for Health Profession Students-The Effect of Mindfulness Training on Psychological Well-Being, Learning and Clinical Performance of Health Professional Students: A Systematic Review of Randomized and Non-randomized Controlled Trials.

    Science.gov (United States)

    McConville, Janet; McAleer, Rachael; Hahne, Andrew

    High levels of stress have been identified in medical students and increasingly in other health profession student population groups. As stress can affect psychological well-being and interfere with learning and clinical performance, there is a clear argument for universities to include health professional student well-being as an outcome in core curriculum. Mindfulness training is a potential construct to manage stress and enhance academic success. The aims of this systematic review were to assess the effectiveness of mindfulness training in medical and other health professional student population groups and to compare the effectiveness of the different mindfulness-based programs. A literature search was completed using The Cochrane library, Medline, Cinahl, Embase, Psychinfo, and ERIC (proquest) electronic databases from inception to June 2016. Randomized and non-randomized controlled trials were included. Of the potential 5355 articles, 19 met the inclusion criteria. Studies focused on medical (n = 10), nursing (n = 4), social work (n = 1), psychology (n = 1), and medical plus other health (n = 3) students. Interventions were based on mindfulness. The 19 studies included 1815 participants. Meta-analysis was performed evaluating the effect of mindfulness training on mindfulness, anxiety, depression, stress, mood, self-efficacy, and empathy. The effect of mindfulness on academic performance was discussed. Mindfulness-based interventions decrease stress, anxiety, and depression and improve mindfulness, mood, self-efficacy, and empathy in health profession students. Due to the range of presentation options, mindfulness training can be relatively easily adapted and integrated into health professional training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

    Directory of Open Access Journals (Sweden)

    Nina Rydland Olsen

    Full Text Available Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs, are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students.We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1 The Adapted Fresno test (AFT, 2 the EBP Belief Scale and 3 the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations.In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1, p < 0.001 and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2, p = 0.002, but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1, p = 0.574. Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only.A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.

  7. A non-randomized study in consecutive patients with postcholecystectomy refractory biliary leaks who were managed endoscopically with the use of multiple plastic stents or fully covered self-expandable metal stents (with videos).

    Science.gov (United States)

    Canena, Jorge; Liberato, Manuel; Meireles, Liliane; Marques, Inês; Romão, Carlos; Coutinho, António Pereira; Neves, Beatriz Costa; Veiga, Pedro Mota

    2015-07-01

    Endoscopic management of postcholecystectomy biliary leaks is widely accepted as the treatment of choice. However, refractory biliary leaks after a combination of biliary sphincterotomy and the placement of a large-bore (10F) plastic stent can occur, and the optimal rescue endotherapy for this situation is unclear. To compare the clinical effectiveness of the use of a fully covered self-expandable metal stent (FCSEMS) with the placement of multiple plastic stents (MPS) for the treatment of postcholecystectomy refractory biliary leaks. Prospective study. Two tertiary-care referral academic centers and one general district hospital. Forty consecutive patients with refractory biliary leaks who underwent endoscopic management. Temporary placement of MPS (n = 20) or FCSEMSs (n = 20). Clinical outcomes of endotherapy as well as the technical success, adverse events, need for reinterventions, and prognostic factors for clinical success. Endotherapy was possible in all patients. After endotherapy, closure of the leak was accomplished in 13 patients (65%) who received MPS and in 20 patients (100%) who received FCSEMSs (P = .004). The Kaplan-Meier (log-rank) leak-free survival analysis showed a statistically significant difference between the 2 patient populations (χ(2) [1] = 8.30; P stents (P = .024), a plastic stent diameter <20F (P = .006), and a high-grade biliary leak (P = .015) were shown to be significant predictors of treatment failure with MPS. The 7 patients in whom placement of MPS failed were retreated with FCSEMSs, resulting in closure of the leaks in all cases. Non-randomized design. In our series, the results of the temporary placement of FCSEMSs for postcholecystectomy refractory biliary leaks were superior to those from the use of MPS. A randomized study is needed to confirm our results before further recommendations. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  8. Biological Feasibility of Measles Eradication

    Science.gov (United States)

    Strebel, Peter

    2011-01-01

    Recent progress in reducing global measles mortality has renewed interest in measles eradication. Three biological criteria are deemed important for disease eradication: (1) humans are the sole pathogen reservoir; (2) accurate diagnostic tests exist; and (3) an effective, practical intervention is available at reasonable cost. Interruption of transmission in large geographical areas for prolonged periods further supports the feasibility of eradication. Measles is thought by many experts to meet these criteria: no nonhuman reservoir is known to exist, accurate diagnostic tests are available, and attenuated measles vaccines are effective and immunogenic. Measles has been eliminated in large geographical areas, including the Americas. Measles eradication is biologically feasible. The challenges for measles eradication will be logistical, political, and financial. PMID:21666201

  9. Hydrogen system (hydrogen fuels feasibility)

    International Nuclear Information System (INIS)

    Guarna, S.

    1991-07-01

    This feasibility study on the production and use of hydrogen fuels for industry and domestic purposes includes the following aspects: physical and chemical properties of hydrogen; production methods steam reforming of natural gas, hydrolysis of water; liquid and gaseous hydrogen transportation and storage (hydrogen-hydride technology); environmental impacts, safety and economics of hydrogen fuel cells for power generation and hydrogen automotive fuels; relevant international research programs

  10. Feasibility of Wind Energy Parks

    International Nuclear Information System (INIS)

    Villar, Jose

    2000-01-01

    The paper discuss the feasibility of wind energy parks including aspects of supply and demand of energy, costs of generation and risks of investment associated. The paper introduce to the situation of wind energy in the word and specifically in Spain, describes the legal framework in promotion of renewables in Spain, the analysis of revenues and the risk of this business in the european market

  11. NTRE extended life feasibility assessment

    Science.gov (United States)

    Results of a feasibility analysis of a long life, reusable nuclear thermal rocket engine are presented in text and graph form. Two engine/reactor concepts are addressed: the Particle Bed Reactor (PBR) design and the Commonwealth of Independent States (CIS) concept. Engine design, integration, reliability, and safety are addressed by various members of the NTRE team from Aerojet Propulsion Division, Energopool (Russia), and Babcock & Wilcox.

  12. Feasibility assessment, Lowell Hydroelectric Project

    Energy Technology Data Exchange (ETDEWEB)

    1979-04-01

    The results are presented of a feasibility analysis for hydroelectric generating facilities on the Merrimack River at Lowell, Massachusetts. The projected facility would utilize the existing Pawtucket Dam and a portion of the existing Northern Canal. The project was examined for economic, engineering, and environmental viability, and the results are favorable. The owners intend to proceed to the next step of negotiating a firm power purchase agreement.

  13. Comparison of transplacental treatment of fetal supraventricular tachyarrhythmias with digoxin, flecainide, and sotalol: results of a nonrandomized multicenter study

    NARCIS (Netherlands)

    Jaeggi, Edgar T.; Carvalho, Julene S.; de Groot, Ernestine; Api, Olus; Clur, Sally-Ann B.; Rammeloo, Lukas; McCrindle, Brian W.; Ryan, Greg; Manlhiot, Cedric; Blom, Nico A.

    2011-01-01

    Fetal tachyarrhythmia may result in low cardiac output and death. Consequently, antiarrhythmic treatment is offered in most affected pregnancies. We compared 3 drugs commonly used to control supraventricular tachycardia (SVT) and atrial flutter (AF). We reviewed 159 consecutive referrals with fetal

  14. Nonrandom variation in Poecilia marcellinoi n. sp. and P. salvatoris Regan, 1907 in El Salvador (Pisces, Poeciliidae)

    NARCIS (Netherlands)

    Poeser, Frederick N.

    1995-01-01

    A new species of the genus Poecilia Bloch & Schneider, 1801 is recorded from El Salvador. Morphological and meristic data of P. marcellinoi n. sp. and of the sympatric P. salvatoris Regan, 1907 are analysed. Intra- and interspecific variation are compared and correlated with environmental and

  15. Effectiveness of yoga program in the management of diabetes using community health workers in the urban slums of Bangalore city: A non-randomized controlled trial

    Science.gov (United States)

    Dasappa, Hemavathi; Fathima, Farah Naaz; Prabhakar, Rugmani

    2016-01-01

    Trial Design: Nonrandomized controlled trial. Methods: Nonrandomized controlled trial. This was an interventional study that was conducted in 4 slums of Bengaluru. Of the 256 diabetes participants, only 109 people agreed to participate in the program. Of 109 people, 52 people agreed to participate in the intervention (agreed to learn and practice Yoga) while the remaining 57 people were assigned to nonintervention group. Randomization and blinding could not be done. Objective and Outcome: The study was conducted with objective of assessing the effectiveness of Yoga, Pranayama, and Sudarshan Kriya in the community-based management of diabetes mellitus. The primary outcome variable was Hb1Ac and secondary outcome variables were systolic blood pressure (SBP), diastolic blood pressure (DBP), adherence to medication, and changes in lifestyle. Results: The study was conducted for 40 days. Community health workers made a total of 6 visits during the study. All the 109 participants were available for weekly follow-up. There were no drop outs among the study population. Statistically significant change was seen in the consumption of vegetable (χ2 = 15.326, P < 0.005), fruits (χ2 = 16.207, P < 0.005), salty food (χ2 = 14.823, P < 0.005), bakery food (χ2 = 10.429, P < 0.005) and fried food (χ2 = 15.470, P < 0.005), adherence to metformin (χ2 = 41.780, P < 0.005) and other medication(χ2 = 21.871, P < 0.005) and proportion of patients with DBP under control (χ2 = 9.396, P < 0.005) and proportion of people with glucose random blood sugar under control (χ2 = 29.693, P < 0.005) between the two groups following the intervention. Statistically significant change was also seen in the proportion of people with SBP/DBP ≤140/90 (χ2 = 10.635, P < 0.005) between the two groups. Conclusion: The Yoga program was successful in improving dietary practices and medication adherence and in increasing the proportion of diabetics and hypertensive patients under control. PMID:28217594

  16. Effectiveness of yoga program in the management of diabetes using community health workers in the urban slums of Bangalore city: A non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hemavathi Dasappa

    2016-01-01

    Full Text Available Trial Design: Nonrandomized controlled trial. Methods: Nonrandomized controlled trial. This was an interventional study that was conducted in 4 slums of Bengaluru . Of the 256 diabetes participants, only 109 people agreed to participate in the program. Of 109 people, 52 people agreed to participate in the intervention (agreed to learn and practice Yoga while the remaining 57 people were assigned to nonintervention group. Randomization and blinding could not be done. Objective and Outcome: The study was conducted with objective of assessing the effectiveness of Yoga, Pranayama, and Sudarshan Kriya in the community-based management of diabetes mellitus. The primary outcome variable was Hb1Ac and secondary outcome variables were systolic blood pressure (SBP, diastolic blood pressure (DBP, adherence to medication, and changes in lifestyle. Results: The study was conducted for 40 days. Community health workers made a total of 6 visits during the study. All the 109 participants were available for weekly follow-up. There were no drop outs among the study population. Statistically significant change was seen in the consumption of vegetable (c2 = 15.326, P < 0.005, fruits (c2 = 16.207, P < 0.005, salty food (c2 = 14.823, P < 0.005, bakery food (c2 = 10.429, P < 0.005 and fried food (c2 = 15.470, P < 0.005, adherence to metformin (c2 = 41.780, P < 0.005 and other medication(c2 = 21.871, P < 0.005 and proportion of patients with DBP under control (c2 = 9.396, P < 0.005 and proportion of people with glucose random blood sugar under control (c2 = 29.693, P < 0.005 between the two groups following the intervention. Statistically significant change was also seen in the proportion of people with SBP/DBP ≤140/90 (c2 = 10.635, P < 0.005 between the two groups. Conclusion: The Yoga program was successful in improving dietary practices and medication adherence and in increasing the proportion of diabetics and hypertensive patients under control.

  17. A non-randomized [corrected] controlled trial of the active music engagement (AME) intervention on children with cancer.

    Science.gov (United States)

    Robb, Sheri L; Clair, Alicia A; Watanabe, Masayo; Monahan, Patrick O; Azzouz, Faouzi; Stouffer, Janice W; Ebberts, Allison; Darsie, Emily; Whitmer, Courtney; Walker, Joey; Nelson, Kirsten; Hanson-Abromeit, Deanna; Lane, Deforia; Hannan, Ann

    2008-07-01

    Coping theorists argue that environmental factors affect how children perceive and respond to stressful events such as cancer. However, few studies have investigated how particular interventions can change coping behaviors. The active music engagement (AME) intervention was designed to counter stressful qualities of the in-patient hospital environment by introducing three forms of environmental support. The purpose of this multi-site randomized controlled trial was to determine the efficacy of the AME intervention on three coping-related behaviors (i.e. positive facial affect, active engagement, and initiation). Eighty-three participants, ages 4-7, were randomly assigned to one of three conditions: AME (n = 27), music listening (ML; n = 28), or audio storybooks (ASB; n = 28). Conditions were videotaped to facilitate behavioral data collection using time-sampling procedures. After adjusting for baseline differences, repeated measure analyses indicated that AME participants had a significantly higher frequency of coping-related behaviors compared with ML or ASB. Positive facial affect and active engagement were significantly higher during AME compared with ML and ASB (p<0.0001). Initiation was significantly higher during AME than ASB (p<0.05). This study supports the use of the AME intervention to encourage coping-related behaviors in hospitalized children aged 4-7 receiving cancer treatment. (c) 2007 John Wiley & Sons, Ltd.

  18. Moroccan wind farm potential feasibility. Case study

    International Nuclear Information System (INIS)

    Nouri, Abdellatif; Ait Babram, Mohamed; Elwarraki, Elmostafa; Enzili, Mustapha

    2016-01-01

    Highlights: • A new methodology for the technical feasibility of wind farm potentials is proposed. • The wind resources of two different sites in Morocco are compared. • Comparison between short and long term data using multivariate analysis is made. • Geographic information system implementation. • A 10 MW wind farm is designed and optimized. - Abstract: The subject of this paper is the elaboration of a methodology to study the technical feasibility of a wind farm potential. The implementation of this methodology allows a comparison between the wind resources of two different sites in Morocco. One site is located in the region of Essaouira, whereas the other one is located in the region of Safi. The comparison is based on real wind data collected from two masts at the heights of 30, 50, and 60 m. Each of the masts is installed at one of the mentioned potential sites over a fixed time period, lasting fifteen months for the first site, and eight months for the second one. The aim is the determination of the most applicable site presenting a good potential for a statistical study in order to predict long-term wind behaviors. Thus, the geographical situation study of the chosen site including topography, roughness and obstacles, is carried out. Furthermore, the wind resource using data, generated by the measuring masts, is evaluated. Finally, the areas which present great wind potential are located and the wind farm turbine locations are optimized by using the WAsP software.

  19. Identification of internal variation in the pseudoautosomal VNTR DXYS17, with nonrandom distribution of the alleles on the X and the Y chromosomes

    Energy Technology Data Exchange (ETDEWEB)

    Decorte, R.; Wu, R.; Marynen, P.; Cassiman, J.J.

    1994-03-01

    The PCR technique was used to analyze the DXYS17 locus in the pseudoautosomal region of the X and the Y chromosomes. Analysis on an automated DNA sequencer allowed for sensitive and highly accurate typing of 16 different alleles with a size between 480 and 1,100 bp. Two DXYS17 alleles migrated with the same size on agarose or denaturing polyacrylamide gels but with different mobilities on nondenaturing polyacrylamide gels. Sequence analysis showed that, while an identical number of repeats were present in both alleles, differences in the composition of the units were observed. The origin of these differences was found in the 28- and 33-bp units, which only had a specific repeat pattern at the 5' and 3' ends of the region. The genotype distribution for DXYS17 in a Caucasian population did not deviate from the values expected under Hardy-Weinberg equilibrium. However, the frequency of one allele and one genotype was significantly different between males and females. Segregation analysis showed that this difference was the result of a nonrandom distribution of certain alleles on the sex chromosomes in males. 31 refs., 4 figs., 2 tabs.

  20. A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study.

    Science.gov (United States)

    Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S

    2015-01-01

    Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

  1. Effects of fluoxetine on fine motor performance in dysthymia: an 8-week, nonrandomized, open-label study.

    Science.gov (United States)

    Schrijvers, Didier; Maas, Yvonne J; Sabbe, Bernard G C

    2009-01-01

    Present findings on psychomotor retardation in dysthymia are inconsistent and changes in psychomotor performance during antidepressant treatment have not been investigated in this population to date. The present study aims to explore the psychomotor effects of an 8-week regimen of fluoxetine in dysthymic patients. Dysthymic patients (both inpatients and outpatients of the Psychiatric Hospital Sint-Norbertus, Duffel, Belgium), presenting over a period of 2 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for dysthymia, and having Hamilton Depression Rating Scale scores of > or = 12 were enrolled. During 8 weeks of treatment with fluoxetine 20 mg/d, depression severity and graphic motor activity were assessed 4 times by recording the time (a reaction time [RT] and a movement time [MT]) participants needed to copy single lines and simple and complex figures. The patients' outcomes were compared with those of untreated, healthy controls, matched for sex and comparable age and education. The assessors were masked to treatment and group. Eighteen dysthymic patients (mean age, 40 years; male/female ratio, 4/14; mean weight, 70 kg; all white) were treated; 18 healthy controls (mean age, 40 years; male/female ratio, 4/14; mean weight, 72 kg; all white) were used as comparison. The overall patient group experienced significant psychomotor changes only in association with the complex figure-copying task (RT: F = 5.67, P 40% decrease in severity scores), significant improvements were observed only for the RT of the line- (F = 4.75, P dysthymia.

  2. DPC loading feasibility study report

    International Nuclear Information System (INIS)

    Dafoe, R.E.; Lopez, D.A.; Williams, K.L.

    1997-11-01

    Disposal of radioactive wastes now stored at the Idaho Chemical Processing Plant at the Idaho National Engineering and Environmental Laboratory is mandated under a ''Settlement Agreement'' between the Department of Energy and the State of Idaho. This study investigates the feasibility of using the Dry Transfer Cell facility to package waste into Dual Purpose Canisters for interim storage at the adjacent Dry Storage System comprised of an interim storage pad with NUHOMS reg-sign storage modules. The wastes would then be road-ready for eventual disposal in a permanent repository. The operating period for these activities is expected to be from 2015 to 2035

  3. Coal pre-feasibility assessment

    International Nuclear Information System (INIS)

    1994-03-01

    It examines the feasibility of using coal from the Delbi-Moya reserve for domestic or institutional cooking, industrial process heating and electricity generation. It indicates as coal can be mined from the Delbi reserve at a cost of EB110/tonne, can be processed for EB400/tonne and transported to Addis Ababa for 150/tonne. The wholesale price of coal briquettes in Addis Ababa would be EB750/tonne. Domestic users can save EB475 per year by switching from charcoal to coal briquettes. And for a 50MW plant annual saving would be of the order of EB30 million per year. 11 tab. 4 figs. 6 appendex

  4. Nonrandom Composition of Flower Colors in a Plant Community: Mutually Different Co-Flowering Natives and Disturbance by Aliens

    Science.gov (United States)

    Makino, Takashi T.; Yokoyama, Jun

    2015-01-01

    When pollinators use flower color to locate food sources, a distinct color can serve as a reproductive barrier against co-flowering species. This anti-interference function of flower color may result in a community assembly of plant species displaying mutually different flower colors. However, such color dispersion is not ubiquitous, suggesting a variable selection across communities and existence of some opposing factors. We conducted a 30-week study in a plant community and measured the floral reflectances of 244 species. The reflectances were evaluated in insect color spaces (bees, swallowtails, and flies), and the dispersion was compared with random expectations. We found that co-existing colors were overdispersed for each analyzed pollinator type, and this overdispersion was statistically significant for bees. Furthermore, we showed that exclusion of 32 aliens from the analysis significantly increased the color dispersion of native flowers in every color space. This result indicated that aliens disturbed a native plant–pollinator network via similarly colored flowers. Our results demonstrate the masking effects of aliens in the detection of color dispersion of native flowers and that variations in pollinator vision yield different outcomes. Our results also support the hypothesis that co-flowering species are one of the drivers of color diversification and affect the community assembly. PMID:26650121

  5. Translocations and deletions with breakpoint on 21q are nonrandomly associated with treatment-related acute nonlymphocytic leukemia and preleukemia

    International Nuclear Information System (INIS)

    Keldsen, N.; Philip, P.; Pedersen-Bjergaard, J.

    1987-01-01

    Six of 70 (8.6%) consecutive cases with therapy-related acute nonlymphocytic leukemia (ANLL) or preleukemia had a translocation or deletion with a breakpoint on 21q. Such aberrations were seen in only one of 200 (0.5%) consecutive cases of de novo ANLL examined at our laboratory. The figures reflect a 17.1-fold increased incidence of 21q aberrations in therapy-related ANLL or preleukemia, compared with ANLL de novo. The difference is highly significant (p = 0.003). The increased incidence of 21q aberrations in therapy-related myelodysplastic syndromes was confirmed by literature studies. Band 21q22 was most often involved. Cases with t(8;21), which is strongly associated with the M2 variant of ANLL, or cases with i(21q), which is supposedly due to a centromeric misdivision, were not included in the count. It is concluded that the 21q aberrations are associated with treatment-related ANLL or preleukemia with at least the same degree of specificity as aberrations of number5 and number7. 61 references

  6. Nonrandom Composition of Flower Colors in a Plant Community: Mutually Different Co-Flowering Natives and Disturbance by Aliens.

    Directory of Open Access Journals (Sweden)

    Takashi T Makino

    Full Text Available When pollinators use flower color to locate food sources, a distinct color can serve as a reproductive barrier against co-flowering species. This anti-interference function of flower color may result in a community assembly of plant species displaying mutually different flower colors. However, such color dispersion is not ubiquitous, suggesting a variable selection across communities and existence of some opposing factors. We conducted a 30-week study in a plant community and measured the floral reflectances of 244 species. The reflectances were evaluated in insect color spaces (bees, swallowtails, and flies, and the dispersion was compared with random expectations. We found that co-existing colors were overdispersed for each analyzed pollinator type, and this overdispersion was statistically significant for bees. Furthermore, we showed that exclusion of 32 aliens from the analysis significantly increased the color dispersion of native flowers in every color space. This result indicated that aliens disturbed a native plant-pollinator network via similarly colored flowers. Our results demonstrate the masking effects of aliens in the detection of color dispersion of native flowers and that variations in pollinator vision yield different outcomes. Our results also support the hypothesis that co-flowering species are one of the drivers of color diversification and affect the community assembly.

  7. Sharps injury reduction using a sharps container with enhanced engineering: a 28 hospital nonrandomized intervention and cohort study.

    Science.gov (United States)

    Grimmond, Terry; Bylund, Suzann; Anglea, Candace; Beeke, Lou; Callahan, Angela; Christiansen, Erik; Flewelling, Kelly; McIntosh, Kathleen; Richter, Kay; Vitale, Monica

    2010-12-01

    The decrease in reported sharps injuries (SI) in the United States has markedly slowed. Additional devices and strategies need investigation. Sharps containers are associated with SI, and more than 90% of these injuries are related to container design. This study addresses the hypothesis that containers with enhanced engineering can reduce SI. In a before/after intervention study from 2006 to 2008, we examined the impact of conversion to a sharps container with enhanced engineering (the Device) on SI categories in 14 Ascension Health hospitals (study group). The Device's safety features included large horizontal aperture, sensitive counterbalanced door, large atrium, and passive overfill prevention. Study group results were also compared with a control cohort of 14 contemporaneous size-matched, Ascension Health hospitals (control group). The Device was associated with significant reductions in after-procedure (-30%), disposal-related (-57%), and container-associated (-81%) SI in the study group. No significant reductions occurred in container-associated sharps injuries in the control group. Hospitals using the Device had significantly fewer total SI than control hospitals. Enhanced aperture design can significantly reduce container-associated sharps injuries. Other factors contributing to reduced injuries may include 1-hand deposit, safe closure, hand restriction, and preassembly. These results, from a country where sharps safety devices are widespread, are particularly applicable to countries where safety devices are not extensively used. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  8. PV solar system feasibility study

    International Nuclear Information System (INIS)

    Ashhab, Moh’d Sami S.; Kaylani, Hazem; Abdallah, Abdallah

    2013-01-01

    Highlights: ► This research studies the feasibility of PV solar systems. ► The aim is to develop the theory and application of a hybrid system. ► Relevant research topics are reviewed and some of them are discussed in details. ► A prototype of the PV solar system is designed and built. - Abstract: This research studies the feasibility of PV solar systems and aims at developing the theory and application of a hybrid system that utilizes PV solar system and another supporting source of energy to provide affordable heating and air conditioning. Relevant research topics are reviewed and some of them are discussed in details. Solar heating and air conditioning research and technology exist in many developed countries. To date, the used solar energy has been proved to be inefficient. Solar energy is an abundant source of energy in Jordan and the Middle East; with increasing prices of oil this source is becoming more attractive alternative. A good candidate for the other system is absorption. The overall system is designed such that it utilizes solar energy as a main source. When the solar energy becomes insufficient, electricity or diesel source kicks in. A prototype of the PV solar system that operates an air conditioning unit is built and proper measurements are collected through a data logging system. The measured data are plotted and discussed, and conclusions regarding the system performance are extracted.

  9. A negative bioventing feasibility test

    International Nuclear Information System (INIS)

    DePaoli, D.W.; Greene, D.W.; Herbes, S.E.; Walzel, A.D.

    1994-01-01

    A bioventing feasibility test was conducted at a hydrocarbon fuel spill site at Oak Ridge National Laboratory. The soils at this site are generally of low air permeability and are representative of the clayey soils encountered at several Department of Energy sites and throughout the southeastern United States. The tests included an in situ air permeability test and in situ respiration tests at three well where highest soil contamination was measured. The in situ respiration tests showed that there was the potential for significant biodegradation in the soil with adequate oxygenation. The in situ permeability tests indicated that the majority of flow was trough fractures, rather than through the bulk soils. A helium tracer test verified that injected gas flowed directly to the surface through a small number of fractures, with no flow reaching the monitoring wells. These results indicate that oxygen transport to the bulk soils would be severely limited by diffusion, such that bioventing was deemed not feasible for this site. In light of these results, the importance of testing for fracture flow in soils of lower permeability is stressed -- whether the technology is bioventing or conventional soil venting

  10. SYNCHEM feasibility report: Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    1995-01-01

    Several Czech and US companies have entered into a development agreement for the purposes of determining the technical and economic feasibility and overall financeability of an integrated gasification combined cycle (IGCC) regional energy facility to be located adjacent to the Chemopetrol refinery in Litvinov, Czech Republic. The Project would use a feedstock comprised of coal supplied by Doly a upravny Komorany s.p. (DUK) coal mining company and mined from the Most/Litvinov area together with high sulfur residual oils from the Chemopetrol refinery. When gasified together with oxygen from an Air Products air separation plant, and based on an average yearly consumption of 2,100K metric tons per year of coal (as delivered) and 630K tonnes per year of oil, approximately 11 million normal cubic meters per day of syngas will be produced. At its current projected design capacity, when combusted in two General Electric advanced technology Frame 9FA gas turbines, the Project will produce approximately 690MW of electric power; 250 metric tons/hour of steam for process; and 135 thermal equivalent MW of district heat. The Feasibility Phase efforts described in this report indicate the real possibility for a successful and profitable IGCC Project for the Czech Republic. It is therefore incumbent upon all the Project Participants to review and evaluate the information contained herein such that a go/no-go decision can be reached by early next year.

  11. Hualapai Wind Project Feasibility Report

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, Kevin [Hualapai Tribe; Randall, Mark [Daystar Consulting; Isham, Tom [Power Engineers; Horna, Marion J [MJH Power Consulting LLC; Koronkiewicz, T [SWCA Environmental, Inc.; Simon, Rich [V-Bar, LLC; Matthew, Rojas [Squire Sanders Dempsey; MacCourt, Doug C. [Ater Wynne, LLP; Burpo, Rob [First American Financial Advisors, Inc.

    2012-12-20

    The Hualapai Department of Planning and Economic Development, with funding assistance from the U.S. Department of Energy, Tribal Energy Program, with the aid of six consultants has completed the four key prerequisites as follows: 1. Identify the site area for development and its suitability for construction. 2. Determine the wind resource potential for the identified site area. 3. Determine the electrical transmission and interconnection feasibility to get the electrical power produced to the marketplace. 4. Complete an initial permitting and environmental assessment to determine the feasibility for getting the project permitted. Those studies indicated a suitable wind resource and favorable conditions for permitting and construction. The permitting and environmental study did not reveal any fatal flaws. A review of the best power sale opportunities indicate southern California has the highest potential for obtaining a PPA that may make the project viable. Based on these results, the recommendation is for the Hualapai Tribal Nation to move forward with attracting a qualified wind developer to work with the Tribe to move the project into the second phase - determining the reality factors for developing a wind project. a qualified developer will bid to a utility or negotiate a PPA to make the project viable for financing.

  12. Ear-EEG from generic earpieces: A feasibility study

    DEFF Research Database (Denmark)

    Kidmose, Preben; Looney, D; Jochumsen, Lars

    2013-01-01

    key patient needs (discreet, unobstrusive, user-friendly, robust) and that is low-cost and suitable for off-the-shelf use; thus promising great advantages for healthcare applications. Its feasibility is validated in a comprehensive comparative study with our established prototype, based...

  13. Commercial feasibility of fusion power based on the tokamak concept

    International Nuclear Information System (INIS)

    Reid, R.L.; Steiner, D.

    1977-01-01

    The impact of plasma operating characteristics, engineering options, and technology on the capital cost trends of tokamak power plants is determined. Tokamak power systems are compared to other advanced energy systems and found to be economically competitive. A three-phase strategy for demonstrating commercial feasibility of fusion power, based on a common-site multiple-unit concept, is presented

  14. Muon Muon Collider: Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Gallardo, J.C.; Palmer, R.B.; /Brookhaven; Tollestrup, A.V.; /Fermilab; Sessler, A.M.; /LBL, Berkeley; Skrinsky, A.N.; /Novosibirsk, IYF; Ankenbrandt, C.; Geer, S.; Griffin, J.; Johnstone, C.; Lebrun, P.; McInturff, A.; Mills, Frederick E.; Mokhov, N.; Moretti, A.; Neuffer, D.; Ng, K.Y.; Noble, R.; Novitski, I.; Popovic, M.; Qian, C.; Van Ginneken, A. /Fermilab /Brookhaven /Wisconsin U., Madison /Tel Aviv U. /Indiana U. /UCLA /LBL, Berkeley /SLAC /Argonne /Sobolev IM, Novosibirsk /UC, Davis /Munich, Tech. U. /Virginia U. /KEK, Tsukuba /DESY /Novosibirsk, IYF /Jefferson Lab /Mississippi U. /SUNY, Stony Brook /MIT /Columbia U. /Fairfield U. /UC, Berkeley

    2012-04-05

    A feasibility study is presented of a 2 + 2 TeV muon collider with a luminosity of L = 10{sup 35} cm{sup -2}s{sup -1}. The resulting design is not optimized for performance, and certainly not for cost; however, it does suffice - we believe - to allow us to make a credible case, that a muon collider is a serious possibility for particle physics and, therefore, worthy of R and D support so that the reality of, and interest in, a muon collider can be better assayed. The goal of this support would be to completely assess the physics potential and to evaluate the cost and development of the necessary technology. The muon collider complex consists of components which first produce copious pions, then capture the pions and the resulting muons from their decay; this is followed by an ionization cooling channel to reduce the longitudinal and transverse emittance of the muon beam. The next stage is to accelerate the muons and, finally, inject them into a collider ring wich has a small beta function at the colliding point. This is the first attempt at a point design and it will require further study and optimization. Experimental work will be needed to verify the validity of diverse crucial elements in the design. Muons because of their large mass compared to an electron, do not produce significant synchrotron radiation. As a result there is negligible beamstrahlung and high energy collisions are not limited by this phenomena. In addition, muons can be accelerated in circular devices which will be considerably smaller than two full-energy linacs as required in an e{sup +} - e{sup -} collider. A hadron collider would require a CM energy 5 to 10 times higher than 4 TeV to have an equivalent energy reach. Since the accelerator size is limited by the strength of bending magnets, the hadron collider for the same physics reach would have to be much larger than the muon collider. In addition, muon collisions should be cleaner than hadron collisions. There are many detailed particle

  15. Feasibility Study on HYSOL CSP

    DEFF Research Database (Denmark)

    Nielsen, Lars Henrik; Skytte, Klaus; Pérez, Cristian Hernán Cabrera

    2016-01-01

    Concentrating Solar Power (CSP) plants utilize thermal conversion of direct solar irradiation. A trough or tower configuration focuses solar radiation and heats up oil or molten salt that subsequently in high temperature heat exchangers generate steam for power generation. High temperature molten...... salt can be stored and the stored heat can thus increase the load factor and the usability for a CSP plant, e.g. to cover evening peak demand. In the HYSOL concept (HYbrid SOLar) such configuration is extended further to include a gas turbine fuelled by upgraded biogas or natural gas. The optimised...... integrated HYSOL concept, therefore, becomes a fully dispatchable (offering firm power) and fully renewable energy source (RES) based power supply alternative, offering CO2-free electricity in regions with sufficient solar resources. The economic feasibility of HYSOL configurations is addressed in this paper...

  16. IPNS upgrade: A feasibility study

    International Nuclear Information System (INIS)

    1995-04-01

    Many of Argonne National Laboratory's (ANL's) scientific staff members were very active in R ampersand D work related to accelerator-based spoliation sources in the 1970s and early 1980s. In 1984, the Seitz/Eastman Panel of the National Academy of Sciences reviewed U.S. materials science research facilities. One of the recommendations of this panel was that the United States build a reactor-based steady-state source, the Advanced Neutron Source (ANS), at Oak Ridge National Laboratory. Subsequently, R ampersand D activities related to the design of an accelerator-based source assumed a lower priority. The resumption of pulsed-source studies in this country started simultaneously with design activities in Europe aimed at the European Spallation Source (ESS). The European Community funded a workshop in September 1991 to define the parameters of the ESS. Participants in this workshop included both accelerator builders and neutron source users. A consortium of European countries has proposed to build a 5-MW pulsed source, and a feasibility study is currently under way. Soon after the birth of the ESS, a small group at ANL set about bringing themselves up to date on pulsed-source information since 1984 and studied the feasibility of upgrading ANL's Intense Pulsed Neutron Source (IPNS) to 1 MW by means of a rapidly cycling synchrotron that could be housed, along with its support facilities, in existing buildings. In early 1993, the Kohn panel recommended that (1) design and construction of the ANS should be completed according to the proposed project schedule and (2) development of competitive proposals for cost-effective design and construction of a 1-MW pulsed spallation source should be authorized immediately

  17. IPNS upgrade: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    Many of Argonne National Laboratory`s (ANL`s) scientific staff members were very active in R&D work related to accelerator-based spoliation sources in the 1970s and early 1980s. In 1984, the Seitz/Eastman Panel of the National Academy of Sciences reviewed U.S. materials science research facilities. One of the recommendations of this panel was that the United States build a reactor-based steady-state source, the Advanced Neutron Source (ANS), at Oak Ridge National Laboratory. Subsequently, R&D activities related to the design of an accelerator-based source assumed a lower priority. The resumption of pulsed-source studies in this country started simultaneously with design activities in Europe aimed at the European Spallation Source (ESS). The European Community funded a workshop in September 1991 to define the parameters of the ESS. Participants in this workshop included both accelerator builders and neutron source users. A consortium of European countries has proposed to build a 5-MW pulsed source, and a feasibility study is currently under way. Soon after the birth of the ESS, a small group at ANL set about bringing themselves up to date on pulsed-source information since 1984 and studied the feasibility of upgrading ANL`s Intense Pulsed Neutron Source (IPNS) to 1 MW by means of a rapidly cycling synchrotron that could be housed, along with its support facilities, in existing buildings. In early 1993, the Kohn panel recommended that (1) design and construction of the ANS should be completed according to the proposed project schedule and (2) development of competitive proposals for cost-effective design and construction of a 1-MW pulsed spallation source should be authorized immediately.

  18. Failure of fluconazole in treating cutaneous leishmaniasis caused by Leishmania guyanensis in the Brazilian Amazon: An open, nonrandomized phase 2 trial.

    Directory of Open Access Journals (Sweden)

    Valeska Albuquerque Francesconi

    2018-02-01

    Full Text Available The treatment of Leishmaniasis caused by Leishmania (Viannia guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure. One drug that has been studied in different clinical presentations of Leishmania is fluconazole, a hydrophilic bis-triazole, which is easily absorbed through the oral route with a low toxicity profile and is considered safe for children. This drug is readily available in poor countries with a reasonable cost making it a potential option for treating leishmaniasis.An adaptive nonrandomized clinical trial with sequential groups with dose escalation of oral fluconazole was designed to treat adult men with localized cutaneous leishmaniasis (LCL in Manaus, Brazil. Eligible participants were patients with LCL with confirmed Leishmania guyanensis infection.Twenty adult male patients were treated with 450 mg of fluconazole daily for 30 days. One patient (5% was cured within 30 days of treatment. Of the 19 failures (95%, 13 developed a worsening of ulcers and six evolved lymphatic spreading of the disease. Planned dose escalation was suspended after the disappointing failure rate during the first stage of the trial.Oral fluconazole, at the dose of 450mg per day, was not efficacious against LCL caused by Leishmania guyanensis in adult men.Brazilian Clinical Trial Registration (ReBec-RBR-8w292w; UTN number-1158-2421.

  19. A nonrandomized, open-label study to evaluate the effect of nasal stimulation on tear production in subjects with dry eye disease.

    Science.gov (United States)

    Friedman, Neil J; Butron, Karla; Robledo, Nora; Loudin, James; Baba, Stephanie N; Chayet, Arturo

    2016-01-01

    Dry eye disease (DED), a chronic disorder affecting the tear film and lacrimal functional unit, is a widely prevalent condition associated with significant burden and unmet treatment needs. Since specific neural circuits play an important role in maintaining ocular surface health, microelectrical stimulation of these pathways could present a promising new approach to treating DED. This study evaluated the efficacy and safety of nasal electrical stimulation in patients with DED. This prospective, open-label, single-arm, nonrandomized pilot study included 40 patients with mild to severe DED. After undergoing two screening visits, enrolled subjects were provided with a nasal stimulation device and instructed to use it at home four times daily (or more often as needed). Follow-up assessments were conducted up to day 180. The primary efficacy endpoint was the difference between unstimulated and stimulated tear production quantified by Schirmer scores. Additional efficacy endpoints included change from baseline in corneal and conjunctival staining, symptoms evaluated on a Visual Analog Scale, and Ocular Surface Disease Index scores. Safety parameters included adverse event (AE) rates, visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, and endoscopic nasal examinations. Mean stimulated Schirmer scores were significantly higher than the unstimulated scores at all visits, and corneal and conjunctival staining and symptom scores from baseline to day 180 were significantly reduced. No serious device-related AEs and nine nonserious AEs (three device-related) were reported. Intraocular pressure remained stable and most subjects showed little or no change in visual acuity at days 30 and 180. No significant findings from other clinical examinations were noted. Neurostimulation of the nasolacrimal pathway is a safe and effective means of increasing tear production and reducing symptoms of dry eye in patients with DED.

  20. Non-random temporary emigration and the robust design: Conditions for bias at the end of a time series: Section VIII

    Science.gov (United States)

    Langtimm, Catherine A.

    2008-01-01

    Deviations from model assumptions in the application of capture–recapture models to real life situations can introduce unknown bias. Understanding the type and magnitude of bias under these conditions is important to interpreting model results. In a robust design analysis of long-term photo-documented sighting histories of the endangered Florida manatee, I found high survival rates, high rates of non-random temporary emigration, significant time-dependence, and a diversity of factors affecting temporary emigration that made it difficult to model emigration in any meaningful fashion. Examination of the time-dependent survival estimates indicated a suspicious drop in survival rates near the end of the time series that persisted when the original capture histories were truncated and reanalyzed under a shorter time frame. Given the wide swings in manatee emigration estimates from year to year, a likely source of bias in survival was the convention to resolve confounding of the last survival probability in a time-dependent model with the last emigration probabilities by setting the last unmeasurable emigration probability equal to the previous year’s probability when the equality was actually false. Results of a series of simulations demonstrated that if the unmeasurable temporary emigration probabilities in the last time period were not accurately modeled, an estimation model with significant annual variation in survival probabilities and emigration probabilities produced bias in survival estimates at the end of the study or time series being explored. Furthermore, the bias propagated back in time beyond the last two time periods and the number of years affected varied positively with survival and emigration probabilities. Truncating the data to a shorter time frame and reanalyzing demonstrated that with additional years of data surviving temporary emigrants eventually return and are detected, thus in subsequent analysis unbiased estimates are eventually realized.

  1. A prospective, non-randomized phase II trial of Trastuzumab and Capecitabine in patients with HER2 expressing metastasized pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Endlicher Esther

    2009-01-01

    Full Text Available Abstract Background Pancreatic cancer is the fourth most common cause of cancer related death in Western countries. Advantages in surgical techniques, radiation and chemotherapy had almost no impact on the long term survival of affected patients. Therefore, the need for better treatment strategies is urgent. HER2, a receptor tyrosine kinase of the EGFR family, involved in signal transduction pathways leading to cell growth and differentiation is overexpressed in a number of cancers, including breast and pancreatic cancer. While in breast cancer HER2 has already been successfully used as a treatment target, there are only limited data evaluating the effects of inhibiting HER2 tyrosine kinases in patients with pancreatic cancer. Methods Here we report the design of a prospective, non-randomized multi-centered Phase II clinical study evaluating the effects of the Fluoropyrimidine-carbamate Capecitabine (Xeloda ® and the monoclonal anti-HER2 antibody Trastuzumab (Herceptin® in patients with non-resectable, HER2 overexpressing pancreatic cancer. Patients eligible for the study will receive Trastuzumab infusions on day 1, 8 and 15 concomitant to the oral intake of Capecitabine from day 1 to day 14 of each three week cylce. Cycles will be repeated until tumor progression. A total of 37 patients will be enrolled with an interim analysis after 23 patients. Discussion Primary end point of the study is to determine the progression free survival after 12 weeks of bimodal treatment with the chemotherapeutic agent Capecitabine and the anti-HER2 antibody Trastuzumab. Secondary end points include patient's survival, toxicity analysis, quality of life, the correlation of HER2 overexpression and clinical response to Trastuzumab treatment and, finally, the correlation of CA19-9 plasma levels and progression free intervals.

  2. Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Michielsen Kristien

    2012-09-01

    Full Text Available Abstract Background While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. Methods In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention and Rwamagana (control. Students (n = 1950 in eight intervention and six control schools participated in three surveys (baseline, six and twelve months in the intervention. Analysis was done using linear and logistic regression using generalized estimation equations adjusted for propensity score. Results The overall retention rate was 72%. Time trends in sexual risk behavior (being sexually active, sex in last six months, condom use at last sex were not significantly different in students from intervention and control schools, nor was the intervention associated with increased knowledge, perceived severity or perceived susceptibility. It did significantly reduce reported stigma. Conclusions Analyzing this and other interventions, we identified several reasons for the observed limited effectiveness of peer education: 1 intervention activities (spreading information are not tuned to objectives (changing behavior; 2 young people prefer receiving HIV information from other sources than peers; 3 outcome indicators are not adequate and the context of the relationship in which sex occurs and the context in which sex occurs is ignored. Effectiveness of peer education may increase through integration in holistic interventions and redefining peer educators’ role as focal points for sensitization and referral to experts and services. Finally, we argue that a

  3. Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

    Science.gov (United States)

    Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J

    2014-11-01

    To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  4. Effect of cognitive behavioral group therapy for recovery of self-esteem on community-living individuals with mental illness: Non-randomized controlled trial.

    Science.gov (United States)

    Kunikata, Hiroko; Yoshinaga, Naoki; Nakajima, Kazuo

    2016-10-01

    The aim of this study was to examine over a 12-month post-intervention period whether the participation of community-living individuals with mental illness in cognitive behavioral group therapy for recovery of self-esteem (CBGTRS) resulted in improved outcomes. This was a non-randomized controlled trial. The participants were persons with mental illness who resided in communities in the Chugoku region of Japan. In total, 41 were assigned to an experimental group (CBGTRS intervention, 12 group sessions), and 21 to a control group. Outcome indices (self-esteem, moods, cognition, subjective well-being, psychiatric symptoms) were measured for the experimental group prior to intervention (T0), immediately post-intervention (T1), and at 3 (T2) and 12 (T3) months post-intervention. The control group was measured at the same intervals. For the experimental group, self-esteem scores at T1, T2, and T3 were significantly higher than at T0. Moods and cognition scores remained significantly low until T2. Scores for Inadequate Mental Mastery in the subjective well-being index had not decreased by T3. Confidence in Coping remained significantly high until T2. Psychiatric symptoms scores at T0, T1, T2, and T3 were significantly lower than at T0. The means and standard errors for self-esteem and Inadequate Mental Mastery increased until T3, and those for Tension-Anxiety, Depression-Dejection, and Confusion decreased until T2. From within-group trends and between-group differences in self-esteem, we conclude that CBGTRS may have a relatively long-term effect on self-esteem recovery. T2 is the turning point for moods and cognition; thus, follow-up is needed 3 months following the initial program. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  5. Two-stage revision surgery with preformed spacers and cementless implants for septic hip arthritis: a prospective, non-randomized cohort study

    Directory of Open Access Journals (Sweden)

    Logoluso Nicola

    2011-05-01

    Full Text Available Abstract Background Outcome data on two-stage revision surgery for deep infection after septic hip arthritis are limited and inconsistent. This study presents the medium-term results of a new, standardized two-stage arthroplasty with preformed hip spacers and cementless implants in a consecutive series of adult patients with septic arthritis of the hip treated according to a same protocol. Methods Nineteen patients (20 hips were enrolled in this prospective, non-randomized cohort study between 2000 and 2008. The first stage comprised femoral head resection, debridement, and insertion of a preformed, commercially available, antibiotic-loaded cement hip spacer. After eradication of infection, a cementless total hip arthroplasty was implanted in the second stage. Patients were assessed for infection recurrence, pain (visual analog scale [VAS] and hip joint function (Harris Hip score. Results The mean time between first diagnosis of infection and revision surgery was 5.8 ± 9.0 months; the average duration of follow up was 56.6 (range, 24 - 104 months; all 20 hips were successfully converted to prosthesis an average 22 ± 5.1 weeks after spacer implantation. Reinfection after total hip joint replacement occurred in 1 patient. The mean VAS pain score improved from 48 (range, 35 - 84 pre-operatively to 18 (range, 0 - 38 prior to spacer removal and to 8 (range, 0 - 15 at the last follow-up assessment after prosthesis implantation. The average Harris Hip score improved from 27.5 before surgery to 61.8 between the two stages to 92.3 at the final follow-up assessment. Conclusions Satisfactory outcomes can be obtained with two-stage revision hip arthroplasty using preformed spacers and cementless implants for prosthetic hip joint infections of various etiologies.

  6. Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study

    Directory of Open Access Journals (Sweden)

    Toni Hesse

    2015-01-01

    Full Text Available Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10±2.6. Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84 of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling; no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.

  7. Exoskeleton for Soldier Enhancement Systems Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, J.F.

    2000-09-28

    The development of a successful exoskeleton for human performance augmentation (EHPA) will require a multi-disciplinary systems approach based upon sound biomechanics, power generation and actuation systems, controls technology, and operator interfaces. The ability to integrate key components into a system that enhances performance without impeding operator mobility is essential. The purpose of this study and report are to address the issue of feasibility of building a fieldable EHPA. Previous efforts, while demonstrating progress and enhancing knowledge, have not approached the level required for a fully functional, fieldable system. It is doubtless that the technologies required for a successful exoskeleton have advanced, and some of them significantly. The question to be addressed in this report is have they advanced to the point of making a system feasible in the next three to five years? In this study, the key technologies required to successfully build an exoskeleton have been examined. The primary focus has been on the key technologies of power sources, actuators, and controls. Power sources, including internal combustion engines, fuel cells, batteries, super capacitors, and hybrid sources have been investigated and compared with respect to the exoskeleton application. Both conventional and non-conventional actuator technologies that could impact EHPA have been assessed. In addition to the current state of the art of actuators, the potential for near-term improvements using non-conventional actuators has also been addressed. Controls strategies, and their implication to the design approach, and the exoskeleton to soldier interface have also been investigated. In addition to these key subsystems and technologies, this report addresses technical concepts and issues relating to an integrated design. A recommended approach, based on the results of the study is also presented.

  8. Economic Feasibility Analysis Report. Strategic Mobility 21

    National Research Council Canada - National Science Library

    Mallon, Lawrence G; Monaco, Kristen; Fetty, George R

    2007-01-01

    .... This multi-disciplinary analysis provides an objective examination of the economic and operational feasibility of a shuttle train intermodal rail operation under various scenarios connecting the San...

  9. A randomized trial comparing primary angioplasty versus stent placement for symptomatic intracranial stenosis

    Science.gov (United States)

    Qureshi, Adnan I; Chaudhry, Saqib A; Siddiq, Farhan; Majidi, Shahram; Rodriguez, Gustavo J; Suri, M Fareed K

    2013-01-01

    Background: Both primary angioplasty alone and angioplasty with a self-expanding stent have been compared in non-randomized concurrent clinical studies that suggest equivalent results. However, there is no randomized trial that has compared the two procedures in patients with symptomatic high grade intracranial stenosis. Objective: The primary aim of the randomized trial was to compare the clinical and angiographic efficacy of primary angioplasty and angioplasty followed by stent placement in preventing restenosis, stroke, requirement for second treatment, and death in patients with symptomatic intracranial stenosis. Methods: The study prospectively evaluated efficacy and safety of the two existing neurointerventional techniques for treatment of moderate intracranial stenosis (stenosis ≥ 50%) with documented failure of medical treatment or severe stenosis (≥70%) with or without failure of medical treatment. Results: A total of 18 patients were recruited in the study (mean age [±SD] was 64.7 ± 15.1 years); out of these, 12 were men. Of these 18, 10 were treated with primary angioplasty and 8 were treated with angioplasty followed by self-expanding stent. The technical success rates of intracranial angioplasty and stent placements defined as ability to achieve <30% residual stenosis when assessed by immediate post-procedure angiography was 5 of 10 and 5 of 8 patients, respectively. The total fluoroscopic time (mean [±SD]) was lower in patients undergoing primary angioplasty 37 [±11] min versus those undergoing angioplasty followed by self-expanding stent 42 [±15] min, P = 0.4321. The stroke and death rate within 1 month was very low in both patient groups (1 of 10 versus 0 of 8 patients). One patient randomized to stent placement continued to have recurrent ischemic symptoms requiring another angioplasty in the vertebral artery on post-procedure Day 2. Conclusions: The trial suggests that a randomized trial comparing primary angioplasty to angioplasty

  10. Muon muon collider: Feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-06-18

    A feasibility study is presented of a 2 + 2 TeV muon collider with a luminosity of L = 10{sup 35} cm{sup {minus}2} s{sup {minus}1}. The resulting design is not optimized for performance, and certainly not for cost; however, it does suffice--the authors believe--to allow them to make a credible case, that a muon collider is a serious possibility for particle physics and, therefore, worthy of R and D support so that the reality of, and interest in, a muon collider can be better assayed. The goal of this support would be to completely assess the physics potential and to evaluate the cost and development of the necessary technology. The muon collider complex consists of components which first produce copious pions, then capture the pions and the resulting muons from their decay; this is followed by an ionization cooling channel to reduce the longitudinal and transverse emittance of the muon beam. The next stage is to accelerate the muons and, finally, inject them into a collider ring which has a small beta function at the colliding point. This is the first attempt at a point design and it will require further study and optimization. Experimental work will be needed to verify the validity of diverse crucial elements in the design.

  11. Muon muon collider: Feasibility study

    International Nuclear Information System (INIS)

    1996-01-01

    A feasibility study is presented of a 2 + 2 TeV muon collider with a luminosity of L = 10 35 cm -2 s -1 . The resulting design is not optimized for performance, and certainly not for cost; however, it does suffice--the authors believe--to allow them to make a credible case, that a muon collider is a serious possibility for particle physics and, therefore, worthy of R and D support so that the reality of, and interest in, a muon collider can be better assayed. The goal of this support would be to completely assess the physics potential and to evaluate the cost and development of the necessary technology. The muon collider complex consists of components which first produce copious pions, then capture the pions and the resulting muons from their decay; this is followed by an ionization cooling channel to reduce the longitudinal and transverse emittance of the muon beam. The next stage is to accelerate the muons and, finally, inject them into a collider ring which has a small beta function at the colliding point. This is the first attempt at a point design and it will require further study and optimization. Experimental work will be needed to verify the validity of diverse crucial elements in the design

  12. Full system decontamination feasibility studies

    International Nuclear Information System (INIS)

    Denault, R.P.; LeSurf, J.E.; Walschot, F.W.

    1988-01-01

    Many chemical decontaminations have been performed on subsystems in light water reactors (BWRs and PWRs) but none on the full system (including the fuel) of large, (>500 MWe) investor owned reactors. Full system decontaminations on pressure-tubed reactors have been shown to facilitate maintenance, inspection, repair and replacement of reactor components. Further advantages are increased reactor availability and plant life extension. A conceptual study has been performed for EPRI (for PWRs) and Commonwealth Edison Co (for BWRs) into the applicability and cost benefit of full system decontaminations (FSD). The joint study showed that FSDs in both PWRs and BWRs, with or without the fuel included in the decontamination, are feasible and cost beneficial provided a large amount of work is to be done following the decontamination. The large amounts of radioactive waste generated can be managed using current technologies. Considerable improvements in waste handling, and consequent cost savings, can be obtained if new techniques which are now reaching commercial application are used. (author)

  13. MRS transfer facility feasibility study

    International Nuclear Information System (INIS)

    Jowdy, A.K.; Smith, R.I.

    1990-12-01

    Under contract to the US Department of Energy, Parsons was requested to evaluate the feasibility of building a simple hot cell (waste handling) transfer facility at the Monitored Retrievable Storage (MRS) site to facilitate acceptance of spent fuel into the Federal Waste Management System starting in early 1998. The Transfer Facility was intended to provide a receiving and transfer to storage capability at a relatively low throughput rate (approximately 500 MTU/yr) and to provide the recovery capability needed on the site in the event of a transport or storage cask seal failure during a period of about two years while the larger Spent Fuel Handling Building (SFHB) was being completed. Although the original study basis postulated an incremental addition to the larger, previously considered MRS configurations, study results show that the Transfer Facility may be capable of receiving and storing spent fuel at annual rates of 3000 MTU/yr or more, making a larger fuel handling structure unnecessary. In addition, the study analyses showed that the Transfer Facility could be constructed and put into service in 15--17 months and would cost less than the previous configurations. 2 figs., 2 tabs

  14. Non-randomized therapy trial to determine the safety and efficacy of heavy ion radiotherapy in patients with non-resectable osteosarcoma

    Directory of Open Access Journals (Sweden)

    Bischof Marc

    2010-03-01

    Full Text Available Abstract Background Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. For effective treatment, local control of the tumor is absolutely critical, because the chances of long term survival are EURAMOS1. Local photon radiotherapy has previously been used in small series and in an uncontrolled, highly individualized fashion, which, however, documented that high dose radiotherapy can, in principle, be used to achieve local control. Generally the radiation dose that is necessary for a curative approach can hardly be achieved with conventional photon radiotherapy in patients with non-resectable tumors that are usually located near radiosensitive critical organs such as the brain, the spine or the pelvis. In these cases particle Radiotherapy (proton therapy (PT/heavy ion therapy (HIT may offer a promising new alternative. Moreover, compared with photons, heavy ion beams provide a higher physical selectivity because of their finite depth coverage in tissue. They achieve a higher relative biological effectiveness. Phase I/II dose escalation studies of HIT in adults with non-resectable bone and soft tissue sarcomas have already shown favorable results. Methods/Design This is a monocenter, single-arm study for patients ≥ 6 years of age with non-resectable osteosarcoma. Desired target dose is 60-66 Cobalt Gray Equivalent (Gy E with 45 Gy PT (proton therapy and a carbon ion boost of 15-21 GyE. Weekly fractionation of 5-6 × 3 Gy E is used. PT/HIT will be administered exclusively at the Ion Radiotherapy Center in Heidelberg. Furthermore, FDG-PET imaging characteristics of non-resectable osteosarcoma before and after PT/HIT will be investigated prospectively. Systemic disease before and after PT/HIT is targeted by standard chemotherapy protocols and is not part of this trial. Discussion The primary objectives of this trial are the determination of feasibility and toxicity of HIT. Secondary objectives are tumor response

  15. 12 CFR 618.8025 - Feasibility reviews.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Feasibility reviews. 618.8025 Section 618.8025 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Related Services § 618.8025 Feasibility reviews. (a) Prior to an association offering a related service program for the...

  16. Sault Tribe Wind Energy Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Toni Osterhout; Global Energy Concepts

    2005-07-31

    The Sault Tribe conducted a feasibility study on tribal lands in the Upper Peninsula of Michigan to determine the technical and economic feasibility of both small and large-scale wind power development on tribal lands. The study included a wind resource assessment, transmission system analysis, engineering and regulatory analyzes and assessments.

  17. A nonrandomized, open-label study to evaluate the effect of nasal stimulation on tear production in subjects with dry eye disease

    Directory of Open Access Journals (Sweden)

    Friedman NJ

    2016-05-01

    Full Text Available Neil J Friedman,1 Karla Butron,2 Nora Robledo,2 James Loudin,3 Stephanie N Baba,3 Arturo Chayet2 1Department of Ophthalmology, Stanford University, Mid-Peninsula Ophthalmology Medical Group, Palo Alto, CA, USA; 2Codet Vision Institute, Tijuana, Mexico; 3Oculeve, Inc., South San Francisco, CA, USA Background: Dry eye disease (DED, a chronic disorder affecting the tear film and lacrimal functional unit, is a widely prevalent condition associated with significant burden and unmet treatment needs. Since specific neural circuits play an important role in maintaining ocular surface health, microelectrical stimulation of these pathways could present a promising new approach to treating DED. This study evaluated the efficacy and safety of nasal electrical stimulation in patients with DED. Methods: This prospective, open-label, single-arm, nonrandomized pilot study included 40 patients with mild to severe DED. After undergoing two screening visits, enrolled subjects were provided with a nasal stimulation device and instructed to use it at home four times daily (or more often as needed. Follow-up assessments were conducted up to day 180. The primary efficacy endpoint was the difference between unstimulated and stimulated tear production quantified by Schirmer scores. Additional efficacy endpoints included change from baseline in corneal and conjunctival staining, symptoms evaluated on a Visual Analog Scale, and Ocular Surface Disease Index scores. Safety parameters included adverse event (AE rates, visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, and endoscopic nasal examinations. Results: Mean stimulated Schirmer scores were significantly higher than the unstimulated scores at all visits, and corneal and conjunctival staining and symptom scores from baseline to day 180 were significantly reduced. No serious device-related AEs and nine nonserious AEs (three device-related were reported. Intraocular pressure remained

  18. Changes in body weight and body mass index among psychiatric patients receiving lithium, valproate, or topiramate: an open-label, nonrandomized chart review.

    Science.gov (United States)

    Chengappa, K N Roy; Chalasani, L; Brar, Jaspreet S; Parepally, H; Houck, Patricia; Levine, Joseph

    2002-10-01

    Subsets of psychiatric patients gain excess body weight while receiving mood-stabilizing agents such as lithium carbonate or valproate sodium. Patients who gain excess weight may discontinue therapy, with severe consequences. Among the newer anticonvulsant agents, topiramate is a candidate agent for bipolar disorder and is associated with weight loss when used as adjunctive treatment. This open-label, nonrandomized, chart-review study assessed changes in body weight and body mass index (BMI) in patients receiving topiramate, lithium, or valproate. Data were extracted from the medical charts of patients admitted in 1999 and 2000 to a state psychiatric hospital with either schizophrenia, schizoaffective disorder, bipolar disorder, or other psychiatric diagnoses who were prescribed valproate, lithium, or topiramate and were reviewed for changes in body weight and BMI. The use of concomitant psychotropic medicines was recorded (eg, antipsychotic agents, antidepressant agents, other mood stabilizers such as gabapentin or carbamazepine). Continuous variables were analyzed using a factorial analysis of variance and the Student t test. Contingency statistics were used to analyze categorical variables. A total of 214 patients were included in the chart review (123 men, 91 women; mean age, 39.4 years). Significantly more women than men received topiramate (P = 0.004). Patients receiving either lithium or valproate gained a mean (SD) of 6.3 (9.0) kg and 6.4 (9.0) kg, respectively, whereas patients receiving topiramate lost a mean 1.2 (6.3) kg (F = 11.54, df = 2,198; P 8% of their baseline body weight (8.2% [11.5%] for lithium-treated patients and 8.5% [11.9%] for valproate-treated patients), whereas topiramate-treated patients lost 0.7% (7.2%) of their body weight (F = 9.93, df= 2,198; P weight loss and a reduction in BMI. This advantage of topiramate may promote long-term adherence to treatment among psychiatric patients and possibly decrease the medical risks associated

  19. Dual-Doppler Feasibility Study

    Science.gov (United States)

    Huddleston, Lisa L.

    2012-01-01

    When two or more Doppler weather radar systems are monitoring the same region, the Doppler velocities can be combined to form a three-dimensional (3-D) wind vector field thus providing for a more intuitive analysis of the wind field. A real-time display of the 3-D winds can assist forecasters in predicting the onset of convection and severe weather. The data can also be used to initialize local numerical weather prediction models. Two operational Doppler Radar systems are in the vicinity of Kennedy Space Center (KSC) and Cape Canaveral Air Force Station (CCAFS); these systems are operated by the 45th Space Wing (45 SW) and the National Weather Service Melbourne, Fla. (NWS MLB). Dual-Doppler applications were considered by the 45 SW in choosing the site for the new radar. Accordingly, the 45th Weather Squadron (45 WS), NWS MLB and the National Aeronautics and Space Administration tasked the Applied Meteorology Unit (AMU) to investigate the feasibility of establishing dual-Doppler capability using the two existing systems. This study investigated technical, hardware, and software requirements necessary to enable the establishment of a dual-Doppler capability. Review of the available literature pertaining to the dual-Doppler technique and consultation with experts revealed that the physical locations and resulting beam crossing angles of the 45 SW and NWS MLB radars make them ideally suited for a dual-Doppler capability. The dual-Doppler equations were derived to facilitate complete understanding of dual-Doppler synthesis; to determine the technical information requirements; and to determine the components of wind velocity from the equation of continuity and radial velocity data collected by the two Doppler radars. Analysis confirmed the suitability of the existing systems to provide the desired capability. In addition, it is possible that both 45 SW radar data and Terminal Doppler Weather Radar data from Orlando International Airport could be used to alleviate any

  20. A Danish randomized trial comparing breast-preserving therapy with mastectomy in mammary carcinoma

    International Nuclear Information System (INIS)

    Blichert-Toft, M.; Brincker, H.; Andersen, J.A.; Andersen, K.W.; Axelsson, C.K.; Mouridsen, H.T.; Dombernowsky, P.; Overgaard, M.; Gadeberg, C.; Knudsen, G.; Borgeskov, S.; Bertelsen, S.; Knudsen, J.B.; Hansen, J.B.; Poulsen, P.E.; Willumsen, H.; Schousen, P.; Froberg, D.; Oernsholt, J.; Andersen, M.; Olesen, S.; Skovgaard, S.; Oester, M.; Schumacher, H.; Lynderup, E.K.; Holm, C.N.

    1988-01-01

    The present study comprises 847 women operated upon for invasive breast carcinoma at 19 surgical departments and enrolled in protocol DBCG-82TM from January 1983 to November 1987. Among them 662 (78%) were allocated for breast-preserving therapy or mastectomy by randomization, while 185 patients (22%) did not accept randomization. Within the randomized group 6% could not be entered into adjuvant protocols, i.e. subsequent programmes of postoperative therapy and follow-up. This left 619 evaluable patients. In the non-randomized series 26% did not fulfil the demands for entrance into the adjuvant protocols, leaving 136 evaluable patients, 60 of whom had chosen a breast-preserving operation and 76 mastectomy. In the randomized series the patients in the two treatment arms were comparable in age, menopausal status, site of tumour, pathoanatomical diameter of the tumour, number of removed axillary lymph nodes, number of metastatic axillary lymph nodes, and distribution on adjuvant regimens. Ninety per cent of the patients in the randomized group accepted the method offered, whereas 10% declined and wanted the alternate form of operation. The median follow-up period was approximately 1.75 years. The cumulative recurrence rate in the randomized group was 13% and in the non-randomized group 7%. These results are preliminary. Life-table analyses have not so far demonstrated differences in recurrence-free survival either in the randomized or the non-randomized series. (orig.)

  1. A Nonrandomized Comparison Study of Self-Hypnosis, Yoga, and Cognitive-Behavioral Therapy to Reduce Emotional Distress in Breast Cancer Patients.

    Science.gov (United States)

    Bragard, Isabelle; Etienne, Anne-Marie; Faymonville, Marie-Elisabeth; Coucke, Philippe; Lifrange, Eric; Schroeder, Hélène; Wagener, Aurélie; Dupuis, Gilles; Jerusalem, Guy

    2017-01-01

    The authors asked breast cancer (BC) patients to participate in 1 of 3 mind-body interventions (cognitive-behavioral therapy (CBT), yoga, or self-hypnosis) to explore their feasibility, ease of compliance, and impact on the participants' distress, quality of life (QoL), sleep, and mental adjustment. Ninety-nine patients completed an intervention (CBT: n = 10; yoga: n = 21; and self-hypnosis: n = 68). Results showed high feasibility and high compliance. After the interventions, there was no significant effect in the CBT group but significant positive effects on distress in the yoga and self-hypnosis groups, and, also, on QoL, sleep, and mental adjustment in the self-hypnosis group. In conclusion, mind-body interventions can decrease distress in BC patients, but RCTs are needed to confirm these findings.

  2. Multnomah County Hydrokinetic Feasibility Study: Final Feasibility Study Report

    Energy Technology Data Exchange (ETDEWEB)

    Spain, Stephen

    2012-03-15

    HDR has completed a study of the technical, regulatory, and economic feasibility of installing hydrokinetic turbines under the Morrison, Broadway, and Sellwood bridges. The primary objective of installing hydrokinetic turbines is a demonstration of in-stream hydrokinetic technologies for public education and outreach. Due to the low gradient of the Lower Willamette and the effects of the tide, velocities in the area in consideration are simply not high enough to economically support a commercial installation. While the velocities in the river may at times provide enough energy for a commercial turbine to reach capacity, the frequency and duration of high flow events which provide suitable velocities is not sufficient to support a commercial hydrokinetic installation. We have observed that over an 11 year period, daily average velocities in the Lower Willamette exceeded a nominal cut-in speed of 0.75 m/s only 20% of the time, leaving net zero power production for the remaining 80% of days. The Sellwood Bridge site was estimated to have the best hydrokinetic resource, with an estimated average annual production of about 9,000 kWh. The estimated production could range from 2,500 kWh to 15,000 kWh. Based on these energy estimates, the amount of revenue generated through either a power purchase agreement (PPA) or recovered through net metering is not sufficient to repay the project costs within the life of the turbine. The hydrokinetic resource at the Morrison and Broadway Bridges is slightly smaller than at the Sellwood Bridge. While the Broadway and Morrison Bridges have existing infrastructure that could be utilized, the project is not expected to generate enough revenue to repay the investment. Despite low velocities and energy production, the sites themselves are favorable for installation of a demonstration or experimental project. With high public interest in renewable energy, the possibility exists to develop a hydrokinetic test site which could provide

  3. WERF MACT Feasibility Study Report

    Energy Technology Data Exchange (ETDEWEB)

    B. Bonnema; D. Moser; J. Riedesel; K. Kooda; K. Liekhus; K. Rebish; S. Poling

    1998-11-01

    This study was undertaken to determine the technical feasibility of upgrading the Waste Experimental Reduction Facility (WERF) at the Idaho National Engineering and Environmental Laboratory to meet the offgas emission limits proposed in the Maximum Achievable Control Technologies (MACT)rule. Four practicable offgas treatment processes were identified, which, if installed, would enable the WERF to meet the anticipated MACT emission limits for dioxins and furans (D/F), hydrochloric acid (HCI), and mercury (Hg). Due to the three-year time restraint for MACT compliance, any technology chosen for the upgrade must be performed within the general plant project funding limit of $5 M. The option selected consists of a partial-quench evaporative cooler with dry sorbent injection for HCI removal followed by a sulfur-impregnated activated carbon bed for Hg control. The planning cost estimate for implementing the option is $4.17 M (with 24% contingency). The total estimated cost includes capital costs, design and construction costs, and project management costs. Capital costs include the purchase of a new offgas evaporative cooler, a dry sorbent injection system with reagent storage, a new fabric filter baghouse, a fixed carbon bed absorber, and two offgas induced draft exhaust fans. It is estimated that 21 months will be required to complete the recommended modification to the WERF. The partial-quench cooler is designed to rapidly cool the offgas exiting the secondary combustion chamber to minimize D/F formation. Dry sorbent injection of an alkali reagent into the offgas is recommended. The alkali reacts with the HCI to form a salt, which is captured with the fly ash in the baghouse. A design HCI removal efficiency of 97.2% allows for the feeding 20 lbs/hr of chlorine to the WERF incinerator. The sorbent feed rate can be adjusted to achieve the desired HCI removal efficiency. A fixed bed of sulfur-impregnated carbon was conservatively sized for a total Hg removal capacity when

  4. Potential use of the non-random distribution of N2 and N2O mole masses in the atmosphere as a tool for tracing atmospheric mixing and isotope fractionation processes

    International Nuclear Information System (INIS)

    Well, R.; Langel, R.; Reineking, A.

    2002-01-01

    The variation in the natural abundance of 15 N in atmospheric gas species is often used to determine the mixing of trace gases from different sources. With conventional budget calculations one unknown quantity can be determined if the remaining quantities are known. From 15 N tracer studies in soils with highly enriched 15 N-nitrate a procedure is known to calculate the mixing of atmospheric and soil derived N 2 based on the measurement of the 30/28 and 29/28 ratios in gas samples collected from soil covers. Because of the non-random distribution of the mole masses 30 N 2 , 29 N 2 and 28 N 2 in the mixing gas it is possible to calculate two quantities simultaneously, i.e. the mixing ratio of atmospheric and soil derived N 2 , and the isotopic signature of the soil derived N 2 . Routine standard measurements of laboratory air had suggested a non-random distribution of N 2 -mole masses. The objective of this study was to investigate and explain the existence of non-random distributions of 15 N 15 N, 14 N 15 N and 14 N 14 N in N 2 and N 2 O in environmental samples. The calculation of theoretical isotope data resulting from hypothetical mixing of two sources differing in 15 N natural abundance demonstrated, that the deviation from an ideal random distribution of mole masses is not detectable with the current precision of mass spectrometry. 15 N-analysis of N 2 or N 2 O was conducted with randomised and non-randomised replicate samples of different origin. 15 N abundance as calculated from 29/28 ratios were generally higher in randomised samples. The differences between the treatments ranged between 0.05 and 0.17 δper mille 15 N. It was concluded that the observed randomisation effect is probably caused by 15 N 15 N fractionation during environmental processes. (author)

  5. Sedimentary Geothermal Feasibility Study: October 2016

    Energy Technology Data Exchange (ETDEWEB)

    Augustine, Chad [National Renewable Energy Lab. (NREL), Golden, CO (United States); Zerpa, Luis [Colorado School of Mines, Golden, CO (United States)

    2017-01-01

    The objective of this project is to analyze the feasibility of commercial geothermal projects using numerical reservoir simulation, considering a sedimentary reservoir with low permeability that requires productivity enhancement. A commercial thermal reservoir simulator (STARS, from Computer Modeling Group, CMG) is used in this work for numerical modeling. In the first stage of this project (FY14), a hypothetical numerical reservoir model was developed, and validated against an analytical solution. The following model parameters were considered to obtain an acceptable match between the numerical and analytical solutions: grid block size, time step and reservoir areal dimensions; the latter related to boundary effects on the numerical solution. Systematic model runs showed that insufficient grid sizing generates numerical dispersion that causes the numerical model to underestimate the thermal breakthrough time compared to the analytic model. As grid sizing is decreased, the model results converge on a solution. Likewise, insufficient reservoir model area introduces boundary effects in the numerical solution that cause the model results to differ from the analytical solution.

  6. Spray drying of bead resins: feasibility tests

    International Nuclear Information System (INIS)

    Gay, R.L.; Grantham, L.F.; Jones, L.J.

    1984-01-01

    Rockwell International has developed a volume reduction system for low-level reactor wastes based on drying the wastes in a heated-air spray dryer. The drying of slurries of sodium sulfate, boric acid, and powdered ion exchange resins was demonstrated in previous tests. The drying of bead ion exchange resins can be especially difficult due to the relatively large size of bead resins (about 500 to 800 microns) and their natural affinity for water. This water becomes part of the pore structure of the resins and normally comprises 50 t 60 wt % of the resin weight. A 76-cm-diameter spray dryer was used for feasibility tests of spray drying of cation and anion bead resins. These resins were fed to the dryer in the as-received form (similar to dewatered resins) and as slurries. A dry, free-flowing product was produced in all the tests. The volume of the spray-dried product was one-half to one-third the volume of the as-received material. An economic analysis was made of the potential cost savings that can be achieved using the Rockwel spray dryer system. In-plant costs, transportation costs, and burial costs of spray-dried resins were compared to similar costs for disposal of dewatered resins. A typical utility producing 170 m 3 (6,000 ft 3 ) per year of dewatered resins can save $600,000 to $700,000 per year using this volume reduction system

  7. Three Affliated Tribes Renewable Energy Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Belvin Pete; Kent Good; Krista Gordon; Ed McCarthy,

    2006-05-26

    The Three Affliated Tribes on the Fort Berthold Reservation studied the feasibility of a commercial wind facility on land selected and owned by the Tribes and examined the potential for the development of renewable energy resources on Tribal Lands.

  8. Conceptual Thermal Treatment Technologies Feasibility Study

    International Nuclear Information System (INIS)

    Suer, A.

    1996-01-01

    This report presents a conceptual Thermal Treatment Technologies Feasibility Study (FS) for the Savannah River Site (SRS) focusing exclusively on thermal treatment technologies for contaminated soil, sediment, or sludge remediation projects

  9. Renewable Energy Park - Preliminary Feasibility & Engineering Report

    Energy Technology Data Exchange (ETDEWEB)

    Ariwite, Roderick [Fallon Paiute Shoshone Tribe, NV (United States)

    2015-07-31

    This "Renewable Energy Park - Preliminary Feasibility & Engineering Report" seeks to provide an overall assessment and review of renewable energy development opportunities on the Fallon Indian Reservation and Colony Lands.

  10. The feasibility Problem in Theorizing Social Justice

    Directory of Open Access Journals (Sweden)

    Eugen Huzum

    2012-10-01

    Full Text Available G. A. Cohen and Andrew Mason have recently argued, against many contemporary philosophers, that feasibility is not a legitimate constraint in theorizing about social justice. Their main argument is that principles of justice are logically independent of issues of feasibility and, consequently, feasibility has no bearing on the correctness of these principles. This article is a critical examination of three attempts to show that Cohen and Mason’s argument is unsound. The examined attempts are those of Harry Brighouse, Collin Farrelly, and David Miller. I argue that all these arguments are based on false, unjustified or implausible, premises and/or assumptions. Consequently, they cannot discredit the soundness of Cohen and Mason’s argument and of the thesis that feasibility is not, in fact, a legitimate constraint in theorizing about social justice.

  11. White Earth Biomass/Biogas Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Triplett, Michael

    2015-03-12

    The White Earth Nation examined the feasibility of cost savings and fossil energy reduction through the installation of biogas/biomass boiler at the tribal casino. The study rejected biogas options due to availability and site constraints, but found a favorable environment for technical and financial feasibility of installing a 5 MMBtu hot water boiler system to offset 60-70 percent of current fuel oil and propane usage.

  12. Sampling, feasibility, and priors in Bayesian estimation

    OpenAIRE

    Chorin, Alexandre J.; Lu, Fei; Miller, Robert N.; Morzfeld, Matthias; Tu, Xuemin

    2015-01-01

    Importance sampling algorithms are discussed in detail, with an emphasis on implicit sampling, and applied to data assimilation via particle filters. Implicit sampling makes it possible to use the data to find high-probability samples at relatively low cost, making the assimilation more efficient. A new analysis of the feasibility of data assimilation is presented, showing in detail why feasibility depends on the Frobenius norm of the covariance matrix of the noise and not on the number of va...

  13. Heat rate variability and dyssomnia and their correlations to neurological defects in cerebral infarction patients complicated by insomnia A concurrent non-randomized case-control study

    Institute of Scientific and Technical Information of China (English)

    Jianping Chu; Xueli Shen; Jun Fan; Changhai Chen; Shuyang Lin

    2008-01-01

    BACKGROUND: Heart rate variability refers to the beat-to-beat alteration in heart rate. It is usually a slight periodic variation of R-R intervals. Much information of autonomic nerve system balance can be obtained by measuring the heart rate variability of patients. It remains to be shown whether heart rate variability can be used as an index for determining the severity of insomnia and cerebral infarction. OBJECTIVE: This study aimed to analyze the correlation for each frequency spectrum parameter of heart rate variability with an insomnia index, as well as the degree of neurological defects in patients with simple cerebral infarction and cerebral infarction complicated by insomnia. The goal was to verify the feasibility of frequency spectrum parameters for heart rate variability as a marker for insomnia and cerebral infarction. DESIGN: A case-control observation. SETTING: Department of Neurology, First Hospital Affiliated to China Medical University. PARTICIPANTS: Sixty inpatients, and/or outpatients, with cerebral infarction were admitted to the 202 Hospital of Chinese PLA between December 2005 and October 2006, confirmed by CT, and recruited to the study. According to the insomnia condition (insomnia is defined by a Pittsburgh Sleep Quality Index score > 7), the patients were assigned to a simple cerebral infarction group and a cerebral infarction complicated by insomnia group, with 30 subjects in each group. Thirty additional subjects, who concurrently received ex-aminations and were confirmed to not suffer from cerebral infarction and insomnia, were recruited into the control group. Written informed consent was obtained from each subject for laboratory specimens. The pro-tocol was approved by the Hospital's Ethics Committee. METHODS: Following admission, each subject's neurological impairment was assessed with the National Institutes of Health Stroke Scale and Pittsburgh Sleep Quality Index. Heart rate variability of each subject was measured with an

  14. Technical design aspects of Feasibility Study-II

    International Nuclear Information System (INIS)

    Zisman, Michael S.

    2001-01-01

    Feasibility Study-II examined a high-performance Neutrino Factory providing 1 x 10 20 neutrinos per year aimed at a long-baseline detector. The Study was sponsored jointly by BNL and the Neutrino Factory and Muon Collider Collaboration ration (MC) and is based on a 1 MW proton driver operating at 24 GeV, i.e., an upgraded version of the AGS accelerator. Compared with the earlier FNAL-sponsored study (Feasibility Study-I), there is a sixfold improvement in performance. Here we describe details of the implementation of Study-II concepts and discuss their efficacy. Alternative approaches that will be pursued in follow-on R and D activities are also described briefly

  15. [Feasibility study for whole plant medicinal use of Tribulus terrestris].

    Science.gov (United States)

    Yang, Li; Wang, Chunyu; Han, Meiw; Yang, Limin

    2009-09-01

    The content differences of leaf, plant and fruit of Tribulus terrestris was compared to study the feasibility of whole plant medicinal use. The samples were collected in three typical habitats and six different production areas of T. terrestris. The main medicinal ingredients saponins and flavonoids were determined in root, stem, leaf and fruit during the harvest time. The two ingredients were abounded in leaf and more than 2.61 times as in other parts of the plant. The results showed that there were no differences between the whole plant and the fruit. It should pay more attentions on the collection, preservation and utilization of the leaf of T. terrestris in the harvesting and processing stage. The whole plant for medical use was feasibility based on the content of the ingredients.

  16. Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.

    Science.gov (United States)

    DiDiodato, Giulio; McArthur, Leslie

    2016-01-01

    The incidence rate of healthcare-associated Clostridium difficile infection (HA-CDI) is estimated at 1 in 100 patients. Antibiotic exposure is the most consistently reported risk factor for HA-CDI. Strategies to reduce the risk of HA-CDI have focused on reducing antibiotic utilization. Prospective audit and feedback is a commonly used antimicrobial stewardship intervention (ASi). The impact of this ASi on risk of HA-CDI is equivocal. This study examines the effectiveness of a prospective audit and feedback ASi on reducing the risk of HA-CDI. Single-site, 339 bed community-hospital in Barrie, Ontario, Canada. Primary outcome is HA-CDI incidence rate. Daily prospective and audit ASi is the exposure variable. ASi implemented across 6 wards in a non-randomized, stepped wedge design. Criteria for ASi; any intravenous antibiotic use for ≥ 48 hrs, any oral fluoroquinolone or oral second generation cephalosporin use for ≥ 48 hrs, or any antimicrobial use for ≥ 5 days. HA-CDI cases and model covariates were aggregated by ward, year and month starting September 2008 and ending February 2016. Multi-level mixed effect negative binomial regression analysis was used to model the primary outcome, with intercept and slope coefficients for ward-level random effects estimated. Other covariates tested for inclusion in the final model were derived from previously published risk factors. Deviance residuals were used to assess the model's goodness-of-fit. The dataset included 486 observation periods, of which 350 were control periods and 136 were intervention periods. After accounting for all other model covariates, the estimated overall ASi incidence rate ratio (IRR) was 0.48 (95% 0.30, 0.79). The ASi effect was independent of antimicrobial utilization. The ASi did not seem to reduce the risk of Clostridium difficile infection on the surgery wards (IRR 0.87, 95% CI 0.45, 1.69) compared to the medicine wards (IRR 0.42, 95% CI 0.28, 0.63). The ward-level burden of Clostridium

  17. Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.

    Directory of Open Access Journals (Sweden)

    Giulio DiDiodato

    Full Text Available The incidence rate of healthcare-associated Clostridium difficile infection (HA-CDI is estimated at 1 in 100 patients. Antibiotic exposure is the most consistently reported risk factor for HA-CDI. Strategies to reduce the risk of HA-CDI have focused on reducing antibiotic utilization. Prospective audit and feedback is a commonly used antimicrobial stewardship intervention (ASi. The impact of this ASi on risk of HA-CDI is equivocal. This study examines the effectiveness of a prospective audit and feedback ASi on reducing the risk of HA-CDI.Single-site, 339 bed community-hospital in Barrie, Ontario, Canada. Primary outcome is HA-CDI incidence rate. Daily prospective and audit ASi is the exposure variable. ASi implemented across 6 wards in a non-randomized, stepped wedge design. Criteria for ASi; any intravenous antibiotic use for ≥ 48 hrs, any oral fluoroquinolone or oral second generation cephalosporin use for ≥ 48 hrs, or any antimicrobial use for ≥ 5 days. HA-CDI cases and model covariates were aggregated by ward, year and month starting September 2008 and ending February 2016. Multi-level mixed effect negative binomial regression analysis was used to model the primary outcome, with intercept and slope coefficients for ward-level random effects estimated. Other covariates tested for inclusion in the final model were derived from previously published risk factors. Deviance residuals were used to assess the model's goodness-of-fit.The dataset included 486 observation periods, of which 350 were control periods and 136 were intervention periods. After accounting for all other model covariates, the estimated overall ASi incidence rate ratio (IRR was 0.48 (95% 0.30, 0.79. The ASi effect was independent of antimicrobial utilization. The ASi did not seem to reduce the risk of Clostridium difficile infection on the surgery wards (IRR 0.87, 95% CI 0.45, 1.69 compared to the medicine wards (IRR 0.42, 95% CI 0.28, 0.63. The ward-level burden of

  18. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  19. Feasibility study on embedded transport core calculations

    International Nuclear Information System (INIS)

    Ivanov, B.; Zikatanov, L.; Ivanov, K.

    2007-01-01

    The main objective of this study is to develop an advanced core calculation methodology based on embedded diffusion and transport calculations. The scheme proposed in this work is based on embedded diffusion or SP 3 pin-by-pin local fuel assembly calculation within the framework of the Nodal Expansion Method (NEM) diffusion core calculation. The SP 3 method has gained popularity in the last 10 years as an advanced method for neutronics calculation. NEM is a multi-group nodal diffusion code developed, maintained and continuously improved at the Pennsylvania State University. The developed calculation scheme is a non-linear iteration process, which involves cross-section homogenization, on-line discontinuity factors generation, and boundary conditions evaluation by the global solution passed to the local calculation. In order to accomplish the local calculation, a new code has been developed based on the Finite Elements Method (FEM), which is capable of performing both diffusion and SP 3 calculations. The new code will be used in the framework of the NEM code in order to perform embedded pin-by-pin diffusion and SP 3 calculations on fuel assembly basis. The development of the diffusion and SP 3 FEM code is presented first following by its application to several problems. Description of the proposed embedded scheme is provided next as well as the obtained preliminary results of the C3 MOX benchmark. The results from the embedded calculations are compared with direct pin-by-pin whole core calculations in terms of accuracy and efficiency followed by conclusions made about the feasibility of the proposed embedded approach. (authors)

  20. FBI fingerprint identification automation study. AIDS 3 evaluation report. Volume 4: Economic feasibility

    Science.gov (United States)

    Mulhall, B. D. L.

    1980-01-01

    The results of the economic analysis of the AIDS 3 system design are presented. AIDS 3 evaluated a set of economic feasibility measures including life cycle cost, implementation cost, annual operating expenditures and annual capital expenditures. The economic feasibility of AIDS 3 was determined by comparing the evaluated measures with the same measures, where applicable, evaluated for the current system. A set of future work load scenarios was constructed using JPL's environmental evaluation study of the fingerprint identification system. AIDS 3 and the current system were evaluated for each of the economic feasibility measures for each of the work load scenarios. They were compared for a set of performance measures, including response time and accuracy, and for a set of cost/benefit ratios, including cost per transaction and cost per technical search. Benefit measures related to the economic feasibility of the system are also presented, including the required number of employees and the required employee skill mix.

  1. Northern New Mexico regional airport market feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Drake, R.H.; Williams, D.S.

    1998-06-01

    This report is about the market for airline travel in northern New Mexico. Interest in developing a northern New Mexico regional airport has periodically surfaced for a number of years. The New Mexico State Legislature passed a memorial during the 1998 Second Session calling for the conduct of a study to determine the feasibility of building a new regional airport in NNM. This report is a study of the passenger market feasibility of such an airport. In addition to commercial passenger market feasibility, there are other feasibility issues dealing with siting, environmental impact, noise, economic impact, intermodal transportation integration, region-wide transportation services, airport engineering requirements, and others. These other feasibility issues are not analyzed in any depth in this report although none were discovered to be show-stoppers as a by-product of the authors doing research on the passenger market itself. Preceding the need for a detailed study of these other issues is the determination of the basic market need for an airport with regular commercial airline service in the first place. This report is restricted to an in-depth look at the market for commercial passenger air service in NNM. 20 figs., 8 tabs.

  2. Feasibility Study for a Hopi Utility-Scale Wind Project

    Energy Technology Data Exchange (ETDEWEB)

    Kendrick Lomayestewa

    2011-05-31

    The goal of this project was to investigate the feasibility for the generation of energy from wind and to parallel this work with the development of a tribal utility organization capable of undertaking potential joint ventures in utility businesses and projects on the Hopi reservation. The goal of this project was to investigate the feasibility for the generation of energy from wind and to parallel this work with the development of a tribal utility organization capable of undertaking potential joint ventures in utility businesses and projects on the Hopi reservation. Wind resource assessments were conducted at two study sites on Hopi fee simple lands located south of the city of Winslow. Reports from the study were recently completed and have not been compared to any existing historical wind data nor have they been processed under any wind assessment models to determine the output performance and the project economics of turbines at the wind study sites. Ongoing analysis of the wind data and project modeling will determine the feasibility of a tribal utility-scale wind energy generation.

  3. Assessment of the advantages and feasibility of a nuclear rocket

    International Nuclear Information System (INIS)

    Howe, S.D.

    1985-01-01

    The feasibility of rebuilding and testing a nuclear thermal rocket (NTR) for the Mars mission has been investigated. Calculations indicate that an NTR would substantially reduce the earth-orbit assembled mass compared to LOX/LH 2 systems. The mass savings were 36% and 65% for the cases of total aerobraking and of total propulsive braking respectively. Consequently, the cost savings for a single mission of using an NTR, if aerobraking is feasible, are probably insufficient to warrant the NTR development. If multiple missions are planned or if propulsive braking is desired at Mars and/or at Earth, then the savings of about $7B will easily pay for the NTR development. Estimates of the cost of rebuilding a NTR were based on the previous NERVA program's budget plus additional costs to develop a flight ready engine. The total cost to build the engine would be between $4 to 5B. The concept of developing a full-power test stand at Johnston Atoll in the Pacific appears very feasible. The added expense of building facilities on the island should be less than $1.4B

  4. Community-Based Adaptive Physical Activity Program for Chronic Stroke: Feasibility, Safety, and Efficacy of the Empoli Model

    Science.gov (United States)

    Stuart, Mary; Benvenuti, Francesco; Macko, Richard; Taviani, Antonio; Segenni, Lucianna; Mayer, Federico; Sorkin, John D.; Stanhope, Steven J.; Macellari, Velio; Weinrich, Michael

    2010-01-01

    Objective To determine whether Adaptive Physical Activity (APA-stroke), a community-based exercise program for participants with hemiparetic stroke, improves function in the community. Methods Nonrandomized controlled study in Tuscany, Italy, of participants with mild to moderate hemiparesis at least 9 months after stroke. Forty-nine participants in a geographic health authority (Empoli) were offered APA-stroke (40 completed the study). Forty-four control participants in neighboring health authorities (Florence and Pisa) received usual care (38 completed the study). The APA intervention was a community-based progressive group exercise regimen that included walking, strength, and balance training for 1 hour, thrice a week, in local gyms, supervised by gym instructors. No serious adverse clinical events occurred during the exercise intervention. Outcome measures included the following: 6-month change in gait velocity (6-Minute Timed Walk), Short Physical Performance Battery (SPPB), Berg Balance Scale, Stroke Impact Scale (SIS), Barthel Index, Hamilton Rating Scale for Depression, and Index of Caregivers Strain. Results After 6 months, the intervention group improved whereas controls declined in gait velocity, balance, SPPB, and SIS social participation domains. These between-group comparisons were statistically significant at P glucose tolerance tests were performed on a subset of participants in the intervention group. For these individuals, insulin secretion declined 29% after 6 months (P = .01). Conclusion APA-stroke appears to be safe, feasible, and efficacious in a community setting. PMID:19318465

  5. The feasibility study: a health economics perspective

    Directory of Open Access Journals (Sweden)

    Brenda Gannon

    2017-02-01

    Full Text Available The remit of research funding bodies is to prioritise funding for research that is of relevance and of high quality. This in turn will aim to raise the quality of healthcare and benefit to patients. Researchers are faced with increasing demands and expectations from the public purse and patients. The emphasis is to improve the quality of their research, with the ultimate aim of improving population health. While guidelines on feasibility study methods concentrate heavily on trials, there appears less guidance on application of health economics within feasibility studies, yet these are a less costly way to determine first of all if a full randomised controlled trial (RCT is feasible. A feasibility study assesses if the study can be done in a small RCT type study. Since by definition, a feasibility study does not evaluate the outcome, researchers often omit the health economics aspects but do however include statistical analysis. This leaves a gap in interpretation for policy makers and potential funders. It also means that any resulting publication does not include relevant information and therefore comparison across studies in terms of difficulty in collecting cost data is not possible. The main aim of this commentary therefore, is to demonstrate a suggested health economics analysis within a feasibility study and to recommend to researchers to include these aspects from the conception of their intervention. This paper proposes a number of points, with rationale for each point, to indicate the health economics data and the potential benefits required for coherent interpretation of the feasibility of future economic evaluations in a full trial. Economic evaluation is necessary if implementation into standard care is anticipated. Therefore, collection and summary analysis of relevant data is good practice at each point of the intervention development. Current guidelines for economic evaluation, for example, The Medical Research Guidelines in the

  6. Gilabert on the Feasibility of Global Justice

    Directory of Open Access Journals (Sweden)

    Colin M. Macleod

    2013-09-01

    Full Text Available In this article, I discuss the analysis of the feasibility of global justice developed by Pablo Gilabert in his recent book From Global Poverty to Global Equality: A Philosophical Exploration. Gilabert makes many valuable contributions to this topic and I agree with most of his analysis. However, I identify a distinction between strategic justification and moral justification that Gilabert neglects. I show how this distinction is useful in addressing objections to the feasibility of global justice. I also claim that Gilabert makes some problematic assumptions concerning the way in which global justice is morally demanding.

  7. Analysis and characterization of security regions in power systems. Part I. Load flow feasibility conditions in power networks

    Energy Technology Data Exchange (ETDEWEB)

    Jarjis, J; Galiana, F D

    1980-03-01

    A set theoretic analysis of loadflow feasibility of a general power network with arbitrary PQ, PV and slack buses is presented. Load-flow feasibility is that property of a power network defining the theoretical limitations on the bus injections under which a steady state equilibrium exists. The set theoretic analysis is based on the study of the conical loadflow feasibility region. This region is characterised by a set of supporting hyperplanes each of which defines an explicit necessary condition for loadflow feasibility on the bus injections. A quantitative measure of loadflow feasibility for an arbitrary given operating injection vector is defined through a computable scalar stability margin. This stability margin permits the loadflow feasibility of different injections and network structures to be quantitatively compared and analysed.

  8. Nonmarket cobenefits and economic feasibility of on-farm biogas energy production

    International Nuclear Information System (INIS)

    Yiridoe, Emmanuel K.; Gordon, Robert; Brown, Bettina B.

    2009-01-01

    Standard analysis of the economic feasibility of on-farm biogas energy production tend to emphasize primarily on direct financial benefits to farmers, and abstracts from the nonmarket cobenefits associated with anaerobic digestion of livestock manure and other biomass feedstock. This shortcoming of the standard feasibility analysis raises a fundamental question: How is the economic feasibility of on-farm anaerobic biogas energy production affected by the associated nonpecuniary cobenefits? Incorporating key nonmarket cobenefits from biogas energy production extends the standard economic feasibility analysis, and provides important insights. When nonmarket cobenefits were excluded, on-farm biogas energy production was generally not financially feasible for the dairy and swine farm size ranges studied (except for 600- and 800-sow farms). Overall, results of the financial feasibility analysis did not change compared to a base scenario (without nonmarket cobenefits) when an estimated annual total nonmarket cobenefits of CND$5000 was incorporated into the analysis, for both dairy and swine farms. Biogas energy production was generally financially viable for small-size dairy (i.e., 50-cow) and swine (i.e., 200-sow) farms when the nonmarket cobenefits were valued at CND$15,000 (or higher). Improvements in financial feasibility were more dramatic for dairy than for swine farms

  9. Perceived impact and feasibility of strategies to improve access to healthy foods in Washington State, USA.

    Science.gov (United States)

    Johnson, Donna B; Quinn, Emilee L; Podrabsky, Mary; Beckwith-Stanley, Nadia; Chan, Nadine; Ellings, Amy; Kovacs, Tricia; Lane, Claire

    2013-12-01

    The present study measured the perceived impact and political and implementation feasibility of state-level policy strategies related to increasing access to healthy foods and limiting unhealthy foods. Potential state-level policy strategies to improve access to healthy foods were identified through a review of evidence-based literature and policy recommendations. Respondents rated the perceived impact and political and implementation feasibility of each policy on a five-point scale using online surveys. Washington State policy process. Forty-nine content experts (national researchers and subject experts), forty policy experts (state elected officials or their staff, gubernatorial or legislative policy analysts) and forty-five other stakeholders (state-level advocates, programme administrators, food producers). In aggregate, respondents rated policy impact and implementation feasibility higher than political feasibility. Policy experts rated policy strategies as less politically feasible compared with content experts (P political and implementation feasibility. These included policies related to nutrition standards in schools and child-care facilities, food distribution systems, urban planning projects, water availability, joint use agreements and breast-feeding supports. Although they may be perceived as potentially impactful, some policies will be more difficult to enact than others. Information about the potential feasibility of policies to improve access to healthy foods can be used to focus limited policy process resources on strategies with the highest potential for enactment, implementation and impact.

  10. Physician Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

  11. Feasibility Study for Operable Unit 7-13/14

    International Nuclear Information System (INIS)

    K. Jean Holdren Thomas E. Bechtold Brian D. Preussner

    2007-01-01

    The Subsurface Disposal Area is a radioactive waste landfill located within the Radioactive Waste Management Complex at the Idaho National Laboratory Site in southeastern Idaho. This Feasibility Study for Operable Unit 7-13/14 analyzes options for mitigating risks to human health and the environment associated with the landfill. Analysis is conducted in accordance with the Comprehensive Environmental Response, Compensation, and Liability Act, using nine evaluation criteria to develop detailed and comparative analysis of five assembled alternatives. Assembled alternatives are composed of discrete modules. Ultimately, decision-makers will select, recombine, and sum various modules into an optimized preferred alternative and final remedial decision

  12. Wind pumps for farms: Economic and environmental feasibility

    International Nuclear Information System (INIS)

    Piccoli, F.

    1992-01-01

    The cost and environmental benefits of four different types of water pumps for use on farms are compared. The factors considered in the analysis of the different pumps categorized according to head (7, 30 and 50 m) and energy source (wind energy, electricity, gasoline or fuel oil) include operating and maintenance costs, and payback periods. Particular attention is given to the socio-economic implications of the use of wind pumps in developing countries. In this case, the various aspects taken into account are: wind pump siting requirements, optimum sizing, the feasibility of water pumping-power production with the use of wind turbines, required skill levels of operators, and environmental compatibility

  13. Feasibility Study for Operable Unit 7-13/14

    Energy Technology Data Exchange (ETDEWEB)

    K. Jean Holdren

    2007-05-29

    The Subsurface Disposal Area is a radioactive waste landfill located within the Radioactive Waste Management Complex at the Idaho National Laboratory Site in southeastern Idaho. This Feasibility Study for Operable Unit 7-13/14 analyzes options for mitigating risks to human health and the environment associated with the landfill. Analysis is conducted in accordance with the Comprehensive Environmental Response, Compensation, and Liability Act, using nine evaluation criteria to develop detailed and comparative analysis of five assembled alternatives. Assembled alternatives are composed of discrete modules. Ultimately, decision-makers will select, recombine, and sum various modules into an optimized preferred alternative and final remedial decision.

  14. Bioventing feasibility test to aid remediation strategy

    CSIR Research Space (South Africa)

    Pearce, K

    1998-01-01

    Full Text Available A case study is presented where the feasibility of bioventing was assessed for the remediation of a petroleum-contaminated site. This was achieved through the determination of the radius of influence of a single vent well, the soil gas permeability...

  15. The Feasibility of Collecting School Nurse Data

    Science.gov (United States)

    Bergren, Martha Dewey

    2016-01-01

    School nurses cite barriers to collecting comprehensive data on the care they provide. This study evaluated the feasibility of collecting school nurse data on selected child health and education outcomes. Outcome variables included school health office visits; health provider, parent, and staff communication; early dismissal; and medications…

  16. A cask maintenance facility feasibility study

    International Nuclear Information System (INIS)

    Rennich, M.J.; Medley, L.G.; Attaway, C.R.

    1989-01-01

    The Oak Ridge National Laboratory (ORNL) is developing a transportation system for spent nuclear fuel (SNF) and defense high level waste (HLW) as a part of the Federal Waste Management System (FWMS). In early 1988, a feasibility study was undertaken to design a stand-alone, ''green field'' facility for maintaining the FWMS casks. The feasibility study provided an initial layout facility design, an estimate of the construction cost, and an acquisition schedule for a Cask Maintenance Facility (CMF). The study also helped to define the interfaces between the transportation system and the waste generators, the repository, and a Monitored Retrievable Storage (MRS) facility. The data, design, and estimated costs resulting from the study have been organized for use in the total transportation system decision-making process. Most importantly, the feasibility study also provides a foundation for continuing design and planning efforts. Fleet servicing facility studies, operational studies from current cask system operators, a definition of the CMF system requirements, and the experience of others in the radioactive waste transportation field were used as a basis for the feasibility study. In addition, several cask handling facilities were visited to observe and discuss cask operations to establish the functions and methods of cask maintenance expected to be used in the facility. Finally, a peer review meeting was held at Oak Ridge, Tennessee in August, 1988, in which the assumptions, design, layout, and functions of the CMF were significantly refined. Attendees included representatives from industry, the repository and transportation operations

  17. Feasibility and Stability in Normative Political Philosophy

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2006-01-01

    Arguments from stability for liberal nationalism rely on considerations about conditions for the feasibility or stability of liberal political ideals and factual claims about the circumstances under which these conditions are fulfilled in order to argue for nationalist conclusions. Such reliance ...

  18. Feasibility of uranium enrichment in Australia

    International Nuclear Information System (INIS)

    1979-10-01

    The Council considered that provided the balance between costs and markets was found to be acceptable, there was no valid reason against the Government proceeding with a study on the feasibility of, and perhaps participating in the establishment of a commercial uranium enrichment industry in Australia. Areas covered include technical expertise and industrial structure in Australia, environmental aspects and safeguards

  19. 7 CFR 1980.442 - Feasibility studies.

    Science.gov (United States)

    2010-01-01

    ... management, nature and extent of market area, marketing plans for sale of projected output, extent of... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS...) PROGRAM REGULATIONS (CONTINUED) GENERAL Business and Industrial Loan Program § 1980.442 Feasibility...

  20. Characterizing CDMA downlink feasibility via effective interference

    NARCIS (Netherlands)

    Endrayanto, A.I.; van den Berg, Hans Leo; Boucherie, Richardus J.

    2003-01-01

    This paper models and analyses downlink power assignment feasibility in Code Division Multiple Access (CDMA) mobile networks. By discretizing the area into small segments, the power requirements are characterized via a matrix representation that separates user and system characteristics. We obtain a

  1. Renewable Energy Feasibility Study Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Rooney, Tim [Antares Group Inc.

    2013-10-30

    The Gila River Indian Community (GRIC or the Community) contracted the ANTARES Group, Inc. (“ANTARES”) to assess the feasibility of solar photovoltaic (PV) installations. A solar energy project could provide a number of benefits to the Community in terms of potential future energy savings, increased employment, environmental benefits from renewable energy generation and usage, and increased energy self-sufficiency. The study addresses a number of facets of a solar project’s overall feasibility, including: Technical appropriateness; Solar resource characteristics and expected system performance; Levelized cost of electricity (LCOE) economic assessment. The Gila River Indian Community (GRIC or the Community) contracted the ANTARES Group, Inc. (“ANTARES”) to prepare a biomass resource assessment study and evaluate the feasibility of a bioenergy project on Community land. A biomass project could provide a number of benefits to the Community in terms of increased employment, environmental benefits from renewable energy generation and usage, and increased energy self-sufficiency. The study addresses a number of facets of a biomass project’s overall feasibility, including: Resource analysis and costs; Identification of potential bioenergy projects; Technical and economic (levelized cost of energy) modeling for selected project configuration.

  2. Bond Feasibility Study. Project Identification Committee Report.

    Science.gov (United States)

    Wichita Public Schools, KS.

    A committee, appointed by the Board of Education, was requested to make a comprehensive study of the school building needs of Unified School District No. 259. In an attempt to determine the feasibility of a general bond election to upgrade the public schools, the specific charge to the committee was to evaluate the needs for physical plant…

  3. Technical feasibility study on polycarbonate solar panels

    NARCIS (Netherlands)

    Hackmann, M.M.; Meuwissen, M.H.H.; Bots, T.L.; Buijs, J.A.H.M.; Broek, K.M.; Kinderman, R.; Tanck, O.B.F.; Schuurmans, F.M.

    2004-01-01

    This paper describes a technical feasibility study on the application of polycarbonate (PC) plates in a superstrate photovoltaic module design. The lamination process was performed in a conventional laminator apparatus using low temperature curing (100°C) ethylene-vinyl-acetate (EVA) as the potting

  4. Management of Uncomplicated Acute Appendicitis as Day Case Surgery: Feasibility and a Critical Analysis of Exclusion Criteria and Treatment Failure.

    Science.gov (United States)

    Grelpois, Gérard; Sabbagh, Charles; Cosse, Cyril; Robert, Brice; Chapuis-Roux, Emilie; Ntouba, Alexandre; Lion, Thierry; Regimbeau, Jean-Marc

    2016-11-01

    Day case surgery (DCS) for uncomplicated acute appendicitis (NCAA) is evaluated. The objective of this prospective, single-center, descriptive, nonrandomized, intention-to-treat cohort study was to assess the feasibility of DCS for NCAA with a critical analysis of the reasons for exclusion and treatment failures and a focus on patients discharged to home and admitted for DCS on the following day. From April 2013 to December 2015, NCAA patients meeting the inclusion criteria were included in the study. The primary end point was the success rate for DCS (length of stay less than 12 hours) in the intention-to-treat population (all NCAA) and in the per-protocol population (no pre- or perioperative exclusion criteria). The secondary end points were morbidity, DCS quality criteria, predictive factors for successful DCS, patient satisfaction, quality of life, and reasons for pre- or perioperative exclusion. A subgroup of patients discharged to home the day before operation was also analyzed. A total of 240 patients were included. The success rate of DCS was 31.5% in the intention-to-treat population and 91.5% in the per-protocol population. The rates of unplanned consultations, hospitalization, and reoperation were 13%, 4%, and 1%, respectively. An analysis of the reasons for DCS exclusion showed that 73% could have been modified. For the 68 patients discharged to home on the day before operation, the DCS success rate was 91%. Day case surgery is feasible in NCAA. A critical analysis of the reasons for exclusion from DCS showed that it should be possible to dramatically increase the eligible population. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Modelling curves of manufacturing feasibilities and demand

    Directory of Open Access Journals (Sweden)

    Soloninko K.S.

    2017-03-01

    Full Text Available The authors research the issue of functional properties of curves of manufacturing feasibilities and demand. Settlement of the problem, and its connection with important scientific and practical tasks. According to its nature, the market economy is unstable and is in constant movement. Economy has an effective instrument for explanation of changes in economic environment; this tool is called the modelling of economic processes. The modelling of economic processes depends first and foremost on the building of economic model which is the base for the formalization of economic process, that is, the building of mathematical model. The effective means for formalization of economic process is the creation of the model of hypothetic or imaginary economy. The building of demand model is significant for the market of goods and services. The problem includes the receiving (as the result of modelling definite functional properties of curves of manufacturing feasibilities and demand according to which one can determine their mathematical model. Another problem lies in obtaining majorant properties of curves of joint demand on the market of goods and services. Analysis of the latest researches and publications. Many domestic and foreign scientists dedicated their studies to the researches and building of the models of curves of manufacturing feasibilities and demand. In spite of considerable work of the scientists, such problems as functional properties of the curves and their practical use in modelling. The purpose of the article is to describe functional properties of curves of manufacturing feasibilities and demand on the market of goods and services on the base of modelling of their building. Scientific novelty and practical value. The theoretical regulations (for functional properties of curves of manufacturing feasibilities and demand received as a result of the present research, that is convexity, give extra practical possibilities in a microeconomic

  6. A cask maintenance facility feasibility study

    International Nuclear Information System (INIS)

    Rennich, M.J.; Medley, L.G.; Attaway, C.R.

    1989-01-01

    The Oak Ridge National Laboratory (ORNL) is supporting the USDOE Office of Civilian Radioactive Waste Management (OCRWM) in developing a transportation system for spent nuclear fuel (SNF) and defense high level waste (HLW) as a part of the Federal Waste Management System (FWMS). In early 1988, a feasibility study was undertaken to design a stand-alone, green field facility for maintaining the FWMS casks. The feasibility study provided an initial layout facility design, an estimate of the construction cost, and an acquisition schedule for a Cask Maintenance Facility (CMF). The study also helped to define the interfaces between the transportation system and the waste generators, the repository, and a Monitored Retrieveable Storage (MRS) facility. The data, design, and estimated cost resulting from the study have been organized for use in the total transportation system decision-making process. Most importantly, the feasibility study also provides a foundation for continuing design and planning efforts. The feasibility study was based on an assumed stand-alone green field configuration because of the flexibility this design approach provides. A stand-alone facility requires the inclusion with support functions as well as the primary process facilities thus yielding a comprehensive design evaluation and cost estimate. For example, items such as roads, security and waste processing which might be shared with an integrated or collocated facility have been fully costed in the feasibility study. Thus, while the details of the facility design might change, the overall concept used in the study can be applied to other facility configurations as planning for the total FWMS develops

  7. Conducting feasibilities in clinical trials: An investment to ensure a good study

    Directory of Open Access Journals (Sweden)

    Viraj Rajadhyaksha

    2010-01-01

    Full Text Available Conducting clinical trial feasibility is one of the first steps in clinical trial conduct. This process includes assessing internal and environmental capacity, alignment of the clinical trial in terms of study design, dose of investigational product, comparator, patient type, with the local environment and assessing potential of conducting clinical trial in a specific country. A robust feasibility also ensures a realistic assessment and capability to conduct the clinical trial. For local affiliates of pharmaceutical organizations, and contract research organizations, this is a precursor to study placement and influences the decision of study placement. This article provides details on different types of feasibilities, information which is to be included and relevance of each. The article also aims to provide practical hands-on suggestions to make feasibilities more realistic and informative.

  8. Conducting feasibilities in clinical trials: an investment to ensure a good study.

    Science.gov (United States)

    Rajadhyaksha, Viraj

    2010-07-01

    Conducting clinical trial feasibility is one of the first steps in clinical trial conduct. This process includes assessing internal and environmental capacity, alignment of the clinical trial in terms of study design, dose of investigational product, comparator, patient type, with the local environment and assessing potential of conducting clinical trial in a specific country. A robust feasibility also ensures a realistic assessment and capability to conduct the clinical trial. For local affiliates of pharmaceutical organizations, and contract research organizations, this is a precursor to study placement and influences the decision of study placement. This article provides details on different types of feasibilities, information which is to be included and relevance of each. The article also aims to provide practical hands-on suggestions to make feasibilities more realistic and informative.

  9. 100-HR-2 Operable Unit Focused Feasibility study report

    International Nuclear Information System (INIS)

    1995-01-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) Feasibility Study (FS) includes development and screening of alternatives (Phases 1 and 2) and the detailed analysis of alternatives (Phase 3). This focused feasibility study (FFS) was conducted for the 100-HR-2 Operable Unit (OU) at the Hanford Site in southeastern Washington. This FFS constitutes the Phase 3 portion of the FS process for the remedial alternatives initially developed and screened in the 100 Area Feasibility Study Phases 1 and 2 (DOE-RL 1993a). The objective of this OU-specific FFS is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures (IRM) for the seven IRM candidate sites associated with the 100-HR-2 OU. The IRM candidate waste sites identified in Table ES-1 are determined in the limited field investigation (DOE-RL 1994b). Site profiles are developed for each of these waste sites. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented. A summary for the 100-HR-2 IRM candidate waste site is as follows: none of the waste sites require additional alternative development. six of the seven waste sites directly plug into the waste site group alternatives. The site-specific detailed analysis is conducted, referencing the waste site group analysis as appropriate. A waste site detailed analysis summary is presented in Table ES-1.A comparative analysis of remedial alternatives is presented for each waste site. A summary of the comparative analysis is presented in Table ES-2

  10. Comparative Genomics

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 8. Comparative Genomics - A Powerful New Tool in Biology. Anand K Bachhawat. General Article Volume 11 Issue 8 August 2006 pp 22-40. Fulltext. Click here to view fulltext PDF. Permanent link:

  11. Comparative Advantage

    DEFF Research Database (Denmark)

    Zhang, Jie; Jensen, Camilla

    2007-01-01

    that are typically explained from the supply-side variables, the comparative advantage of the exporting countries. A simple model is proposed and tested. The results render strong support for the relevance of supply-side factors such as natural endowments, technology, and infrastructure in explaining international...

  12. Comparative perspectives

    African Journals Online (AJOL)

    IT

    Ideology, policy and implementation: Comparative perspectives from two ... how both political as well as particular language ideologies play a major role in influencing and ..... attitudes as a field of research, many scholars still draw on the concept of .... The data for this study were collected through the use of questionnaires ...

  13. A study protocol for a non-randomised comparison trial evaluating the feasibility and effectiveness of a mobile cognitive-behavioural programme with integrated coaching for anxious adults in primary care.

    Science.gov (United States)

    Szigethy, Eva; Solano, Francis; Wallace, Meredith; Perry, Dina L; Morrell, Lauren; Scott, Kathryn; Bell, Megan Jones; Oser, Megan

    2018-01-13

    Generalised anxiety disorder (GAD) and subclinical GAD are highly prevalent in primary care. Unmanaged anxiety worsens quality of life in patients seen in primary care practices and leads to increased medical utilisation and costs. Programmes that teach patients cognitive-behavioural therapy (CBT) techniques have been shown to improve anxiety and to prevent the evolution of anxiety symptoms to disorders, but access and engagement have hampered integration of CBT into medical settings. This pragmatic study takes place in University of Pittsburgh Medical Center primary care practices to evaluate a coach-supported mobile cognitive- behavioural programme (Lantern) on anxiety symptoms and quality of life. Clinics were non-randomly assigned to either enhanced treatment as usual or Lantern. All clinics provide electronic screening for anxiety and, within clinics assigned to Lantern, patients meeting a threshold level of mild anxiety (ie, >5 on Generalised Anxiety Disorder 7-Item Questionnaire (GAD-7)) are referred to Lantern. The first study phase is aimed at establishing feasibility, acceptability and effectiveness. The second phase focuses on long-term impact on psychosocial outcomes, healthcare utilisation and clinic/provider adoption/sustainable implementation using a propensity score matched parallel group study design. Primary outcomes are changes in anxiety symptoms (GAD-7) and quality of life (Short-Form Health Survey) between baseline and 6-month follow-ups, comparing control and intervention. Secondary outcomes include provider and patient satisfaction, patient engagement, durability of changes in anxiety symptoms and quality of life over 12 months and the impact of Lantern on healthcare utilisation over 12 months. Patients from control sites will be matched to the patients who use the mobile app. Ethics and human subject research approval were obtained. A data safety monitoring board is overseeing trial data and ethics. Results will be communicated to

  14. Novel Formulation Strategy to Improve the Feasibility of Amifostine Administration.

    Science.gov (United States)

    Ranganathan, Kavitha; Simon, Eric; Lynn, Jeremy; Snider, Alicia; Zhang, Yu; Nelson, Noah; Donneys, Alexis; Rodriguez, Jose; Buchman, Lauren; Reyna, Dawn; Lipka, Elke; Buchman, Steven R

    2018-03-19

    Amifostine (AMF), a radioprotectant, is FDA-approved for intravenous administration in cancer patients receiving radiation therapy (XRT). Unfortunately, it remains clinically underutilized due to adverse side effects. The purpose of this study is to define the pharmacokinetic profile of an oral AMF formulation potentially capable of reducing side effects and increasing clinical feasibility. Calvarial osteoblasts were radiated under three conditions: no drug, AMF, and WR-1065 (active metabolite). Osteogenic potential of cells was measured using alkaline phosphatase staining. Next, rats were given AMF intravenously or directly into the jejunum, and pharmacokinetic profiles were evaluated. Finally, rats were given AMF orally or subcutaneously, and blood samples were analyzed for pharmacokinetics. WR-1065 preserved osteogenic potential of calvarial osteoblasts after XRT to a greater degree than AMF. Direct jejunal AMF administration incurred a systemic bioavailability of 61.5%. Subcutaneously administrated AMF yielded higher systemic levels, a more rapid peak exposure (0.438 vs. 0.875 h), and greater total systemic exposure of WR-1065 (116,756 vs. 16,874 ng*hr/ml) compared to orally administered AMF. Orally administered AMF achieves a similar systemic bioavailability and decreased peak plasma level of WR-1065 compared to intravenously administered AMF, suggesting oral AMF formulations maintain radioprotective efficacy without causing onerous side effects, and are clinically feasible.

  15. COLD-SAT feasibility study safety analysis

    Science.gov (United States)

    Mchenry, Steven T.; Yost, James M.

    1991-01-01

    The Cryogenic On-orbit Liquid Depot-Storage, Acquisition, and Transfer (COLD-SAT) satellite presents some unique safety issues. The feasibility study conducted at NASA-Lewis desired a systems safety program that would be involved from the initial design in order to eliminate and/or control the inherent hazards. Because of this, a hazards analysis method was needed that: (1) identified issues that needed to be addressed for a feasibility assessment; and (2) identified all potential hazards that would need to be controlled and/or eliminated during the detailed design phases. The developed analysis method is presented as well as the results generated for the COLD-SAT system.

  16. Human reliability data bank: feasibility study

    International Nuclear Information System (INIS)

    Comer, K.; Miller, D.P.; Donovan, M.

    1984-01-01

    The US Nuclear Regulatory Commission and Sandia National Laboratories have been developing a plan for a human reliability data bank since August 1981. This research is in response to the data needs of the nuclear power industry's probabilistic risk assessment community. The three phases of the program are to: (A) develop the data bank concept, (B) develop an implementation plan and conduct a feasibility study, and (C) assist a sponsor in implementing the data bank. The program is now in Phase B. This paper describes the methods used in the feasibility study. Decisions to be made in the future regarding full-scale implementation will be based, in part, on the outcome of this study. 3 references, 2 figures

  17. Construction feasibility of OTEC platforms. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brewer, J H; Harwood, P; Solberg, K; Fjeld, S

    1978-12-01

    This study provides an evaluation of the feasibility of constructing either steel or concrete OTEC platforms of both spar and ship shape configurations for a range of platform sizes with respect to existing, developed shipyard or fabrication yard facilities that are currently active in marine vessel construction within the US. This brief study is quite broad in scope. Many parameters, including plant size; vessel type, size, configuration, and dimensions; position of heat exchangers; existing construction facility size, geographic location, and potential for modification; and, availability of undeveloped deep water construction sites affect the conclusions drawn. Nevertheless, the conclusions should remain valid and not change significantly, unless there are major changes in either vessel size or US construction capabilities. The various concepts are ranked in order of their feasibility and practicality of construction in existing or modified existing facilities and new facilities.

  18. B Plant process piping replacement feasibility study

    International Nuclear Information System (INIS)

    Howden, G.F.

    1996-01-01

    Reports on the feasibility of replacing existing embedded process piping with new more corrosion resistant piping between cells and between cells and a hot pipe trench of a Hanford Site style canyon facility. Provides concepts for replacement piping installation, and use of robotics to replace the use of the canyon crane as the primary means of performing/supporting facility modifications (eg, cell lining, pipe replacement, equipment reinstallation) and operational maintenenace

  19. Feasibility of solar-pumped dye lasers

    Science.gov (United States)

    Lee, Ja H.; Kim, Kyung C.; Kim, Kyong H.

    1987-01-01

    Dye laser gains were measured at various pump-beam irradiances on a dye cell in order to evaluate the feasibility of solar pumping. Rhodamine 6G dye was considered as a candidate for the solar-pumped laser because of its high utilization of the solar spectrum and high quantum efficiency. Measurements show that a solar concentration of 20,000 is required to reach the threshold of the dye.

  20. Feasibility Study of Renewable Energy in Singapore

    OpenAIRE

    King, Sebastian; Wettergren, Per

    2011-01-01

    Singapore is a country that is currently highly dependent on import of oil and gas. In order to be able to shift into a more sustainable energy system, Singapore is investing in research regarding different technologies and systems so as to establish more sustainable energy solutions. Seeing how air-conditioning accounts for approximately 30 % of Singapore’s total energy consumption, a feasibility study is being conducted on whether an integrated system using a thermally active building syste...

  1. Feasibility study on volcanic power generation system

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-07-01

    Investigations were carried out to determine the feasibility of volcanic power generation on Satsuma Io Island. Earthquakes were studied, as were the eruptions of subaerial and submarine hot springs. Hydrothermal rock alteration was studied and electrical surveys were made. General geophysical surveying was performed with thermocameras and radiation monitoring equipment. In particular, the Toyoba mine was studied, both with respect to its hot spring and its subsurface temperatures.

  2. Feasibility study on tandem fuel cycle

    International Nuclear Information System (INIS)

    Han, P.S.; Suh, I.S.; Rim, C.S.; Kim, B.K.; Suh, K.S.; Ro, S.K.; Juhn, P.I.; Kim, S.Y.

    1983-01-01

    The objective of this feasibility study is to review and assess the current state of technology concerning the tandem fuel cycle. Based on the results from this study, a long-term development plan suitable for Korea has been proposed for this cycle, i.e., the PWR → CANDU tandem fuel cycle which used plutonium and uranium, recovered from spent PWR fuel by co-processing, as fuel material for CANDU reactors. (Author)

  3. FEASIBILITY OF INVESTMENT IN BUSINESS ANALYTICS

    Directory of Open Access Journals (Sweden)

    Mladen Varga

    2007-12-01

    Full Text Available Trends in data processing for decision support show that business users need business analytics, i.e. analytical applications which incorporate a variety of business oriented data analysis techniques and task-specific knowledge. The paper discusses the feasibility of investment in two models of implementing business analytics: custom development and packed analytical applications. The consequences of both models are shown on two models of business analytics implementation in Croatia.

  4. Feasibility of satellite quantum key distribution

    OpenAIRE

    Bonato, Cristian; Tomaello, Andrea; Da Deppo, Vania; Naletto, Giampiero; Villoresi, Paolo

    2009-01-01

    In this paper we present a novel analysis of the feasibility of quantum key distribution between a LEO satellite and a ground station. First of all, we study signal propagation through a turbulent atmosphere for uplinks and downlinks, discussing the contribution of beam spreading and beam wandering. Then we introduce a model for the background noise of the channel during night-time and day-time, calculating the signal-to-noise ratio for different configurations. We also discuss the expected e...

  5. Feasibility, safety, and potential demand of emergent brain magnetic resonance imaging of patients with cardiac implantable electronic devices

    Directory of Open Access Journals (Sweden)

    Maki Ono

    2017-10-01

    Conclusions: Our study found the potential demand of brain MRI of patients with CIEDs in emergency situations compared with scheduled scanning, which was shown to be feasible and safe for the diagnosis and treatment of an acute stroke.

  6. Gasohol: economic feasibility study. Final report

    Energy Technology Data Exchange (ETDEWEB)

    David, M. L.; Hammaker, G. S.; Buzenberg, R. J.; Wagner, J. P.

    1978-07-01

    This report was prepared by Development Planning and Research Associates, Inc. under a contract with the Energy Research and Development Center of the University of Nebraska in cooperation with the Agricultural Products Industrial Utilization Committee and the State of Nebraska. Funding for this study was provided to the Energy Research and Development Center by the U.S. Department of Energy and the Old West Regional Commission. The primary objective of the study was to: determine the fiscal and market conditions under which the production of gasohol would be profitable for private producers. For purposes of this study, gasohol is a motor fuel consisting of 10 percent agriculturally-derived anhydrous ethanol and 90 percent unleaded gasoline. The study assumes that gasohol can be a fuel substitute for gasoline; indeed, the cost of gasoline will significantly influence that for gasohol. Gasoline prices are determined by factors external to ethanol; thus, the economic feasibility study of gasohol is in large part an economic feasibility study of fuel-grade ethanol production. More specifically, the study examined the following: the technical aspects of distributing, marketing, and using gasohol; the costs of the distribution and marketing of ethanol and gasohol; the energy balance of ethanol production; the cost of producing ethanol; the factors influencing ehtanol plant size and location; and the conditions that would make ethanol economicaly feasible for private producers.

  7. Development and feasibility of falls prevention advice.

    Science.gov (United States)

    van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth

    2011-10-01

    This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

  8. Video Comparator

    International Nuclear Information System (INIS)

    Rose, R.P.

    1978-01-01

    The Video Comparator is a comparative gage that uses electronic images from two sources, a standard and an unknown. Two matched video cameras are used to obtain the electronic images. The video signals are mixed and displayed on a single video receiver (CRT). The video system is manufactured by ITP of Chatsworth, CA and is a Tele-Microscope II, Model 148. One of the cameras is mounted on a toolmaker's microscope stand and produces a 250X image of a cast. The other camera is mounted on a stand and produces an image of a 250X template. The two video images are mixed in a control box provided by ITP and displayed on a CRT. The template or the cast can be moved to align the desired features. Vertical reference lines are provided on the CRT, and a feature on the cast can be aligned with a line on the CRT screen. The stage containing the casts can be moved using a Boeckleler micrometer equipped with a digital readout, and a second feature aligned with the reference line and the distance moved obtained from the digital display

  9. Concurrent paclitaxel and radiotherapy. Treatment feasibility studies

    International Nuclear Information System (INIS)

    Vogt, H.G.; Martin, T.; Kolotas, C.; Hey, S.; Schneider, L.; Templin, T.; Zamboglou, N.; Dornoff, W.; Kettner, H.

    1997-01-01

    Background: The anti-neoplastic effect of paclitaxel has been demonstrated in various clinical studies in different malignant diseases. Clinical studies have also demonstrated a greater efficacy for simultaneous radio-chemotherapy compared with radiotherapy alone when using radiosensitizing drugs. Based on these clinical and in-vitro data we initiated several pilot studies using paclitaxel as a radiosensitizing agent and we now present our initial experience in its use in a combined modality protocol, radiation and simultaneous chemotherapy with paclitaxel. Methods: I. Concurrent paclitaxel and radiation for locally advanced non-small-cell lung cancer (NSCLC): In a phase-I-study we applicated paclitaxel (45 to 65 mg/m 2 ) as a 3-hour infusion weekly for 3 to 7 weeks simultaneously with primary radiotherapy in shrinking field technique with 5x1.8 Gy/week up to 59.4 Gy. - II. Concurrent paclitaxel and radiation for breast cancer as neoadjuvant or palliative: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 6 weeks simultaneous with neoadjuvant or palliative radiotherapy of the breast/chest wall with 5x1.8 Gy/week up to 54.0 Gy. - III./IV. Concurrent paclitaxel/carboplatin and combined radiation (EBRT+brachytherapy) for locally advanced inoperable cancer of the cervix: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 5 weeks, 50 mg/m 2 carboplatin at day 1 to 5 in week 1 and 5 simultaneously with external beam radiotherapy of the pelvis with 5x1.8 Gy/week up to 54.0 Gy and endocavitary LDR-brachytherapy (4x5 Gy). - V. Concurrent paclitaxel and radiation for locally advanced inoperable cancer of the bladder: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 5 weeks simultaneous with radiotherapy of the pelvis with 5x1.8 Gy/week up to 50.4 Gy. VI. Concurrent paclitaxel and radiation in locally advanced inoperable head and neck cancer: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 7 to 8 weeks simultaneous with radiotherapy in shrinking field technique

  10. Distributed Manufacturing of Flexible Products: Technical Feasibility and Economic Viability

    Directory of Open Access Journals (Sweden)

    Aubrey L. Woern

    2017-10-01

    Full Text Available Distributed manufacturing even at the household level is now well established with the combined use of open source designs and self-replicating rapid prototyper (RepRap 3-D printers. Previous work has shown substantial economic consumer benefits for producing their own polymer products. Now flexible filaments are available at roughly 3-times the cost of more conventional 3-D printing materials. To provide some insight into the potential for flexible filament to be both technically feasible and economically viable for distributed digital manufacturing at the consumer level this study investigates 20 common flexible household products. The 3-D printed products were quantified by print time, electrical energy use and filament consumption by mass to determine the cost to fabricate with a commercial RepRap 3-D printer. Printed parts were inspected and when necessary tested for their targeted application to ensure technical feasibility. Then, the experimentally measured cost to DIY manufacturers was compared to low and high market prices for comparable commercially available products. In addition, the mark-up and potential for long-term price declines was estimated for flexible filaments by converting thermoplastic elastomer (TPE pellets into filament and reground TPE from a local recycling center into filament using an open source recyclebot. This study found that commercial flexible filament is economically as well as technically feasible for providing a means of distributed home-scale manufacturing of flexible products. The results found a 75% savings when compared to the least expensive commercially equivalent products and 92% when compared to high market priced products. Roughly, 160 flexible objects must be substituted to recover the capital costs to print flexible materials. However, as previous work has shown the Lulzbot Mini 3-D printer used in this study would provide more than a 100% ROI printing one object a week from hard thermoplastics

  11. A Regularized Algorithm for the Proximal Split Feasibility Problem

    Directory of Open Access Journals (Sweden)

    Zhangsong Yao

    2014-01-01

    Full Text Available The proximal split feasibility problem has been studied. A regularized method has been presented for solving the proximal split feasibility problem. Strong convergence theorem is given.

  12. Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. A pilot study.

    Directory of Open Access Journals (Sweden)

    Willem J R Bossers

    Full Text Available OBJECTIVES: We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. METHODS: Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0. In phase 1 of the study, seventeen patients in the Exercise group (EG received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. RESULTS: Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003, Six-Minute Walk Test (p = .031, and isometric quadriceps strength (p = .012. CONCLUSIONS: The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. TRIAL REGISTRATION: trialregister.nl 1230.

  13. Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. A pilot study.

    Science.gov (United States)

    Bossers, Willem J R; Scherder, Erik J A; Boersma, Froukje; Hortobágyi, Tibor; van der Woude, Lucas H V; van Heuvelen, Marieke J G

    2014-01-01

    We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0). In phase 1 of the study, seventeen patients in the Exercise group (EG) received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG) received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003), Six-Minute Walk Test (p = .031), and isometric quadriceps strength (p = .012). The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. trialregister.nl 1230.

  14. Transcatheter vs. surgical aortic valve replacement and medical treatment : Systematic review and meta-analysis of randomized and non-randomized trials.

    Science.gov (United States)

    Ak, A; Porokhovnikov, I; Kuethe, F; Schulze, P C; Noutsias, M; Schlattmann, P

    2017-04-27

    Transcatheter aortic valve replacement (TAVR) has emerged as the procedure of choice for patients with severe aortic stenosis (AS) and high perioperative risk. We performed a meta-analysis to compare the mortality related to TAVR with medical therapy (MT) and surgical aortic valve replacement (SAVR). A systematic literature search was conducted by two independent investigators from the database inception to 30 December 2014. Relative risk (RR) and odds ratio (OR) were calculated and graphically displayed in forest plots. We used I 2 for heterogeneity (meta-regression) and Egger's regression test of asymmetry (funnel plots). We included 24 studies (n = 19 observational studies; n = 5 randomized controlled trials), with a total of 7356 patients in this meta-analysis. Mean age had a substantial negative impact on the long-term survival of AS patients (OR = 1.544; 95% CI: 1.25-1.90). Compared with MT, TAVR showed a statistically significant benefit for all-cause mortality at 12 months (OR = 0.68; 95% CI: 0.49-0.95). Both TAVR and SAVR were associated with better outcomes compared with MT. TAVR showed lower all-cause mortality over SAVR at 12 months (OR = 0.81; 95% CI: 0.68-0.97). The comparison between SAVR and TAVR at 2 years revealed no significant difference (OR = 1.09; 95% CI: 1.01-1.17). In AS, both TAVR and SAVR provide a superior prognosis to MT and, therefore, MT is not the preferred treatment option for AS. Furthermore, our data show that TAVR is associated with lower mortality at 12 months compared with SAVR. Further studies are warranted to compare the long-term outcome of TAVR versus SAVR beyond a 2-year follow-up period.

  15. 7 CFR 3575.47 - Economic feasibility requirements.

    Science.gov (United States)

    2010-01-01

    ... credit quality in a written financial feasibility analysis which includes adequacy of equity, cash flow, security, history, and management capabilities. Financial feasibility reports must take into consideration... financial credit analysis may also serve as the feasibility analysis when sufficient evidence is included to...

  16. Feasibility analysis of heat pump dryer to dry hawthorn cake

    Energy Technology Data Exchange (ETDEWEB)

    Wang, D.C., E-mail: wdechang@163.com [College of Electromechanical Engineering, Qingdao University, Qingdao 266071 (China); Zhang, G.; Han, Y.P.; Zhang, J.P.; Tian, X.L. [College of Electromechanical Engineering, Qingdao University, Qingdao 266071 (China)

    2011-08-15

    Highlights: {yields} A heat pump dryer (HPD) is effectively proposed to dry hawthorn cake-likely materials. {yields} Low drying temperature and high COP of heat pump are obtained in drying beginning. {yields} HPD is more effective, economic than a traditional hot air dryer. {yields} Feasibility of the HPD is also validated by the operation economy estimation. - Abstract: A heat pump dryer (HPD) would be an economic, environmentally friendly, hygienic drying machine used to dry some food, such as hawthorn cakes. Based on the production process of the hawthorn cake, a HPD is proposed and its basic principle is introduced. The experimental drying curves of the hawthorn cake using the heat pump drying method and the traditional hot air drying method are compared and analyzed. The drying process of hawthorn cakes is similar to that of the other drying materials. The higher drying temperature causes a faster drying process. But in the initial stage of the heat pump drying process, the water content of the hawthorn cake is not sensitive to the drying temperature, so a lower drying air temperature can be available in order to get a higher coefficient of performance (COP) of the heat pump (HP). The experimental results and the economic analysis indicate that the HPD is feasibly used to dry hawthorn cakes.

  17. The feasibility study on fuel types for the KALIMER

    International Nuclear Information System (INIS)

    Hwang, W.; Nam, C.; Yim, J. S.; Na, B. C.; Hahn, D. H.; Kim, Y. I.; Kim, Y. C.; Park, C. K.

    1997-08-01

    The economics of LMR is largely dependent on the construction cost of the power plant, and the fuel cycle options usually constitute 20 to 30 % of total electricity generation cost. The choice of fuel cycle technology and the fuel type is important in order to develop a LMR with better economics, performance and safety. The LMR fuel types, whose performances have been proven up to 15 at% burnup, are MOX and IFR metal fuel. The base alloy, binary (U-10% Zr) metal fuel with HT9 is used as structural materials of KALIMER. The design concept of KALIMER fuel has been established through the investigation of technical feasibilities on the fuel and recycle systems for MOX and IFR metal fuel. According to the results of comparative analysis for MOX and metal fuel, metal fuel is better than MOX in view of safety, in-reactor performance, nuclear characteristics, economics and non-proliferation, while MOX fuels have advantages in the developmental status and technical cooperation potential. The overall performance of binary (U-10% Zr) metal fuel with HT9 cladding, which is a potential start-up fuel for KALIMER, is not only superior to that of MOX fuel, but also has enough technical feasibility in its high-burnup performance, safety and economics. (author). 54 ref., 13 tabs., 20 figs

  18. Feasibility Study of Laser Cutting for Fabrication of Tensile Specimen

    International Nuclear Information System (INIS)

    Jin, Y. G.; Baik, S. J.; Kim, G. S.; Heo, G. S.; Yoo, B. O.; Ahn, S. B.; Chun, Y. B.

    2015-01-01

    The specimen fabrication technique was established to machine the specimen from the irradiated materials. The wire cut EDM(electric discharge machine) was modified to fabricate the mechanical testing specimens from irradiated components and fuel claddings. The oxide layer removal system was also developed because the oxide layer on the surface of the irradiated components and claddings interrupted the applying the electric current during the processing. However, zirconium oxide is protective against further corrosion as well as beneficial to mechanical strength for the tensile deformation of the cladding. Thus, it is important to fabricate the irradiated specimens without removal of oxide layer on the surface of the irradiated structural components and claddings. In the present study, laser cutting system was introduced to fabricate the various mechanical testing specimens from the unirradiated fuel cladding and the feasibility of the laser cutting system was studied for the fabrication of various types of irradiated specimens in a hot cell at IMEF (Irradiated Materials Examination Facility) of KAERI. Laser beam machining system was introduced to fabricate the various mechanical testing specimens from the unirradiated fuel cladding and the dimensions were compared for the feasibility of the laser cutting system. The effect of surface oxide layer was also investigated for machining process of the zircaloy-4 fuel cladding and it was found that laser beam machining could be a useful tool to fabricate the specimens with surface oxide layer

  19. Feasibility analysis of heat pump dryer to dry hawthorn cake

    International Nuclear Information System (INIS)

    Wang, D.C.; Zhang, G.; Han, Y.P.; Zhang, J.P.; Tian, X.L.

    2011-01-01

    Highlights: → A heat pump dryer (HPD) is effectively proposed to dry hawthorn cake-likely materials. → Low drying temperature and high COP of heat pump are obtained in drying beginning. → HPD is more effective, economic than a traditional hot air dryer. → Feasibility of the HPD is also validated by the operation economy estimation. - Abstract: A heat pump dryer (HPD) would be an economic, environmentally friendly, hygienic drying machine used to dry some food, such as hawthorn cakes. Based on the production process of the hawthorn cake, a HPD is proposed and its basic principle is introduced. The experimental drying curves of the hawthorn cake using the heat pump drying method and the traditional hot air drying method are compared and analyzed. The drying process of hawthorn cakes is similar to that of the other drying materials. The higher drying temperature causes a faster drying process. But in the initial stage of the heat pump drying process, the water content of the hawthorn cake is not sensitive to the drying temperature, so a lower drying air temperature can be available in order to get a higher coefficient of performance (COP) of the heat pump (HP). The experimental results and the economic analysis indicate that the HPD is feasibly used to dry hawthorn cakes.

  20. Power generation from MSW of Haridwar city: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Jain, Siddharth; Sharma, M.P. [Biofuel Research Laboratory, Alternate Hydro Energy Centre, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand 247667 (India)

    2011-01-15

    Energy plays significant role in the development of a nation. The conventional sources, though exhausting and not environment friendly are being increasingly used. Looking at limited supplies and various environment problems associated with its uses, renewable energy sources are getting attention. Municipal solid waste [MSW] is getting importance in recent years. Having fewer disposal problems is being considered as valuable bio-energy resources. The MSW management involves collection, transportation, handling and conversion to energy by biological and thermal routes. The present paper reports the results of physical, proximate and TGA/DTA analysis, used to select the most appropriate method of energy conversion. Based on the energy potential available, the feasibility of energy conversion through biogas production using available waste has been carried out. The CDM benefits have also been considered. The cost of generation with and without CDM benefits is Rs. 1.36/- and Rs. 1.41/- per kWh respectively as compared to cost of energy from grid [Rs. 3.50/- per kWh]. Therefore power generation from MSW of Haridwar city using biomethanation conversion technology is feasible. (author)

  1. Feasibility Study of Laser Cutting for Fabrication of Tensile Specimen

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Y. G.; Baik, S. J.; Kim, G. S.; Heo, G. S.; Yoo, B. O.; Ahn, S. B.; Chun, Y. B. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    The specimen fabrication technique was established to machine the specimen from the irradiated materials. The wire cut EDM(electric discharge machine) was modified to fabricate the mechanical testing specimens from irradiated components and fuel claddings. The oxide layer removal system was also developed because the oxide layer on the surface of the irradiated components and claddings interrupted the applying the electric current during the processing. However, zirconium oxide is protective against further corrosion as well as beneficial to mechanical strength for the tensile deformation of the cladding. Thus, it is important to fabricate the irradiated specimens without removal of oxide layer on the surface of the irradiated structural components and claddings. In the present study, laser cutting system was introduced to fabricate the various mechanical testing specimens from the unirradiated fuel cladding and the feasibility of the laser cutting system was studied for the fabrication of various types of irradiated specimens in a hot cell at IMEF (Irradiated Materials Examination Facility) of KAERI. Laser beam machining system was introduced to fabricate the various mechanical testing specimens from the unirradiated fuel cladding and the dimensions were compared for the feasibility of the laser cutting system. The effect of surface oxide layer was also investigated for machining process of the zircaloy-4 fuel cladding and it was found that laser beam machining could be a useful tool to fabricate the specimens with surface oxide layer.

  2. Assessment of apical periodontitis by MRI. A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Geibel, M.A. [Ulm Univ. (Germany). Oral and Maxillofacial Surgery; Schreiber, E.S.; Bracher, A.K.; Rasche, V. [Ulm Univ. (Germany). Internal Medicine II; Hell, E.; Ulrici, J. [Sirona Dental Systems GmbH, Bensheim (Germany). Dental Imaging; Sailer, L.K. [DOC Praxisklinik im Wiley, Neu-Ulm (Germany). MKG; Ozpeynirci, Y. [Ulm Univ. (Germany). Diagnostic and Interventional Radiology

    2015-04-15

    The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). 19 consecutive patients (average age 43 ± 13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap. No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions.

  3. Feasibility of using fiber optics for monitoring ground water contaminants

    International Nuclear Information System (INIS)

    Hirschfeld, T.; Deaton, T.; Milanovich, F.; Klainer, S.M.

    1984-06-01

    The report contains the results of the initial feasibility study for a research program undertaken to develop the technology needed to use fiber optics for monitoring groundwater contaminants. The technology appears especially well suited to the requirements of detection monitoring where a few indicator parameters can be measured continuously by sensors placed down small-diameter monitoring wells. Data are generated at a remote, centrally located fluorimeter, connected to the sampling sites by inexpensive optical fibers. The analytical method is laser-induced fluorescence which gives the desired sensitivity. The optrode, a chemical system and/or a mechanical device at the distal end of a fiber optic, furnishes the needed specificity. Various fiber and optrode configurations have been evaluated and their applications to groundwater monitoring are discussed. Feasibility is shown for physical measurements such as temperature, pressure and pH. Chemical detection and quantification of the actinides, inorganic and organic chlorides, sulfates, alcohols, aldehydes, pesticides and tracer materials are presented. Finally, it is shown that the need for smaller diameter wells (as compared to conventional sampling methods), and the ability to make up to 50 unattended in situ measurements, using a reasonably priced centralized fluorometer system connected to the sampling sites by inexpensive optical fibers, results in acceptable economy

  4. Assessment of apical periodontitis by MRI. A feasibility study

    International Nuclear Information System (INIS)

    Geibel, M.A.; Schreiber, E.S.; Bracher, A.K.; Rasche, V.; Hell, E.; Ulrici, J.; Sailer, L.K.; Ozpeynirci, Y.

    2015-01-01

    The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). 19 consecutive patients (average age 43 ± 13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap. No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions.

  5. A Feasibility study of a mining business

    Directory of Open Access Journals (Sweden)

    Cehlár Michal

    2001-06-01

    Full Text Available The economic evaluation of a project requires a great deal of diverse information to be brought together in one place. The greatest concern is that there will be an error by omission, so it is useful to have a detailed list of what one needs to know in order to make a thorough evaluation.There are various of detail required at the different stages of evaluation in the project, from the "quick and dirty" overview to the pre-feasibility study, through a full detailed feasibility study, to a due diligence review. This list addresses most of the economic variables in project and can be used at all levels of studies. Its purpose is to identify a variable or issue and to raise a question, which the review can pursue in more detail using an increasingly more comprehensive checklist for each topic. While developed from the point of view of a new project, this list is equally valid for an ongoing operation.A feasibility study is defined as an assessment of all aspects of a project including technical, infrastructural, environmental, social, legislative and commercial factors, which is sufficiently detailed to support a decision on the implementation. Each project has an associated level of risk. For a proposed investment to increase the value of a firm's stock, it should have a higher expected rate of return than shareholders require for assuming that risk. Since investors demand for a higher potential returns from a riskier project, the cost of capital depends on the venture's risk.

  6. Understanding Regulation of Metabolism through Feasibility Analysis

    Science.gov (United States)

    Nikerel, Emrah; Berkhout, Jan; Hu, Fengyuan; Teusink, Bas; Reinders, Marcel J. T.; de Ridder, Dick

    2012-01-01

    Understanding cellular regulation of metabolism is a major challenge in systems biology. Thus far, the main assumption was that enzyme levels are key regulators in metabolic networks. However, regulation analysis recently showed that metabolism is rarely controlled via enzyme levels only, but through non-obvious combinations of hierarchical (gene and enzyme levels) and metabolic regulation (mass action and allosteric interaction). Quantitative analyses relating changes in metabolic fluxes to changes in transcript or protein levels have revealed a remarkable lack of understanding of the regulation of these networks. We study metabolic regulation via feasibility analysis (FA). Inspired by the constraint-based approach of Flux Balance Analysis, FA incorporates a model describing kinetic interactions between molecules. We enlarge the portfolio of objectives for the cell by defining three main physiologically relevant objectives for the cell: function, robustness and temporal responsiveness. We postulate that the cell assumes one or a combination of these objectives and search for enzyme levels necessary to achieve this. We call the subspace of feasible enzyme levels the feasible enzyme space. Once this space is constructed, we can study how different objectives may (if possible) be combined, or evaluate the conditions at which the cells are faced with a trade-off among those. We apply FA to the experimental scenario of long-term carbon limited chemostat cultivation of yeast cells, studying how metabolism evolves optimally. Cells employ a mixed strategy composed of increasing enzyme levels for glucose uptake and hexokinase and decreasing levels of the remaining enzymes. This trade-off renders the cells specialized in this low-carbon flux state to compete for the available glucose and get rid of over-overcapacity. Overall, we show that FA is a powerful tool for systems biologists to study regulation of metabolism, interpret experimental data and evaluate hypotheses. PMID

  7. Feasibility analysis of recycling radioactive scrap steel

    International Nuclear Information System (INIS)

    Nichols, F.; Balhiser, B.; Cignetti, N.

    1995-09-01

    The purpose of this study is to: (1) establish a conceptual design that integrates commercial steel mill technology with radioactive scrap metal (RSM) processing to produce carbon and stainless steel sheet and plate at a grade suitable for fabricating into radioactive waste containers; (2) determine the economic feasibility of building a micro-mill in the Western US to process 30,000 tons of RSM per year from both DOE and the nuclear utilities; and (3) provide recommendations for implementation. For purposes of defining the project, it is divided into phases: economic feasibility and conceptual design; preliminary design; detail design; construction; and operation. This study comprises the bulk of Phase 1. It is divided into four sections. Section 1 provides the reader with a complete overview extracting pertinent data, recommendations and conclusions from the remainder of the report. Section 2 defines the variables that impact the design requirements. These data form the baseline to create a preliminary conceptual design that is technically sound, economically viable, and capitalizes on economies of scale. Priorities governing the design activities are: (1) minimizing worker exposure to radionuclide hazards, (2) maximizing worker safety, (3) minimizing environmental contamination, (4) minimizing secondary wastes, and (5) establishing engineering controls to insure that the plant will be granted a license in the state selected for operation. Section 3 provides details of the preliminary conceptual design that was selected. The cost of project construction is estimated and the personnel needed to support the steel-making operation and radiological and environmental control are identified. Section 4 identifies the operational costs and supports the economic feasibility analysis. A detailed discussion of the resulting conclusions and recommendations is included in this section

  8. Feasibility analysis of gravitational experiments in space

    Science.gov (United States)

    Everitt, C. W. F.

    1977-01-01

    Experiments on gravitation and general relativity suggested by different workers in the past ten or more years are reviewed, their feasibility examined, and the advantages of performing them in space were studied. The experiments include: (1) the gyro relativity experiment; (2) experiments to test the equivalence of gravitational and inertial mass; (3) an experiment to look for nongeodesic motion of spinning bodies in orbit around the earth; (4) experiments to look for changes of the gravitational constant G with time; (5) a variety of suggestions; laboratory tests of experimental gravity; and (6) gravitational wave experiments.

  9. The feasibility of a brain tumour website

    DEFF Research Database (Denmark)

    Piil, K; Jakobsen, J; Juhler, M

    2015-01-01

    PURPOSE: Patients with a high-grade glioma (HGG) and their caregivers have imminent and changing informational and supportive care needs. The purpose of this study was to investigate the feasibility and safety of a Danish brain tumour website (BTW) in patients with HGG and their caregivers. We...... one overarching theme 'challenges and barriers'. Being newly diagnosed, patients described a chaotic and overwhelming life situation and had difficulties in identifying with their new and changed role. When using the BTW, some patients and caregivers experienced technological challenges, while...

  10. Feasibility Study of Thin Film Thermocouple Piles

    Science.gov (United States)

    Sisk, R. C.

    2001-01-01

    Historically, thermopile detectors, generators, and refrigerators based on bulk materials have been used to measure temperature, generate power for spacecraft, and cool sensors for scientific investigations. New potential uses of small, low-power, thin film thermopiles are in the area of microelectromechanical systems since power requirements decrease as electrical and mechanical machines shrink in size. In this research activity, thin film thermopile devices are fabricated utilizing radio frequency sputter coating and photoresist lift-off techniques. Electrical characterizations are performed on two designs in order to investigate the feasibility of generating small amounts of power, utilizing any available waste heat as the energy source.

  11. Feasibility Study for the Development of SCWR

    International Nuclear Information System (INIS)

    Bae, Y. Y.; Kim, H. Y.; Cho, B. H.

    2010-04-01

    - As a result of feasibility study, following conclusions were drawn: · SCWR can be a strong candidate to a large-scale electric power production plant. · Infra-structure for development of an economic and safe SCWR is well established. · It is recommended to focus on the university-level fundamental research along with an international collaboration, for the time being. - The supercritical heat transfer research produced a lot of database on the small tubes and annular channels. - Among the candidate materials such as T92, Incolloy 800, MA956, ODS showed the superior characteristics

  12. Economic feasibility of radioactive scrap steel recycling

    International Nuclear Information System (INIS)

    Balhiser, R.; Rosholt, D.; Nichols, F.

    1995-01-01

    The goal of MSE's Radioactive Scrap Steel (RSS) Recycle Program is to develop practical methods for recycling RSS into useful product. This paper provides interim information about ongoing feasibility investigations that are scheduled for completion by September 1995. The project approach, major issues, and cost projections are outlined. Current information indicates that a cost effective RSS Recycling Facility can be designed, built, and in operation by 1999. The RSS team believes that high quality steel plate can be made from RSS at a conversion cost of $1500 per ton or less

  13. Feasibility investigation of allogeneic endometrial regenerative cells

    Directory of Open Access Journals (Sweden)

    Reid Michael

    2009-02-01

    Full Text Available Abstract Endometrial Regenerative Cells (ERC are a population of mesenchymal-like stem cells having pluripotent differentiation activity and ability to induce neoangiogenesis. In vitro and animal studies suggest ERC are immune privileged and in certain situations actively suppress ongoing immune responses. In this paper we describe the production of clinical grade ERC and initial safety experiences in 4 patients with multiple sclerosis treated intravenously and intrathecally. The case with the longest follow up, of more than one year, revealed no immunological reactions or treatment associated adverse effects. These preliminary data suggest feasibility of clinical ERC administration and support further studies with this novel stem cell type.

  14. Depleted uranium concrete container feasibility study

    International Nuclear Information System (INIS)

    Haelsig, R.T.

    1994-09-01

    The purpose of this report is to consider the feasibility of using containers constructed of depleted uranium aggregate concrete (DUCRETE) to store and transport radioactive materials. The method for this study was to review the advantages and disadvantages of DUCRETE containers considering design requirements for potential applications. The author found that DUCRETE is a promising material for onsite storage containers, provided DUCRETE vessels can be certified for one-way transport to disposal sites. The author also found that DUCRETE multipurpose spent nuclear fuel storage/transport packages are technically viable, provided altered temperature acceptance limits can be developed for DUCRETE

  15. The PHLAME firefighters' study: feasibility and findings.

    Science.gov (United States)

    Elliot, Diane L; Goldberg, Linn; Duncan, Terry E; Kuehl, Kerry S; Moe, Esther L; Breger, Rosemary K R; DeFrancesco, Carol L; Ernst, Denise B; Stevens, Victor J

    2004-01-01

    To assess efficacy of 2 worksite health promotion interventions. Randomly assign 3 fire stations to (a) team-based curriculum, (b) individual counselor meetings, and (c) control. Both interventions were feasible and acceptable, and they resulted in significant reductions in LDL cholesterol. The team approach significantly increased coworker cohesion, personal exercise habits, and coworkers' healthy behaviors. The one-on-one strategy significantly increased dietary self-monitoring, decreased fat intake, and reduced depressed feelings. Although both interventions promoted healthy behaviors, specific outcomes differed and reflected their conceptual underpinnings. The team-based curriculum is innovative and may enlist influences not accessed with individual formats.

  16. Nuclear power planning and feasibility studies

    International Nuclear Information System (INIS)

    Streeton, D.F.

    1977-01-01

    This lecture will review the basic steps associated with planning the introduction of nuclear power. Areas covered will include power market surveys, energy resources evaluations, potential alternative strategies, organisational factors and implementational requirements. The lecture will then consider the implications and requirements associated with establishing the feasibility of a nuclear project. Among others, aspects of power systems integration, site selection reactor type evaluation, cost and economic analysis, influence of contracting strategies, comparison with alternative power generation solutions, financial impact, etc. will be discussed and reviewed. (HK) [de

  17. Image-guided intensity-modulated radiotherapy for patients with locally advanced gastric cancer: a clinical feasibility study.

    Science.gov (United States)

    Badakhshi, Harun; Gruen, Arne; Graf, Reinhold; Boehmer, Dirk; Budach, Volker

    2014-01-01

    The aim of this study was to determine the medical and technical feasibility of intensity-modulated radiotherapy (IMRT) in high-risk nonmetastatic gastric cancer stage II and III after primary gastrectomy and D2 lymphadenectomy. A prospective nonrandomized phase II trial was performed on 25 consecutive patients with gastric cancer with high risk (T3-4, N1-3, G2-3, R0-1). The dose delivered was 45 Gy (1.80 Gy per fraction) in IMRT technique. Concurrent 5-fluorouracil-based chemotherapy at 225 mg/m(2) was administered as a continuous intravenous infusion. Primary endpoints were acute gastrointestinal toxicity (CTC 4.0) and technical feasibility of IMRT in regard to dose planning and radiation delivery. Early acute events were defined as clinical and chemical adverse effects of IMRT and concurrent chemotherapy during treatment. By definition, 90 days after the end of IMRT has been evaluated as acute-phase toxicity. No patient had grade 4 or higher acute adverse events. Clinical grade 3 toxicity occurred in two patients (8%) with diarrhea and in one case (4%) with nausea. Hematological changes with grade 3 occurred in three cases (12%) with hemoglobin decrease, in five cases (25%) as leukopenia, and in one case (4%) with thrombocytopenia. The mean dose for liver was 16 Gy and the percentage volume exceeding 30 Gy (V30) was 21%. Mean dose for right and left kidney was 9 and 13 Gy, respectively, and V20 was 9% and 13%, respectively. Heart received a median dose of 15 Gy and V40 was 17%. The mean dose to the bowel was 11 Gy and V40 was 6%. Spinal cord had at maximum 33 Gy in median. Specifics of dose distribution, including the coverage, for the target region were as follows: minimum was 33 Gy, maximum 48.6 Gy, and mean dose 44.6 Gy. The prescribed dose (45 Gy) covered 99% and 95% of planning target volume (OTV) in 66% and 92% of cases, respectively. Median PTV was 15.77 ml (range, 805-3,604 ml). The data support the practical feasibility of IMRT in adjuvant treatment in

  18. Feasibility Assessment of Cesium Removal using Microaglae

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ilgook; Ryu, Byung-Gon; Seo, Bum-Kyoung; Moon, Jei Kwon; Choi, Jong-Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    The aim of this work is to assess the feasibility of selected one of microalgae in the uptake of Cs+. The obtained results showed the maximum Cs+ removal by D. armatus SCK was 280μM indicating 70% removal efficiency. Also, D. armatus SCK could uptake Cs+ in the presence of K+, is particularly known to be transported into cells as an analog of Cs+ in freshwater condition. Recently, increased attention has been directed on the use of biological technologies for the removal of radionuclides as the cheap and eco-friendly alternative to the non-biological methods. Metal including radioactive compounds uptake by microorganisms can be occurred by metabolism –independent and/or -dependent processes. One involves biosorption based on the ability of microbial cells to bind dissolved metals; on the other involves bioaccumulation, which depends on the metabolic ability of cells to transport metals into the cytoplasm. The purpose of this work is to investigate the feasibility of microalgae in bioaccumulation system to remove cesium from solution. The effect of different environmental parameters on cesium removal was also examined.

  19. Baxter elastomeric pumps: Feasibility of weight estimates.

    Science.gov (United States)

    Chambers, Carole R; Pabia, Mica; Sawyer, Michael; Tang, Patricia A

    2017-09-01

    Purpose Elastomeric pumps are used to infuse a 46-h fluorouracil protocol and patients are asked to visually inspect the pump daily. The pump has a variability of ±10% and there are additional patient variables that can increase this. The feasibility of weighing the pump rather than a visual inspection along with the secondary objective to confirm the pump's variability in real world conditions was undertaken. Methods Empty pumps were weighed using both pharmacy and kitchen scales. Pumps upon completion of the 46-h infusion were also weighed using both pharmacy and kitchen scales. Results The kitchen scale was as accurate as the pharmacy grade scale. Disconnected pumps showed the expected variability from using these infusor pumps along with a few showing greater variability likely due to patient variables. Conclusion Weighing pumps appears to be feasible both at the pharmacy and home level. Next steps would be to weigh pumps during the infusion to validate an alternate method to simple visual inspection for patients to confirm proper infusing of the pump at their home.

  20. Feasibility study on intersection in North Sumatera

    Science.gov (United States)

    Hastuty, I. P.; Sembiring, I. S.; Anas, R.; Lubis, A. S.

    2018-02-01

    Traffic congestion is one of the problems faced by big cities, One of them is Binjai city and Medan city in North Sumatera. One of the causes of congestion is intersection of roads with highway and roads with railroads. To ensure the smooth movement of vehicles, technical handling at the intersection is needed. Therefore, it is necessary to pre-study the feasibility of level crossing in Binjai and Medan to be able to assess the investment needs and the level of importance of road development in the region. The development of transportation infrastructure and facilities is based on the thought of improving the transportation network system. The necessity of systemical integrated transportation system handling is needed in creating a transportation efficiency. The purpose of this study is to identify and prioritize the needs of the railway crossings. The objective which we want to be achieved is to obtain a document that contains technical, economic and environmental ability indicators as a reference in the feasibility and planning studies. The methodology used is collecting the primary data, secondary data, introduction of study area as the initial analysis of the problem. From the study it can be concluded that the existence of railway interchange will move the movement through traffic so it will not interfere the movement of traffic within urban areas and it keeps the national road network performance is still good.

  1. Hoopa Valley Small Scale Hydroelectric Feasibility Project

    Energy Technology Data Exchange (ETDEWEB)

    Curtis Miller

    2009-03-22

    This study considered assessing the feasibility of developing small scale hydro-electric power from seven major tributaries within the Hoopa Valley Indian Reservation of Northern California (http://www.hoopa-nsn.gov/). This study pursued the assessment of seven major tributaries of the Reservation that flow into the Trinity River. The feasibility of hydropower on the Hoopa Valley Indian Reservation has real potential for development and many alternative options for project locations, designs, operations and financing. In order to realize this opportunity further will require at least 2-3 years of intense data collection focusing on stream flow measurements at multiple locations in order to quantify real power potential. This also includes on the ground stream gradient surveys, road access planning and grid connectivity to PG&E for sale of electricity. Imperative to this effort is the need for negotiations between the Hoopa Tribal Council and PG&E to take place in order to finalize the power rate the Tribe will receive through any wholesale agreement that utilizes the alternative energy generated on the Reservation.

  2. Telerehabilitation Feasibility in Total Joint Replacement

    Directory of Open Access Journals (Sweden)

    Mark J. Nelson

    2017-11-01

    Full Text Available Despite documented benefits, many Total Joint Replacement (TJR patients find it difficult to access rehabilitation following discharge from hospital. One solution to improve access for TJR patients is telerehabilitation. This study aimed to assess the feasibility of introducing a telerehabilitation program for TJR patients.   TJR patients at QEII Jubilee Hospital were invited to complete a questionnaire regarding their access, feelings towards and preferences in using technology. Seventy-five patients were recruited. Most patients had computer access (72% and internet (69% at home. Sixty-five percent of participants were willing to participate in telerehabilitation. A significant difference was found between older and younger patients. Watching videos on an electronic device was the preferred method for a technology-based home exercise program and phone call the preferred method of communication.  Results indicate telerehabilitation in the TJR population is feasible from the perspective of access to, feelings toward, and preferences for technology. Keywords: Hip replacement, Knee replacement, Telerehabilitation, Telemedicine, Total joint replacement

  3. Impact of vacuum-assisted closure (VAC) therapy on clinical outcomes of patients with sternal wound infections: a meta-analysis of non-randomized studies.

    Science.gov (United States)

    Falagas, Matthew E; Tansarli, Giannoula S; Kapaskelis, Anastasios; Vardakas, Konstantinos Z

    2013-01-01

    To examine the impact of VAC therapy on mortality of patients with sternal wound infections after cardiothoracic surgery. Controversial results regarding mortality of patients with sternal wound infections were published. We performed a systematic search in PubMed and Scopus. Mortality was the primary outcome of the meta-analysis. Recurrences, complications and length of stay were secondary outcomes. Twenty-two retrospective studies including 2467 patients were eligible for inclusion. Patients treated with VAC had significantly lower mortality compared to those treated without VAC [2233 patients, RR = 0.40, (95% CI 0.28, 0.57)]. This finding was consistent regardless of the study design, the exclusion of studies with positive findings, the criteria for establishment of the compared groups, the time of mortality assessment or the type of infections under study, provided that adequate data was available. VAC therapy was associated with fewer recurrences (RR = 0.34, 95% CI: 0.19-0.59). The meta-analysis did not show any difference in the length of stay (RR = -2.25, 95% CI: -7.52-3.02). VAC therapy was associated with lower mortality than other surgical techniques in retrospective cohorts of patients with DSWIs following cardiothoracic surgery.

  4. Feasibility analysis of AP1000 wireless communication system and selection of technical solutions

    International Nuclear Information System (INIS)

    Zhao Xin

    2012-01-01

    This article expatiates the rationality and feasibility of AP1000 nuclear power plant adopts wireless communication system as the first choice in routine and emergency operations, compares and analysed. 5 major wireless communication technology solutions, and introduces the Wi-Fi based wireless communication system architecture. (author)

  5. Partial Root-Zone Drying (PRD) Feasibility on Potato in a Sub-Humid Climate

    DEFF Research Database (Denmark)

    Battilani, A; Jensen, C R; Liu, F

    2014-01-01

    A field experiment was carried out in Northern Italy, within the frame of the EU project SAFIR, to test the feasibility of partial root-zone drying (PRD) irrigation management in potatoes and to compare the PRD irrigation strategy with regulated deficit irrigation (RDI). PRD increased total...

  6. Feasibility of a Text-Based Smoking Cessation Intervention in Rural Older Adults

    Science.gov (United States)

    Noonan, D.; Silva, S.; Njuru, J.; Bishop, T.; Fish, L. J.; Simmons, L. A.; Choi, S. H.; Pollak, K. I.

    2018-01-01

    Text-based interventions are effective for smoking cessation, but have not been tested in rural older adults. The purpose of this study was to compare the feasibility, acceptability and preliminary efficacy of a text-based Scheduled Gradual Reduction (SGR) program to a non-SGR text messaging support condition among rural older adults. Adults over…

  7. The Feasibility of Using Lead in Hair Concentration in Monitoring Environmental Exposure in Children

    NARCIS (Netherlands)

    Wibowo, A.A.E.; Brunekreef, B.; Lebret, E.; Pieters, H.

    1980-01-01

    The feasibility of lead in hair as an indicator of lead exposure has been compared to that of lead in blood and zinc protoporphyrin in blood levels in 1-3 year-old children living within 1 km of a lead smelter. Lead exposure was measured as lead in house dust, outdoor and indoor lead in air

  8. Comparative study on current trading system and online trading: the ...

    African Journals Online (AJOL)

    Comparative study on current trading system and online trading: the case of ... of online trading and factors affecting its feasibility of implementation in ECX. ... The study found that there is significant capacity problem with major skills gap with ...

  9. Feasibility of simultaneous PET/MR of the carotid artery

    DEFF Research Database (Denmark)

    Ripa, Rasmus S; Knudsen, Andreas; Hag, Anne Mette F

    2013-01-01

    The study aimed at comparing PET/MR to PET/CT for imaging the carotid arteries in patients with known increased risk of atherosclerosis. Six HIV-positive men underwent sequential PET/MR and PET/CT of the carotid arteries after injection of 400 MBq of (18)F-FDG. PET/MR was performed a median of 131......) indicating that the luminal (18)F-FDG content had minimal influence on the values. The study shows for the first time that simultaneous PET/MR of the carotid arteries is feasible in patients with increased risk of atherosclerosis. Quantification of (18)F-FDG uptake correlated well between PET/MR and PET...

  10. Feasibility of ballistic strengthening exercises in neurologic rehabilitation.

    Science.gov (United States)

    Williams, Gavin; Clark, Ross A; Hansson, Jessica; Paterson, Kade

    2014-09-01

    Conventional methods for strength training in neurologic rehabilitation are not task specific for walking. Ballistic strength training was developed to improve the functional transfer of strength training; however, no research has investigated this in neurologic populations. The aim of this pilot study was to evaluate the feasibility of applying ballistic principles to conventional leg strengthening exercises in individuals with mobility limitations as a result of neurologic injuries. Eleven individuals with neurologic injuries completed seated and reclined leg press using conventional and ballistic techniques. A 2 × 2 repeated-measures analysis of variance was used to compare power measures (peak movement height and peak velocity) between exercises and conditions. Peak jump velocity and peak jump height were greater when using the ballistic jump technique rather than the conventional concentric technique (P ballistic principles was associated with increased peak height and peak velocities.

  11. Feasibility Study on Nuclear Propulsion Ship according to Economic Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Gil, Youngmi; Yoo, Seongjin; Oh, June; Byun, Yoonchul; Woo, Ilguk [Daewoo Shipbuilding and Marine Engineering Co., Ltd, Seoul (Korea, Republic of); Kim, Jiho; Choi, Suhn [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    The use of nuclear ships has been extending to the icebreaker, the deep-water exploration ship, and the floating nuclear power plant. Prior to developing the new ship, the relevant regulations need to be considered. In this study, we reviewed the nuclear ship-related regulations. In addition, economic value is one of the most important factors which should be considered in the pre-design phase. To evaluate the economics of the nuclear ship, we calculated Capital Expenditure (abbreviated as CAPEX) and Operation Expenditure (abbreviated as OPEX) for various types of ships. We reviewed the nuclear ship-related regulations and evaluated the economics of the nuclear ship compared to the diesel ship. The calculation result shows that economic feasibility of the nuclear ship depends on the oil price as well as the cost of the nuclear reactor.

  12. Feasibility of BCI Control in a Realistic Smart Home Environment

    Science.gov (United States)

    Kosmyna, Nataliya; Tarpin-Bernard, Franck; Bonnefond, Nicolas; Rivet, Bertrand

    2016-01-01

    Smart homes have been an active area of research, however despite considerable investment, they are not yet a reality for end-users. Moreover, there are still accessibility challenges for the elderly or the disabled, two of the main potential targets for home automation. In this exploratory study we design a control mechanism for smart homes based on Brain Computer Interfaces (BCI) and apply it in the “Domus”1 smart home platform in order to evaluate the potential interest of users about BCIs at home. We enable users to control lighting, a TV set, a coffee machine and the shutters of the smart home. We evaluate the performance (accuracy, interaction time), usability and feasibility (USE questionnaire) on 12 healthy subjects and 2 disabled subjects. We find that healthy subjects achieve 77% task accuracy. However, disabled subjects achieved a better accuracy (81% compared to 77%). PMID:27616986

  13. Feasibility of BCI Control in a Realistic Smart Home Environment

    Directory of Open Access Journals (Sweden)

    Nataliya Kosmyna

    2016-08-01

    Full Text Available Smart homes have been an active area of research, however despite considerable investment, they are not yet a reality for end-users. Moreover, there are still accessibility challenges for the elderly or the disabled, two of the main potential targets for home automation. In this exploratory study we design a control mechanism for smart homes based on Brain Computer Interfaces (BCI and apply it in the Domus smart home platform in order to evaluate the potential interest of users about BCIs at home. We enable users to control lighting, a TV set, a coffee machine and the shutters of the smart home. We evaluate the performance (accuracy, interaction time, usability and feasibility (USE questionnaire on 12 healthy subjects and 2 disabled subjects. We find that healthy subjects achieve 77% task accuracy. However, disabled subjects achieved a better accuracy (81% compared to 77%.

  14. Feasibility study of CANDU-9 fuel handling system

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jeong Ki; Jo, C. H.; Kim, H. M.

    1996-12-01

    CANDU`s combination of natural uranium, heavy water and on-power refuelling is unique in its design and remarkable for reliable power production. In order to offer more output, better site utilization, shorter construction time, improved station layout, safety enhancements and better control panel layout, CANDU-9 is now under development with design improvement added to all proven CANDU advantages or applicable technologies. One of its major improvement has been applied to fuel handling system. This system is very similar to that of CANDU-3, and some parts of the system are applied to those of the existing CANDU-6 or CANDU-9. Design concepts and design requirements of fuel handling system for CANDU-9 have been identified to compare with those of the existing CANDU and the design feasibilities have been evaluated. (author). 4 tabs., 13 figs., 9 refs.

  15. Feasibility of BCI Control in a Realistic Smart Home Environment.

    Science.gov (United States)

    Kosmyna, Nataliya; Tarpin-Bernard, Franck; Bonnefond, Nicolas; Rivet, Bertrand

    2016-01-01

    Smart homes have been an active area of research, however despite considerable investment, they are not yet a reality for end-users. Moreover, there are still accessibility challenges for the elderly or the disabled, two of the main potential targets for home automation. In this exploratory study we design a control mechanism for smart homes based on Brain Computer Interfaces (BCI) and apply it in the "Domus" smart home platform in order to evaluate the potential interest of users about BCIs at home. We enable users to control lighting, a TV set, a coffee machine and the shutters of the smart home. We evaluate the performance (accuracy, interaction time), usability and feasibility (USE questionnaire) on 12 healthy subjects and 2 disabled subjects. We find that healthy subjects achieve 77% task accuracy. However, disabled subjects achieved a better accuracy (81% compared to 77%).

  16. A comparison of combined heat and power feasibility models

    Energy Technology Data Exchange (ETDEWEB)

    Hinojosa, L.R.; Day, A.R.; Maidment, G.G. [Department of Engineering Systems, Faculty of Engineering, Science and the Built Environment, London South Bank University, 103 Borough Road, London SE1 0AA (United Kingdom); Dunham, C.; Kirk, P. [SEA/RENUE, 42 Braganza Street, London SE17 3RJ (United Kingdom)

    2007-09-15

    Carrying out feasibility studies for combined heat and power (CHP) in buildings systems is one of the most important steps in the decision-making process. This paper compares the features of different software packages available in the market and some custom-built models. It also discusses the advantages and disadvantages of building one's own application. The number of variables that need to be considered will depend on the level of accuracy and flexibility sought. Software packages are a good start, but they tend to be either overly simple or extremely complicated, and sometimes not very flexible. On the other hand, building custom-built generic models that include different technologies, unit sizes, control modes, market restrictions and benefits, can be a complex and laborious process, but will be more transparent to the user. (author)

  17. Economic feasibility of solar water and space heating.

    Science.gov (United States)

    Bezdek, R H; Hirshberg, A S; Babcock, W H

    1979-03-23

    The economic feasibility in 1977 and 1978 of solar water and combined water and space heating is analyzed for single-family detached residences and multi-family apartment buildings in four representative U.S. cities: Boston, Massachusetts; Washington, D.C.; Grand Junction, Colorado; and Los Angeles, California. Three economic decision criteria are utilized: payback period, years to recovery of down payment, and years to net positive cash flow. The cost competitiveness of the solar systems compared to heating systems based on electricity, fuel oil, and natural gas is then discussed for each city, and the impact of the federal tax credit for solar energy systems is assessed. It is found that even without federal incentives some solar water and space heating systems are competitive. Enactment of the solar tax credit, however, greatly enhances their competitiveness. The implications of these findings for government tax and energy pricing policies are discussed.

  18. Slaughterhouse sewage treatment using gamma radiation - economical feasibility study

    International Nuclear Information System (INIS)

    Melo, Rita; Botelho, M. Luisa; Branco, Joaquim

    2005-01-01

    This paper presents preliminary results of a financial viability study for the implementation of gamma radiation technology on a slaughterhouse wastewater treatment industry. Five scenarios were studied, including the current practice, representing different types of treatments and goals, e.g.: water reuse and/or sludge add value as agriculture fertilizers. Cost-benefit analysis, including the net present value (NPV) of each scenario, was used as a technique to compare the relative value of various strategies. Taking in account that the initial investment is amortized after 20 years, the implementation of Co-60 treatment with 20% water reuse and sludge application as agriculture fertilizers represents the most profitable project with the highest NPV. Therefore, the implementation of gamma radiation technology on a slaughterhouse wastewater treatment industry is not only technically viable as well as economically feasible. (author)

  19. A feasibility study on nuclear power options in Mongolia

    International Nuclear Information System (INIS)

    Minato, A.; Sekimoto, H.; Amartaivan, T.

    2010-10-01

    There is a growing interest among utilities in the United States in small and medium reactors due primarily to the smaller investment and perhaps shorter construction time involved as compared to those large reactors. The potential market for small reactors (those below 300 M We) exists, specially with sizes of 50 and 100 M We. A feasibility study was conducted on nuclear power options for Ulaanbaatar, Mongolia, a country which has a potential market for small reactors. The study was focused on an optimization of a combination of coal-fired and nuclear power plants taking into account Mongolia's future nuclear program plan, future population and economic growth, and the increased electricity and district heating demands. (Author)

  20. Comparative study of potato cultivation through micropropagation ...

    African Journals Online (AJOL)

    sonu

    Comparative study of potato cultivation through micropropagation and conventional farming methods .... and Murate potash were used as fertilizer source of nitrogen, phosphorus and potassium, respectively (Table 1) ..... through Tissue culture- Application and Feasibility. U.S.D.A.,. Beltsville. Agric. Res. Sci. Educ. Admin.

  1. Complex Systems Analysis of Cell Cycling Models in Carcinogenesis:II. Cell Genome and Interactome, Neoplastic Non-random Transformation Models in Topoi with Lukasiewicz-Logic and MV Algebras

    CERN Document Server

    Baianu, I C

    2004-01-01

    Quantitative Biology, abstract q-bio.OT/0406045 From: I.C. Baianu Dr. [view email] Date (v1): Thu, 24 Jun 2004 02:45:13 GMT (164kb) Date (revised v2): Fri, 2 Jul 2004 00:58:06 GMT (160kb) Complex Systems Analysis of Cell Cycling Models in Carcinogenesis: II. Authors: I.C. Baianu Comments: 23 pages, 1 Figure Report-no: CC04 Subj-class: Other Carcinogenesis is a complex process that involves dynamically inter-connected modular sub-networks that evolve under the influence of micro-environmentally induced perturbations, in non-random, pseudo-Markov chain processes. An appropriate n-stage model of carcinogenesis involves therefore n-valued Logic treatments of nonlinear dynamic transformations of complex functional genomes and cell interactomes. Lukasiewicz Algebraic Logic models of genetic networks and signaling pathways in cells are formulated in terms of nonlinear dynamic systems with n-state components that allow for the generalization of previous, Boolean or "fuzzy", logic models of genetic activities in vivo....

  2. Evaluation of physical activity interventions in children via the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework: A systematic review of randomized and non-randomized trials.

    Science.gov (United States)

    McGoey, Tara; Root, Zach; Bruner, Mark W; Law, Barbi

    2016-01-01

    Existing reviews of physical activity (PA) interventions designed to increase PA behavior exclusively in children (ages 5 to 11years) focus primarily on the efficacy (e.g., internal validity) of the interventions without addressing the applicability of the results in terms of generalizability and translatability (e.g., external validity). This review used the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) framework to measure the degree to which randomized and non-randomized PA interventions in children report on internal and external validity factors. A systematic search for controlled interventions conducted within the past 12years identified 78 studies that met the inclusion criteria. Based on the RE-AIM criteria, most of the studies focused on elements of internal validity (e.g., sample size, intervention location and efficacy/effectiveness) with minimal reporting of external validity indicators (e.g., representativeness of participants, start-up costs, protocol fidelity and sustainability). Results of this RE-AIM review emphasize the need for future PA interventions in children to report on real-world challenges and limitations, and to highlight considerations for translating evidence-based results into health promotion practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

    Science.gov (United States)

    Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

    2015-01-01

    Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p students.

  4. RANDOMNESS of Numbers DEFINITION(QUERY:WHAT? V HOW?) ONLY Via MAXWELL-BOLTZMANN CLASSICAL-Statistics(MBCS) Hot-Plasma VS. Digits-Clumping Log-Law NON-Randomness Inversion ONLY BOSE-EINSTEIN QUANTUM-Statistics(BEQS) .

    Science.gov (United States)

    Siegel, Z.; Siegel, Edward Carl-Ludwig

    2011-03-01

    RANDOMNESS of Numbers cognitive-semantics DEFINITION VIA Cognition QUERY: WHAT???, NOT HOW?) VS. computer-``science" mindLESS number-crunching (Harrel-Sipser-...) algorithmics Goldreich "PSEUDO-randomness"[Not.AMS(02)] mea-culpa is ONLY via MAXWELL-BOLTZMANN CLASSICAL-STATISTICS(NOT FDQS!!!) "hot-plasma" REPULSION VERSUS Newcomb(1881)-Weyl(1914;1916)-Benford(1938) "NeWBe" logarithmic-law digit-CLUMPING/ CLUSTERING NON-Randomness simple Siegel[AMS Joint.Mtg.(02)-Abs. # 973-60-124] algebraic-inversion to THE QUANTUM and ONLY BEQS preferentially SEQUENTIALLY lower-DIGITS CLUMPING/CLUSTERING with d = 0 BEC, is ONLY VIA Siegel-Baez FUZZYICS=CATEGORYICS (SON OF TRIZ)/"Category-Semantics"(C-S), latter intersection/union of Lawvere(1964)-Siegel(1964)] category-theory (matrix: MORPHISMS V FUNCTORS) "+" cognitive-semantics'' (matrix: ANTONYMS V SYNONYMS) yields Siegel-Baez FUZZYICS=CATEGORYICS/C-S tabular list-format matrix truth-table analytics: MBCS RANDOMNESS TRUTH/EMET!!!

  5. Relationship of nocturnal concentrations of melatonin, gamma-aminobutyric acid and total antioxidants in peripheral blood with insomnia after stroke: study protocol for a prospective non-randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Fang Li; Tong Zhang

    2017-01-01

    Melatonin and gamma-aminobutyric acid (GABA) have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective single-center non-randomized controlled clinical trial performed in the China Rehabilitation Research Center, we analyzed the relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke. Patients during rehabilitation of stroke were recruited and assigned to the insomnia group or non-insomnia group. Simultaneously, persons without stroke or insomnia served as normal controls. Each group contained 25 cases. The primary outcome was nocturnal concentrations of melatonin, GABA and total antioxidants in peripheral blood. The secondary outcomes were Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire (Chinese version), and National Institute of Health Stroke Scale. The relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke was analyzed and showed that they were lower in the insomnia group than in the non-insomnia group. The severity of stroke was higher in the insomnia group than in the non-insomnia group. Correlation analysis demonstrated that the nocturnal concentrations of melatonin and GABA were associated with insomnia after stroke. This trial was regis-tered at ClinicalTrials.gov, identifier: NCT03202121.

  6. Early crisis nontechnical skill teaching in residency leads to long-term skill retention and improved performance during crises: A prospective, nonrandomized controlled study.

    Science.gov (United States)

    Doumouras, Aristithes G; Engels, Paul T

    2017-07-01

    Medical error is common in crises, and the majority of observed errors are nontechnical in nature. The long-term impact of teaching crisis nontechnical skills to residents has not been evaluated. The objective of this study was to determine the effect of simulation-based teaching of crisis nontechnical skills compared to controls one year after initial teaching. This was a prospective study using both historical controls and a before-and-after methodology to evaluate the effect of a high-fidelity simulation curriculum that used crisis resource management principles to teach nontechnical skills. Postgraduate year 2 and 3 residents were invited to take part in a prospective training course over 2 years. The primary outcome was leader performance evaluated by expert raters using the previously validated 7-point Ottawa Global Rating Scale. Overall, 23 residents performed 30 simulations over the 2 years with the intervention group of 7 residents being assessed in both years. After adjustment, the postgraduate year 3 intervention group who received training the previous year had significantly higher overall performance scores than all postgraduate year 2 scores (1.09 95% confidence interval 0.70-1.47, P crisis performance compared to historical postgraduate year 3 controls and untrained postgraduate year 2 residents. There were no significant differences between the crisis performance of postgraduate year 2 residents and the untrained postgraduate year 3 controls. This confirms the beneficial effect and long-term retention after crisis nontechnical skill training. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Dynamic electron arc radiotherapy (DEAR): a feasibility study

    International Nuclear Information System (INIS)

    Rodrigues, Anna; Yin, Fang-Fang; Wu, Qiuwen

    2014-01-01

    Compared to other radiation therapy modalities, clinical electron beam therapy has remained practically unchanged for the past few decades even though electron beams with multiple energies are widely available on most linacs. In this paper, we present the concept of dynamic electron arc radiotherapy (DEAR), a new conformal electron therapy technique with synchronized couch motion. DEAR utilizes combination of gantry rotation, couch motion, and dose rate modulation to achieve desirable dose distributions in patient. The electron applicator is kept to minimize scatter and maintain narrow penumbra. The couch motion is synchronized with the gantry rotation to avoid collision between patient and the electron cone. In this study, we investigate the feasibility of DEAR delivery and demonstrate the potential of DEAR to improve dose distributions on simple cylindrical phantoms. DEAR was delivered on Varian's TrueBeam linac in Research Mode. In conjunction with the recorded trajectory log files, mechanical motion accuracies and dose rate modulation precision were analyzed. Experimental and calculated dose distributions were investigated for different energies (6 and 9 MeV) and cut-out sizes (1×10 cm 2  and 3×10 cm 2  for a 15×15 cm 2  applicator). Our findings show that DEAR delivery is feasible and has the potential to deliver radiation dose with high accuracy (root mean square error, or RMSE of <0.1 MU, <0.1° gantry, and <0.1 cm couch positions) and good dose rate precision (1.6 MU min −1 ). Dose homogeneity within ±2% in large and curved targets can be achieved while maintaining penumbra comparable to a standard electron beam on a flat surface. Further, DEAR does not require fabrication of patient-specific shields. These benefits make DEAR a promising technique for conformal radiotherapy of superficial tumors. (paper)

  8. Feasibility of Energy Harvesting Using a Piezoelectric Tire

    Science.gov (United States)

    Malotte, Christopher

    While the piezoelectric effect has been around for some time, it has only recently caught interest as a potential sustainable energy harvesting device. Piezoelectric energy harvesting has been developed for shoes and panels, but has yet to be integrated into a marketable bicycle tire. For this thesis, the development and feasibility of a piezoelectric tire was done. This includes the development of a circuit that incorporates piezoceramic elements, energy harvesting circuitry, and an energy storage device. A single phase circuit was designed using an ac-dc diode rectifier. An electrolytic capacitor was used as the energy storage device. A financial feasibility was also done to determine targets for manufacturing cost and sales price. These models take into account market trends for high performance tires, economies of scale, and the possibility of government subsidies. This research will help understand the potential for the marketability of a piezoelectric energy harvesting tire that can create electricity for remote use. This study found that there are many obstacles that must be addressed before a piezoelectric tire can be marketed to the general public. The power output of this device is minuscule compared to an alkaline battery. In order for this device to approach the power output of an alkaline battery the weight of the device would also become an issue. Additionally this device is very costly compared to the average bicycle tire. Lastly, this device is extreme fragile and easily broken. In order for this device to become marketable the issues of power output, cost, weight, and durability must all be successfully overcome.

  9. Feasibility study of plutonium recycling in light water reactors

    International Nuclear Information System (INIS)

    Tabuchi, Hideoto

    1979-01-01

    The feasibility of plutonium recycling in light water reactors has been studied by the Agency of Natural Resources and Energy, MITI. As the first step of the feasibility study, it was planned to charge two fuel assemblies, containing uranium-plutonium mixed oxide (MO 2 ), in the core of the Tsuruga nuclear power plant (BWR) for testing. The design of fuel the safety of these fuel and the operating characteristics of these special fuel assemblies were evaluated. The specifications of MO 2 fuel pin and fuel assembly are compared to those of present uranium oxide (UO 2 ) fuel. The weight of fissile plutonium in one MO 2 fuel assembly is 2.22 kg. The characteristics of MO 2 fuel assemblies, such as reactivity, control rod worth and power distribution can be kept similar to UO 2 fuel. The plutonium isotope ratio of the MO 2 fuel is assumed as that obtained in the fuel taken out of the Tokai No. 1 gas cooled reactor. The temperature distribution in the fuel pellets is shown, compared to that of UO 2 fuel. The linear power density is 440 w/cm at the beginning of the fuel life and 360 w/cm after the burn-up of 44,000 Mwd/t. The stress in the cladding tubes of MO 2 fuel is not different from that of UO 2 fuel. The pellet-cladding interaction (PCM1) was analyzed, utilizing the FEM code, FEAST. Concerning the calculation of resonance absorption, the space dependence of thermal neutron spectra and the nuclear behavior of hollow pellets the methods of design calculation were checked up. It was recognized that regarding the nuclear characteristics of MO 2 fuel, no special technical question remains. (Nakai, Y.)

  10. Economic feasibility of EBFGT technology for removal of pollutants from combustion of liquid fuels

    International Nuclear Information System (INIS)

    Basfar, A. A.; Fageeha, O.I.; Kunnummal, N.; Al-Ghamdi, S.; Pawelec, A.; Chmielewski, A.G.; Tyminski, B.; Zimek, Z.; Licki, J.

    2011-01-01

    A project on feasibility of electron beam flue gas treatment (EBFGT) technology at oil fired boiler was conducted for Saudi Arabian Oil Company (Saudi Aramco). As part of this project, economic feasibility of EBFGT technology was performed for heavy oil fired boilers in Saudi Arabia. Economic evaluation was performed for two options of EBFGT installation; the first for 65 000 Nm3/h and the second for 130 000 Nm 3 /h. The main factors affecting investment and operation costs were discussed and costs were compared to conventional methods. The results of the evaluation showed that EBFGT method is economically attractive. (author)

  11. Economic feasibility of EBFGT technology for removal of pollutants from combustion of liquid fuels

    Energy Technology Data Exchange (ETDEWEB)

    Basfar, A. A. [King Abdulaziz City for Science and Technology, Atomic Energy Research Institute, Radiation Technology Center, Riyadh (Saudi Arabia); Fageeha, O. I.; Kunnummal, N.; Al-Ghamdi, S. [Saudi Arabian Oil Company (Saudi Aramco), Environmental Protection Department, Dhahran (Saudi Arabia); Pawelec, A.; Chmielewski, A. G.; Tyminski, B.; Zimek, Z. [Institute of Nuclear Chemistry and Technology, Warsaw (Poland); Licki, J. [Institute of Atomic Energy, Otwock-Świerk (Poland)

    2011-07-01

    A project on feasibility of electron beam flue gas treatment (EBFGT) technology at oil fired boiler was conducted for Saudi Arabian Oil Company (Saudi Aramco). As part of this project, economic feasibility of EBFGT technology was performed for heavy oil fired boilers in Saudi Arabia. Economic evaluation was performed for two options of EBFGT installation; the first for 65 000 Nm3/h and the second for 130 000 Nm{sup 3}/h. The main factors affecting investment and operation costs were discussed and costs were compared to conventional methods. The results of the evaluation showed that EBFGT method is economically attractive. (author)

  12. Feasibility study of the immunogenicity and safety of a novel DTPw/Hib (PRP-T Brazilian combination compared to a licensed vaccine in healthy children at 2, 4, and 6 months of age Estudo de viabilidade de imunogenicidade e segurança de uma nova vacina brasileira combinada DTPw/Hib (PRP-T, comparada com uma vacina registrada, em crianças de 2, 4 e 6 meses de idade

    Directory of Open Access Journals (Sweden)

    SueAnn Costa Clemens

    2003-06-01

    Full Text Available Vaccination of infants with conjugated Haemophilus influenzae type b (Hib vaccines has been proven to reduce Hib meningitis by 95% and pneumoniae by 20%. The routine use of Hib vaccine is facilitated by the introduction of combination vaccines into the EPI (Expanded Plan of Immunization. The objective of this study was to compare the immunogenicity and reactogenicity of an extemporaneously mixed DTPw/Hib (diphtheria-tetanus-whole cell pertussis combination, using the technology of two Brazilian manufacturers, against a licensed DTPw/Hib European combination in 108 infants vaccinated at 2, 4 and 6 months according to the local national schedule. The Brazilian combination was highly immunogenic with Hib seroprotection rates (anti-PRP > 0.15 mg /ml of 98% after 2 doses and 100% after 3. Also for tetanus and pertussis the new Brazilian combination was as immunogenic as the European counterpart, except the diphtheria seroprotection rates and titers were lower. There was also no clinically relevant difference in reactogenicity. If these feasibility results are confirmed, the Brazilian DTPw/Hib combination should help to boost the uptake of Hib vaccination in Brazil.A vacinação contra (Haemophilus influenzae tipo b (Hib, utilizando vacinas conjugadas, provou reduzir em 95% os casos de meningite e em 20% as pneumonias por Hib. O uso rotineiro da vacina Hib foi facilitado pela introdução das vacinas combinadas no Programa Ampliado de Imunização (PAI. O objetivo deste estudo foi comparar a imunogenicidade e reatogenicidade da mistura extemporânea da vacina combinada contra difteria-tétano-pertussis de células inteiras/Haemophilus influenzae (DTPw/Hib, de tecnologia e produção de 2 fabricantes brasileiros, à vacina européia registrada DTPw/Hib. Estudo realizado em 108 crianças em idade de 2, 4 e 6 meses, seguindo o esquema nacional de imunização. A vacina combinada brasileira foi altamente imunogênica, apresentando taxas de soroprote

  13. Aleutian Pribilof Islands Wind Energy Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Bruce A. Wright

    2012-03-27

    Under this project, the Aleutian Pribilof Islands Association (APIA) conducted wind feasibility studies for Adak, False Pass, Nikolski, Sand Point and St. George. The DOE funds were also be used to continue APIA's role as project coordinator, to expand the communication network quality between all participants and with other wind interest groups in the state and to provide continued education and training opportunities for regional participants. This DOE project began 09/01/2005. We completed the economic and technical feasibility studies for Adak. These were funded by the Alaska Energy Authority. Both wind and hydro appear to be viable renewable energy options for Adak. In False Pass the wind resource is generally good but the site has high turbulence. This would require special care with turbine selection and operations. False Pass may be more suitable for a tidal project. APIA is funded to complete a False Pass tidal feasibility study in 2012. Nikolski has superb potential for wind power development with Class 7 wind power density, moderate wind shear, bi-directional winds and low turbulence. APIA secured nearly $1M from the United States Department of Agriculture Rural Utilities Service Assistance to Rural Communities with Extremely High Energy Costs to install a 65kW wind turbine. The measured average power density and wind speed at Sand Point measured at 20m (66ft), are 424 W/m2 and 6.7 m/s (14.9 mph) respectively. Two 500kW Vestas turbines were installed and when fully integrated in 2012 are expected to provide a cost effective and clean source of electricity, reduce overall diesel fuel consumption estimated at 130,000 gallons/year and decrease air emissions associated with the consumption of diesel fuel. St. George Island has a Class 7 wind resource, which is superior for wind power development. The current strategy, led by Alaska Energy Authority, is to upgrade the St. George electrical distribution system and power plant. Avian studies in Nikolski

  14. Infant-mother attachment can be improved through group intervention: a preliminary evaluation in Spain in a non-randomized controlled trial.

    Science.gov (United States)

    Torres, Bárbara; Alonso-Arbiol, Itziar; Cantero, María José; Abubakar, Amina

    2011-11-01

    The quality of infant-mother attachment has been linked to competence in different domains of child development. Research indicates that early intervention can enhance the quality of infant-mother attachment, though its efficacy in a group format has yet to be evaluated. The current study is aimed at examining the usefulness of a group intervention in enhancing infant-mother attachment. An intervention aimed at addressing aspects such as maternal responsivity, sensitivity and childrearing behaviour was developed by the researchers and experienced psychologists. The intervention spanned a period of 14 months starting from the third quarter of pregnancy. The intervention was evaluated among 24 mothers from the Basque region of Spain. The sample consisted of children of both genders in a similar proportion: 45.8% were boys and 54.2% were girls. The children in this sample were full-term born and did not present symptoms of any serious pre- or postnatal complications. The intervention had a statistically non-significant medium effect. Infants whose mothers had received the intervention showed higher rates of secure attachment compared to children from the control group, as assessed by the Strange Situation observation procedure. A potentially significant confounding variable, maternal attachment, was balanced across the intervention and comparison groups. We can tentatively point out that a group intervention may enhance the quality of infant-mother attachment. Nevertheless, because the study design was not randomized, the results of this study remain preliminary and need replication in a full randomized controlled trial designed study.

  15. The effects of onabotulinum toxin A injection into rectus femoris muscle in hemiplegic stroke patients with stiff-knee gait: a placebo-controlled, nonrandomized trial.

    Science.gov (United States)

    Tok, Fatih; Balaban, Birol; Yaşar, Evren; Alaca, Rdvan; Tan, Arif Kenan

    2012-04-01

    This study aimed to compare the efficacy of onabotulinum toxin A (onabot) injection into the rectus femoris muscle with that of placebo in the treatment of hemiplegic stroke patients presenting with stiff-knee gait. Twenty-five chronic hemiparetic stroke patients presenting with a stiff-knee gait were included in this study. Fifteen patients received 100-125 U of onabot, and 10 patients received placebo into the rectus femoris muscle. Three-dimensional gait analysis, energy expenditure, 10-m and 6-min walk tests, and spasticity level of the rectus femoris were evaluated at baseline and 2 mos posttreatment. The mean age of patients who received onabot was 53.86 ± 14.74 yrs and of those who received placebo was 59.00 ± 8.11 yrs. At study onset, groups were similar with respect to all parameters (P > 0.05). We observed significant improvement in knee flexion (7 degrees average) during swing and a reduction in energy cost of 0.8-J/kg per meter response to injection of 100-125 U of onabot into the rectus femoris muscle. Onabot treatment significantly reduced muscle tone and improved knee kinematics, energy expenditure during walking, and functional assessments at 2 mos (P application of onabot into the rectus femoris muscle in stroke patients who presented with stiff-knee gait may be a treatment option to provide independent, safe, and less tiring ambulation.

  16. Battery energy storage market feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Kraft, S. [Frost and Sullivan, Mountain View, CA (United States); Akhil, A. [Sandia National Labs., Albuquerque, NM (United States). Energy Storage Systems Analysis and Development Dept.

    1997-07-01

    Under the sponsorship of the Department of Energy`s Office of Utility Technologies, the Energy Storage Systems Analysis and Development Department at Sandia National Laboratories (SNL) contracted Frost and Sullivan to conduct a market feasibility study of energy storage systems. The study was designed specifically to quantify the energy storage market for utility applications. This study was based on the SNL Opportunities Analysis performed earlier. Many of the groups surveyed, which included electricity providers, battery energy storage vendors, regulators, consultants, and technology advocates, viewed energy storage as an important enabling technology to enable increased use of renewable energy and as a means to solve power quality and asset utilization issues. There are two versions of the document available, an expanded version (approximately 200 pages, SAND97-1275/2) and a short version (approximately 25 pages, SAND97-1275/1).

  17. Development of Model for Providing Feasible Scholarship

    Directory of Open Access Journals (Sweden)

    Harry Dhika

    2016-05-01

    Full Text Available The current work focuses on the development of a model to determine a feasible scholarship recipient on the basis of the naiv¨e Bayes’ method using very simple and limited attributes. Those attributes are the applicants academic year, represented by their semester, academic performance, represented by their GPa, socioeconomic ability, which represented the economic capability to attend a higher education institution, and their level of social involvement. To establish and evaluate the model performance, empirical data are collected, and the data of 100 students are divided into 80 student data for the model training and the remaining of 20 student data are for the model testing. The results suggest that the model is capable to provide recommendations for the potential scholarship recipient at the level of accuracy of 95%.

  18. Feasibility studies for the Forward Spectrometer

    International Nuclear Information System (INIS)

    Biernat, Jacek

    2015-01-01

    The Forward Spectrometer designed for the P-barANDA detector will consist of many different detector systems allowing for precise track reconstruction and particle identification. Feasibility studies for Forward Spectrometer done by means of specific reactions will be presented. In the first part of the paper, results of simulations focussing on rate estimates of the tracking stations based on straw tubes will be presented. Next, the importance of the Forward Tracker will be demonstrated through the reconstruction of the ψ(4040) → DD-bar decay. Finally, results from the analysis of the experimental data collected with a straw tube prototype designed and constructed at the Research Center in Juelich will be discussed. (paper)

  19. Lunar Wireless Power Transfer Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Freid, Sheldon [National Security Technologies, LLC. (NSTec), Mercury, NV (United States); Popovic, Zoya [Univ. of Colorado, Boulder, CO (United States); Beckett, David R. [Independent Consultant; Anderson, Scott R. [Independent Consultant; Mann, Diana [Independent Consultant; Walker, Stuart [Independent Consultant

    2008-03-01

    This study examines the feasibility of a multi-kilowatt wireless radio frequency (RF) power system to transfer power between lunar base facilities. Initial analyses, show that wireless power transfer (WPT) systems can be more efficient and less expensive than traditional wired approaches for certain lunar and terrestrial applications. The study includes evaluations of the fundamental limitations of lunar WPT systems, the interrelationships of possible operational parameters, and a baseline design approach for a notionial system that could be used in the near future to power remote facilities at a lunar base. Our notional system includes state-of-the-art photovoltaics (PVs), high-efficiency microwave transmitters, low-mass large-aperture high-power transmit antennas, high-efficiency large-area rectenna receiving arrays, and reconfigurable DC combining circuitry.

  20. Assessing and Improving the Feasibility of LCM

    DEFF Research Database (Denmark)

    Garcia-Sanchez, Inés; Wenzel, Henrik; Jørgensen, Michael Søgaard

    2003-01-01

    A theoretical approach to Life Cycle Management (LCM) is used to develop an operational model helping companies to understand their present level of LCM and implement LCM as management strategy. As part of the development, the model has been tested and evaluated by a number of Danish companies...... within different branches. A self-assessment tool for companies to assess their present level of LCM is developed. The assessment is based on a qualitative assessment of the frequency of the integration of life cycle considerations within the decision-making processes of the company. Moreover, a tool...... for assessing the conditions shaping a company’s ability to do LCM is developed. The ability is understood as the combination of two aspects: the company’s own capability and the feasibility within the context where the company operates. Four categories of conditions are identified as the most influential...

  1. Feasibility of mass cultivation of Porphyridium

    Energy Technology Data Exchange (ETDEWEB)

    Vonshak, A; Cohen, Z; Richmond, A

    1985-01-01

    The feasibility of growing Porphyridium biomass outdoors was investigated. Laboratory studies indicated that although the optimum temperature for growth is 25 degrees C no damage to the photosynthetic activity can be detected after exposure of the organism to higher temperatures, up to 35 degrees C. Also, high O/sub 2/ evolution activity was observed even at relatively high cell concentrations. No inhibition of O/sub 2/ evolution was detected at high light intensity, i.e. 2000 ..mu..E/sq.m/s. In cultures grown outdoors an output rate of up to 22 g dry wt sq.m/day was obtained for several weeks. The biomass contained, on a dry weight basis, up to 40% polysaccharides and about 1.5% arachidonic acid. The cultures were maintained essentially monoalgal for over 3 months. The biomass can be readily removed from the medium by autofloculation.

  2. Battery energy storage market feasibility study

    International Nuclear Information System (INIS)

    Kraft, S.; Akhil, A.

    1997-07-01

    Under the sponsorship of the Department of Energy's Office of Utility Technologies, the Energy Storage Systems Analysis and Development Department at Sandia National Laboratories (SNL) contracted Frost and Sullivan to conduct a market feasibility study of energy storage systems. The study was designed specifically to quantify the energy storage market for utility applications. This study was based on the SNL Opportunities Analysis performed earlier. Many of the groups surveyed, which included electricity providers, battery energy storage vendors, regulators, consultants, and technology advocates, viewed energy storage as an important enabling technology to enable increased use of renewable energy and as a means to solve power quality and asset utilization issues. There are two versions of the document available, an expanded version (approximately 200 pages, SAND97-1275/2) and a short version (approximately 25 pages, SAND97-1275/1)

  3. Feasibility study for core protection calculator development

    International Nuclear Information System (INIS)

    In, W. K.; Han, J. B.

    2003-06-01

    This project confirmed the development feasibility of new digital core protection system and established development plan for ITOPS that can replace the CPC system. The development plan and implementation strategy for ITOPS proposed in this project will be useful to successfully develop advanced digital core protection system for the CPC replacement in KSNP plants. YGN units 3 and 4 are expected to replace the CPC system within next ten years and the other KSNP plants are followed. The localization model for advanced digital core protection system, ITOPS, is judged to upgrade the Common Q CPC system in both system configuration and algorithm performance and can reduce the cost for supply and maintenance. Hence, ITOPS is expected to be installed in new Korea nuclear power plants and also useful to export the associated technology in the future

  4. Feasibility of abdominoplasty with Cesarean section [Retraction

    Directory of Open Access Journals (Sweden)

    Thabet WN

    2013-01-01

    Full Text Available The Editor-in-Chief and Publisher of the International Journal of Women’s Health have been alerted by Dr Nadine Sherif, the corresponding author, to unacceptable levels of duplication with a previously published paper: Ali A, Essam A. Abdominoplasty Combined with Cesarean Delivery: Evaluation of the Practice. Aesthetic Plastic Surgery. 2011;35(1:80–86.It is worth noting that this paper was peer-reviewed by two peer-reviewers and the Editor-in-Chief of the International Journal of Women’s Health before publication. The paper concerned is: Thabet WN, Hossny AS, Sherif NA. Feasibility of abdominoplasty with Cesarean section. International Journal of Women’s Health. 2012;4:115–121.

  5. Feasibility Study for Paragon - Bisti Solar Ranch

    Energy Technology Data Exchange (ETDEWEB)

    Benally, Thomas [Navajo Hopi Land Commission Office (NHLCO), Window Rock, AZ (United States)

    2015-06-01

    The Navajo Hopi Land Commission Office (NHLCO) and Navajo Nation (NN) plan to develop renewable energy (RE) projects on the Paragon-Bisti Ranch (PBR) lands, set aside under the Navajo Hopi Land Settlement Act (NHLSA) for the benefit of Relocatees. This feasibility study (FS), which was funded under a grant from DOE’s Tribal Energy Program (TEP), was prepared in order to explore the development of the 22,000-acre PBR in northwestern New Mexico for solar energy facilities. Topics covered include: • Site Selection • Analysis of RE, and a Preliminary Design • Transmission, Interconnection Concerns and Export Markets • Financial and Economic Analysis • Environmental Study • Socioeconomic and Cultural Factors • Next Steps.

  6. MRS feasibility assessment grant technical progress report

    International Nuclear Information System (INIS)

    1993-01-01

    On January 13, 1993, Governor of the State of Utah, Mike Leavitt officially announced that he was opposing a MRS Facility in the State of Utah and informed San Juan County of his decision which will preclude the County from applying for a Phase IIa feasibility grant. A copy of the policy statement made by Governor Leavitt is included in this report. Additionally, a bill in the State House of Representative has been filed opposing the facility. A copy of the bill is also included. The work accomplished under Phase I, indicated that there was about an equal amount of residents in San Juan County opposed and in favor of the facility. There were many concerns and issues presented during the Phase I grant period that would have been continued to Phase IIa, if allowed, including the citizen committee

  7. Feasibility study on fission moly target development

    International Nuclear Information System (INIS)

    Kim, Byung Ku; Kim, Seong Nyun; Shon, Dong Seong; Choi, Chang Beom; Lee, Jae Kuk; Park, Jin Ho; Jeong, Won Myung; Jeon, Kwan Sik; You, Jae Hyung; Kang, Kyung Chul; Ahn, Jong Hwan; Ju, Po Kuk

    1996-01-01

    A multi-purpose research reactor, HANARO has been operated on the beginning of 1995 and can be utilized for production of various radioisotopes. And a R and D program for fission Mo production was established, and the technical and economical feasibility study has been performed for fission Mo production in Korea. In this study the process for fission Mo production was recommended as follows; 1. Target : UO 2 of annulus type. 2. Separation and purification : Nitric acid dissolution → Alumina adsorption → Benzoin oxime precipitation → Alumina adsorption. And more desirable plan for steady supply of fission Mo were suggested in following viewpoints; 1. Technical collaboration with foreign company. 2. Backup supply system. 3. Marketing arrangement. (Author)

  8. From Virtual Creatures to Feasible Robots

    DEFF Research Database (Denmark)

    Faina, Andres; Souto, Daniel; Orjales, Félix

    with the main objective of obtaining feasible and manufacturable robots. To this end, a modular architecture has been defined and implemented [2], which faces real hardware issues and promotes the evolvability of the robotic structures by considering heterogeneous modules with a large number of connection faces......This paper provides a brief description of the robots obtained using the evolutionary design system called EDHMoR (Evolutionary Designer of Heterogeneous Modular Robots) that are displayed in the corresponding video [1]. This system is based on the coevolution of morphology and control...... per module. These modules constitute the building blocks the EDHMoR system uses to design the robots. Moreover, an evaluation methodology is proposed as a key element of EDMHoR, which is based on modifications in the environment that can produce more useful and realistic robots without limiting...

  9. Feasibility of landmine detection using transgenic plants

    Science.gov (United States)

    Deyholos, Michael; Faust, Anthony A.; Miao, Minmin; Montoya, Rebecca; Donahue, D. Aaron

    2006-05-01

    Genetically modified plants that detect TNT and its degradation products are potentially powerful aids in humanitarian demining and detection of unexploded ordnance. Although the feasibility of TNT detection by plants and microorganisms has been demonstrated by several research teams world wide, thus far, none of these previously demonstrated systems has the sensitivity and specificity to be effective under field conditions. We are using two approaches to increase the potential effectiveness of these and related biological detection systems. First, we are expanding the repertoire of explosive-responsive promoters by conducting DNA microarray experiments with plants treated with TNT-degradation products, and characterizing the inducibility of reporter gene expression by these promoters. Second, we are evaluating the dynamics and limiting factors in the transmission of artificial signals from roots to shoots. This will increase the ability of soil-based TNT perception strategies to effect human-readable changes in shoot morphology as part of a practical plant-based explosives detection system.

  10. The Versatile Link common project: feasibility report

    International Nuclear Information System (INIS)

    Vasey, F; Soos, C; Troska, J; Hall, D; Huffman, T; Weidberg, T; Kwan, S; Prosser, A; Xiang, A; Ye, J

    2012-01-01

    The Versatile Link is a bi-directional digital optical data link operating at rates up to 4.8 Gbit/s and featuring radiation-resistant low-power and low-mass front-end components. The system is being developed in multimode or singlemode versions operating at 850 nm or 1310 nm wavelength respectively. It has serial data interfaces and is protocol-agnostic, but is targeted to operate in tandem with the GigaBit Transceiver (GBT) serializer/deserializer chip being designed at CERN. This paper gives an overview of the project status three and a half years after its launch. It describes the challenges encountered and highlights the solutions proposed at the system as well as the component level. It concludes with a positive feasibility assesment and an outlook for future project development directions.

  11. Feasibility of modern airships - Preliminary assessment

    Science.gov (United States)

    Ardema, M. D.

    1977-01-01

    Attention is given to the NASA program, Feasibility Study of Modern Airships, initiated to investigate potential research and technology programs associated with airship development. A historical survey of the program is presented, including the development of past airship concepts, aerodynamical and design improvements, structure and material concepts, and research in controls, avionics, instrumentation, flight operations, and ground handling. A mission analysis was carried out which considered passenger and cargo transportation, heavy-lift, short-haul applications, surveillance missions, and the transportation of natural gas. A vehicle parametric analysis examined the entire range of airship concepts, discussing both conventional airships and hybrids. Various design options were evaluated, such as choice of structural materials, use of boundary-layer control, and choice of lifting gas.

  12. Feasibility of vitrifying EPICOR II organic resins

    International Nuclear Information System (INIS)

    Buelt, J.L.

    1981-11-01

    Two laboratory-scale runs have recently been completed to test the feasibility of a single-step incineration/vitrification process for Three Mile Island EPICOR II resins. The process utilizes vitrification equipment, specifically a 15-cm-dia in-can melter, and a specially designed feed technique. Two process tests, each conducted with 1.2 kg of EPICOR II resins loaded with nonradioactive cesium and strontium, showed excellent operational characteristics. Less than 0.8 wt% of the resins were entrained with the gaseous effluents in the second test. Cesium and strontium losses were controlled to 0.71 wt% and less. In addition, all the carbonaceous resins were converted completely to CO 2 with no detectable CO. Future activities are being directed to longer-term tests in laboratory-scale equipment to determine attainable volume reduction, process rates, and material conformance to processing conditions

  13. The feasibility of recycling contaminated concrete

    International Nuclear Information System (INIS)

    Ayers, K.W.; Corroon, W.; Parker, F.L.

    1999-01-01

    The changing mission of the Department of Energy along with the aging of many of its facilities has resulted in renewed emphasis on decontaminating and decommissioning surplus structures. Currently DOE is decontaminating some concrete and sending the clean material to C and D disposal facilities. In other instance, DOE is sending contaminated concrete to LLW disposal facilities. This paper examines the economic feasibility of decontaminating the concrete and recycling the rubble as clean aggregate. A probabilistic cost model was used to examine six potential recycling and disposal scenarios. The model predicted potential costs saving across the DOE complex of nearly one billion dollars. The ability of local markets to assimilate the recycled material was estimated for Washington, Idaho, Tennessee, New Mexico, and South Carolina. The relationships between a number of the economic model's variables were examined to develop operating ranges for initial managerial evaluation of recycling

  14. Substituting telecommunications for travel - Feasible or desirable

    Science.gov (United States)

    Van Vleck, E. M.

    1974-01-01

    This paper reviews recent advances in telecommunications and examines the detailed structure of travel to estimate the feasibility of substituting telecommunications for various travel objectives. The impact of travel is analyzed from a social, economic, energy, and pollution standpoint to assess the desirability of substitution. Perhaps 35-50% of the nation's travel could, in theory, be replaced by very advanced telecommunications (such as a much improved large-screen teleconferencing network), but public resistance would be massive. Much economic dislocation would result since, for example, over 25% of retail sales are travel-related. The energy savings would be modest since only 25% of the nation's energy is consumed by transportation. However, all pollution would be reduced substantially since transportation accounts for 75% of the carbon monoxide, 60% of the hydrocarbon, and 55% of the nitrogen oxide pollution in the nation. Problems related to the implementation of large-scale substitution are discussed.

  15. Preliminary study on the feasibility of ductless fuel assembly for fast reactors

    International Nuclear Information System (INIS)

    Shibahara, Itaru; Enokido, Yuji

    1988-01-01

    Preliminary study on the feasibility of ductless fuel assembly for fast reactors has been conducted. The primary concern is with forecasting the thermal hydraulic characteristics and the heat removal efficiency from the core. The thermal hydraulic analysis revealed the coolant mixing in the core at steady state operating condition was not intensive and the coolant temperature increase was almost proportional to the power of each assembly. The hot spot analysis of the ductless core indicated that the hottest temperature in the core could be comparable with the temperature of the conventional ducted core, even in case the radial power flattening was not actively pursued but with adopting ducted radial blanket assemblies. Under off-normal conditions, the ductless core had improved heat removal capability which was caused by inter-assembly coolant flow. The study has indicated the feasibility of the ductless fuel assembly for fast reactors. The experiments to demonstrate the feasibility will be the next key process for the development. (author)

  16. Testing Skype as an interview method in epidemiologic research: response and feasibility.

    Science.gov (United States)

    Weinmann, Tobias; Thomas, Silke; Brilmayer, Susanne; Heinrich, Sabine; Radon, Katja

    2012-12-01

    Despite its popularity, Skype has not been tested as a tool for epidemiologic research. We examined its feasibility in Germany. A population-based sample of young adults was randomly invited to a Skype (n = 150) or a phone interview (n = 150). Response and duration of interviews were analysed to evaluate the feasibility of Skype interviews. Response was low and, with 10 % (95 % CI 5-15 %), even worse among Skype candidates, compared to 22 % (15-28 %) in the phone group. A third of the Skype group asked for being interviewed by phone. Median duration was 34.0 minutes for Skype interviews and 37.0 minutes for phone interviews. Skype is not yet a feasible tool for data collection in Germany.

  17. Feasibility of videoconferencing in lifestyle group counselling.

    Science.gov (United States)

    Laitinen, Jaana; Korkiakangas, Eveliina; Alahuhta, Maija; Keinänen-Kiukaanniemi, Sirkka; Rajala, Ulla; Timonen, Olavi; Jokelainen, Terhi; Keränen, Anna-Maria; Remes, Jouko; Ruokonen, Aimo; Hedberg, Pirjo; Taanila, Anja; Husman, Päivi; Olkkonen, Seppo

    2010-12-01

    The rapid increase in the prevalence of type 2 diabetes (T2D) has created an urgent need to develop new practices to prevent and treat it. One possibility is to provide specialists services to remote areas through videoconferencing (VC). Therefore, the aim was to study the feasibility of short-term group counselling by a clinical nutritionist (4 sessions at 1.5-hour each at 2-week intervals from baseline, and the session 5 at 6 months) performed by videoconferencing (VC). We recruited 74 subjects at high risk of T2D, and compiled 5 VC groups (each group included 5-9 subjects, total n=33) and 6 face-to-face groups (FF, total n=44). The subjects were also asked to participate in a follow-up visit 15 months after the last counselling session. Data were collected by a questionnaire (satisfaction with group counselling via videoconferencing), by theme interviews (experiences on group counselling) and by metabolic measures (laboratory tests). Only one of the 74 subjects dropped out during the first 6 months. The proportion of subjects who had received social support from group peers was higher in the videoconferencing group than in the face-to-face groups (p=0.001). The experiences of group counselling transmitted by videoconferencing were positive. Waist circumference decreased significantly at 0 to 6 months of counselling (pgroups (p=0.015). However, no significant differences were observed in most of the measurements between VC and face-to-face groups. Short-term group counselling by a clinical nutritionist through videoconferencing is a feasible way and a practical model to provide specialists services to remote areas, and thus can be used as an option to diminish inequality related to restricted health care services in sparsely inhabited areas.

  18. Bin Set 1 Calcine Retrieval Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    R. D. Adams; S. M. Berry; K. J. Galloway; T. A. Langenwalter; D. A. Lopez; C. M. Noakes; H. K. Peterson; M. I. Pope; R. J. Turk

    1999-10-01

    At the Department of Energy's Idaho Nuclear Technology and Engineering Center, as an interim waste management measure, both mixed high-level liquid waste and sodium bearing waste have been solidified by a calculation process and are stored in the Calcine Solids Storage Facilities. This calcined product will eventually be treated to allow final disposal in a national geologic repository. The Calcine Solids Storage Facilities comprise seven ''bit sets.'' Bin Set 1, the first to be constructed, was completed in 1959, and has been in service since 1963. It is the only bin set that does not meet current safe-shutdown earthquake seismic criteria. In addition, it is the only bin set that lacks built-in features to aid in calcine retrieval. One option to alleviate the seismic compliance issue is to transport the calcine from Bin Set 1 to another bin set which has the required capacity and which is seismically qualified. This report studies the feasibility of retrieving the calcine from Bi n Set 1 and transporting it into Bin Set 6 which is located approximately 650 feet away. Because Bin Set 1 was not designed for calcine retrieval, and because of the high radiation levels and potential contamination spread from the calcined material, this is a challenging engineering task. This report presents preconceptual design studies for remotely-operated, low-density, pneumatic vacuum retrieval and transport systems and equipment that are based on past work performed by the Raytheon Engineers and Constructors architectural engineering firm. The designs presented are considered feasible; however, future development work will be needed in several areas during the subsequent conceptual design phase.

  19. Bin Set 1 Calcine Retrieval Feasibility Study

    International Nuclear Information System (INIS)

    Adams, R.D.; Berry, S.M.; Galloway, K.J.; Langenwalter, T.A.; Lopez, D.A.; Noakes, C.M.; Peterson, H.K.; Pope, M.I.; Turk, R.J.

    1999-01-01

    At the Department of Energy's Idaho Nuclear Technology and Engineering Center, as an interim waste management measure, both mixed high-level liquid waste and sodium bearing waste have been solidified by a calculation process and are stored in the Calcine Solids Storage Facilities. This calcined product will eventually be treated to allow final disposal in a national geologic repository. The Calcine Solids Storage Facilities comprise seven ''bit sets.'' Bin Set 1, the first to be constructed, was completed in 1959, and has been in service since 1963. It is the only bin set that does not meet current safe-shutdown earthquake seismic criteria. In addition, it is the only bin set that lacks built-in features to aid in calcine retrieval. One option to alleviate the seismic compliance issue is to transport the calcine from Bin Set 1 to another bin set which has the required capacity and which is seismically qualified. This report studies the feasibility of retrieving the calcine from Bi n Set 1 and transporting it into Bin Set 6 which is located approximately 650 feet away. Because Bin Set 1 was not designed for calcine retrieval, and because of the high radiation levels and potential contamination spread from the calcined material, this is a challenging engineering task. This report presents preconceptual design studies for remotely-operated, low-density, pneumatic vacuum retrieval and transport systems and equipment that are based on past work performed by the Raytheon Engineers and Constructors architectural engineering firm. The designs presented are considered feasible; however, future development work will be needed in several areas during the subsequent conceptual design phase

  20. Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial.

    Science.gov (United States)

    Nathan, Nicole; Wolfenden, Luke; Bell, Andrew C; Wyse, Rebecca; Morgan, Philip J; Butler, Michelle; Sutherland, Rachel; Milat, Andrew J; Hector, Debra; Wiggers, John

    2012-08-13

    Limited evidence exists describing the effectiveness of strategies in facilitating the implementation of vegetable and fruit programs by schools on a population wide basis. The aim of this study was to examine the effectiveness of a multi-strategy intervention in increasing the population-wide implementation of vegetable and fruit breaks by primary schools and to determine if intervention effectiveness varied by school characteristics. A quasi-experimental study was conducted in primary schools in the state of New South Wales, Australia. All primary schools in one region of the state (n = 422) received a multi-strategy intervention. A random sample of schools (n = 406) in the remainder of the state served as comparison schools. The multi-strategy intervention to increase vegetable and fruit breaks involved the development and provision of: program consensus and leadership; staff training; program materials; incentives; follow-up support; and implementation feedback. Comparison schools had access to routine information-based Government support. Data to assess the prevalence of vegetable and fruit breaks were collected by telephone from Principals of the intervention and comparison schools at baseline (2006-2007) and 11 to 15 months following the commencement of the intervention (2009-2010). GEE analysis was used to examine the change in the prevalence of vegetable and fruit breaks in intervention schools compared to comparison schools. At follow-up, prevalence of vegetable and fruit breaks increased significantly in both intervention (50.3% to 82.0%, p strategy intervention can significantly increase the implementation of vegetable and fruit breaks by a large number of Australian primary schools.

  1. Does working with the Veder Contact Method influence the job satisfaction of caregivers? A non-randomized controlled trial in nursing homes for people with dementia.

    Science.gov (United States)

    Boersma, P; Dröes, R M; Lissenberg-Witte, B I; van Meijel, B; van Weert, J C M

    2017-12-01

    Person-centered care interventions can improve the quality of life and decrease behavioral problems of people with dementia. Although not convincingly proven, person-centered care interventions may benefit the caregivers as well. This study aims to gain insight into how working with the Veder Contact Method (VCM) - a new person-centered care method - influences the job satisfaction of caregivers. Within a quasi-experimental study, the job satisfaction of caregivers of six experimental wards (n = 75) was compared with caregivers of six control wards (n = 36) that applied Care-As-Usual. The Leiden Quality of Work Questionnaire (LQWQ) was filled in by caregivers in both conditions. Additionally, on the experimental wards, qualitative research, i.e. focus groups with 42 caregivers and interviews with 11 managers, was conducted to obtain a deeper understanding of the influence of applying VCM on caregivers' job satisfaction. The transcripts were analyzed using deductive analysis. No quantitatively significant differences were found on the subscales of the LQWQ: work and time pressure, job satisfaction, autonomous decision making, social support from colleagues, and social support from supervisors. From the qualitative research, some caregivers and managers reported that implementing VCM contributed to their job satisfaction and that applying VCM supported handling difficult behavior and depressed mood of residents and contributed to team building. No significant effects on job satisfaction were demonstrated. Qualitative findings indicate that VCM positively influences the daily work performances of nursing home caregivers. The relation between the experience of offering quality care and job satisfaction of caregivers needs further investigation.

  2. BioEnergy Feasibility in South Africa

    Science.gov (United States)

    Hugo, Wim

    2015-04-01

    The BioEnergy Atlas for South Africa is the result of a project funded by the South African Department of Science and Technology, and executed by SAEON/ NRF with the assistance of a number of collaborators in academia, research institutions, and government. Now nearing completion, the Atlas provides an important input to policy and decision support in the country, significantly strengthens the availability of information resources on the topic, and provides a platform whereby current and future contributions on the subject can be managed, preserved, and disseminated. Bioenergy assessments have been characterized in the past by poor availability and quality of data, an over-emphasis on potentials and availability studies instead of feasibility assessment, and lack of comprehensive evaluation in competition with alternatives - both in respect of competing bioenergy resources and other renewable and non-renewable options. The BioEnergy Atlas in its current edition addresses some of these deficiencies, and identifies specific areas of interest where future research and effort can be directed. One can qualify the potentials and feasible options for BioEnergy exploitation in South Africa as follows: (1) Availability is not a fixed quantum. Availability of biomass and resulting energy products are sensitive to both the exclusionary measures one applies (food security, environmental, social and economic impacts) and the price at which final products will be competitive. (2) Availability is low. Even without allowing for feasibility and final product costs, the availability of biomass is low: biomass productivity in South Africa is not high by global standards due to rainfall constraints, and most arable land is used productively for food and agribusiness-related activities. This constrains the feasibility of purposely cultivated bioenergy crops. (3) Waste streams are important. There are significant waste streams from domestic solid waste and sewage, some agricultural

  3. Retrospective, nonrandomized controlled study on autoadjusting, dual-pressure positive airway pressure therapy for a consecutive series of complex insomnia disorder patients

    Directory of Open Access Journals (Sweden)

    Krakow B

    2017-03-01

    compared to previous experience with CPAP. Both adaptive servoventilation and autobilevel PAP showed similar ISI score improvement without statistical differences between devices. Total weekly hours of PAP use correlated inversely with change in insomnia symptoms (r=-0.256, P<0.01.Conclusion: Insomnia severity significantly decreased in patients using autoadjusting PAP devices, but the study design restricts interpretation to an association. Future research must elucidate the interaction between insomnia and OSA/UARS as well as the adverse influence of pressure intolerance on PAP adaptation in complex insomnia patients. Randomized controlled studies must determine whether advanced PAP modes provide benefits over standard CPAP modes in these comorbidity patients. Keywords: insomnia, obstructive sleep apnea, upper airway resistance syndrome, CPAP failure, autobilevel, adaptive servoventilation

  4. Economic feasibility of animal welfare improvements in Dutch intensive livestock production: A comparison between broiler, laying hen, and fattening pig farms

    NARCIS (Netherlands)

    Gocsik, E.; Oude Lansink, A.G.J.M.; Voermans, G.; Saatkamp, H.W.

    2015-01-01

    This study compared the economic feasibility of production systems with different levels of animal welfare (AW) in the broiler, laying hen, and fattening pig sectors. Economic feasibility over a five-year time horizon was assessed using stochastic bio-economic simulation models. The results suggest

  5. The Eczema Education Programme: intervention development and model feasibility.

    Science.gov (United States)

    Jackson, K; Ersser, S J; Dennis, H; Farasat, H; More, A

    2014-07-01

    The systematic support of parents of children with eczema is essential to their effective management; however, we have few models of support. This study examines the rationale, evidence base and development of a large-scale, structured, theory-based, nurse-led intervention, the 'Eczema Education Programme' (EEP), for parents of children with eczema. To outline development of the EEP, model of delivery, determine its feasibility and evaluate this based on service access and parental satisfaction data. Parent-child dyads meeting EEP referral criteria were recruited and demographic information recorded. A questionnaire survey of parental satisfaction was conducted 4 weeks post EEP; parental focus groups at 6 weeks provided comparative qualitative data. Descriptive statistics were derived from the questionnaire data using Predictive Analytics Software (PASW); content analysis was applied to focus group data. A total of 356 parents attended the EEP during the evaluation period. Service access was achieved for those in a challenging population. Both survey data (n = 146 parents, 57%) and focus group data (n = 21) revealed a significant level of parental satisfaction with the programme. It was feasible to provide the EEP as an adjunct to normal clinical care on a large scale, achieving a high level of patient/parent satisfaction and access within an urban area of multiple deprivation and high mobility. The intervention is transferable and the results are generalizable to other ethnically diverse child eczema populations within metropolitan areas in Britain. A multicentre RCT is required to test the effectiveness of this intervention on a larger scale. © 2013 European Academy of Dermatology and Venereology.

  6. Feasibility study: Assess the feasibility of siting a monitored retrievable storage facility

    International Nuclear Information System (INIS)

    King, J.W.

    1993-01-01

    The purpose of phase one of this study are: To understand the waste management system and a monitored retrievable storage facility; and to determine whether the applicant has real interest in pursuing the feasibility assessment process. Contents of this report are: Generating electric power; facts about exposure to radiation; handling storage, and transportation techniques; description of a proposed monitored retrievable storage facility; and benefits to be received by host jurisdiction

  7. Feasibility study: Assess the feasibility of siting a monitored retrievable storage facility. Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    King, J.W.

    1993-08-01

    The purpose of phase one of this study are: To understand the waste management system and a monitored retrievable storage facility; and to determine whether the applicant has real interest in pursuing the feasibility assessment process. Contents of this report are: Generating electric power; facts about exposure to radiation; handling storage, and transportation techniques; description of a proposed monitored retrievable storage facility; and benefits to be received by host jurisdiction.

  8. Feasibility of a rural palliative supportive service.

    Science.gov (United States)

    Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

    2015-01-01

    Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between

  9. Feasibility of Biomass Biodrying for Gasification Process

    Science.gov (United States)

    Hamidian, Arash

    and the pilot-scale continuous system was designed in 2010 to demonstrate the feasibility of mixed sludge biodrying for efficient combustion in biomass boilers. Mixed sludge was biodried in the reactor to 45% moisture level, which was the suitable level for boiler application. Techno-economic analysis also revealed the potential economic benefits for pulp and paper mills. However, considerable uncertainties existed in terms of feasibility of the biodrying technology for other types of biomass that are usually used in the gasification process, mainly because of low nutrient level of typical lignocellulosic biomass used as feedstock. Furthermore, the technology had not been shown to be economically viable in conjunction with gasification process at pulp and paper mills. In this work the feasibility of low-nutrient biomass biodrying was tested by experiments and techno-economic model was developed to identify the performance of biodrying process for commercial-scale application. In the economic analysis, a comprehensive approach for biodrying cost assessment was introduced that is based on the well-known approach widely used in the process industry and few sources of benefits were identified.

  10. Immunogenicity and safety of an adjuvanted herpes zoster subunit candidate vaccine in adults ≥ 50 years of age with a prior history of herpes zoster: A phase III, non-randomized, open-label clinical trial.

    Science.gov (United States)

    Godeaux, Olivier; Kovac, Martina; Shu, Daniel; Grupping, Katrijn; Campora, Laura; Douha, Martine; Heineman, Thomas C; Lal, Himal

    2017-05-04

    This phase III, non-randomized, open-label, multi-center study (NCT01827839) evaluated the immunogenicity and safety of an adjuvanted recombinant subunit herpes zoster (HZ) vaccine (HZ/su) in adults aged ≥ 50 y with prior physician-documented history of HZ. Participants (stratified by age: 50-59, 60-69 and ≥ 70 y) received 2 doses of HZ/su 2 months apart and were followed-up for another 12 months. Anti-glycoprotein E (gE) antibodies were measured by enzyme-linked immunosorbent assay before vaccination and 1 month after the second dose (Month 3). Solicited local and general adverse events (AEs) were recorded for 7 d and unsolicited AEs for 30 d after each vaccination. Serious AEs were recorded until study end. The primary immunogenicity objective was met if the lower limit of the 95% confidence interval (CI) of the vaccine response rate (VRR), defined as a 4-fold increase in anti-gE over baseline, at Month 3 was ≥ 60%. 96 participants (32/age group) were enrolled. The primary immunogenicity objective was met, as the VRR at Month 3 was 90.2% (95% CI: 81.7-95.7). Geometric mean anti-gE antibody concentrations at Month 3 were similar across age groups. 77.9% and 71.6% of participants reported local and general solicited AEs, respectively. The most frequent solicited AEs were pain at injection site, fatigue, headache, myalgia and shivering. The HZ/su vaccine was immunogenic in adults aged ≥ 50 y with a physician-documented history of HZ, and no safety concerns were identified.

  11. Online Recruitment: Feasibility, Cost, and Representativeness in a Study of Postpartum Women.

    Science.gov (United States)

    Leach, Liana S; Butterworth, Peter; Poyser, Carmel; Batterham, Philip J; Farrer, Louise M

    2017-03-08

    Online recruitment is feasible, low-cost, and can provide high-quality epidemiological data. However, little is known about the feasibility of recruiting postpartum women online, or sample representativeness. The current study investigates the feasibility of recruiting a population of postpartum women online for health research and examines sample representativeness. Two samples of postpartum women were compared: those recruited online as participants in a brief survey of new mothers (n=1083) and those recruited face-to-face as part of a nationally representative study (n=579). Sociodemographic, general health, and mental health characteristics were compared between the two samples. Obtaining a sample of postpartum women online for health research was highly efficient and low-cost. The online sample over-represented those who were younger (aged 25-29 years), were in a de facto relationship, had higher levels of education, spoke only English at home, and were first-time mothers. Members of the online sample were significantly more likely to have poor self-rated health and poor mental health than the nationally representative sample. Health differences remained after adjusting for sociodemographic differences. Potential exists for feasible and low-cost e-epidemiological research with postpartum populations; however, researchers should consider the potential influence of sample nonrepresentativeness. ©Liana S Leach, Peter Butterworth, Carmel Poyser, Philip J Batterham, Louise M Farrer. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.03.2017.

  12. Feasibility study of the AOSTA experimental campaign

    Directory of Open Access Journals (Sweden)

    Carta M.

    2016-01-01

    Full Text Available The reduction of the nuclear waste is one of the most important nuclear issues. The high radiotoxicity of the spent fuel is due to plutonium and some minor actinides (MAs such as neptunium, americium and curium, above all. One way to reduce their hazard is to destroy by fission MAs in appropriate nuclear reactors. To allow the MAs destruction an important effort have been done on the nuclear data due to the poor knowledge in this field. In the framework of one of the NEA Expert Group on Integral Experiments for Minor Actinide Management an analysis of the feasibility of MAs irradiation campaign in the TAPIRO fast research reactor is carried out. This paper provides preliminary results obtained by calculations modelling the irradiation, in different TAPIRO irradiation channels, of some CEA samples coming from the French experimental campaign OSMOSE, loaded with different contents of MAs, in order to access, through particular peak spectrometry, to their capture cross section. On the basis of neutron transport calculation results, obtained by both deterministic and Monte Carlo methods, an estimate of the irradiated samples counting levels from the AOSTA (Activation of OSMOSE Samples in TAPIRO experimental campaign is provided.

  13. Feasibility of spirometry testing in preschool children.

    Science.gov (United States)

    Kampschmidt, Jordan C; Brooks, Edward G; Cherry, Debra C; Guajardo, Jesus R; Wood, Pamela R

    2016-03-01

    The primary purpose of this study was to evaluate the feasibility of obtaining acceptable and reproducible spirometry data in preschool aged children (3-5 years) by technicians without prior experience with spirometry. Two technicians were trained to perform spirometry testing (ndd Easy on-PC) and to administer standardized questionnaires. Preschool aged children were enrolled from two Head Start centers and a local primary care clinic. Subjects were trained in proper spirometry technique and tested until at least two acceptable efforts were obtained or the subject no longer produced acceptable efforts. 200 subjects were enrolled: mean age 4.0 years (± 0.7 SD); age distribution: 51 (25.5%) 3 years old, 103 (51.5%) 4 years old, and 46 (23%) 5 years old. Fifty-six percent male and 75% Hispanic. One hundred thirty (65%) subjects produced at least one acceptable effort on their first visit: 23 (45%) for 3 years old, 67 (65%) for 4 years old, and 40 (87%) for 5 years old. The number of acceptable efforts correlated with age (r = 0.29, P spirometry results from the preschool aged children; the number of acceptable efforts correlated significantly with age. © 2015 Wiley Periodicals, Inc.

  14. Morbidity follow-up feasibility study

    International Nuclear Information System (INIS)

    Carpenter, M.

    1988-02-01

    The report reviews the available sources of data within Canada for undertaking morbidity follow-up studies to both supplement and complement studies using Canadian mortality data. Such studies would permit earlier detection and more sensitive measures of differences in risk for exposures to radiation and allow timely measures to be taken to minimize any occupational and environmental health risk to radiation workers. The technical feasibility of using these sources was reviewed using the criteria of adequate personal identifying information, automation of data records, file size and the accuracy of the morbidity diagnosis information. At the present time certain of the provincial cancer registry files meet these criteria best. A work plan was prepared suggesting a morbidity pilot study to clarify the role of occupational factors in the incidence of cancer among radiation workers using the Alberta Cancer Registry file and the National Dose Registry (NDR) file of radiation workers. For the longer term a full cohort study using the National Cancer Incidence Reporting System (NCIRS) and the NDR workers as the study population would provide information on all radiation workers on a national basis. A work plan was prepared and some initial format conversion of historical data was undertaken to begin developing the NCIRS into a data base suitable for long-term health studies

  15. Gas core nuclear rocket feasibility project

    International Nuclear Information System (INIS)

    Howe, S.D.; DeVolder, B.; Thode, L.; Zerkle, D.

    1997-09-01

    The next giant leap for mankind will be the human exploration of Mars. Almost certainly within the next thirty years, a human crew will brave the isolation, the radiation, and the lack of gravity to walk on and explore the Red planet. However, because the mission distances and duration will be hundreds of times greater than the lunar missions, a human crew will face much greater obstacles and a higher risk than those experienced during the Apollo program. A single solution to many of these obstacles is to dramatically decrease the mission duration by developing a high performance propulsion system. The gas core nuclear rocket (GCNR) has the potential to be such a system. The gas core concept relies on the use of fluid dynamic forces to create and maintain a vortex. The vortex is composed of a fissile material which will achieve criticality and produce high power levels. By radiatively coupling to the surrounding fluids, extremely high temperatures in the propellant and, thus, high specific impulses can be generated. The ship velocities enabled by such performance may allow a 9 month round trip, manned Mars mission to be considered. Alternatively, one might consider slightly longer missions in ships that are heavily shielded against the intense Galactic Cosmic Ray flux to further reduce the radiation dose to the crew. The current status of the research program at the Los Alamos National Laboratory into the gas core nuclear rocket feasibility will be discussed

  16. Monitor of spatial plans. Feasibility study

    International Nuclear Information System (INIS)

    Bollen, M.J.S.; Ritsema van Eck, J.; Farjon, J.M.J.

    2008-01-01

    The national government needs assessments of consequences of building projects in relation to spatial policy objectives such as the prevention of urban sprawl or the development of landscape qualities. Normally the effects of spatial policies appear after several years. Spatial plans can possibly indicate these effects earlier. To allow policies to be adapted to unwanted developments, the assessments should be available in the early planning stages of these building projects. The Dutch Minister of VROM has asked the Netherlands Environmental Assessment Agency to investigate the feasibility of a monitoring system based on building plans. As building projects take a long period from conception until realization, a monitoring system for these projects should include all plans for the next ten to fifteen years with an indication of the chance that these plans are realized. The existing databases in the Netherlands provide sufficient information to assess consequences of plans for those objectives that are directly related to the urbanization pattern. However, an improvement of these databases is necessary, amongst other things by coordination of these databases [nl

  17. Assessing biomass chains feasibility at local level

    Energy Technology Data Exchange (ETDEWEB)

    Colonna, N.; Pignatelli, V.; Alfano, V. [Italian National Agency for New Technologies, Rome (Italy). Energy and Sustainable Economic Development; Lupia, F. [National Inst. of Agricultural Economics, Rome (Italy)

    2010-07-01

    This paper reported on a study that identified all bioenergy resources available in Italy's agro-energy district known as Valle dei Latini. The study involved a multidisciplinary approach through which rural districts were analyzed for their socioeconomic characteristics. The information was integrated with the agroindustry sector, networks and land morphology. Data on biomass production, potential and energy consumption were processed and integrated via spatial analysis. A specially designed GIS was used as a support tool for a feasibility analysis for different biomass chains. In particular, the suitability of the land for growing sunflowers for biofuel was determined. The methodology included various analytical steps such as data collection, geodatabase creation, sunflower suitability factors, constraints and GIS processing. The core processing is based on the set up and resolution of a multi-criteria analysis of multi-attribute form. The methodology has been optimized to obtain the maximum spatial resolution and analysis related to the available data. A sunflower land suitability map characterized by the subdivision of the area in distinct land suitability classes was subsequently created.

  18. Real-time earthquake data feasible

    Science.gov (United States)

    Bush, Susan

    Scientists agree that early warning devices and monitoring of both Hurricane Hugo and the Mt. Pinatubo volcanic eruption saved thousands of lives. What would it take to develop this sort of early warning and monitoring system for earthquake activity?Not all that much, claims a panel assigned to study the feasibility, costs, and technology needed to establish a real-time earthquake monitoring (RTEM) system. The panel, drafted by the National Academy of Science's Committee on Seismology, has presented its findings in Real-Time Earthquake Monitoring. The recently released report states that “present technology is entirely capable of recording and processing data so as to provide real-time information, enabling people to mitigate somewhat the earthquake disaster.” RTEM systems would consist of two parts—an early warning system that would give a few seconds warning before severe shaking, and immediate postquake information within minutes of the quake that would give actual measurements of the magnitude. At this time, however, this type of warning system has not been addressed at the national level for the United States and is not included in the National Earthquake Hazard Reduction Program, according to the report.

  19. Feasibility study on floating nuclear power station

    International Nuclear Information System (INIS)

    Kajima, Ryoichi

    1987-01-01

    It is stipulated that nuclear power plants are to be built on solid rock bases on land in Japan. However, there are a limited number of appropriate siting grounds. The Central Research Institute of Electric Power Industry has engaged since 1981 in the studies on the construction technology of power plants, aiming at establishing new siting technology to expand the possible siting areas for nuclear power plants. Underground siting is regarded as a proven technology due to the experience in underground hydroelectric power plants. The technology of siting on quaternary ground is now at the stage of verification. In this report, the outline of floating type offshore/inshore siting technology is introduced, which is considered to be feasible in view of the technical and economical aspects. Three fixed structure types were selected, of which the foundations are fixed to seabed, plant superstructures are above sea surface, and which are floating type. Aiming at ensuring the aseismatic stability of the plant foundations, the construction technology is studied, and the structural concept omitting buoyancy is possible. The most practical water depth is not more than 20 m. The overall plant design, earthquake isolation effect and breakwater are described. (Kako, I.)

  20. Pinellas Plant feasibility study. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-09-01

    The Pinellas Plant was built in 1956 to manufacture neutron generators, a principal component in nuclear weapons. In September 1990, the Department of Health and Rehabilitative Services (HRS) entered into an agreement with DOE to independently examine environmental monitoring data from the plant and health data from Pinellas County to determine if an epidemiological study is technically feasible to measure possible off-site health effects from ionizing radiation. Through normal plant operations, some radioactive materials have been released to the environment. Eighty percent of the total plant releases of 107,707 curies occurred in the early years of plant operation (1957--1960). The primary materials released were tritium gas, tritium oxide and krypton-85. Environmental monitoring for radioactive releases from the plant has been done regularly since 1975. The US Public Health Service Centers for Disease Control and Prevention (CDC), in assisting HRS, has determined that sufficient radiological data exist by which a dose reconstruction can be done. A dose reconstruction can provide an estimate of how much radiological exposure someone living in the vicinity of the Pinellas Plant may have suffered from environmental releases.

  1. Feasibility study on Ashuganj NGL Fractionation Plant

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    A feasibility study has been performed on Ashuganj NGL Fractionation Plant being planned in the People's Republic of Bangladesh. The present study has discussed a plant to manufacture liquefied oil gas, automotive fuel, and diesel fuel from liquefied natural gas. The plan calls for the plant life of 20 years, liquefied natural gas as the raw material to be supplied continuously and stably from the gas reservoir areas via the existing pipelines, the storage tank to have a size of 10-day production, and the product to be transported by barges on Meghna River. As a result of the discussions, the liquefied oil gas produced annually will correspond to crude oil of 44,690 tons, and to 858,048 tons of crude oil cumulatively for 20 years of the plant life. This is an energy derived from unutilized natural gas, which is creation of a new energy. With regard to the reduction of global warming gas emission, it was revealed that a reduction effect of 16,540,000 t-CO2 can be obtained in twenty years, if comparison is made based on combustion of firewood. (NEDO)

  2. Feasibility of seismic alert systems in India

    International Nuclear Information System (INIS)

    Chauhan, P.K.S.; Pandey, Y.

    2012-01-01

    Natural disasters like flood, earthquakes and cyclones are very frequent in India since historical times. As far as the casualties are concerned, globally earthquakes are second in the list after the flood. The loss of property due to these earthquakes is huge and enormous. In the light of the present knowledge base, earthquake prediction is far from being a reality. An early earthquake warning has potential to save the precious human lives. In the present day scenario seismic instrumentation and telecommunication permits the implementation of seismic alert system (SAS) based on the real-time measurement of ground motions near the source. SAS is capable of providing a warning of several seconds before the arrival of destructive seismic waves caused by a large earthquake. SAS is successfully operational in many countries of the world. In a country, like India where earthquakes are taking heavy toll on the human lives and property, seismic alert system may prove to be very important step in natural hazard mitigation strategy. In this paper, an attempt has been made to compute the available alarm time before the destructive earthquake waves reaches to the cities like Delhi, Lucknow, Patna and Kolkata taking Himalaya as the source and feasibility of seismic alert system in Indian scenario. (author)

  3. Northern gas: Williams petrochemical feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Chappell, D. [Williams Energy Canada, Calgary, AB (Canada)

    2002-07-01

    Williams Energy is a company that is involved in the following fields: gas pipelines, exploration and production, midstream, refining, petrochemical, power, and marketing and trading. The author provides an overview of the global and Canadian infrastructure before proceeding to discuss Arctic gas, which is viewed by Williams Energy as necessary. It favors the Alaska Highway route with a consortium for project development. Williams performed a petrochemical study to determine the feasibility of a petrochemical complex utilizing natural gas liquid from an Arctic gas pipeline. The scope of the study encompassed facilities (extraction plant, cracker, polyolefins plant), size (world scale, approximately 2 billion pounds per year), and location (Fairbanks or Alberta). The study led to the following findings: (1) review of several scenarios for both locations, (2) complex to produce two grades of polyethylene, (3) feedstock cost favors Alaska, (4) construction costs lower in Alberta, (5) and the primary market for the Alaska complex would be northeast Asia, while the primary market for the Alberta location would be the United States. It was determined that both options would be viable, however Alberta was favored due to the polyethylene forecast. The challenges still being faced by Williams include low frac spread, market inefficiencies, empress volumes, carbon dioxide, and fuel and electricity cost. Each of these challenges is discussed separately. The author concludes by indicating that incremental ethane is available, carbon dioxide issues need resolution, and Alberta and Alaska are attractive for Arctic ethane petrochemical production. figs.

  4. Feasibility of VVER-440 type SFAT

    International Nuclear Information System (INIS)

    Kaartinen, J.; Tarvainen, M.

    1995-05-01

    Spent fuel attribute tester, SFAT, has been constructed and tested for gross defect verification of VVER-440 type spent fuel assemblies. Based on earlier optimisation studies, the VVER-440 SFAT is kept hanging from the mast of the fuel handling machine moved by the operator. The device tested includes a standard 2' x 2' NaI(T1) detector connected to a commercial MCA. The results achieved with normal VVER-440 spent fuel assemblies at the Loviisa npp in Finland in November 1994 show that the method is feasible. The design of the so-called fuel follower assemblies, however, prevents SFAT verification, at least with moderate measurement times. Verification of the presence of the assemblies based on the detection of the fission product 137 Cs (662 keV) is possible even in 10-30 seconds. Measurement times of the order of 1-2 minutes make it possible to draw also semi-quantitative conclusions of the burnup and cooling time of the operator declared data (consistency check). (orig.) (7 refs., 11 figs., 3 tabs.)

  5. Feasibility study on Ashuganj NGL Fractionation Plant

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    A feasibility study has been performed on Ashuganj NGL Fractionation Plant being planned in the People's Republic of Bangladesh. The present study has discussed a plant to manufacture liquefied oil gas, automotive fuel, and diesel fuel from liquefied natural gas. The plan calls for the plant life of 20 years, liquefied natural gas as the raw material to be supplied continuously and stably from the gas reservoir areas via the existing pipelines, the storage tank to have a size of 10-day production, and the product to be transported by barges on Meghna River. As a result of the discussions, the liquefied oil gas produced annually will correspond to crude oil of 44,690 tons, and to 858,048 tons of crude oil cumulatively for 20 years of the plant life. This is an energy derived from unutilized natural gas, which is creation of a new energy. With regard to the reduction of global warming gas emission, it was revealed that a reduction effect of 16,540,000 t-CO2 can be obtained in twenty years, if comparison is made based on combustion of firewood. (NEDO)

  6. Automated docking screens: a feasibility study.

    Science.gov (United States)

    Irwin, John J; Shoichet, Brian K; Mysinger, Michael M; Huang, Niu; Colizzi, Francesco; Wassam, Pascal; Cao, Yiqun

    2009-09-24

    Molecular docking is the most practical approach to leverage protein structure for ligand discovery, but the technique retains important liabilities that make it challenging to deploy on a large scale. We have therefore created an expert system, DOCK Blaster, to investigate the feasibility of full automation. The method requires a PDB code, sometimes with a ligand structure, and from that alone can launch a full screen of large libraries. A critical feature is self-assessment, which estimates the anticipated reliability of the automated screening results using pose fidelity and enrichment. Against common benchmarks, DOCK Blaster recapitulates the crystal ligand pose within 2 A rmsd 50-60% of the time; inferior to an expert, but respectrable. Half the time the ligand also ranked among the top 5% of 100 physically matched decoys chosen on the fly. Further tests were undertaken culminating in a study of 7755 eligible PDB structures. In 1398 cases, the redocked ligand ranked in the top 5% of 100 property-matched decoys while also posing within 2 A rmsd, suggesting that unsupervised prospective docking is viable. DOCK Blaster is available at http://blaster.docking.org .

  7. Pinellas Plant feasibility study. Final report

    International Nuclear Information System (INIS)

    1994-09-01

    The Pinellas Plant was built in 1956 to manufacture neutron generators, a principal component in nuclear weapons. In September 1990, the Department of Health and Rehabilitative Services (HRS) entered into an agreement with DOE to independently examine environmental monitoring data from the plant and health data from Pinellas County to determine if an epidemiological study is technically feasible to measure possible off-site health effects from ionizing radiation. Through normal plant operations, some radioactive materials have been released to the environment. Eighty percent of the total plant releases of 107,707 curies occurred in the early years of plant operation (1957--1960). The primary materials released were tritium gas, tritium oxide and krypton-85. Environmental monitoring for radioactive releases from the plant has been done regularly since 1975. The US Public Health Service Centers for Disease Control and Prevention (CDC), in assisting HRS, has determined that sufficient radiological data exist by which a dose reconstruction can be done. A dose reconstruction can provide an estimate of how much radiological exposure someone living in the vicinity of the Pinellas Plant may have suffered from environmental releases

  8. Feasibility study of CT perfusion imaging for prostate carcinoma

    International Nuclear Information System (INIS)

    Cullu, Nesat; Kantarci, Mecit; Ogul, Hayri; Pirimoglu, Berhan; Karaca, Leyla; Kizrak, Yesim; Adanur, Senol; Koc, Erdem; Polat, Ozkan; Okur, Aylin

    2014-01-01

    The aim of this feasibility study was to obtain initial data with which to assess the efficiency of perfusion CT imaging (CTpI) and to compare this with magnetic resonance imaging (MRI) in the diagnosis of prostate carcinoma. This prospective study involved 25 patients with prostate carcinoma undergoing MRI and CTpI. All analyses were performed on T2-weighted images (T2WI), apparent diffusion coefficient (ADC) maps, diffusion-weighted images (DWI) and CTp images. We compared the performance of T2WI combined with DWI and CTp alone. The study was approved by the local ethics committee, and written informed consent was obtained from all patients. Tumours were present in 87 areas according to the histopathological results. The diagnostic performance of the T2WI+DWI+CTpI combination was significantly better than that of T2WI alone for prostate carcinoma (P < 0.001). The diagnostic value of CTpI was similar to that of T2WI+DWI in combination. There were statistically significant differences in the blood flow and permeability surface values between prostate carcinoma and background prostate on CTp images. CTp may be a valuable tool for detecting prostate carcinoma and may be preferred in cases where MRI is contraindicated. If this technique is combined with T2WI and DWI, its diagnostic value is enhanced. (orig.)

  9. Electrical Energy Storage Systems Feasibility; the Case of Terceira Island

    Directory of Open Access Journals (Sweden)

    Ana Rodrigues

    2017-07-01

    Full Text Available The Azores Regional Government, through the Sustainable Energy Action Plan for the Azorean Islands, assumed that by the year 2018, 60% of electricity would be generated from renewable energy sources. Nevertheless, by increasing renewable energy sources share in the electricity mix, peak energy that exceeds grid capacity cannot be used unless when considering energy storage systems. Therefore, this article aims at determining, among batteries and Pumped Hydro Systems, the most cost-effective energy storage system to deploy in Terceira Island, along with geothermal, wind, thermal and bio waste energy, while considering demand and supply constraints. It is concluded that a pumped hydro system sited in Serra do Morião-Nasce Água is the best option for storage of the excess generated energy when compared with batteries. However, further studies should analyze environmental constraints. It is demonstrated that by increasing the storage power capacity, a pumped hydro system improves its cost efficiency when compared with batteries. It is also demonstrated that, to ensure quality, economic feasibility, reliability and a reduction of external costs, it is preferable to replace fuel-oil by wind to generate electricity up to a conceivable technical limit, while building a pumped hydro system, or dumping the excess peak energy generated.

  10. Technical and economic feasibility of thermal storage. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Shelpuk, B.; Joy, P.; Crouthamel, M.

    1977-06-01

    The technical and economic feasibility of various thermal energy storage alternatives is determined by comparing the system performance and annualized cost which result from each storage alternative operating with the same solar collector model, the same building load model, and the same heating system and controls model. Performance and cost calculations are made on the basis of an hour-by-hour time step using actual weather bureau data for Albuquerque, N. M., and New York City for a single six-month heating season. The primary approach to comparing various storage alternatives is to allow the collector area and storage mass to vary until a minimum cost combination is achieved. In the Albuquerque location collector area of 325 ft/sup 2/, water storage mass of 12.5 lb/ft/sup 2/ of collector area, and phase change mass of 6.25 lb/ft/sup 2/ of collector area results in minimum cost systems, each of which delivers about 50% of the total building demand. The primary conclusion is that, using current costs for materials and containers, water is the cheapest storage alternative for heating applications in both Albuquerque and New York City. The cost of containing or encapsulating phase change materials, coupled with their small system performance advantage, is the main reason for this conclusion. The use of desiccant materials for thermal storage is considered to be impractical due to irreversibilities in thermal cycling.

  11. Day care monopolar transurethral resection of prostate: Is it feasible?

    Directory of Open Access Journals (Sweden)

    Altaf Khan

    2014-01-01

    Full Text Available Introduction: Benign prostatic hyperplasia is a common disease accounting for 30% of our OPD cases and about 25% of our surgery cases. Various treatment options are now available for more efficient care and early return to work. We wanted to determine the safety and feasibility of day care monopolar transurethral resection of prostate (m-TURP, by admitting the patients on the day of surgery and discharging the patient without catheter on the same day. We also compared the morbidity associated with conventional TURP where in the catheter is removed after 24-48 h of surgery and day care TURP where in the catheter is removed on the day of surgery. Materials and Methods: A total of 120 patients who fulfilled the criteria were included in the study which was conducted between November 2008 and December 2010. A total of 60 patients were assigned for day care and 60 for conventional monopolar TURP. There was no significant difference in age, prostatic volume or IPSS score. Day care patients were admitted on day of surgery and discharged the same day after the removal of catheter. Results: Both the groups were comparable in outcome. Stricture rate was less with day care TURP. Mean catheterization time was similar to laser TURP. Conclusion: Monopolar TURP is still the gold standard of care for BPH. If cases are selected properly and surgery performed diligently it remains the option of choice for small and medium sized glands and patients can be back to routine work early.

  12. Feasibility Study of 8-Bit Microcontroller Applications for Ethernet

    Directory of Open Access Journals (Sweden)

    Lech Gulbinovič

    2011-08-01

    Full Text Available Feasibility study of 8-bit microcontroller applications for Ethernet is presented. Designed device is based on ATmega32 microcontroller and 10 Mbps Ethernet controller ENC28J60. Device is simulated as mass queuing theoretical model with ticket booking counter. Practical explorations are accomplished and characteristics are determined. Practical results are compared to theoretical ones. Program code and device packet processing speed optimization are discussed. Microcontroller packet processing speed and packet latency depend on packet size. For ICMP protocol packet processing speed varies 1.4–2.1 Mbps, latency – 0.8–8.4 ms. UDP protocol packet processing speed varies 1.3–1.8 Mbps, latency – 1.1–9.6 ms. Packet processing speed depends on compilation settings and program code compression level. Best results are reached on optimization le­vel ‑O3, then speed increased ~3% but program code size increased 68% comparing to –Os optimization level.Article in Lithuanian

  13. 7 CFR 1779.47 - Economic feasibility requirements.

    Science.gov (United States)

    2010-01-01

    ... complete the financial feasibility analysis for WW systems. If the facility is used by businesses and the success or failure of the facility is dependent on individual businesses, then the economic viability of..., security, history, and management capabilities. Financial feasibility reports must take into consideration...

  14. Feasibility Study on Solar District Heating in China

    DEFF Research Database (Denmark)

    Huang, Junpeng; Fan, Jianhua; Furbo, Simon

    This paper analyzes the feasibility of developing solar district heating (SDH) in China from the perspective of incentive policy, selections of technical route, regional adaptability and economic feasibility for clean heating. Based on the analyzation, this proposes a road map for the development...

  15. Feasibility and acceptability of workers' health surveillance for fire fighters

    NARCIS (Netherlands)

    Plat, Marie-Christine J.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2011-01-01

    The objective of this study was to test the feasibility and acceptability of a new workers' health surveillance (WHS) for fire fighters in a Dutch pilot-implementation project. In three fire departments, between November 2007 and February 2009, feasibility was tested with respect to i) worker intent

  16. Feasibility of progressive strength training shortly after hip fracture surgery

    DEFF Research Database (Denmark)

    Overgaard, Jan; Kristensen, Morten T

    2013-01-01

    To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients.......To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients....

  17. Texting to increase adolescent physical activity: Feasibility assessment

    Science.gov (United States)

    Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity. A 4-group ran...

  18. 100-BC-1 Operable Unit focused feasibility study

    International Nuclear Information System (INIS)

    Day, R.E.

    1994-01-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act feasibility study includes development and screening of alternatives (Phases 1 and 2) and the detailed analysis of alternatives (Phase 3). This focused feasibility study constitutes the Phase 3 portion of the feasibility study process for the remedial alternatives initially developed and screened in the 100 Area Feasibility Study Phases 1 and 2 (DOE-RL 1993a). The focused feasibility study process is conducted in two stages, a Process Document (DOE-RL 1994a) and an operable unit-specific focused feasibility study document, such as this one. The focused feasibility study process is performed by implementing a ''plug-in'' style approach; as defined in greater detail in the Process Document, which is a companion to this document. The objective of this focused feasibility study is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures for candidate waste sites associated with the 100-BC-1 Operable Unit which is located in the north-central part of the Hanford Site. The interim remedial measure candidate waste sites are determined in the Limited Field Investigation (DOE-RL 1993b). Site profiles are developed for each of these waste sites. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented

  19. Feasibility study on a cosmic-ray level gauge

    International Nuclear Information System (INIS)

    Matsuda, H.; Fukaya, M.; Minato, S.

    1989-01-01

    Cosmic-ray intensities were measured at the stairs in a subway station in Nagoya City, inside a tall concrete building and under a cylindrical water tank, to examine the feasibility of a cosmic-ray level gauge. The measured results agreed quite well with the theoretical calculations. These results show that a cosmic-ray level gauge is feasible. (author)

  20. 41 CFR 101-5.306 - Economic feasibility.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Economic feasibility. 101... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.306 Economic feasibility. (a) The studies... § 101-5.104. (b) Each determination to provide health services will be governed by the principles stated...

  1. A feasible central limit theory for realised volatility under leverage

    DEFF Research Database (Denmark)

    Barndorff-Nielsen, Ole Eiler; Shephard, Neil

    In this note we show that the feasible central limit theory for realised volatility and realised covariation recently developed by Barndor-Nielsen and Shephard applies under arbitrary diusion based leverage eects. Results from a simulation experiment suggest that the feasible version of the limit...

  2. Feasibility of lunar Helium-3 mining

    Science.gov (United States)

    Kleinschneider, Andreas; Van Overstraeten, Dmitry; Van der Reijnst, Roy; Van Hoorn, Niels; Lamers, Marvin; Hubert, Laurent; Dijk, Bert; Blangé, Joey; Hogeveen, Joel; De Boer, Lennaert; Noomen, Ron

    With fossil fuels running out and global energy demand increasing, the need for alternative energy sources is apparent. Nuclear fusion using Helium-3 may be a solution. Helium-3 is a rare isotope on Earth, but it is abundant on the Moon. Throughout the space community lunar Helium-3 is often cited as a major reason to return to the Moon. Despite the potential of lunar Helium-3 mining, little research has been conducted on a full end-to-end mission. This abstract presents the results of a feasibility study conducted by students from Delft University of Technology. The goal of the study was to assess whether a continuous end-to-end mission to mine Helium-3 on the Moon and return it to Earth is a viable option for the future energy market. The set requirements for the representative end-to-end mission were to provide 10% of the global energy demand in the year 2040. The mission elements have been selected with multiple trade-offs among both conservative and novel concepts. A mission architecture with multiple decoupled elements for each transportation segment (LEO, transfer, lunar surface) was found to be the best option. It was found that the most critical element is the lunar mining operation itself. To supply 10% of the global energy demand in 2040, 200 tons of Helium-3 would be required per year. The resulting regolith mining rate would be 630 tons per second, based on an optimistic concentration of 20 ppb Helium-3 in lunar regolith. Between 1,700 to 2,000 Helium-3 mining vehicles would be required, if using University of Wisconsin’s Mark III miner. The required heating power, if mining both day and night, would add up to 39 GW. The resulting power system mass for the lunar operations would be in the order of 60,000 to 200,000 tons. A fleet of three lunar ascent/descent vehicles and 22 continuous-thrust vehicles for orbit transfer would be required. The costs of the mission elements have been spread out over expected lifetimes. The resulting profits from Helium

  3. Technical feasibility of the Diamex process

    International Nuclear Information System (INIS)

    Sorel, Ch

    2007-01-01

    Full text of publication follows. The DIAMEX process was developed to facilitate the separation of the trivalent actinides from the trivalent lanthanides. It consists in co-extracting the trivalent actinides and lanthanides using a diamide extractant: Di-Methyl Di-Octyl Hexyl Ethoxy Malonamide (DMDOHEMA). The flow-sheet comprises: Co-extraction at high acidity (3 M HNO 3 ) of the trivalent actinides and lanthanides by the diamide; scrubbing of some fission products (Zr, Mo, Fe, Pd) by a mixture of oxalic acid and HEDTA, followed by de-acidification to prepare for the next step; stripping of the actinides + lanthanides at low acidity; solvent treatment prior to recycling. This flow-sheet was successfully tested at laboratory scale from 1999 to 2003 in mixer-settlers and subsequently in ECLHA centrifugal extractors on active solutions from the dissolution of actual spent fuel samples. Actinide recovery factors above 99.9% were obtained with high purification factors for spurious fission products. The main objectives of the final ''technical feasibility'' demonstration tests at the end of 2005 with a PUREX raffinate solution were to test continuous solvent recycling (not included during the earlier tests) and to carry out essential operations in continuous contactors representative of pulsed columns that could be used at industrial scale. We therefore decided to carry out the demonstration in the shielded process line (CBP) with some of the devices already used for a PUREX test. During these tests the first two steps in the flow-sheet were therefore carried out in pulsed columns 4 meters high; An+Ln stripping was performed in mixer-settlers and the solvent treatment in ECRAN. The americium and curium recovery yield exceeded 99.9% and the decontamination factors obtained at the end of the test with respect to the fission products Zr, Mo and Fe were 800, 100 and 10, respectively. (author)

  4. Economic feasibility of thermal energy storage systems

    Energy Technology Data Exchange (ETDEWEB)

    Habeebullah, B.A. [Faculty of Engineering, King Abdulaziz University, Jeddah (Saudi Arabia)

    2007-07-01

    This paper investigates the economic feasibility of both building an ice thermal storage and structure a time of rate tariff for the unique air conditioning (A/C) plant of the Grand Holy Mosque of Makkah, Saudi Arabia. The features of the building are unique where the air-conditioned 39,300 m{sup 2} zone is open to the atmosphere and the worshippers fully occupy the building five times a day, in addition hundreds of thousands of worshippers attend the blessed weekend's prayer at noontime, which escalates the peak electricity load. For economic analysis, the objective function is the daily electricity bill that includes the operation cost and the capital investment of the ice storage system. The operation cost is function of the energy imported for operating the plant in which the tariff structure, number of operating hours and the ambient temperature are parameters. The capital recovery factor is calculated for 10% interest rate and payback period of 10 years. Full and partial load storage scenarios are considered. The results showed that with the current fixed electricity rate (0.07 $/kWh), there is no gain in introducing ice storage systems for both storage schemes. Combining energy storage and an incentive time structured rate showed reasonable daily bill savings. For base tariff of 0.07 $/kWh during daytime operation and 0.016 $/kWh for off-peak period, savings were achieved for full load storage scenario. Different tariff structure is discussed and the break-even nighttime rate was determined (varies between 0.008 and 0.03 $/kWh). Partial load storage scenario showed to be unattractive where the savings for the base structured tariff was insignificant. (author)

  5. Computed tomography with energy-resolved detection: a feasibility study

    Science.gov (United States)

    Shikhaliev, Polad M.

    2008-03-01

    The feasibility of computed tomography (CT) with energy-resolved x-ray detection has been investigated. A breast CT design with multi slit multi slice (MSMS) data acquisition was used for this study. The MSMS CT includes linear arrays of photon counting detectors separated by gaps. This CT configuration allows for efficient scatter rejection and 3D data acquisition. The energy-resolved CT images were simulated using a digital breast phantom and the design parameters of the proposed MSMS CT. The phantom had 14 cm diameter and 50/50 adipose/glandular composition, and included carcinoma, adipose, blood, iodine and CaCO3 as contrast elements. The x-ray technique was 90 kVp tube voltage with 660 mR skin exposure. Photon counting, charge (energy) integrating and photon energy weighting CT images were generated. The contrast-to-noise (CNR) improvement with photon energy weighting was quantified. The dual energy subtracted images of CaCO3 and iodine were generated using a single CT scan at a fixed x-ray tube voltage. The x-ray spectrum was electronically split into low- and high-energy parts by a photon counting detector. The CNR of the energy weighting CT images of carcinoma, blood, adipose, iodine, and CaCO3 was higher by a factor of 1.16, 1.20, 1.21, 1.36 and 1.35, respectively, as compared to CT with a conventional charge (energy) integrating detector. Photon energy weighting was applied to CT projections prior to dual energy subtraction and reconstruction. Photon energy weighting improved the CNR in dual energy subtracted CT images of CaCO3 and iodine by a factor of 1.35 and 1.33, respectively. The combination of CNR improvements due to scatter rejection and energy weighting was in the range of 1.71-2 depending on the type of the contrast element. The tilted angle CZT detector was considered as the detector of choice. Experiments were performed to test the effect of the tilting angle on the energy spectrum. Using the CZT detector with 20° tilting angle decreased the

  6. Moxibustion for cephalic version: a feasibility randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Bisits Andrew

    2011-09-01

    Full Text Available Abstract Background Moxibustion (a type of Chinese medicine which involves burning a herb close to the skin has been used to correct a breech presentation. Evidence of effectiveness and safety from systematic reviews is encouraging although significant heterogeneity has been found among trials. We assessed the feasibility of conducting a randomised controlled trial of moxibustion plus usual care compared with usual care to promote cephalic version in women with a breech presentation, and examined the views of women and health care providers towards implementing a trial within an Australian context. Methods The study was undertaken at a public hospital in Newcastle, New South Wales, Australia. Women at 34-36.5 weeks of gestation with a singleton breech presentation (confirmed by ultrasound, were randomised to moxibustion plus usual care or usual care alone. The intervention was administered over 10 days. Clinical outcomes included cephalic presentation at birth, the need for ECV, mode of birth; perinatal morbidity and mortality, and maternal complications. Feasibility outcomes included: recruitment rate, acceptability, compliance and a sample size for a future study. Interviews were conducted with 19 midwives and obstetricians to examine the acceptability of moxibustion, and views on the trial. Results Twenty women were randomised to the trial. Fifty one percent of women approached accepted randomisation to the trial. A trend towards an increase in cephalic version at delivery (RR 5.0; 95% CI 0.7-35.5 was found for women receiving moxibustion compared with usual care. There was also a trend towards greater success with version following ECV. Two babies were admitted to the neonatal unit from the moxibustion group. Compliance with the moxibustion protocol was acceptable with no reported side effects. Clinicians expressed the need for research to establish the safety and efficacy of moxibustion, and support for the intervention was given to

  7. Energy efficiency and economic feasibility of CCHP driven by stirling engine

    International Nuclear Information System (INIS)

    Kong, X.Q.; Wang, R.Z.; Huang, X.H.

    2004-01-01

    This paper deals with the problem of energy efficiency evaluation and economic feasibility analysis of a small scale trigeneration system for combined cooling, heating and power generation (CCHP) with an available Stirling engine. Trigeneration systems have a large potential of energy saving and economical efficiency. The decisive values for energetic efficiency evaluation of such systems are the primary energy rate and comparative primary energy saving (Δq), while the economic feasibility analysis of such systems relates the avoided cost, the total annual saving and payback period. The investigation calculates and compares the energy saving and economic efficiency of trigeneration system with Stirling engine against contemporary conventional independent cooling, heating and power, showing that a CCHP system saves fuel resources and has the assurance of economic benefits

  8. Feasibility study of a fission supressed blanket for a tandem-mirror hybrid reactor

    International Nuclear Information System (INIS)

    Moir, R.W.; Lee, J.D.; Barr, W.L.

    1981-01-01

    A study of fission suppressed blankets for the tandem mirror not only showed such blankets to be feasible but also to be safer than fissioning blankets. Such hybrids could produce enough fissile material to support up to 17 light water reactors of the same nuclear power rating. Beryllium was compared to 7 Li for neutron multiplication; both were considered feasible but the blanket with Li produced 20% less fissile fuel per unit of nuclear power in the reactor. The beryllium resource, while possibly being too small for extensive pure fusion application, would be adequate (with carefully planned industrial expansion) for the hybrid because of the large support ratio, and hence few hybrids required. Radiation damage and coatings for beryllium remain issues to be resolved by further study and experimentation. Molten salt reprocessing was compared to aqueous solution reprocessing

  9. CRASH - Community Road Accident System Homepage : feasibility study on a European Road Safety Information System, financ