The effect of hospital volume on patient outcomes in severe acute pancreatitis

Directory of Open Access Journals (Sweden)

Shen Hsiu-Nien

2012-08-01

Full Text Available Abstract Background We investigated the relation between hospital volume and outcome in patients with severe acute pancreatitis (SAP. The determination is important because patient outcome may be improved through volume-based selective referral. Methods In this cohort study, we analyzed 22,551 SAP patients in 2,208 hospital-years (between 2000 and 2009 from Taiwan’s National Health Insurance Research Database. Primary outcome was hospital mortality. Secondary outcomes were hospital length of stay and charges. Hospital SAP volume was measured both as categorical and as continuous variables (per one case increase each hospital-year. The effect was assessed using multivariable logistic regression models with generalized estimating equations accounting for hospital clustering effect. Adjusted covariates included patient and hospital characteristics (model 1, and additional treatment variables (model 2. Results Irrespective of the measurements, increasing hospital volume was associated with reduced risk of hospital mortality after adjusting the patient and hospital characteristics (adjusted odds ratio [OR] 0.995, 95% confidence interval [CI] 0.993-0.998 for per one case increase. The patients treated in the highest volume quartile (≥14 cases per hospital-year had 42% lower risk of hospital mortality than those in the lowest volume quartile (1 case per hospital-year after adjusting the patient and hospital characteristics (adjusted OR 0.58, 95% CI 0.40-0.83. However, an inverse relation between volume and hospital stay or hospital charges was observed only when the volume was analyzed as a categorical variable. After adjusting the treatment covariates, the volume effect on hospital mortality disappeared regardless of the volume measures. Conclusions These findings support the use of volume-based selective referral for patients with SAP and suggest that differences in levels or processes of care among hospitals may have contributed to the volume

Savannah River Site Approved Site Treatment Plan, 2001 Annual Update (Volumes I and II)

Energy Technology Data Exchange (ETDEWEB)

Lawrence, B.

2001-04-30

The Compliance Plan Volume (Volume I) identifies project activity scheduled milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information.

Combination of Mean Platelet Volume/Platelet Count Ratio and the APACHE II Score Better Predicts the Short-Term Outcome in Patients with Acute Kidney Injury Receiving Continuous Renal Replacement Therapy.

Science.gov (United States)

Li, Junhui; Li, Yingchuan; Sheng, Xiaohua; Wang, Feng; Cheng, Dongsheng; Jian, Guihua; Li, Yongguang; Feng, Liang; Wang, Niansong

2018-03-29

Both the Acute physiology and Chronic Health Evaluation (APACHE II) score and mean platelet volume/platelet count Ratio (MPR) can independently predict adverse outcomes in critically ill patients. This study was aimed to investigate whether the combination of them could have a better performance in predicting prognosis of patients with acute kidney injury (AKI) who received continuous renal replacement therapy (CRRT). Two hundred twenty-three patients with AKI who underwent CRRT between January 2009 and December 2014 in a Chinese university hospital were enrolled. They were divided into survivals group and non-survivals group based on the situation at discharge. Receiver Operating Characteristic (ROC) curve was used for MPR and APACHE II score, and to determine the optimal cut-off value of MPR for in-hospital mortality. Factors associated with mortality were identified by univariate and multivariate logistic regression analysis. The mean age of the patients was 61.4 years, and the overall in-hospital mortality was 48.4%. Acute cardiorenal syndrome (ACRS) was the most common cause of AKI. The optimal cut-off value of MPR for mortality was 0.099 with an area under the ROC curve (AUC) of 0.636. The AUC increased to 0.851 with the addition of the APACHE II score. The mortality of patients with of MPR > 0.099 was 56.4%, which was significantly higher than that of the control group with of ≤ 0.099 (39.6%, P= 0.012). Logistic regression analysis showed that average number of organ failure (OR = 2.372), APACHE II score (OR = 1.187), age (OR = 1.028) and vasopressors administration (OR = 38.130) were significantly associated with poor prognosis. Severity of illness was significantly associated with prognosis of patients with AKI. The combination of MPR and APACHE II score may be helpful in predicting the short-term outcome of AKI. © 2018 The Author(s). Published by S. Karger AG, Basel.

Combination of Mean Platelet Volume/Platelet Count Ratio and the APACHE II Score Better Predicts the Short-Term Outcome in Patients with Acute Kidney Injury Receiving Continuous Renal Replacement Therapy

Directory of Open Access Journals (Sweden)

Junhui Li

2018-03-01

Full Text Available Background/Aims: Both the Acute physiology and Chronic Health Evaluation (APACHE II score and mean platelet volume/platelet count Ratio (MPR can independently predict adverse outcomes in critically ill patients. This study was aimed to investigate whether the combination of them could have a better performance in predicting prognosis of patients with acute kidney injury (AKI who received continuous renal replacement therapy (CRRT. Methods: Two hundred twenty-three patients with AKI who underwent CRRT between January 2009 and December 2014 in a Chinese university hospital were enrolled. They were divided into survivals group and non-survivals group based on the situation at discharge. Receiver Operating Characteristic (ROC curve was used for MPR and APACHE II score, and to determine the optimal cut-off value of MPR for in-hospital mortality. Factors associated with mortality were identified by univariate and multivariate logistic regression analysis. Results: The mean age of the patients was 61.4 years, and the overall in-hospital mortality was 48.4%. Acute cardiorenal syndrome (ACRS was the most common cause of AKI. The optimal cut-off value of MPR for mortality was 0.099 with an area under the ROC curve (AUC of 0.636. The AUC increased to 0.851 with the addition of the APACHE II score. The mortality of patients with of MPR > 0.099 was 56.4%, which was significantly higher than that of the control group with of ≤ 0.099 (39.6%, P= 0.012. Logistic regression analysis showed that average number of organ failure (OR = 2.372, APACHE II score (OR = 1.187, age (OR = 1.028 and vasopressors administration (OR = 38.130 were significantly associated with poor prognosis. Conclusion: Severity of illness was significantly associated with prognosis of patients with AKI. The combination of MPR and APACHE II score may be helpful in predicting the short-term outcome of AKI.

Tokamak experimental power reactor conceptual design. Volume II

International Nuclear Information System (INIS)

1976-08-01

Volume II contains the following appendices: (1) summary of EPR design parameters, (2) impurity control, (3) plasma computational models, (4) structural support system, (5) materials considerations for the primary energy conversion system, (6) magnetics, (7) neutronics penetration analysis, (8) first wall stress analysis, (9) enrichment of isotopes of hydrogen by cryogenic distillation, and (10) noncircular plasma considerations

Does delivery volume of family physicians predict maternal and newborn outcome?

International Nuclear Information System (INIS)

Klein, M.C.; Spence, A.; Kaczorowski, J.; Kelly, A.; Grzybowski, S.

2002-01-01

The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

Does delivery volume of family physicians predict maternal and newborn outcome?

Energy Technology Data Exchange (ETDEWEB)

Klein, M.C. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada); Spence, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Kaczorowski, J. [McMaster Univ., Depts. of Family Medicine and of Clinical Epidemiology and Biostatistics, Hamilton, Ontario (Canada); Kelly, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Health Care and Epidemiology, Vancouver, British Columbia (Canada); Grzybowski, S. [Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada)

2002-05-01

The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

Improved Short-Term Outcomes following Orthognathic Surgery Are Associated with High-Volume Centers.

Science.gov (United States)

Berlin, Nicholas L; Tuggle, Charles T; Steinbacher, Derek M

2016-08-01

Previous studies assessing outcomes following orthognathic surgery rely primarily on single-center/surgeon experience. In addition to issues of generalizability, these studies are limited in evaluating the effect of operative volume on patient outcomes. Orthognathic procedures were identified in the 1999 to 2011 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Outcomes included occurrence of any in-hospital complication, extended length of stay (>2 days), and increased costs (>$10,784). High-volume hospitals were defined as the 90th percentile of case volume or higher (>31 cases/year). Univariate and multivariate analyses were conducted to identify independent predictors of outcomes. Trend analyses were performed to assess changes in the annual rate of patients treated at high-volume hospitals over the study period. Among 101,692 orthognathic surgery patients, 19.6 percent underwent concurrent ancillary procedures (i.e., genioplasty, rhinoplasty, or septoplasty), and 37.6 percent underwent double-jaw surgery. Fifty-three percent were treated at high-volume hospitals. High-volume hospitals more often performed ancillary procedures (21.4 percent versus 17.4 percent; p surgery (41.3 percent versus 33.4 percent; p orthognathic cases nationwide are performed at a small number of high-volume hospitals. These hospitals discharge patients earlier, perform more complex procedures, and have fewer complications. Risk, III.

Phonons: Theory and experiments II. Volume 2

International Nuclear Information System (INIS)

Bruesch, P.

1986-01-01

The present second volume titled as ''Phonons: Theory and Experiments II'', contains, a thorough study of experimental techniques and the interpretation of experimental results. This three-volume set tries to bridge the gap between theory and experiment, and is addressed to those working in both camps in the vast field of dynamical properties of solids. Topics presented in the second volume include; infrared-, Raman and Brillouin spectroscopy, interaction of X-rays with phonons, and inelastic neutron scattering. In addition an account is given of some other techniques, including ultrasonic methods, inelastic electron tunneling spectroscopy, point contact spectroscopy, and spectroscopy of surface phonons, thin films and adsorbates. Both experimental aspects and theoretical concepts necessary for the interpretation of experimental data are discussed. An attempt is made to present the descriptive as well as the analytical aspects of the topics. Simple models are often used to illustrate the basic concepts and more than 100 figures are included to illustrate both theoretical and experimental results. Many chapters contain a number of problems with hints and results giving additional information

Is the Distance Worth It? Patients With Rectal Cancer Traveling to High-Volume Centers Experience Improved Outcomes.

Science.gov (United States)

Xu, Zhaomin; Becerra, Adan Z; Justiniano, Carla F; Boodry, Courtney I; Aquina, Christopher T; Swanger, Alex A; Temple, Larissa K; Fleming, Fergal J

2017-12-01

It is unclear whether traveling long distances to high-volume centers would compensate for travel burden among patients undergoing rectal cancer resection. The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers. This was a population-based study. The National Cancer Database was queried for patients with rectal cancer. Patients with stage II or III rectal cancer who underwent surgical resection between 2006 and 2012 were included. The outcomes of interest were margins, lymph node yield, receipt of neoadjuvant chemoradiation, adjuvant chemotherapy, readmission within 30 days, 30-day and 90-day mortality, and 5-year overall survival. A total of 18,605 patients met inclusion criteria; 2067 patients were in the long-distance/high-volume group and 1362 in the short-distance/low-volume group. The median travel distance was 62.6 miles for the long-distance/high-volume group and 2.3 miles for the short-distance/low-volume group. Patients who were younger, white, privately insured, and stage III were more likely to have traveled to a high-volume center. When controlled for patient factors, stage, and hospital factors, patients in the short-distance/low-volume group had lower odds of a lymph node yield ≥12 (OR = 0.51) and neoadjuvant chemoradiation (OR = 0.67) and higher 30-day (OR = 3.38) and 90-day mortality (OR = 2.07) compared with those in the long-distance/high-volume group. The short-distance/low-volume group had a 34% high risk of overall mortality at 5 years compared with the long-distance/high-volume group. We lacked data regarding patient and physician decision making and surgeon-specific factors. Our results indicate that when controlled for patient, tumor, and hospital factors, patients who traveled a long distance to a high-volume center had improved lymph node yield

TIBER II/ETR final design report: Volume 2, 3.0 Engineering

International Nuclear Information System (INIS)

Lee, J.D.

1987-09-01

This paper discusses the design of the TIBER II Tokamak. This particular volume discusses: mechanical systems; electrical systems; shield nuclear analysis and tritium issues; reactor building facilities; and tritium systems

A Curriculum Activities Guide to Water Pollution and Environmental Studies, Volume II - Appendices.

Science.gov (United States)

Hershey, John T., Ed.; And Others

This publication, Volume II of a two volume set of water pollution studies, contains seven appendices which support the studies. Appendix 1, Water Quality Parameters, consolidates the technical aspects of water quality including chemical, biological, computer program, and equipment information. Appendix 2, Implementation, outlines techniques…

Residual limb fluid volume change and volume accommodation: Relationships to activity and self-report outcomes in people with trans-tibial amputation.

Science.gov (United States)

Sanders, Joan E; Youngblood, Robert T; Hafner, Brian J; Ciol, Marcia A; Allyn, Katheryn J; Gardner, David; Cagle, John C; Redd, Christian B; Dietrich, Colin R

2018-02-01

Fluctuations in limb volume degrade prosthesis fit and require users to accommodate changes using management strategies, such as donning and doffing prosthetic socks. To examine how activities and self-report outcomes relate to daily changes in residual limb fluid volume and volume accommodation. Standardized, two-part laboratory protocol with an interim observational period. Participants were classified as "accommodators" or "non-accommodators," based on self-report prosthetic sock use. Participants' residual limb fluid volume change was measured using a custom bioimpedance analyzer and a standardized in-laboratory activity protocol. Self-report health outcomes were assessed with the Socket Comfort Score and Prosthesis Evaluation Questionnaire. Activity was monitored while participants left the laboratory for at least 3 h. They then returned to repeat the bioimpedance test protocol. Twenty-nine people were enrolled. Morning-to-afternoon percent limb fluid volume change per hour was not strongly correlated to percent time weight-bearing or to self-report outcomes. As a group, non-accommodators ( n = 15) spent more time with their prosthesis doffed and reported better outcomes than accommodators. Factors other than time weight-bearing may contribute to morning-to-afternoon limb fluid volume changes and reported satisfaction with the prosthesis among trans-tibial prosthesis users. Temporary doffing may be a more effective and satisfying accommodation method than sock addition. Clinical relevance Practitioners should be mindful that daily limb fluid volume change and prosthesis satisfaction are not dictated exclusively by activity. Temporarily doffing the prosthesis may slow daily limb fluid volume loss and should be investigated as an alternative strategy to sock addition.

Mn(II), Zn(II) and VO(II) Schiff

Indian Academy of Sciences (India)

Home; Journals; Journal of Chemical Sciences; Volume 113; Issue 3. Synthesis and characterisation of Cu(II), Ni(II), Mn(II), Zn(II) and VO(II) Schiff base complexes derived from o-phenylenediamine and acetoacetanilide. N Raman Y Pitchaikani Raja A Kulandaisamy. Inorganic Volume 113 Issue 3 June 2001 pp 183-189 ...

Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data.

Science.gov (United States)

Amato, Laura; Fusco, Danilo; Acampora, Anna; Bontempi, Katia; Rosa, Alessandro Cesare; Colais, Paola; Cruciani, Fabio; D'Ovidio, Mariangela; Mataloni, Francesca; Minozzi, Silvia; Mitrova, Zuzana; Pinnarelli, Luigi; Saulle, Rosella; Soldati, Salvatore; Sorge, Chiara; Vecchi, Simona; Ventura, Martina; Davoli, Marina

2017-01-01

BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions. OBJECTIVES To identify conditions/interventions for which an association between volume and outcome has been investigated. To identify conditions/interventions for which an association between volume and outcome has been proved. To analyze the distribution of Italian health providers by volume of activity. To measure the association between volume of care and outcomes of the health providers of the Italian National Health Service (NHS). METHODS Systematic review An overview of systematic reviews was performed searching PubMed, EMBASE, and The Cochrane Library up to November 2016. Studies were evaluated by 2 researchers independently; quality assessment was performed using the AMSTAR checklist. For each health condition and outcome, if available, total number of studies, participants, high volume cut-off values, and metanalysis have been reported. According to the considered outcomes, health topics were classified into 3 groups: positive association: a positive association was demonstrated in the majority of studies/participants and/or a pooled measure (metanalysis) with positive results was reported; lack of association: both studies and/or metanalysis showed no association; no sufficient evidence of association: both results of single studies and metanalysis do not allow to draw firm conclusions

International and Domestic Market Opportunities for Biomass Power: Volumes I and II

Energy Technology Data Exchange (ETDEWEB)

1998-09-01

This report examines the domestic and international markets for biopower. Domestic and foreign markets present fundamentally different challenges to private power developers. Volume I focuses on the domestic market for biopower. The domestic challenge lies in finding economically viable opportunities for biopower. Vol. I outlines the current state of the U.S. biomass industry, discusses policies affecting biomass development, describes some demonstration projects currently underway, and discusses the future direction of the industry. Volume II focuses on the international market for biopower. Recent literature states that the electricity investment and policy climate in foreign markets are the key elements in successful private project development. Vol. II discusses the financing issues, policy climate, and business incentives and barriers to biopower development. As India and China are the largest future markets for biopower, they are the focus of this volume. Three other top markets- -Brazil, Indonesia, and the Philippines--are also discussed. Potential financial resources wrap up the discussion.

Minerals Yearbook, volume II, Area Reports—Domestic

Science.gov (United States)

,

2018-01-01

The U.S. Geological Survey (USGS) Minerals Yearbook discusses the performance of the worldwide minerals and materials industries and provides background information to assist in interpreting that performance. Content of the individual Minerals Yearbook volumes follows:Volume I, Metals and Minerals, contains chapters about virtually all metallic and industrial mineral commodities important to the U.S. economy. Chapters on survey methods, summary statistics for domestic nonfuel minerals, and trends in mining and quarrying in the metals and industrial mineral industries in the United States are also included.Volume II, Area Reports: Domestic, contains a chapter on the mineral industry of each of the 50 States and Puerto Rico and the Administered Islands. This volume also has chapters on survey methods and summary statistics of domestic nonfuel minerals.Volume III, Area Reports: International, is published as four separate reports. These regional reports contain the latest available minerals data on more than 180 foreign countries and discuss the importance of minerals to the economies of these nations and the United States. Each report begins with an overview of the region’s mineral industries during the year. It continues with individual country chapters that examine the mining, refining, processing, and use of minerals in each country of the region and how each country’s mineral industry relates to U.S. industry. Most chapters include production tables and industry structure tables, information about Government policies and programs that affect the country’s mineral industry, and an outlook section.The USGS continually strives to improve the value of its publications to users. Constructive comments and suggestions by readers of the Minerals Yearbook are welcomed.

Subseabed disposal program annual report, January-December 1979. Volume II. Appendices (principal investigator progress reports). Part 2 of 2

International Nuclear Information System (INIS)

Talbert, D.M.

1981-04-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume II, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-O; Part 2 contains Appendices P-FF. Separate abstracts have been prepared for each appendix for inclusion in the Energy Data Base

Provider volume and outcomes for abdominal aortic aneurysm repair, carotid endarterectomy, and lower extremity revascularization procedures.

LENUS (Irish Health Repository)

Killeen, Shane D

2012-02-03

BACKGROUND: Intuitively, vascular procedures performed by high-volume vascular subspecialists working at high-volume institutions should be associated with improved patient outcome. Although a large number of studies assess the relationship between volume and outcome, a single contemporary compilation of such studies is lacking. METHODS: A review of the English language literature was performed incorporating searches of the Medline, EMBASE, and Cochrane collaboration databases for abdominal aortic aneurysm repair (elective and emergent), carotid endarterectomy, and arterial lower limb procedures for any volume outcome relationship. Studies were included if they involved a patient cohort from 1980 onwards, were community or population based, and assessed health outcomes (mortality and morbidity) as a dependent variable and volume as an independent variable. RESULTS: We identified 74 relevant studies, and 54 were included. All showed either an inverse relationship of variable magnitude between provider volume and mortality, or no volume-outcome effect. The reduction in the risk-adjusted mortality rate (RAMR) for high-volume providers was 3% to 11% for elective abdominal aortic aneurysm (AAA) repair, 2.5 to 5% for emergent AAA repair, 0.7% to 4.7% carotid endarterectomy, and 0.3% to 0.9% for lower limb arterial bypass procedures. Subspeciality training also conferred a considerable morbidity and mortality benefit for emergent AAA repair, carotid endarterectomy, and lower limb arterial procedures. CONCLUSION: High-volume providers have significantly better outcomes for vascular procedures both in the elective and emergent setting. Subspeciality training also has a considerable impact. These data provide further evidence for the specialization of vascular services, whereby vascular procedures should generally be preformed by high-volume, speciality trained providers.

Subseabed disposal program annual report, January-December 1980. Volume II. Appendices (principal investigator progress reports). Part 1

International Nuclear Information System (INIS)

Hinga, K.R.

1981-07-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume I, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-Q; Part 2 contains Appendices R-MM. Separate abstracts have been prepared for each appendix for inclusion in the Energy Data Base

Subseabed disposal program annual report, January-December 1980. Volume II. Appendices (principal investigator progress reports). Part 1

Energy Technology Data Exchange (ETDEWEB)

Hinga, K.R. (ed.)

1981-07-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume I, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-Q; Part 2 contains Appendices R-MM. Separate abstracts have been prepared for each appendix for inclusion in the Energy Data Base.

The influence of hospital volume on long-term oncological outcome after rectal cancer surgery

NARCIS (Netherlands)

Jonker, Frederik H. W.; Hagemans, Jan A. W.; Burger, Jacobus W. A.; Verhoef, Cornelis; Borstlap, Wernard A. A.; Tanis, Pieter J.; Aalbers, A.; Acherman, Y.; Algie, G. D.; Alting von Geusau, B.; Amelung, F.; Aukema, T. S.; Bakker, I. S.; Bartels, S. A.; Basha, S.; Bastiaansen, A. J. N. M.; Belgers, E.; Bemelman, W. A.; Bleeker, W.; Blok, J.; Bosker, R. J. I.; Bosmans, J. W.; Boute, M. C.; Bouvy, N. D.; Bouwman, H.; Brandt-Kerkhof, A.; Brinkman, D. J.; Bruin, S.; Bruns, E. R. J.; Burbach, J. P. M.; Clermonts, S.; Coene, P. P. L. O.; Compaan, C.; Consten, E. C. J.; Darbyshire, T.; de Mik, S. M. L.; de Graaf, E. J. R.; de Groot, I.; de Vos Tot Nederveen Cappel, R. J. L.; de Wilt, J. H. W.; van der Wolde, J.; den Boer, F. C.; Dekker, J. W. T.; Demirkiran, A.; van Duijvendijk, P.; Marres, C. C.; Musters, G. D.; van Rossem, C. C.; Schreuder, A. M.; Swank, H. A.

2017-01-01

The association between hospital volume and outcome in rectal cancer surgery is still subject of debate. The purpose of this study was to assess the impact of hospital volume on outcomes of rectal cancer surgery in the Netherlands in 2011. In this collaborative research with a cross-sectional study

National Environmental Policy Act compliance guide. Volume II (reference book)

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-09-01

This document (Volume II of the National Environmental Policy Act Compliance Guide) contains current copies of regulations and guidance from the Council on Environmental Quality, the Department of Energy, the Department of State, and the Environmental Protection Agency, related to compliance with the National Environmental Policy Act of 1969 (NEPA).

Technology transfer package on seismic base isolation - Volume II

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-02-14

This Technology Transfer Package provides some detailed information for the U.S. Department of Energy (DOE) and its contractors about seismic base isolation. Intended users of this three-volume package are DOE Design and Safety Engineers as well as DOE Facility Managers who are responsible for reducing the effects of natural phenomena hazards (NPH), specifically earthquakes, on their facilities. The package was developed as part of DOE's efforts to study and implement techniques for protecting lives and property from the effects of natural phenomena and to support the International Decade for Natural Disaster Reduction. Volume II contains the proceedings for the Short Course on Seismic Base Isolation held in Berkeley, California, August 10-14, 1992.

Controlled air incinerator for radioactive waste. Volume II. Engineering design references manual

International Nuclear Information System (INIS)

Koenig, R.A.; Draper, W.E.; Newmyer, J.M.; Warner, C.L.

1982-11-01

This two-volume report is a detailed design and operating documentation of the Los Alamos National Laboratory Controlled Air Incinerator (CAI) and is an aid to technology transfer to other Department of Energy contractor sites and the commercial sector. Volume I describes the CAI process, equipment, and performance, and it recommends modifications based on Los Alamos experience. It provides the necessary information for conceptual design and feasibility studies. Volume II provides descriptive engineering information such as drawings, specifications, calculations, and costs. It aids duplication of the process at other facilities

Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center.

Science.gov (United States)

Kim, Min Gyu; Kwon, Sung Joon

2014-05-01

The volume-outcome relationship in laparoscopic surgery is controversial. This study was designed to identify differences in laparoscopic gastrectomy outcomes between a low-volume hospital and a high-volume center and to provide guidelines for overcoming the problems associated with a low-volume hospital. From April 2009 to November 2012, one surgeon performed 134 totally laparoscopic distal gastrectomies (TLDGs) at a high-volume center (HVC; ASAN Medical Center) and at a low-volume hospital (LVH; Hanyang University Guri Hospital). All laparoscopically assisted gastrectomies were excluded from this study. During the early period of laparoscopic gastrectomy at the low-volume hospital, TLDG with Roux-en-Y gastrojejunostomy (RYGJ) was performed according to the surgeon's choice. The reconstruction method was classified as gastroduodenostomy (GD) or RYGJ. Early surgical outcomes achieved at the LVH were investigated and compared with those obtained at the HVC. The early surgical outcomes differed significantly between the two hospitals. In particular, the postoperative complication rate for the patients who underwent TLDG RYGJ at the LVH was higher than at the HVC (LVH 15.4 % vs. HVC 0 %; p = 0.037). Furthermore, significant differences were observed in the mean operation time (TLDG GD: LVH 141.0 min vs. HVC 117.4 min, p = 0.001; TLDG RYGJ: LVH 186.3 min vs. HVC 134.6 min, p = 0.009) and length of hospital stay (TLDG GD: LVH 8.1 days vs. HVC 7.2 days, p = 0.044; TLDG RYGJ: LVH 11.5 day vs. HVC 6.8 day, p = 0.009). Although all the operations were performed by one experienced surgeon, the early surgical outcomes differed significantly between the low- and high-volume hospitals. Low-volume hospitals often lack well-trained surgical professionals such as first assistants and scrub nurses. Therefore, the authors recommend that a surgeon who works at an LVH should assess potential personnel shortages and find a solution before operating.

Predictive value of SAPS II and APACHE II scoring systems for patient outcome in a medical intensive care unit

Directory of Open Access Journals (Sweden)

Amina Godinjak

2016-11-01

Full Text Available Objective. The aim is to determine SAPS II and APACHE II scores in medical intensive care unit (MICU patients, to compare them for prediction of patient outcome, and to compare with actual hospital mortality rates for different subgroups of patients. Methods. One hundred and seventy-four patients were included in this analysis over a oneyear period in the MICU, Clinical Center, University of Sarajevo. The following patient data were obtained: demographics, admission diagnosis, SAPS II, APACHE II scores and final outcome. Results. Out of 174 patients, 70 patients (40.2% died. Mean SAPS II and APACHE II scores in all patients were 48.4±17.0 and 21.6±10.3 respectively, and they were significantly different between survivors and non-survivors. SAPS II >50.5 and APACHE II >27.5 can predict the risk of mortality in these patients. There was no statistically significant difference in the clinical values of SAPS II vs APACHE II (p=0.501. A statistically significant positive correlation was established between the values of SAPS II and APACHE II (r=0.708; p=0.001. Patients with an admission diagnosis of sepsis/septic shock had the highest values of both SAPS II and APACHE II scores, and also the highest hospital mortality rate of 55.1%. Conclusion. Both APACHE II and SAPS II had an excellent ability to discriminate between survivors and non-survivors. There was no significant difference in the clinical values of SAPS II and APACHE II. A positive correlation was established between them. Sepsis/septic shock patients had the highest predicted and observed hospital mortality rate.

Site Environmental Report for 2005 Volume I and Volume II

Energy Technology Data Exchange (ETDEWEB)

Ruggieri, Michael

2006-07-07

Each year, Ernest Orlando Lawrence Berkeley National Laboratory prepares an integrated report on its environmental programs to satisfy the requirements of United States Department of Energy Order 231.1A, ''Environment, Safety, and Health Reporting''. The ''Site Environmental Report for 2005'' summarizes Berkeley Lab's environmental management performance, presents environmental monitoring results, and describes significant programs for calendar year 2005. (Throughout this report, Ernest Orlando Lawrence Berkeley National Laboratory is referred to as ''Berkeley Lab'', ''the Laboratory'', ''Lawrence Berkeley National Laboratory'', and ''LBNL''.) The report is separated into two volumes. Volume I contains an overview of the Laboratory, the status of environmental programs, and summarized results from surveillance and monitoring activities. This year's Volume I text body is organized into an executive summary followed by six chapters. The report's structure has been reorganized this year, and it now includes a chapter devoted to environmental management system topics. Volume II contains individual data results from surveillance and monitoring activities. The ''Site Environmental Report'' is distributed by releasing it on the Web from the Berkeley Lab Environmental Services Group (ESG) home page, which is located at http://www.lbl.gov/ehs/esg/. Many of the documents cited in this report also are accessible from the ESG Web page. CD and printed copies of this Site Environmental Report are available upon request. The report follows the Laboratory's policy of using the International System of Units (SI), also known as the metric system of measurements. Whenever possible, results are also reported using the more conventional (non-SI) system of measurements, because the non-SI system is referenced by several current

S-1 project. Volume II. Hardware. 1979 annual report

Energy Technology Data Exchange (ETDEWEB)

1979-01-01

This volume includes highlights of the design of the Mark IIA uniprocessor (SMI-2), and the SCALD II user's manual. SCALD (structured computer-aided logic design system) cuts the cost and time required to design logic by letting the logic designer express ideas as naturally as possible, and by eliminating as many errors as possible - through consistency checking, simulation, and timing verification - before the hardware is built. (GHT)

Volume overload and adverse outcomes in chronic kidney disease: clinical observational and animal studies.

Science.gov (United States)

Hung, Szu-Chun; Lai, Yi-Shin; Kuo, Ko-Lin; Tarng, Der-Cherng

2015-05-05

Volume overload is frequently encountered and is associated with cardiovascular risk factors in patients with chronic kidney disease (CKD). However, the relationship between volume overload and adverse outcomes in CKD is not fully understood. A prospective cohort of 338 patients with stage 3 to 5 CKD was followed for a median of 2.1 years. The study participants were stratified by the presence or absence of volume overload, defined as an overhydration index assessed by bioimpedance spectroscopy exceeding 7%, the 90th percentile for the healthy population. The primary outcome was the composite of estimated glomerular filtration rate decline ≥50% or end-stage renal disease. The secondary outcome included a composite of morbidity and mortality from cardiovascular causes. Animal models were used to simulate fluid retention observed in human CKD. We found that patients with volume overload were at a higher risk of the primary and secondary end points in the adjusted Cox models. Furthermore, overhydration appears to be more important than hypertension in predicting an elevated risk. In rats subjected to unilateral nephrectomy and a high-salt diet, the extracellular water significantly increased. This fluid retention was associated with an increase in blood pressure, proteinuria, renal inflammation with macrophage infiltration and tumor necrosis factor-α overexpression, glomerular sclerosis, and cardiac fibrosis. Diuretic treatment with indapamide attenuated these changes, suggesting that fluid retention might play a role in the development of adverse outcomes. Volume overload contributes to CKD progression and cardiovascular diseases. Further research is warranted to clarify whether the correction of volume overload would improve outcomes for CKD patients. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

The long-term functional outcome of type II odontoid fractures managed non-operatively.

LENUS (Irish Health Repository)

Butler, J S

2010-10-01

Odontoid fractures currently account for 9-15% of all adult cervical spine fractures, with type II fractures accounting for the majority of these injuries. Despite recent advances in internal fixation techniques, the management of type II fractures still remains controversial with advocates still supporting non-rigid immobilization as the definitive treatment of these injuries. At the NSIU, over an 11-year period between 1 July 1996 and 30 June 2006, 66 patients (n = 66) were treated by external immobilization for type II odontoid fractures. The medical records, radiographs and CT scans of all patients identified were reviewed. Clinical follow-up evaluation was performed using the Cervical Spine Outcomes Questionnaire (CSOQ). The objectives of this study were to evaluate the long-term functional outcome of patients suffering isolated type II odontoid fractures managed non-operatively and to correlate patient age and device type with clinical and functional outcome. Of the 66 patients, there were 42 males and 24 females (M:F = 1.75:1) managed non-operatively for type II odontoid fractures. The mean follow-up time was 66 months. Advancing age was highly correlated with poorer long-term functional outcomes when assessing neck pain (r = 0.19, P = 0.1219), shoulder and arm pain (r = 0.41, P = 0.0007), physical symptoms (r = 0.25, P = 0.472), functional disability (r = 0.24, P = 0.0476) and psychological distress (r = 0.41, P = 0.0007). Patients >65 years displayed a higher rate of pseudoarthrosis (21.43 vs. 1.92%) and established non-union (7.14 vs. 0%) than patients <65 years. The non-operative management of type II odontoid fractures is an effective and satisfactory method of treating type II odontoid fractures, particularly those of a stable nature. However, patients of advancing age have been demonstrated to have significantly poorer functional outcomes in the long term. This may be linked to higher rates of non-union.

Hippocampal volume in relation to clinical and cognitive outcome after electroconvulsive therapy in depression.

Science.gov (United States)

Nordanskog, P; Larsson, M R; Larsson, E-M; Johanson, A

2014-04-01

In a previous magnetic resonance imaging (MRI) study, we found a significant increase in hippocampal volume immediately after electroconvulsive therapy (ECT) in patients with depression. The aim of this study was to evaluate hippocampal volume up to 1 year after ECT and investigate its possible relation to clinical and cognitive outcome. Clinical and cognitive outcome in 12 in-patients with depression receiving antidepressive pharmacological treatment referred for ECT were investigated with the Montgomery-Asberg Depression Rating Scale (MADRS) and a broad neuropsychological test battery within 1 week before and after ECT. The assessments were repeated 6 and 12 months after baseline in 10 and seven of these patients, respectively. Hippocampal volumes were measured on all four occasions with 3 Tesla MRI. Hippocampal volume returned to baseline during the follow-up period of 6 months. Neither the significant antidepressant effect nor the significant transient decrease in executive and verbal episodic memory tests after ECT could be related to changes in hippocampal volume. No persistent cognitive side effects were observed 1 year after ECT. The immediate increase in hippocampal volume after ECT is reversible and is not related to clinical or cognitive outcome. © 2013 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.

The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature

Directory of Open Access Journals (Sweden)

Lau Rick L

2012-12-01

Full Text Available Abstract Background A number of factors have been identified as influencing total knee arthroplasty outcomes, including patient factors such as gender and medical comorbidity, technical factors such as alignment of the prosthesis, and provider factors such as hospital and surgeon procedure volumes. Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of total joint arthroplasty to higher volume centers, and adoption of volume standards. To contribute to the discussions concerning the optimization of provider factors and proposals to regionalize total knee arthroplasty practices, we undertook a systematic review to investigate the association between surgeon volume and primary total knee arthroplasty outcomes. Methods We performed a systematic review examining the association between surgeon volume and primary knee arthroplasty outcomes. To be included in the review, the study population had to include patients undergoing primary total knee arthroplasty. Studies had to report on the association between surgeon volume and primary total knee arthroplasty outcomes, including perioperative mortality and morbidity, patient-reported outcomes, or total knee arthroplasty implant survivorship. There were no restrictions placed on study design or language. Results Studies were variable in defining surgeon volume (‘low’: 5 to >70 total knee arthroplasty per year. Mortality rate, survivorship and thromboembolic events were not found to be associated with surgeon volume. We found a significant association between low surgeon volume and higher rate of infection (0.26% - 2.8% higher, procedure time (165 min versus 135 min, longer length of stay (0.4 - 2.13 days longer, transfusion rate (13% versus 4%, and worse patient reported outcomes. Conclusions Findings suggest a trend towards better outcomes for higher volume surgeons, but results must be interpreted with caution.

Outcomes of Peripheral Endovascular Interventions Based on Hospital Volume: A Mini Review of Published Literature

Directory of Open Access Journals (Sweden)

Samir V Patel

2016-01-01

Full Text Available Previous literature showed hospital procedural volume is an independent predictor for outcomes of various cardiac procedures. However, very few studies shown similar results for peripheral endovascular interventions especially peripheral atherectomy. Here we are reviewing previously published articles to provide volume-outcome relationship for peripheral atherectomy and angioplasty with or without endovascular stenting. We found higher hospital volume significantly and independently lowers in-hospital mortality, amputation rates, peri-procedural complications, length and cost of hospitalization for peripheral endovascular interventions.

Proceedings of the natural gas RD&D contractors review meeting, Volume II

Energy Technology Data Exchange (ETDEWEB)

Malone, R.D. [ed.

1995-04-01

This is volume II of papers which were presented at the natural gas RD&D contractors review meeting. Topics include: natural gas upgrading, storage, well drilling, completion, and stimulation. Individual papers were processed separately for the United States Department of Energy databases.

Subseabed disposal program annual report, January-December 1979. Volume II. Appendices (principal investigator progress reports). Part 1 of 2

International Nuclear Information System (INIS)

Talbert, D.M.

1981-04-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume I, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-O; Part 2 contains Appendices P-FF. Separate abstracts have been prepared of each Appendix for inclusion in the Energy Data Base

Operative volume and outcomes of cerebrovascular neurosurgery in children.

Science.gov (United States)

Bekelis, Kimon; Connolly, Ian D; Do, Huy M; Choudhri, Omar

2016-11-01

OBJECTIVE The impact of procedural volume on the outcomes of cerebrovascular surgery in children has not been determined. In this study, the authors investigated the association of operative volume on the outcomes of cerebrovascular neurosurgery in pediatric patients. METHODS The authors performed a cohort study of all pediatric patients who underwent a cerebrovascular procedure between 2003 and 2012 and were registered in the Kids' Inpatient Database (KID). To control for confounding, the authors used multivariable regression models, propensity-score conditioning, and mixed-effects analysis to account for clustering at the hospital level. RESULTS During the study period, 1875 pediatric patients in the KID underwent cerebrovascular neurosurgery and met the inclusion criteria for the study; 204 patients (10.9%) underwent aneurysm clipping, 446 (23.8%) underwent coil insertion for an aneurysm, 827 (44.1%) underwent craniotomy for arteriovenous malformation resection, and 398 (21.2%) underwent bypass surgery for moyamoya disease. Mixed-effects multivariable regression analysis revealed that higher procedural volume was associated with fewer inpatient deaths (OR 0.58; 95% CI 0.40-0.85), a lower rate of discharges to a facility (OR 0.87; 95% CI 0.82-0.92), and shorter length of stay (adjusted difference -0.22; 95% CI -0.32 to -0.12). The results in propensity-adjusted multivariable models were robust. CONCLUSIONS In a national all-payer cohort of pediatric patients who underwent a cerebrovascular procedure, the authors found that higher procedural volume was associated with fewer deaths, a lower rate of discharges to a facility, and decreased lengths of stay. Regionalization initiatives should include directing children with such rare pathologies to a center of excellence.

Simulation model for wind energy storage systems. Volume II. Operation manual. [SIMWEST code

Energy Technology Data Exchange (ETDEWEB)

Warren, A.W.; Edsinger, R.W.; Burroughs, J.D.

1977-08-01

The effort developed a comprehensive computer program for the modeling of wind energy/storage systems utilizing any combination of five types of storage (pumped hydro, battery, thermal, flywheel and pneumatic). An acronym for the program is SIMWEST (Simulation Model for Wind Energy Storage). The level of detail of SIMWEST is consistent with a role of evaluating the economic feasibility as well as the general performance of wind energy systems. The software package consists of two basic programs and a library of system, environmental, and load components. Volume II, the SIMWEST operation manual, describes the usage of the SIMWEST program, the design of the library components, and a number of simple example simulations intended to familiarize the user with the program's operation. Volume II also contains a listing of each SIMWEST library subroutine.

The history of the IEA volume II: major policies and actions

International Nuclear Information System (INIS)

Scott, R.

1995-01-01

Volume II of the History of the International Energy Agency (IEA) continues the story which began with the Origins and Structure of the Agency in Volume I. After examining the industrial countries'energy policies leading up to the 1973-1974 crisis, the current Volume focuses on the new policies adopted in the IEA during its first twenty years.The first part of this book deals with a section on 'Energy Policy Origins of the 1973-1974 Oil Supply Vulnerability : The Optimistic-Passive Approach to Oil Policy'. The main events and developments leading up to the crisis are briefly outlined together with a short presentation of the policy views and critical conclusions that were made on that situation by some of the most knowledgeable oil specialists of the period. The second part surveys IEA oil security, beginning with the oil Emergency Sharing System. The IAE's long-term policies for reducing its Members'dependence on imported oil are the subject of the third part. In this part is described the development of some of the leading IEA work in the field of energy and the environment, the Agency's far-reaching reviews of Members'policies in this sector and a discussion of the 'free markets' policy and of the IEA Shared Goals of 1993. The fourth part deals with the still longer-term Energy Research and Development in the IEA and is a review of the internal organization of IEA work in the R and D field. The fifth part follows with a discussion of the Oil Market policies and practices of the Agency, where the main and durable goals are 'transparency and information dissemination'. The last part addresses the Agency's policies and actions with respect to Co-operation with Non-Member Countries. Then, it takes up Members'policies and activities in connection with the oil producer and consumer country dialogue of 1976-1977 and outlines its disappointing outcome. (O.L.). 2 figs., 13 tabs

Mechanical Behaviour of Materials Volume II Fracture Mechanics and Damage

CERN Document Server

François, Dominique; Zaoui, André

2013-01-01

Designing new structural materials, extending lifetimes and guarding against fracture in service are among the preoccupations of engineers, and to deal with these they need to have command of the mechanics of material behaviour. This ought to reflect in the training of students. In this respect, the first volume of this work deals with elastic, elastoplastic, elastoviscoplastic and viscoelastic behaviours; this second volume continues with fracture mechanics and damage, and with contact mechanics, friction and wear. As in Volume I, the treatment links the active mechanisms on the microscopic scale and the laws of macroscopic behaviour. Chapter I is an introduction to the various damage phenomena. Chapter II gives the essential of fracture mechanics. Chapter III is devoted to brittle fracture, chapter IV to ductile fracture and chapter V to the brittle-ductile transition. Chapter VI is a survey of fatigue damage. Chapter VII is devoted to hydogen embrittlement and to environment assisted cracking, chapter VIII...

Methodological issues in radiation dose-volume outcome analyses: Summary of a joint AAPM/NIH workshop

International Nuclear Information System (INIS)

Deasy, Joseph O.; Niemierko, Andrzej; Herbert, Donald; Yan, Di; Jackson, Andrew; Ten Haken, Randall K.; Langer, Mark; Sapareto, Steve

2002-01-01

This report represents a summary of presentations at a joint workshop of the National Institutes of Health and the American Association of Physicists in Medicine (AAPM). Current methodological issues in dose-volume modeling are addressed here from several different perspectives. Areas of emphasis include (a) basic modeling issues including the equivalent uniform dose framework and the bootstrap method, (b) issues in the valid use of statistics, including the need for meta-analysis, (c) issues in dealing with organ deformation and its effects on treatment response, (d) evidence for volume effects for rectal complications, (e) the use of volume effect data in liver and lung as a basis for dose escalation studies, and (f) implications of uncertainties in volume effect knowledge on optimized treatment planning. Taken together, these approaches to studying volume effects describe many implications for the development and use of this information in radiation oncology practice. Areas of significant interest for further research include the meta-analysis of clinical data; interinstitutional pooled data analyses of volume effects; analyses of the uncertainties in outcome prediction models, minimal parameter number outcome models for ranking treatment plans (e.g., equivalent uniform dose); incorporation of the effect of motion in the outcome prediction; dose-escalation/isorisk protocols based on outcome models; the use of functional imaging to study radio-response; and the need for further small animal tumor control probability/normal tissue complication probability studies

Tank waste source term inventory validation. Volume II. Letter report

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-04-01

This document comprises Volume II of the Letter Report entitled Tank Waste Source Term Inventory Validation. This volume contains Appendix C, Radionuclide Tables, and Appendix D, Chemical Analyte Tables. The sample data for selection of 11 radionuclides and 24 chemical analytes were extracted from six separate sample data sets, were arranged in a tabular format and were plotted on scatter plots for all of the 149 single-shell tanks, the 24 double-shell tanks and the four aging waste tanks. The solid and liquid sample data was placed in separate tables and plots. The sample data and plots were compiled from the following data sets: characterization raw sample data, recent core samples, D. Braun data base, Wastren (Van Vleet) data base, TRAC and HTCE inventories.

Tank waste source term inventory validation. Volume II. Letter report

International Nuclear Information System (INIS)

1995-04-01

This document comprises Volume II of the Letter Report entitled Tank Waste Source Term Inventory Validation. This volume contains Appendix C, Radionuclide Tables, and Appendix D, Chemical Analyte Tables. The sample data for selection of 11 radionuclides and 24 chemical analytes were extracted from six separate sample data sets, were arranged in a tabular format and were plotted on scatter plots for all of the 149 single-shell tanks, the 24 double-shell tanks and the four aging waste tanks. The solid and liquid sample data was placed in separate tables and plots. The sample data and plots were compiled from the following data sets: characterization raw sample data, recent core samples, D. Braun data base, Wastren (Van Vleet) data base, TRAC and HTCE inventories

Infinite dilution partial molar volumes of platinum(II) 2,4-pentanedionate in supercritical carbon dioxide.

Science.gov (United States)

Kong, Chang Yi; Siratori, Tomoya; Funazukuri, Toshitaka; Wang, Guosheng

2014-10-03

The effects of temperature and density on retention of platinum(II) 2,4-pentanedionate in supercritical fluid chromatography were investigated at temperatures of 308.15-343.15K and pressure range from 8 to 40MPa by the chromatographic impulse response method with curve fitting. The retention factors were utilized to derive the infinite dilution partial molar volumes of platinum(II) 2,4-pentanedionate in supercritical carbon dioxide. The determined partial molar volumes were small and positive at high pressures but exhibited very large and negative values in the highly compressible near critical region of carbon dioxide. Copyright © 2014 Elsevier B.V. All rights reserved.

Three Mile Island: a report to the commissioners and to the public. Volume II, Part 3

International Nuclear Information System (INIS)

1979-01-01

This is the third and final part of the second volume of a study of the Three Mile Island accident. Part 3 of Volume II contains descriptions and assessments of responses to the accident by the utility and by the NRC and other government agencies

Los Alamos Controlled Air Incinerator for radioactive waste. Volume II. Engineering design reference manual

Energy Technology Data Exchange (ETDEWEB)

Koenig, R.A.; Draper, W.E.; Newmyer, J.M.; Warner, C.L.

1982-10-01

This two-volume report is a detailed design and operating documentation of the Los Alamos National Laboratory Controlled Air Incinerator (CAI) and is an aid to technology transfer to other Department of Energy contractor sites and the commercial sector. Volume I describes the CAI process, equipment, and performance, and it recommends modifications based on Los Alamos experience. It provides the necessary information for conceptual design and feasibility studies. Volume II provides descriptive engineering information such as drawings, specifications, calculations, and costs. It aids duplication of the process at other facilities.

Los Alamos Controlled Air Incinerator for radioactive waste. Volume II. Engineering design reference manual

International Nuclear Information System (INIS)

Koenig, R.A.; Draper, W.E.; Newmyer, J.M.; Warner, C.L.

1982-10-01

This two-volume report is a detailed design and operating documentation of the Los Alamos National Laboratory Controlled Air Incinerator (CAI) and is an aid to technology transfer to other Department of Energy contractor sites and the commercial sector. Volume I describes the CAI process, equipment, and performance, and it recommends modifications based on Los Alamos experience. It provides the necessary information for conceptual design and feasibility studies. Volume II provides descriptive engineering information such as drawings, specifications, calculations, and costs. It aids duplication of the process at other facilities

High volume improves outcomes: The argument for centralization of rectal cancer surgery.

Science.gov (United States)

Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Iannuzzi, James C; Kelly, Kristin N; Hensley, Bradley J; Rickles, Aaron S; Noyes, Katia; Fleming, Fergal J; Monson, John R T

2016-03-01

Centralization of care to "centers of excellence" in Europe has led to improved oncologic outcomes; however, little is known regarding the impact of nonmandated regionalization of rectal cancer care in the United States. The Statewide Planning and Research Cooperative System (SPARCS) was queried for elective abdominoperineal and low anterior resections for rectal cancer from 2000 to 2011 in New York with the use of International Classification of Diseases, Ninth Revision codes. Surgeon volume and hospital volume were grouped into quartiles, and high-volume surgeons (≥ 10 resections/year) and hospitals (≥ 25 resections/year) were defined as the top quartile of annual caseload of rectal cancer resection and compared with the bottom 3 quartiles during analyses. Bivariate and multilevel regression analyses were performed to assess factors associated with restorative procedures, 30-day mortality, and temporal trends in these endpoints. Among 7,798 rectal cancer resections, the overall rate of no-restorative proctectomy and 30-day mortality decreased by 7.7% and 1.2%, respectively, from 2000 to 2011. In addition, there was a linear increase in the proportion of cases performed by both high-volume surgeons and high-volume hospitals and a decrease in the number of surgeons and hospitals performing rectal cancer surgery. High-volume surgeons at high-volume hospitals were associated independently with both less nonrestorative proctectomies (odds ratio 0.65, 95% confidence interval 0.48-0.89) and mortality (odds ratio 0.43, 95% confidence interval 0.21-0.87) rates. No patterns of significant improvement within the volume strata of the surgeon and hospitals were observed over time. This study suggests that the current trend toward regionalization of rectal cancer care to high-volume surgeons and high-volume centers has led to improved outcomes. These findings have implications regarding the policy of health care delivery in the United States, supporting referral to high-volume

Kilowatt isotope power system, Phase II Plan. Volume IV. Teledyne FSCD vs GDS

Energy Technology Data Exchange (ETDEWEB)

1978-03-15

This Volume contains Teledyne's input to the Kilowatt Isotope Power System Phase II Plan. Included is a description of the Flight System Heat Generation System, Flight System Radiator, Thermal Insulation Stability, GDS Heat Generation System and GDS Radiator.

Association of Very Low-Volume Practice With Vascular Surgery Outcomes in New York.

Science.gov (United States)

Mao, Jialin; Goodney, Philip; Cronenwett, Jack; Sedrakyan, Art

2017-08-01

Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals. Surgeons who performed 1 or less designated procedure per year on average were considered very low volume, as opposed to higher-volume surgeons. Temporal trends of the existence of very low-volume practice were evaluated. Hierarchical logistic regression was used to compare in-hospital outcomes and health care resource use between patients treated by very low-volume surgeons and higher-volume surgeons for both OAR and CEA, adjusting for patient, surgeon, and hospital characteristics. There were 8781 OAR procedures and 68 896 CEA procedures included in the study. The mean (SD) patient age was 71.7 (8.4) years for OAR and 71.5 (9.1) years for CEA. A total of 614 surgeons performed OAR and 1071 performed CEA in New York during the study period. Of these, 318 (51.8%) and 512 (47.8%), respectively, were very low-volume surgeons. Very low-volume surgeons were less likely to be vascular surgeons. The number and proportion of very low-volume surgeons decreased over years. Compared with patients treated by higher-volume surgeons, those treated by very low-volume surgeons were more likely to have higher in-hospital mortality (odds ratio [OR], 2.09; 95% CI, 1.41-3.08) following OAR and higher risks of postoperative myocardial infarction (OR, 1.83; 95% CI, 1.03-3.26) and stroke (OR, 1.78; 95% CI, 1.21-2.62) following CEA. Patients treated by very low-volume surgeons also had greater health care resource use following both surgeries, including prolonged length of stay (OR, 1.37; 95% CI, 1.11-1.70) following OAR as

Biennial Survey of Education, 1916-18. Volume II. Bulletin, 1919, No. 89

Science.gov (United States)

Bureau of Education, Department of the Interior, 1921

1921-01-01

Volume II of the Biennial Survey of Education, 1916-1918 includes the following chapters: (1) Education in Great Britain and Ireland (I. L. Kandel); (2) Education in parts of the British Empire: Educational Developments in the Dominion of Canada (Walter A. Montgomery), Public School System of Jamaica (Charles A. Asbury), Recent Progress of…

Proceedings of the 1995 U.S. DOE hydrogen program review. Volume II

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

The 1995 US DOE Hydrogen Program Review was held April 18-21, 1995 in Coral Gables, FL. Volume II of the Proceedings contains 8 papers presented under the subject of hydrogen storage and 17 papers presented on hydrogen production. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

Energy extension service pilot program evaluation report: the first year. Volume II: pilot state reports

Energy Technology Data Exchange (ETDEWEB)

1979-09-01

Volume II of the Energy Extension Service Evaluation presents a discussion of the operations of the ten EES pilot-state programs during the period from October 1, 1977 through September 30, 1978. Each of the ten pilot states - Alabama, Connecticut, Michigan, New Mexico, Pennsylvania, Tennessee, Texas, Washington, Wisconsin, and Wyoming - received a grant of approximately $1.1 million to develop and implement a 19-month program beginning on October 1, 1977. Volume II provides a case-study description of the operations of the pilot program in each state, with special attention given to the two programs selected in each state for more detailed study and survey research. Some survey data and analysis are presented for the emphasis programs.

Surgeons’ Volume-Outcome Relationship for Lobectomies and Wedge Resections for Cancer Using Video-Assisted Thoracoscopic Techniques

Directory of Open Access Journals (Sweden)

Guy David

2012-01-01

Full Text Available This study examined the effect of surgeons’ volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures.

Outcome of Mainz II pouch urinary diversion after radical cystectomy ...

African Journals Online (AJOL)

Outcome of Mainz II pouch urinary diversion after radical cystectomy in patients with muscle-invasive bladder cancer: our experience. ... Nine (82%) had a histological diagnosis of transitional cell carcinoma, and two (18%) were squamous cell carcinoma (SCC). Ten (91%) patients had high‑grade disease, whereas only 1 ...

Preliminary feasibility study on storage of radioactive wastes in Columbia River basalts. Volume II

Energy Technology Data Exchange (ETDEWEB)

,

1976-11-01

Volume II comprises four appendices: analytical data and sample locations for basalt flow type localities; Analytical data and sample locations for measured field sections in Yakima basalts; core hole lithology and analytical data; and geophysical logs. (LK)

Proceedings of the advanced coal-fired power systems `95 review meeting, Volume II

Energy Technology Data Exchange (ETDEWEB)

McDaniel, H.M.; Mollot, D.J.; Venkataraman, V.K.

1995-06-01

This report contains papers which were presented at the advanced coal-fired power sytems review meeting. This is volume II. Topics include: hot gas filter issues, hazardous air pollutants, sorbent development, and separation technologies. Individual papers were processed separately for the United States Department of Energy databases.

The impact of surgeon volume on colostomy reversal outcomes after Hartmann's procedure for diverticulitis.

Science.gov (United States)

Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Hensley, Bradley J; Iannuzzi, James C; Noyes, Katia; Monson, John R T; Fleming, Fergal J

2016-11-01

Colostomy reversal after Hartmann's procedure for diverticulitis is a morbid procedure, and studies investigating factors associated with outcomes are lacking. This study identifies patient, surgeon, and hospital-level factors associated with perioperative outcomes after stoma reversal. The Statewide Planning and Research Cooperative System was queried for urgent/emergency Hartmann's procedures for diverticulitis between 2000-2012 in New York State and subsequent colostomy reversal within 1 year of the procedure. Surgeon and hospital volume were categorized into tertiles based on the annual number of colorectal resections performed each year. Bivariate and mixed-effects analyses were used to assess the association between patient, surgeon, and hospital-level factors and perioperative outcomes after colostomy reversal, including a laparoscopic approach; duration of stay; intensive care unit admission; complications; mortality; and 30-day, unscheduled readmission. Among 10,487 patients who underwent Hartmann's procedure and survived to discharge, 63% had the colostomy reversed within 1 year. After controlling for patient, surgeon, and hospital-level factors, high-volume surgeons (≥40 colorectal resections/yr) were independently associated with higher odds of a laparoscopic approach (unadjusted rates: 14% vs 7.6%; adjusted odds ratio = 1.84, 95% confidence interval = 1.12, 3.00), shorter duration of stay (median: 6 versus 7 days; adjusted incidence rate ratio = 0.87, 95% confidence interval = 0.81, 0.95), and lower odds of 90-day mortality (unadjusted rates: 0.4% vs 1.0%; adjusted odds ratio = 0.30, 95% confidence interval = 0.10, 0.88) compared with low-volume surgeons (1-15 colorectal resections/yr). High-volume surgeons are associated with better perioperative outcomes and lower health care utilization after Hartmann's reversal for diverticulitis. These findings support referral to high-volume surgeons for colostomy reversal. Copyright © 2016

Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"?

Science.gov (United States)

Hranjec, Tjasa; Turrentine, Florence E; Stukenborg, George; Young, Jeffrey S; Sawyer, Robert G; Calland, James F

2012-05-01

Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes.

Recommended criteria for the evaluation of on-site nuclear power plant emergency plans, volume II: criteria

International Nuclear Information System (INIS)

1997-01-01

A critical review of existing Canadian and international nuclear power plant (NPP) emergency plans, evaluation criteria, and approaches has been conducted to provide AECB staff with information which can be used to assess the adequacy of NPP on-site emergency response plans. The results of this work are published in two volumes. Volume I, Basis Document, provides the reasons why certain requirements are in place. It also gives comprehensive references to various standards.Volume II, Criteria, contains the criteria which relate to on-site actions and their integration with control room activities and the roles of off-site responsible organizations. The recommended criteria provide information on what is required, and not on how to accomplish the requirements. The licensees are given the latitude to decide on the methods and processes needed to meet the requirements. The documents do not address NPP off-site plans and response capability, or the control room emergency operating procedures and response capability. This report contains only Volume II: Criteria. 55 refs., 2 tabs., 1 fig

Proceedings of the 1984 DOE nuclear reactor and facility safety conference. Volume II

Energy Technology Data Exchange (ETDEWEB)

1984-01-01

This report is a collection of papers on reactor safety. The report takes the form of proceedings from the 1984 DOE Nuclear Reactor and Facility Safety Conference, Volume II of two. These proceedings cover Safety, Accidents, Training, Task/Job Analysis, Robotics and the Engineering Aspects of Man/Safety interfaces.

Proceedings of the 1984 DOE nuclear reactor and facility safety conference. Volume II

International Nuclear Information System (INIS)

1984-01-01

This report is a collection of papers on reactor safety. The report takes the form of proceedings from the 1984 DOE Nuclear Reactor and Facility Safety Conference, Volume II of two. These proceedings cover Safety, Accidents, Training, Task/Job Analysis, Robotics and the Engineering Aspects of Man/Safety interfaces

Hepatic transplantation outcomes for carefully selected cirrhotic patients with hepatocellular carcinoma: experience at a small- to medium-volume centre.

LENUS (Irish Health Repository)

Qasim, A

2012-02-01

BACKGROUND: Hepatic transplantation outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) at a small- to medium-volume centre are not fully known due to relative novelty of patient selection criteria. AIM: To determine hepatic transplantation outcomes for HCC at a small- to medium-volume centre. Patients and methods Hepatocellular carcinoma patients were listed for transplantation according to the International Guideline and further categorized as those fulfilling or exceeding Milan or University of San Francisco (UCSF) criteria on explanted liver morphology. Outcomes including mortality, retransplantation, and tumour recurrence rate were analysed. RESULTS: Twenty-six patients had HCC and on explanted liver morphology, Milan and UCSF criteria met 15 and 18 patients, respectively. Patients and graft survival at 3 months, 1 and 5 years were 100, 96, 84, and 88, 84, 77%, respectively. Outcomes favoured Milan criteria but did not reach statistical significance. CONCLUSIONS: Hepatic transplantation for HCC at a small-to medium-volume transplant centre had comparable survival outcomes to high-volume centres.

ALICE: Physics Performance Report, Volume II

International Nuclear Information System (INIS)

Alessandro, B; Antinori, F; Belikov, J A

2006-01-01

of the subsystem designs, and a description of the offline framework and Monte Carlo event generators. The present volume, Volume II, contains the majority of the information relevant to the physics performance in proton-proton, proton-nucleus, and nucleus-nucleus collisions. Following an introductory overview, Chapter 5 describes the combined detector performance and the event reconstruction procedures, based on detailed simulations of the individual subsystems. Chapter 6 describes the analysis and physics reach for a representative sample of physics observables, from global event characteristics to hard processes

Final report on Phase II remedial action at the former Middlesex Sampling Plant and associated properties. Volume 2

International Nuclear Information System (INIS)

1985-04-01

Volume 2 presents the radiological measurement data taken after remedial action on properties surrounding the former Middlesex Sampling Plant during Phase II of the DOE Middlesex Remedial Action Program. Also included are analyses of the confirmatory radiological survey data for each parcel with respect to the remedial action criteria established by DOE for the Phase II cleanup and a discussion of the final status of each property. Engineering details of this project and a description of the associated health physics and environmental monitoring activities are presented in Volume 1

Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014: A nationwide multicenter study.

Science.gov (United States)

Barba, Carmen; Specchio, Nicola; Guerrini, Renzo; Tassi, Laura; De Masi, Salvatore; Cardinale, Francesco; Pellacani, Simona; De Palma, Luca; Battaglia, Domenica; Tamburrini, Gianpiero; Didato, Giuseppe; Freri, Elena; Consales, Alessandro; Nozza, Paolo; Zamponi, Nelia; Cesaroni, Elisabetta; Di Gennaro, Giancarlo; Esposito, Vincenzo; Giulioni, Marco; Tinuper, Paolo; Colicchio, Gabriella; Rocchi, Raffaele; Rubboli, Guido; Giordano, Flavio; Lo Russo, Giorgio; Marras, Carlo Efisio; Cossu, Massimo

2017-10-01

The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and types of surgical interventions, and etiologies and seizure outcomes in pediatric epilepsy surgery between 2008 and 2014. Retrospective data on 527 surgical procedures were collected. The most frequent surgical approaches were temporal lobe resections and disconnections (133, 25.2%) and extratemporal lesionectomies (128, 24.3%); the most frequent etiologies were FCD II (107, 20.3%) and glioneuronal tumors (105, 19.9%). Volumes of surgeries increased over time independently from the age at surgery and the epilepsy surgery center. Engel class I was achieved in 73.6% of patients (range: 54.8 to 91.7%), with no significant changes between 2008 and 2014. Univariate analyses showed a decrease in the proportion of temporal resections and tumors and an increase in the proportion of FCDII, while multivariate analyses revealed an increase in the proportion of extratemporal surgeries over time. A higher proportion of temporal surgeries and tumors and a lower proportion of extratemporal and multilobar surgeries and of FCD were observed in low (epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Type I-II laryngeal cleft: clinical course and outcome.

Science.gov (United States)

Slonimsky, Guy; Carmel, Eldar; Drendel, Michael; Lipschitz, Noga; Wolf, Michael

2015-04-01

Laryngeal cleft (LC) is a rare congenital anomaly manifesting in a variety of symptoms, including swallowing disorders and aspirations, dyspnea, stridor and hoarseness. The mild forms (types I-II) may be underdiagnosed, leading to protracted symptomatology and morbidity. To evaluate the diagnostic process, clinical course, management and outcome in children with type I-II laryngeal clefts. We conducted a retrospective case analysis for the years 2005-2012 in a tertiary referral center. Seven children were reviewed: five boys and two girls ranging in age from birth to 5 years. The most common presenting symptoms were cough, aspirations and pneumonia. Evaluation procedures included fiber-optic laryngoscopy (FOL), direct laryngoscopy (DL) and videofluoroscopy. Other pathologies were seen in three children. Six children underwent successful endoscopic surgery and one child was treated conservatively. The postoperative clinical course was uneventful in most of the cases. Types I-II LC should be considered in the differential diagnosis of children presenting with protracted cough and aspirations. DL is crucial for establishing the diagnosis. Endoscopic surgery is safe and should be applied promptly when conservative measures fail.

Recovery of Navy distillate fuel from reclaimed product. Volume II. Literature review

Energy Technology Data Exchange (ETDEWEB)

Brinkman, D.W.; Whisman, M.L.

1984-11-01

In an effort to assist the Navy to better utilize its waste hydrocarbons, NIPER, with support from the US Department of Energy, is conducting research designed to ultimately develop a practical technique for converting Reclaimed Product (RP) into specification Naval Distillate Fuel (F-76). This first phase of the project was focused on reviewing the literature and available information from equipment manufacturers. The literature survey has been carefully culled for methodology applicable to the conversion of RP into diesel fuel suitable for Navy use. Based upon the results of this study, a second phase has been developed and outlined in which experiments will be performed to determine the most practical recycling technologies. It is realized that the final selection of one particular technology may be site-specific due to vast differences in RP volume and available facilities. A final phase, if funded, would involve full-scale testing of one of the recommended techniques at a refueling depot. The Phase I investigations are published in two volumes. Volume 1, Technical Discussion, includes the narrative and Appendices I and II. Appendix III, a detailed Literature Review, includes both a narrative portion and an annotated bibliography containing about 800 references and abstracts. This appendix, because of its volume, has been published separately as Volume 2.

Nitric oxide, prostaglandins and angiotensin II in the regulation of renal medullary blood flow during volume expansion.

Science.gov (United States)

Moreno, Carol; Llinás, María T; Rodriguez, Francisca; Moreno, Juan M; Salazar, F Javier

2016-03-01

Regulation of medullary blood flow (MBF) is essential in maintaining renal function and blood pressure. However, it is unknown whether outer MBF (OMBF) and papillary blood flow (PBF) are regulated independently when extracellular volume (ECV) is enhanced. The aim of this study was to determine whether OMBF and PBF are differently regulated and whether there is an interaction between nitric oxide (NO), prostaglandins (PGs) and angiotensin II (Ang II) in regulating OMBF and PBF when ECV is enhanced. To achieve these goals, OMBF and PBF were measured by laser-Doppler in volume-expanded rats treated with a cyclooxygenase inhibitor (meclofenamate, 3 mg/kg) and/or a NO synthesis inhibitor (L-nitro-arginine methyl ester (L-NAME), 3 μg/kg/min) and/or Ang II (10 ng/kg/min). OMBF was unchanged by NO or PGs synthesis inhibition but decreased by 36 % (P blood flows to the outer medulla and renal papilla are differently regulated and showing that there is a complex interaction between NO, PGs and Ang II in regulating OMBF and PBF when ECV is enhanced.

Results of site validation experiments. Volume II. Supporting documents 5 through 14

Energy Technology Data Exchange (ETDEWEB)

1983-01-01

Volume II contains the following supporting documents: Summary of Geologic Mapping of Underground Investigations; Logging of Vertical Coreholes - ''Double Box'' Area and Exploratory Drift; WIPP High Precision Gravity Survey; Basic Data Reports for Drillholes, Brine Content of Facility Internal Strata; Mineralogical Content of Facility Interval Strata; Location and Characterization of Interbedded Materials; Characterization of Aquifers at Shaft Locations; and Permeability of Facility Interval Strate.

Birth outcomes of cases with isolated atrial septal defect type II--a population-based case-control study.

Science.gov (United States)

Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Urbán, Róbert; Czeizel, Andrew E

2013-07-01

In general, epidemiological studies have evaluated cases with congenital cardiovascular abnormalities together. The aim of this study is to describe the birth outcomes of cases with isolated/single atrial septal defect type II (ASD-II, i.e. only a fossa ovalis defect) after surgical correction or lethal outcome in the light of maternal sociodemographic data. Comparison of birth outcomes and maternal characteristics of cases with ASD-II and controls without defect. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities. Hungarian newborn infants with or without ASD-II. Medically recorded birth outcomes, maternal age and birth order were evaluated. Marital and employment status was based on maternal information. The lifestyle factors were analyzed in a subsample of mothers visited at home based on a personal interview with mothers and their close relatives, and the family consensus was accepted. Mean gestational age at delivery and birthweight, rate of preterm birth and low birthweight, maternal age, birth order, marital and employment status. The evaluation of 471 cases with ASD-II and 38,151 controls without any defects showed a female excess in cases with ASD-II, having shorter gestational age and lower mean birthweight, and thus a higher rate of preterm births and low birthweight. Intrauterine growth restriction and shorter gestational age were found in cases with ASD-II, particularly in female children. These factors may have a general developmental process in which there was not closure of the foramen ovale, thus echocardiographic screening of these babies might be of value. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Estimating the cold war mortgage: The 1995 baseline environmental management report. Volume II: Site summaries

International Nuclear Information System (INIS)

1995-03-01

This volume, Volume II presents the site data that was used to generate the Department of Energy's (DOE) initial Baseline Environmental Management Report (BEMR). The raw data was obtained by DOE field personnel from existing information sources and anticipated environmental management strategies for their sites and was tempered by general assumptions and guidance developed by DOE Headquarters personnel. This data was then integrated by DOE Headquarters personnel and modified to ensure that overall constraints such as funding and waste management capacity were addressed. The site summaries are presented by State and broken out by discrete activities and projects. The Volume I Glossary has been repeated to facilitate the reader's review of Volume II. The information presented in the site summaries represents the best data and assumptions available as of February 1, 1995. Assumptions that have not been mandated by formal agreement with appropriate regulators and other stakeholders do not constitute decisions by the Department nor do they supersede existing agreements. In addition, actions requiring decisions from external sources regarding unknowns such as future land use and funding/scheduling alternatives, as well as internal actions such as the Department's Strategic Realignment initiative, will alter the basis and general assumptions used to generate the results for this report. Consequently, the numbers presented in the site summaries do not represent outyear budget requests by the field installations

Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome

International Nuclear Information System (INIS)

Lee, Ching-Chih; Huang, Tze-Ta; Lee, Moon-Sing; Hsiao, Shih-Hsuan; Lin, Hon-Yi; Su, Yu-Chieh; Hsu, Feng-Chun; Hung, Shih-Kai

2010-01-01

Current staging systems have limited ability to adjust optimal therapy in advanced nasopharyngeal carcinoma (NPC). This study aimed to delineate the correlation between tumor volume, treatment outcome and chemotherapy cycles in advanced NPC. A retrospective review of 110 patients with stage III-IV NPC was performed. All patients were treated first with neoadjuvant chemotherapy, then concurrent chemoradiation, and followed by adjuvant chemotherapy as being the definitive therapy. Gross tumor volume of primary tumor plus retropharyngeal nodes (GTVprn) was calculated to be an index of treatment outcome. GTVprn had a close relationship with survival and recurrence in advanced NPC. Large GTVprn (≧13 ml) was associated with a significantly poorer local control, lower distant metastasis-free rate, and poorer survival. In patients with GTVprn ≧ 13 ml, overall survival was better after ≧4 cycles of chemotherapy than after less than 4 cycles. The incorporation of GTVprn can provide more information to adjust treatment strategy

Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States.

Science.gov (United States)

Fanaroff, Alexander C; Zakroysky, Pearl; Dai, David; Wojdyla, Daniel; Sherwood, Matthew W; Roe, Matthew T; Wang, Tracy Y; Peterson, Eric D; Gurm, Hitinder S; Cohen, Mauricio G; Messenger, John C; Rao, Sunil V

2017-06-20

Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. The median annual number of procedures performed per operator was 59; 44% of operators performed PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk

Kilowatt isotope power system. Phase II plan. Volume I. Phase II program plan

International Nuclear Information System (INIS)

1978-01-01

The development of a Kilowatt Isotope Power System (KIPS) was begun in 1975 for the purpose of satisfying the power requirements of satellites in the 1980's. The KIPS is a 238 PuO 2 -fueled organic Rankine cycle turbine power system to provide a design output of 500 to 2000 W. Phase II of the overall 3-phase KIPS program is described. This volume presents a program plan for qualifying the organic Rankine power system for flight test in 1982. The program plan calls for the design and fabrication of the proposed flight power system; conducting a development and a qualification program including both environmental and endurance testing, using an electrical and a radioisotope heat source; planning for flight test and spacecraft integration; and continuing ground demonstration system testing to act as a flight system breadboard and to accumulate life data

The Value of the SYNTAX Score II in Predicting Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation.

Science.gov (United States)

Ryan, Nicola; Nombela-Franco, Luis; Jiménez-Quevedo, Pilar; Biagioni, Corina; Salinas, Pablo; Aldazábal, Andrés; Cerrato, Enrico; Gonzalo, Nieves; Del Trigo, María; Núñez-Gil, Iván; Fernández-Ortiz, Antonio; Macaya, Carlos; Escaned, Javier

2017-11-27

The predictive value of the SYNTAX score (SS) for clinical outcomes after transcatheter aortic valve implantation (TAVI) is very limited and could potentially be improved by the combination of anatomic and clinical variables, the SS-II. We aimed to evaluate the value of the SS-II in predicting outcomes in patients undergoing TAVI. A total of 402 patients with severe symptomatic aortic stenosis undergoing transfemoral TAVI were included. Preprocedural TAVI angiograms were reviewed and the SS-I and SS-II were calculated using the SS algorithms. Patients were stratified in 3 groups according to SS-II tertiles. The coprimary endpoints were all-cause death and major adverse cardiovascular events (MACE), a composite of all-cause death, cerebrovascular event, or myocardial infarction at 1 year. Increased SS-II was associated with higher 30-day mortality (P=.036) and major bleeding (P=.015). The 1-year risk of death and MACE was higher among patients in the 3rd SS-II tertile (HR, 2.60; P=.002 and HR, 2.66; P<.001) and was similar among patients in the 2nd tertile (HR, 1.27; P=.507 and HR, 1.05; P=.895) compared with patients in the 1st tertile. The highest SS-II tertile was an independent predictor of long-term mortality (P=.046) and MACE (P=.001). The SS-II seems more suited to predict clinical outcomes in patients undergoing TAVI than the SS-I. Increased SS-II was associated with poorer clinical outcomes at 1 and 4 years post-TAVI, independently of the presence of coronary artery disease. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Dead layer and active volume determination for GERDA Phase II detectors

Energy Technology Data Exchange (ETDEWEB)

Lehnert, Bjoern [TU Dresden (Germany); Collaboration: GERDA-Collaboration

2013-07-01

The GERDA experiment investigates the neutrinoless double beta decay of {sup 76}Ge and is currently running Phase I of its physics program. Using the same isotope as the Heidelberg Moscow (HDM) experiment, GERDA aims to directly test the claim of observation by a subset of the HDM collaboration. For the update to Phase II of the experiment in 2013, the collaboration organized the production of 30 new Broad Energy Germanium (BEGe) type detectors from original 35 kg enriched material and tested their performance in the low background laboratory HADES in SCK.CEN, Belgium. With additional 20 kg of detectors, GERDA aims to probe the degenerated hierarchy scenario. One of the crucial detector parameters is the active volume (AV) fraction which directly enters into all physics analysis. This talk presents the methodology of dead layer and AV determination with different calibration sources such as {sup 241}Am, {sup 133}Ba, {sup 60}Co and {sup 228}Th and the results obtained for the new Phase II detectors. Furthermore, the AV fraction turned out to be the largest systematic uncertainty in the analysis of Phase I data which makes it imperative to reduce its uncertainty for Phase II. This talk addresses the major contributions to the AV uncertainty and gives an outlook for improvements in Phase II analysis.

Does surgeon volume matter in the outcome of endoscopic inguinal hernia repair?

Science.gov (United States)

Köckerling, F; Bittner, R; Kraft, B; Hukauf, M; Kuthe, A; Schug-Pass, C

2017-02-01

For open and endoscopic inguinal hernia surgery, it has been demonstrated that low-volume surgeons with fewer than 25 and 30 procedures, respectively, per year are associated with significantly more recurrences than high-volume surgeons with 25 and 30 or more procedures, respectively, per year. This paper now explores the relationship between the caseload and the outcome based on the data from the Herniamed Registry. The prospective data of patients in the Herniamed Registry were analyzed using the inclusion criteria minimum age of 16 years, male patient, primary unilateral inguinal hernia, TEP or TAPP techniques and availability of data on 1-year follow-up. In total, 16,290 patients were enrolled between September 1, 2009, and February 1, 2014. Of the participating surgeons, 466 (87.6 %) had carried out fewer than 25 endoscopic/laparoscopic operations (low-volume surgeons) and 66 (12.4 %) surgeons 25 or more operations (high-volume surgeons) per year. Univariable (1.03 vs. 0.73 %; p = 0.047) and multivariable analysis [OR 1.494 (1.065-2.115); p = 0.023] revealed that low-volume surgeons had a significantly higher recurrence rate compared with the high-volume surgeons, although that difference was small. Multivariable analysis also showed that pain on exertion was negatively affected by a lower caseload <25 [OR 1.191 (1.062-1.337); p = 0.003]. While here, too, the difference was small, the fact that in that group there was a greater proportion of patients with small hernia defect sizes may have also played a role since the risk in that group was higher. In this analysis, no evidence was found that pain at rest [OR 1.052 (0.903-1.226); p = 0.516] or chronic pain requiring treatment [OR 1.108 (0.903-1.361); p = 0.326] were influenced by the surgeon volume. As confirmed by previously published studies, the data in the Herniamed Registry also demonstrated that the endoscopic/laparoscopic inguinal hernia surgery caseload impacted the outcome. However

Airborne gamma-ray spectrometer and magnetometer survey: Cameron A, Arizona, detail area. Volume II A. Final report

International Nuclear Information System (INIS)

1983-01-01

Volume II A contains appendices for: stacked profiles; geologic histograms; geochemical histograms; speed and altitude histograms; geologic statistical tables; geochemical statistical tables; magnetic and ancillary profiles; and test line data

Persistent type II endoleak after EVAR: the predictive value of the AAA thrombus volume.

Science.gov (United States)

Gallitto, Enrico; Gargiulo, Mauro; Mascoli, Chiara; Freyrie, Antonio; DE Matteis, Massimo; Serra, Carla; Bianchini Massoni, Claudio; Faggioli, Gianluca; Stella, Andrea

2018-02-01

Persistent type II endoleaks (ELIIp, ≥6 months) after an endovascular aneurysm repair (EVAR) can be associated with adverse outcomes. The aims of this study are the evaluation of the incidence of ELIIp, their preoperative morphological predictive features (PMF) and the post-EVAR abdominal aortic aneurysm (AAA) evolution in the presence of ELIIp. Patients underwent EVAR between 2008 and 2010 were prospectively collected. Cases with ELIIp (group A: AG) were identified. A control group without ELIIp (group B: BG), homogeneous for clinical characteristics, follow-up timing and methods (CTA and/or CEUS at 6.12 months and yearly thereafter) was retrospectively selected. The PMF evaluated by computed-tomography-angiography (CTA) were: AAA-diameter, number and diameter of AAA efferent patent vessels (EPV), AAA-total volume (TV), AAA-thrombus volume (THV) and TV/THV rate (%VR). Volumes were calculated by the dedicated vessels analysis software. AG and BG were compared. The primary endpoint was to evaluate the incidence of ELIIp. Secondary endpoints were to analyze the relation between PMF and ELIIp and to assess the post-EVAR AAA-evolution in the presence of ELIIp. Between 2008 and 2010, 200 patients underwent EVAR to treat AAA electively. An ELIIp was detected in 35cases (17.5%) (AG). Twenty-seven patients (13.5%) were included in BG. An overall of 62 patients (GA+GB) were analyzed. The mean pre-operative AAA diameter and EPV were 58±11.6 mm and 5.5±1.8 mm, respectively. The mean TV and THV were 187±111.5 cc and 82±75 cc, respectively. The median %VR was 42.3%. ELIIp was correlated to EPV≥6 (χ2, p=.015) and %VR AAA growth post-EVAR. ELIIp is a not rare complication and it could require re-interventions. Our data suggest that VEP≥6 or %VT<40% are risk factors for ELIIp. No PMF was able to predict the ELIIp evolution. The relative high rate of re-interventions, could suggest the need of adjunctive/preventing primary procedures in patients at high-risk for ELIIp.

Nuclear legislation analytical study. Regulatory and institutional framework for nuclear activities in OECD member countries. Volume II

International Nuclear Information System (INIS)

1984-01-01

This study is part of a series of analytical studies of the major aspects of nuclear legislation in OECD Member countries and is published in two volumes. This volume II of the study is a revision and an expansion of a 1969 study concerning the organisation and general regime governing nuclear activities. The national studies were prepared, to the extent possible, following a standard plan for all countries to facilitate information retrieval and comparison. This volume also contains tables of international conventions of relevance to the nuclear field. (NEA) [fr

Discourse, Paragraph, and Sentence Structure in Selected Philippine Languages. Final Report. Volume II, Sentence Structure.

Science.gov (United States)

Longacre, Robert E.

Volume II of "Discourse, Paragraph, and Sentence Structure in Selected Philippine Languages" begins with an explanation of certain assumptions and postulates regarding sentence structure. A detailed treatment of systems of sentence structure and the parameters of such systems follows. Data in the various indigenous languages are…

Surgical outcomes of Majewski osteodysplastic primordial dwarfism Type II with intracranial vascular anomalies.

Science.gov (United States)

Teo, Mario; Johnson, Jeremiah N; Bell-Stephens, Teresa E; Marks, Michael P; Do, Huy M; Dodd, Robert L; Bober, Michael B; Steinberg, Gary K

2016-12-01

OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical revascularization or aneurysm-clipping cases have been reported because of the diminutive arteries and narrow surgical corridors in these patients. Here, the authors report on a large series of patients with MOPD II who underwent surgery for an intracranial vascular anomaly. METHODS In conjunction with an approved prospective registry of patients with MOPD II, a prospectively collected institutional surgical database of children with MOPD II and intracranial vascular anomalies who underwent surgery was analyzed retrospectively to establish long-term outcomes. RESULTS Ten patients with MOPD II underwent surgery between 2005 and 2012; 5 patients had moyamoya disease (MMD), 2 had intracranial aneurysms, and 3 had both MMD and aneurysms. Patients presented with transient ischemic attack (TIA) (n = 2), ischemic stroke (n = 2), intraparenchymal hemorrhage from MMD (n = 1), and aneurysmal subarachnoid hemorrhage (n = 1), and 4 were diagnosed on screening. The mean age of the 8 patients with MMD, all of whom underwent extracranial-intracranial revascularization (14 indirect, 1 direct) was 9 years (range 1-17 years). The mean age of the 5 patients with aneurysms was 15.5 years (range 9-18 years). Two patients experienced postoperative complications (1 transient weakness after clipping, 1 femoral thrombosis that required surgical repair). During a mean follow-up of 5.9 years (range 3-10 years), 3 patients died (1 of subarachnoid hemorrhage, 1 of myocardial infarct, and 1 of respiratory failure), and 1 patient had continued TIAs. All of the surviving patients recovered to their neurological baseline. CONCLUSIONS Patients with MMD

OUTCOME OF GARTLAND TYPE – II SUPRACONDYLAR FRACTURES OF HUMERUS TREATED BY CONSERVATIVE METHOD

Directory of Open Access Journals (Sweden)

Dinesh Mitra

2015-08-01

Full Text Available BACKGROUND: The current literatures recommend operative method (closed reduction and pinning for type II supracondylar fractures of humerus. But some surgeons still prefer conservative method for type II supracondylar fractures of humerus. We pr esent results of 14 cases of type II supracondylar fractures treated with CR and AE POP immobilization . The purpose of this study is to evaluate the outcome of conservative treatment in management of type II supracondylar fracture of humerus. MATERIALS AND METHODS: Fourteen children treated by conservative methods (CR & AE POP between January 2013 and December 2014 is included in this study. The mean age group is 6.8 years (3 years - 11 years. The patient follow up is done for a minimum of 10 - 12 weeks. Treatment outcome is based on final clinical and radiological assessments and grading of results was done using Flynn’s criteria. RESULTS: Gartland type II fracture gives 82% excellent results and 28 % good results as per Flynn’s criteria. Of the 14 patien ts only two cases required re manipulation. Surgical intervention was not needed for any of the patients. No patients in this study developed compartment syndrome / cubitus varus deformity. CONCLUSION: Satisfactory results can be obtained with conservative treatment (closed reduction and above elbow POP if proper selection of the patient and careful clinical and radiological follow up is done

Impact of Medicaid Expansion on Cardiac Surgery Volume and Outcomes.

Science.gov (United States)

Charles, Eric J; Johnston, Lily E; Herbert, Morley A; Mehaffey, J Hunter; Yount, Kenan W; Likosky, Donald S; Theurer, Patricia F; Fonner, Clifford E; Rich, Jeffrey B; Speir, Alan M; Ailawadi, Gorav; Prager, Richard L; Kron, Irving L

2017-10-01

Thirty-one states approved Medicaid expansion after implementation of the Affordable Care Act. The objective of this study was to evaluate the effect of Medicaid expansion on cardiac surgery volume and outcomes comparing one state that expanded to one that did not. Data from the Virginia (nonexpansion state) Cardiac Services Quality Initiative and the Michigan (expanded Medicaid, April 2014) Society of Thoracic and Cardiovascular Surgeons Quality Collaborative were analyzed to identify uninsured and Medicaid patients undergoing coronary bypass graft or valve operations, or both. Demographics, operative details, predicted risk scores, and morbidity and mortality rates, stratified by state and compared across era (preexpansion: 18 months before vs postexpansion: 18 months after), were analyzed. In Virginia, there were no differences in volume between eras, whereas in Michigan, there was a significant increase in Medicaid volume (54.4% [558 of 1,026] vs 84.1% [954 of 1,135], p Medicaid patients, there were no differences in predicted risk of morbidity or mortality or postoperative major morbidities. In Michigan Medicaid patients, a significant decrease in predicted risk of morbidity or mortality (11.9% [8.1% to 20.0%] vs 11.1% [7.7% to 17.9%], p = 0.02) and morbidities (18.3% [102 of 558] vs 13.2% [126 of 954], p = 0.008) was identified. Postexpansion was associated with a decreased risk-adjusted rate of major morbidity (odds ratio, 0.69; 95% confidence interval, 0.51 to 0.91; p = 0.01) in Michigan Medicaid patients. Medicaid expansion was associated with fewer uninsured cardiac surgery patients and improved predicted risk scores and morbidity rates. In addition to improving health care financing, Medicaid expansion may positively affect patient care and outcomes. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Successful Pregnancy Outcome In Maternal Crigler Najjar Syndrome Type II

Directory of Open Access Journals (Sweden)

Shakuntala PN

2012-10-01

Full Text Available Estimated incidence of Crigler-Najjar syndrome(CNS is 1 case per 1,000,000 births(1 million. The overall prevalence of CN syndrome is unknown, with only several hundred people reported to have this disease. It is interestingly very rare to encounter a pregnant adult women with congenital jaundice. Pregnancy in CN type II patients is a diagnostic and a therapeutic challenge because of the high risk of bilirubin encephalopathy with serious neurological damage as life-threatening complications for the fetus. To date 8 pregnancy outcome have been reported from 5 women and we report the6 woman with a successful 9 th pregnancy outcome. We have discussed detail history, presentation and management during pregnancy and care of the new born.

Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome

International Nuclear Information System (INIS)

Yi, Chin A; Na, Dong Gyu; Ryoo, Jae Wook; Moon, Chan Hong; Byun, Hong Sik; Roh, Hong Gee; Moon, Won Jin; Lee, Kwang Ho; Lee, Soo Joo

2002-01-01

To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy. Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores. Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R2=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R2=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p≤0.007). CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome

Comparative assessment of TRU waste forms and processes. Volume II. Waste form data, process descriptions, and costs

International Nuclear Information System (INIS)

Ross, W.A.; Lokken, R.O.; May, R.P.; Roberts, F.P.; Thornhill, R.E.; Timmerman, C.L.; Treat, R.L.; Westsik, J.H. Jr.

1982-09-01

This volume contains supporting information for the comparative assessment of the transuranic waste forms and processes summarized in Volume I. Detailed data on the characterization of the waste forms selected for the assessment, process descriptions, and cost information are provided. The purpose of this volume is to provide additional information that may be useful when using the data in Volume I and to provide greater detail on particular waste forms and processes. Volume II is divided into two sections and two appendixes. The first section provides information on the preparation of the waste form specimens used in this study and additional characterization data in support of that in Volume I. The second section includes detailed process descriptions for the eight processes evaluated. Appendix A lists the results of MCC-1 leach test and Appendix B lists additional cost data. 56 figures, 12 tables

The Oxford History of English Lexicography. Volume I: General ...

African Journals Online (AJOL)

A.P. Cowie (Editor). The Oxford History of English Lexicography. Volume I: General-purpose Dictionaries. Volume II: Specialized Dictionaries. 2009. Volume I: xviii + 467 pp., Volume II: xix + 551 pp. ISBN Volume I–II: 978-0-19-928562-4. Volume I: 978-0-19-928560-0. Volume II: 978-0-19-928561-7. Oxford: Oxford University ...

World Energy Data System (WENDS). Volume II. Country data, CZ-KS

Energy Technology Data Exchange (ETDEWEB)

None

1979-06-01

The World Energy Data System contains organized data on those countries and international organizations that may have critical impact on the world energy scene. Included in this volume, Vol. II, are Czechoslovakia, Denmark, Egypt, Finland, France, Germany (East), Germany (West), Greece, Guinea, India, Indonesia, Iran, Italy, Japan, and Korea (South). The following topics are covered for most of the countries: economic, demographic, and educational profiles; energy policy; indigenous energy resources and uses; forecasts, demand, exports, imports of energy supplies; environmental considerations of energy use; power production facilities; energy industries; commercial applications of energy; research and development activities of energy; and international activities.

Forecasting the Future Food Service World of Work. Final Report. Volume II. Centralized Food Service Systems. Service Management Reports.

Science.gov (United States)

Powers, Thomas F., Ed.; Swinton, John R., Ed.

Volume II of a three-volume study on the future of the food service industry considers the effects that centralized food production will have on the future of food production systems. Based on information from the Fair Acres Project and the Michigan State University Vegetable Processing Center, the authors describe the operations of a centralized…

Predictors of favorable soft tissue profile outcomes following Class II Twin-block treatment.

Science.gov (United States)

Kim, Ji-Eun; Mah, Su-Jung; Kim, Tae-Woo; Kim, Su-Jung; Park, Ki-Ho; Kang, Yoon-Goo

2018-01-01

The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. An independent t -test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment.

Airborne gamma-ray spectrometer and magnetometer survey: Monument Valley B, Utah, detail area. Volume II A. Final report

International Nuclear Information System (INIS)

1983-01-01

Volume II A contains appendices for: stacked profiles; geologic histograms; geochemical histograms; speed and altitude histograms; geologic statistical tables; geochemical statistical tables; magnetic and ancillary profiles; and test line data

Airborne gamma-ray spectrometer and magnetometer survey: Monument Valley B, Utah, detail area. Volume II B. Final report

International Nuclear Information System (INIS)

1983-01-01

Volume II B contains appendices for: flight line maps; geology maps; explanation of geologic legend; flight line/geology maps; radiometric contour maps; magnetic contour maps; and geochemical factor analysis maps

Complex-wide review of DOE's Low-Level Waste Management ES ampersand H vulnerabilities. Volume II. Final report

International Nuclear Information System (INIS)

1996-05-01

Volume I of this report presents a summary of DOE's complex-wide review of its low-level waste management system, including the assessment scope and methodology, site-specific and complex-wide vulnerabilities, and DOE's conclusions and recommendations. Volume II presents a more detailed discussion of the assessment methodology and evaluation instruments developed by the Assessment Working Group for identifying site-specific vulnerabilities, categorizing and classifying vulnerabilities, and identifying and analyzing complex-wide vulnerabilities. Attachments A and B of this volume contain, respectively, the Site Evaluation Survey and the Vulnerability Assessment Form used in those processes. Volume III contains the site-specific assessment reports for the 36 sites (38 facilities) assessed in the complex-wide review from which the complex-wide vulnerabilities were drawn

Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears.

Science.gov (United States)

Yoon, Jong Pil; Seo, Anna; Kim, Jeong Jun; Lee, Chang-Hwa; Baek, Seung-Hun; Kim, Shin Yoon; Jeong, Eun Taek; Oh, Kyung-Soo; Chung, Seok Won

2017-01-01

We aimed to estimate the interrelation between preoperative deltoid muscle status by measuring the 3-dimensional deltoid muscle volume and postoperative functional outcomes after reverse total shoulder arthroplasty(RTSA). Thirty-five patients who underwent RTSA participated in this study. All patients underwent preoperative magnetic resonance imaging(MRI) as well as pre- and postoperative radiography and various functional outcome evaluations at least 1 year. The primary outcome parameter was set as age- and sex-matched Constant scores. The 3-dimensional deltoid muscle model was generated using a medical image processing software and in-house code, and the deltoid muscle volume was calculated automatically. Various clinical and radiographic factors comprising the deltoid muscle volume adjusted for body mass index(BMI) were analyzed, and their interrelation with the outcome parameters was appraised using a multivariate analysis. As a result, all practical consequences considerably improved following surgery(all pmuscle volume adjusted for BMI(p = 0.009), absence of a subscapularis complete tear (p = 0.040), and greater change in acromion-deltoid tuberosity distance(p = 0.013) were associated with higher matched Constant scores. Multivariate analysis indicated that the deltoid muscle volume was the single independent prognostic factor for practical consequences(p = 0.011). In conclusion, the preoperative deltoid muscle volume significantly affected the functional outcome following RTSA in patients with cuff tear arthropathy or irreparable cuff tears. Therefore, more attention should be paid to patients with severe atrophied deltoid muscle who are at a high risk for poor practical consequences subsequent to RTSA.

Dutch surgeons' views on the volume-outcome mechanism in surgery: A qualitative interview study

NARCIS (Netherlands)

Mesman, R.; Faber, M.J.; Westert, G.P.; Berden, H.

2017-01-01

Objective: To contribute to a better understanding of volume-outcome relationships in surgery by exploring Dutch surgeons' views on the underlying mechanism. Design: A qualitative study based on face-to-face semi structured interviews and an inductive content analysis approach. Setting: Interviews

Orthodontic Class II:1 treatment-efficiency and outcome quality of Herbst-multibracket appliance therapy.

Science.gov (United States)

Bock, N; Ruehl, J; Ruf, S

2017-12-08

The aim of this retrospective investigation was to assess the efficiency and outcome quality of Class II:1 treatment (Tx). The investigation is based on the evaluation of all Class II:1 patients that ever (1986-2014) started Tx with a Herbst appliance and subsequently a multibracket appliance (MBA) at the study center. Study casts from before Tx, after Herbst-MBA Tx, and (if available) after ≥ 24 months of retention were evaluated using the Peer Assessment Rating (PAR) index, the Ahlgren scale, and standard occlusal variables. In total, 526 Class II:1 patients with a mean pre-Tx age of 14.4 years (range 9.8-44.4) had received Herbst-MBA Tx; 18 patients discontinued Tx before completion. For 240 patients, data from ≥ 24 months of retention were available. The pre-Tx PAR score of 32.4 ± 8.83 was reduced to 8.0 ± 4.51 during Tx. A slight increase to 8.8 ± 5.11 occurred during retention. The percentage of patients which could be assigned to the category "greatly improved" was 62% after Tx and 57% after retention; only 2-3% had to be assigned to the category "worse/no different." The outcome ratings according to the Ahlgren scale revealed 17% excellent, 35% good, 45% satisfactory, and 3% unsuccessful results. Class II:1 Tx using Herbst-MBA is an efficient approach in orthodontic care. During a mean active Tx period of 2 years, high-quality results can be obtained in the majority of patients. The present investigation is the first to investigate a large unselected cohort of consecutive Herbst-MBA patients to determine representative data on the efficiency and the outcome quality of this Tx approach.

Personal, societal, and ecological values of wilderness: Sixth World Wilderness Congress proceedings on research, management, and allocation, Volume II

Science.gov (United States)

Alan E. Watson; Greg H. Aplet; John C. Hendee

2000-01-01

The papers contained in Volume II of these Proceedings represent a combination of papers originally scheduled for the delayed 1997 meeting of the World Wilderness Congress and those submitted in response to a second call for papers when the Congress was rescheduled for October 24-29, 1998, in Bangalore, India. Just as in Volume I, the papers are divided into seven...

ARPA-E Impacts: A Sampling of Project Outcomes, Volume II

Energy Technology Data Exchange (ETDEWEB)

Rohlfing, Eric [Dept. of Energy (DOE), Washington DC (United States). Advanced Research Projects Agency-Energy (ARPA-E)

2017-02-27

The Advanced Research Projects Agency-Energy (ARPA-E) is demonstrating that a collaborative model has the power to deliver real value. The Agency’s first compilation booklet of impact sheets, published in 2016, began to tell the story of how ARPA-E has already made an impact in just seven years—funding a diverse and sophisticated research portfolio on advanced energy technologies that enable the United States to tackle our most pressing energy challenges. One year later our research investments continue to pay off, with a number of current and alumni project teams successfully commercializing their technologies and advancing the state of the art in transformative areas of energy science and engineering. There is no single measure that can fully illustrate ARPA-E’s success to date, but several statistics viewed collectively begin to reveal the Agency’s impact. Since 2009, ARPA-E has provided more than $1.5 billion in funding for 36 focused programs and three open funding solicitations, totaling over 580 projects. Of those, 263 are now alumni projects. Many teams have successfully leveraged ARPA-E’s investment: 56 have formed new companies, 68 have partnered with other government agencies to continue their technology development, and 74 teams have together raised more than $1.8 billion in reported funding from the private sector to bring their technologies to market. However, even when viewed together, those measures do not capture ARPA-E’s full impact. To best understand the Agency’s success, the specific scientific and engineering challenges that ARPA-E project teams have overcome must be understood. This booklet provides concrete examples of those successes, ranging from innovations that will bear fruit in the future to ones that are beginning to penetrate the market as products today. Importantly, half of the projects highlighted in this volume stem from OPEN solicitations, which the agency has run in 2009, 2012, and 2015. ARPA-E’s OPEN programs

Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children

International Nuclear Information System (INIS)

Lind, Annika; Parkkola, Riitta; Lehtonen, Liisa; Maunu, Jonna; Lapinleimu, Helena; Munck, Petriina; Haataja, Leena

2011-01-01

Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children. (orig.)

Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children

Energy Technology Data Exchange (ETDEWEB)

Lind, Annika [Turku University Hospital, Department of Pediatrics, Turku (Finland); Aabo Akademi University, Department of Psychology, Turku (Finland); Parkkola, Riitta [University of Turku and Turku University Hospital, Department of Radiology and Turku PET Center, PO Box 52, Turku (Finland); Lehtonen, Liisa; Maunu, Jonna; Lapinleimu, Helena [University of Turku and Turku University Hospital, Department of Pediatrics, Turku (Finland); Munck, Petriina [Turku University Hospital, Department of Pediatrics, Turku (Finland); University of Turku, Department of Psychology, Turku (Finland); Haataja, Leena [University of Turku and Turku University Hospital, Department of Pediatric Neurology, Turku (Finland)

2011-08-15

Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children. (orig.)

Airborne gamma-ray spectrometer and magnetometer survey: Monument Valley A, Utah, detail area. Volume II B. Final report

International Nuclear Information System (INIS)

1983-01-01

Volume II B contains appendices for: flight line maps; geology maps; explanation of geologic legend; flight line/geology maps; radiometric contour maps; magnetic contour maps; multi-variant analysis maps; and geochemical factor analysis maps

Cranial Tumor Surgical Outcomes at a High-Volume Academic Referral Center.

Science.gov (United States)

Brown, Desmond A; Himes, Benjamin T; Major, Brittny T; Mundell, Benjamin F; Kumar, Ravi; Kall, Bruce; Meyer, Fredric B; Link, Michael J; Pollock, Bruce E; Atkinson, John D; Van Gompel, Jamie J; Marsh, W Richard; Lanzino, Giuseppe; Bydon, Mohamad; Parney, Ian F

2018-01-01

To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal. Complications were categorized as neurologic, medical, wound, mortality, or none and compared for patients managed by a chief resident vs a consultant neurosurgeon. A total of 6277 neurosurgical procedures for intracranial neoplasms were performed. After excluding radiosurgical procedures and pediatric patients, 4151 adult patients who underwent 4423 procedures were available for analysis. Complications were infrequent, with overall rates of 9.8% (435 of 4423 procedures), 1.7% (73 of 4423), and 1.4% (63 of 4423) for neurologic, medical, and wound complications, respectively. The rate of perioperative mortality was 0.3% (14 of 4423 procedures). Case performance and management by a chief resident did not negatively impact outcome. In our large-volume brain tumor practice, rates of complications were low, and management of cases by chief residents in a semiautonomous manner did not negatively impact surgical outcomes. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

International Nuclear Information System (INIS)

Protto, Sara; Pienimäki, Juha-Pekka; Seppänen, Janne; Numminen, Heikki; Sillanpää, Niko

2017-01-01

BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

Energy Technology Data Exchange (ETDEWEB)

Protto, Sara, E-mail: sara.protto@pshp.fi; Pienimäki, Juha-Pekka; Seppänen, Janne [Tampere University Hospital, Medical Imaging Center (Finland); Numminen, Heikki [Tampere University Hospital, Department of Neurology (Finland); Sillanpää, Niko [Tampere University Hospital, Medical Imaging Center (Finland)

2017-04-15

BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

Surgical outcomes in two different age groups with Focal Cortical Dysplasia type II: Any real difference?

Science.gov (United States)

Ramírez-Molina, Jorge Luis; Di Giacomo, Roberta; Mariani, Valeria; Deleo, Francesco; Cardinale, Francesco; Uscátegui-Daccarett, Angélica María; Lorenzana, Pablo; Tassi, Laura

2017-05-01

Focal Cortical Dysplasias (FCDs) represent a common architectural cortical disorder underlying drug-resistant focal epilepsy. So far, studies aimed at evaluating whether age at surgery is a factor influencing surgical outcome are lacking, so that data on the comparison between patients harboring Type II FCD operated at younger age and those operated at adult age are still scarce. We compared presurgical clinical features and surgical outcomes of patients with histopathologically diagnosed Type II FCD undergoing surgery at an earlier age with those operated after 20 years of age. We retrospectively analyzed 1660 consecutive patients operated at the "Claudio Munari" Epilepsy Surgery Centre. There were 289 patients (17.4%) with a neuropathological diagnosis of Type II FCD. We included two different groups of patients, the first one including patients operated on at less than 6years, the second sharing the same seizure onset age but with delayed surgery, carried out after the age of 20. Seizure characteristics and, neuropsychological and postoperative seizure outcomes were evaluated by study group. Forty patients underwent surgery before the age of 6 and 66 patients after the age of 20. Surgical outcome was favorable in the whole population (72.6% were classified in Engel's Class Ia+Ic), independently from age at surgery. In the children group, 32 patients were classified in Class I, including 30 (75%) children in classes Ia and Ic. In the adult group, 53 belonged to Class I of whom 47 (71%) were in classes Ia and Ic. The percentage of permanent complications, the surgical outcomes, and AED withdrawal did not significantly differ by study group. Our results indicate that there is no difference between the groups, suggesting that outcome depends mainly on the histological findings and not on timing of surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Role of percent peripheral tissue ablated on refractive outcomes following hyperopic LASIK

Science.gov (United States)

Stapleton, Fiona; Versace, Patrick

2017-01-01

Objectives To determine the effect of hyperopic laser in situ keratomileusis (H-LASIK) on corneal integrity, by investigating relationships between proportionate corneal tissue ablated and refractive outcomes at 3 months. Methods 18 eyes of 18 subjects treated with H-LASIK by Technolas 217c Excimer Laser were included in the study. Orbscan II Topography System was used to determine corneal volume and pachymetry 3mm temporally (3T). The volume of corneal tissue ablated was determined from the laser nomogram. Univariate associations between age, treatment, corneal volume, overall proportion of tissue removed, proportion of tissue removed at 3T, residual bed thickness at 3T and refractive outcomes 3 months post-LASIK were examined and independent factors associated with refractive outcomes determined using linear regression models. Results At 3 months post-LASIK, the mean difference to expected refractive outcome was -0.20 ± 0.64 (Range -2.00 to +1.00). In univariate analysis, difference to expected refractive outcome was associated with proportion of tissue removed at 3T (PLASIK, may present as either over or under-corrected at 3 months. The proportion of tissue removed at 3T was the single significant determinant of this outcome, suggesting unexpected biomechanical alterations resulting in corneal steepening. Future hyperopic LASIK procedures could consider proportionate volume of corneal tissue removed at 3T in addition to laser nomograms to achieve improved refractive outcomes. PMID:28151939

Association of time-to-surgery with outcomes in clinical stage I-II pancreatic adenocarcinoma treated with upfront surgery.

Science.gov (United States)

Swords, Douglas S; Zhang, Chong; Presson, Angela P; Firpo, Matthew A; Mulvihill, Sean J; Scaife, Courtney L

2018-04-01

Time-to-surgery from cancer diagnosis has increased in the United States. We aimed to determine the association between time-to-surgery and oncologic outcomes in patients with resectable pancreatic ductal adenocarcinoma undergoing upfront surgery. The 2004-2012 National Cancer Database was reviewed for patients undergoing curative-intent surgery without neoadjuvant therapy for clinical stage I-II pancreatic ductal adenocarcinoma. A multivariable Cox model with restricted cubic splines was used to define time-to-surgery as short (1-14 days), medium (15-42), and long (43-120). Overall survival was examined using Cox shared frailty models. Secondary outcomes were examined using mixed-effects logistic regression models. Of 16,763 patients, time-to-surgery was short in 34.4%, medium in 51.6%, and long in 14.0%. More short time-to-surgery patients were young, privately insured, healthy, and treated at low-volume hospitals. Adjusted hazards of mortality were lower for medium (hazard ratio 0.94, 95% confidence interval, .90, 0.97) and long time-to-surgery (hazard ratio 0.91, 95% confidence interval, 0.86, 0.96) than short. There were no differences in adjusted odds of node positivity, clinical to pathologic upstaging, being unresectable or stage IV at exploration, and positive margins. Medium time-to-surgery patients had higher adjusted odds (odds ratio 1.11, 95% confidence interval, 1.03, 1.20) of receiving an adequate lymphadenectomy than short. Ninety-day mortality was lower in medium (odds ratio 0.75, 95% confidence interval, 0.65, 0.85) and long time-to-surgery (odds ratio 0.72, 95% confidence interval, 0.60, 0.88) than short. In this observational analysis, short time-to-surgery was associated with slightly shorter OS and higher perioperative mortality. These results may suggest that delays for medical optimization and referral to high volume surgeons are safe. Published by Elsevier Inc.

SLIM-MAUD: an approach to assessing human error probabilities using structured expert judgment. Volume II. Detailed analysis of the technical issues

International Nuclear Information System (INIS)

Embrey, D.E.; Humphreys, P.; Rosa, E.A.; Kirwan, B.; Rea, K.

1984-07-01

This two-volume report presents the procedures and analyses performed in developing an approach for structuring expert judgments to estimate human error probabilities. Volume I presents an overview of work performed in developing the approach: SLIM-MAUD (Success Likelihood Index Methodology, implemented through the use of an interactive computer program called MAUD-Multi-Attribute Utility Decomposition). Volume II provides a more detailed analysis of the technical issues underlying the approach

Solid Waste Operations Complex W-113, Detail Design Report (Title II). Volume 3: Specifications

International Nuclear Information System (INIS)

1995-09-01

The Solid Waste Retrieval Facility--Phase 1 (Project W113) will provide the infrastructure and the facility required to retrieve from Trench 04, Burial ground 4C, contact handled (CH) drums and boxes at a rate that supports all retrieved TRU waste batching, treatment, storage, and disposal plans. This includes (1) operations related equipment and facilities, viz., a weather enclosure for the trench, retrieval equipment, weighing, venting, obtaining gas samples, overpacking, NDE, NDA, shipment of waste and (2) operations support related facilities, viz., a general office building, a retrieval staff change facility, and infrastructure upgrades such as supply and routing of water, sewer, electrical power, fire protection, roads, and telecommunication. Title I design for the operations related equipment and facilities was performed by Raytheon/BNFL, and that for the operations support related facilities including infrastructure upgrade was performed by KEH. These two scopes were combined into an integrated W113 Title II scope that was performed by Raytheon/BNFL. Volume 3 is a compilation of the construction specifications that will constitute the Title II materials and performance specifications. This volume contains CSI specifications for non-equipment related construction material type items, performance type items, and facility mechanical equipment items. Data sheets are provided, as necessary, which specify the equipment overall design parameters

Solid Waste Operations Complex W-113, Detail Design Report (Title II). Volume 3: Specifications

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

The Solid Waste Retrieval Facility--Phase 1 (Project W113) will provide the infrastructure and the facility required to retrieve from Trench 04, Burial ground 4C, contact handled (CH) drums and boxes at a rate that supports all retrieved TRU waste batching, treatment, storage, and disposal plans. This includes (1) operations related equipment and facilities, viz., a weather enclosure for the trench, retrieval equipment, weighing, venting, obtaining gas samples, overpacking, NDE, NDA, shipment of waste and (2) operations support related facilities, viz., a general office building, a retrieval staff change facility, and infrastructure upgrades such as supply and routing of water, sewer, electrical power, fire protection, roads, and telecommunication. Title I design for the operations related equipment and facilities was performed by Raytheon/BNFL, and that for the operations support related facilities including infrastructure upgrade was performed by KEH. These two scopes were combined into an integrated W113 Title II scope that was performed by Raytheon/BNFL. Volume 3 is a compilation of the construction specifications that will constitute the Title II materials and performance specifications. This volume contains CSI specifications for non-equipment related construction material type items, performance type items, and facility mechanical equipment items. Data sheets are provided, as necessary, which specify the equipment overall design parameters.

Treatment outcome of bimaxillary surgery for asymmetric skeletal class II deformity.

Science.gov (United States)

Chen, Yun-Fang; Liao, Yu-Fang; Chen, Yin-An; Chen, Yu-Ray

2018-05-04

Facial asymmetry is one of the main concerns in patients with a dentofacial deformity. The aims of the study were to (1) evaluate the changes in facial asymmetry after bimaxillary surgery for asymmetric skeletal class II deformity and (2) compare preoperative and postoperative facial asymmetry of class II patients with normal controls. The facial asymmetry was assessed for 30 adults (21 women and 9 men, mean age: 29.3 years) who consecutively underwent bimaxillary surgery for asymmetric skeletal class II deformity using cone-beam computed tomography before and at least 6 months after surgery. Thirty soft tissue and two dental landmarks were identified on each three-dimensional facial image, and the asymmetry index of each landmark was calculated. Results were compared with those of 30 normal control subjects (21 women and 9 men, mean age: 26.2 years) with skeletal class I structure. Six months after surgery, the asymmetric index of the lower face and total face decreased significantly (17.8 ± 29.4 and 16.6 ± 29.5 mm, respectively, both p class II patients had residual chin asymmetry. The postoperative total face asymmetric index was positively correlated with the preoperative asymmetric index (r = 0.37, p class II deformity resulted in a significant improvement in lower face asymmetry. However, approximately 50% of the patients still had residual chin asymmetry. The total face postoperative asymmetry was moderately related to the initial severity of asymmetry. These findings could help clinicians better understand orthognathic outcomes on different facial regions for patients with asymmetric class II deformity.

White Matter Volume Predicts Language Development in Congenital Heart Disease.

Science.gov (United States)

Rollins, Caitlin K; Asaro, Lisa A; Akhondi-Asl, Alireza; Kussman, Barry D; Rivkin, Michael J; Bellinger, David C; Warfield, Simon K; Wypij, David; Newburger, Jane W; Soul, Janet S

2017-02-01

To determine whether brain volume is reduced at 1 year of age and whether these volumes are associated with neurodevelopment in biventricular congenital heart disease (CHD) repaired in infancy. Infants with biventricular CHD (n = 48) underwent brain magnetic resonance imaging (MRI) and neurodevelopmental testing with the Bayley Scales of Infant Development-II and the MacArthur-Bates Communicative Development Inventories at 1 year of age. A multitemplate based probabilistic segmentation algorithm was applied to volumetric MRI data. We compared volumes with those of 13 healthy control infants of comparable ages. In the group with CHD, we measured Spearman correlations between neurodevelopmental outcomes and the residuals from linear regression of the volumes on corrected chronological age at MRI and sex. Compared with controls, infants with CHD had reductions of 54 mL in total brain (P = .009), 40 mL in cerebral white matter (P Development-II scores but did correlate positively with MacArthur-Bates Communicative Development Inventory language development. Infants with biventricular CHD show total brain volume reductions at 1 year of age, driven by differences in cerebral white matter. White matter volume correlates with language development, but not broader developmental indices. These findings suggest that abnormalities in white matter development detected months after corrective heart surgery may contribute to language impairment. ClinicalTrials.gov: NCT00006183. Copyright © 2016 Elsevier Inc. All rights reserved.

Outcomes of endovascular interventions for TASC II B and C femoropopliteal lesions.

Science.gov (United States)

Baril, Donald T; Marone, Luke K; Kim, Justine; Go, Michael R; Chaer, Rabih A; Rhee, Robert Y

2008-09-01

To evaluate outcomes of endovascular interventions on femoropopliteal occlusive disease and determine predictors of restenosis of Trans Atlantic Inter-Societal Consensus (TASC) II B and C lesions. All patients undergoing endovascular interventions for femoropopliteal occlusive disease between May 2003 and July 2007 were reviewed. Patient demographics, pre- and post-procedure ankle-brachial indices (ABI), and anatomic factors (including categorization by TASC II classification, lesion length, and runoff vessel status) were analyzed. Outcomes evaluated included freedom from restenoses, freedom from re-intervention, overall patency, and assisted-patency. A total of 237 total limbs were treated during the period reviewed. The study group included 108 TASC B and 32 TASC C limbs in 125 patients (mean age 73.1 +/- 10.4 years, male sex: 59%). Seventy-one percent of patients were Rutherford classification 2/3 while the remaining 29% were Rutherford classification 4/5. Mean follow-up period was 12.7 months (range, 1-52 m). Forty-one (41) limbs experienced restenosis or occlusion at a mean time of 8 months (range, 1-24 m). Freedom from restenosis/occlusion was 58.9% at 12 months and 47.9% at 24 months. Predictors of restenosis included a preoperative ABI <0.5 (hazard ratio [HR] 3.05, 95% confidence interval [CI] 1.36-6.86, P = .007) and hypercholesterolemia (HR 2.42, 95% CI 1.11-5.25, P = .025). Lesion length as a continuous variable (per centimeter) also correlated with a higher risk of restenosis (HR 1.06, 95% CI 1.00-1.12, P = .057). The overall assisted-primary and secondary-patency rates were 87% and 94% respectively at 3 years with no significant differences between TASC B and TASC C limbs. Endovascular interventions for TASC II B and C lesions are associated with restenosis/occlusion rates that are at least as good as those of open femoropopliteal bypass surgery from historical, previously published series. Furthermore, overall assisted-patency rates are excellent

Three Mile Island: a report to the commissioners and to the public. Volume II, Part 1

International Nuclear Information System (INIS)

1979-01-01

This is part one of three parts of the second volume of the Special Inquiry Group's report to the Nuclear Regulatory Commission on the accident at Three Mile Island. The first volume contained a narrative description of the accident and a discussion of the major conclusions and recommendations. This second volume is divided into three parts. Part 1 of Volume II focuses on the pre-accident licensing and regulatory background. This part includes an examination of the overall licensing and regulatory system for nuclear powerplants viewed from different perspectives: the system as it is set forth in statutes and regulations, as described in Congressional testimony, and an overview of the system as it really works. In addition, Part 1 includes the licensing, operating, and inspection history of Three Mile Island Unit 2, discussions of relevant regulatory matters, a discussion of specific precursor events related to the accident, a case study of the pressurizer design issue, and an analysis of incentives to declare commercial operation

Field Operations and Enforcement Manual for Air Pollution Control. Volume II: Control Technology and General Source Inspection.

Science.gov (United States)

Weisburd, Melvin I.

The Field Operations and Enforcement Manual for Air Pollution Control, Volume II, explains in detail the following: technology of source control, modification of operations, particulate control equipment, sulfur dioxide removal systems for power plants, and control equipment for gases and vapors; inspection procedures for general sources, fuel…

Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears.

Directory of Open Access Journals (Sweden)

Jong Pil Yoon

Full Text Available We aimed to estimate the interrelation between preoperative deltoid muscle status by measuring the 3-dimensional deltoid muscle volume and postoperative functional outcomes after reverse total shoulder arthroplasty(RTSA. Thirty-five patients who underwent RTSA participated in this study. All patients underwent preoperative magnetic resonance imaging(MRI as well as pre- and postoperative radiography and various functional outcome evaluations at least 1 year. The primary outcome parameter was set as age- and sex-matched Constant scores. The 3-dimensional deltoid muscle model was generated using a medical image processing software and in-house code, and the deltoid muscle volume was calculated automatically. Various clinical and radiographic factors comprising the deltoid muscle volume adjusted for body mass index(BMI were analyzed, and their interrelation with the outcome parameters was appraised using a multivariate analysis. As a result, all practical consequences considerably improved following surgery(all p<0.01. Overall, 20 and 15 indicated a higher and a lower practical consequence than the average, respectively, which was assessed by the matched Constant scores. The deltoid muscle volume adjusted for BMI(p = 0.009, absence of a subscapularis complete tear (p = 0.040, and greater change in acromion-deltoid tuberosity distance(p = 0.013 were associated with higher matched Constant scores. Multivariate analysis indicated that the deltoid muscle volume was the single independent prognostic factor for practical consequences(p = 0.011. In conclusion, the preoperative deltoid muscle volume significantly affected the functional outcome following RTSA in patients with cuff tear arthropathy or irreparable cuff tears. Therefore, more attention should be paid to patients with severe atrophied deltoid muscle who are at a high risk for poor practical consequences subsequent to RTSA.

Method of tumor volume evaluation using magnetic resonance imaging for outcome prediction in cervical cancer treated with concurrent chemotherapy and radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Kim, Hun Jung; Kim, Woo Chul [Inha University Hospital, Inha University School of Medicine, Seoul (Korea, Republic of)

2012-06-15

To evaluate the patterns of tumor shape and to compare tumor volume derived from simple diameter-based ellipsoid measurement with that derived from tracing the entire tumor contour using region of interest (ROI)-based 3D volumetry with respect to the prediction outcome in cervical cancer patients treated with concurrent chemotherapy and radiotherapy. Magnetic resonance imaging was performed in 98 patients with cervical cancer (stage IB-IIIB). The tumor shape was classified into two categories: ellipsoid and non-ellipsoid shape. ROI-based volumetry was derived from each magnetic resonance slice on the work station. For the diameter-based surrogate 'ellipsoid volume,' the three orthogonal diameters were measured to calculate volume as an ellipsoid. The more than half of tumor (55.1%) had a non-ellipsoid configuration. The predictions for outcome were consistent between two volume groups, with overall survival of 93.6% and 87.7% for small tumor (<20 mL), 62.9% and 69.1% for intermediate-size tumor (20-39 mL), and 14.5% and 16.7% for large tumors ({>=}40 mL) using ROI and diameter based measurement, respectively. Disease-free survival was 93.8% and 90.6% for small tumor, 54.3% and 62.7% for intermediate-size tumor, and 13.7% and 10.3% for large tumor using ROI and diameter based method, respectively. Differences in outcome between size groups were statistically significant, and the differences in outcome predicted by the tumor volume by two different methods. Our data suggested that large numbers of cervical cancers are not ellipsoid. However, simple diameter-based tumor volume measurement appears to be useful in comparison with ROI-based volumetry for predicting outcome in cervical cancer patients.

Method of tumor volume evaluation using magnetic resonance imaging for outcome prediction in cervical cancer treated with concurrent chemotherapy and radiotherapy

International Nuclear Information System (INIS)

Kim, Hun Jung; Kim, Woo Chul

2012-01-01

To evaluate the patterns of tumor shape and to compare tumor volume derived from simple diameter-based ellipsoid measurement with that derived from tracing the entire tumor contour using region of interest (ROI)-based 3D volumetry with respect to the prediction outcome in cervical cancer patients treated with concurrent chemotherapy and radiotherapy. Magnetic resonance imaging was performed in 98 patients with cervical cancer (stage IB-IIIB). The tumor shape was classified into two categories: ellipsoid and non-ellipsoid shape. ROI-based volumetry was derived from each magnetic resonance slice on the work station. For the diameter-based surrogate 'ellipsoid volume,' the three orthogonal diameters were measured to calculate volume as an ellipsoid. The more than half of tumor (55.1%) had a non-ellipsoid configuration. The predictions for outcome were consistent between two volume groups, with overall survival of 93.6% and 87.7% for small tumor (<20 mL), 62.9% and 69.1% for intermediate-size tumor (20-39 mL), and 14.5% and 16.7% for large tumors (≥40 mL) using ROI and diameter based measurement, respectively. Disease-free survival was 93.8% and 90.6% for small tumor, 54.3% and 62.7% for intermediate-size tumor, and 13.7% and 10.3% for large tumor using ROI and diameter based method, respectively. Differences in outcome between size groups were statistically significant, and the differences in outcome predicted by the tumor volume by two different methods. Our data suggested that large numbers of cervical cancers are not ellipsoid. However, simple diameter-based tumor volume measurement appears to be useful in comparison with ROI-based volumetry for predicting outcome in cervical cancer patients.

Increasing volume and complexity of pediatric epilepsy surgery with stable seizure outcome between 2008 and 2014

DEFF Research Database (Denmark)

Barba, Carmen; Specchio, Nicola; Guerrini, Renzo

2017-01-01

Objective The objective of the study was to assess common practice in pediatric epilepsy surgery in Italy between 2008 and 2014. Methods A survey was conducted among nine Italian epilepsy surgery centers to collect information on presurgical and postsurgical evaluation protocols, volumes and type...... and facilities. Significance This survey reveals an increase in volume and complexity of pediatric epilepsy surgery in Italy between 2008 and 2014, associated with a stable seizure outcome....

Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children.

Science.gov (United States)

Lind, Annika; Parkkola, Riitta; Lehtonen, Liisa; Munck, Petriina; Maunu, Jonna; Lapinleimu, Helena; Haataja, Leena

2011-08-01

Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children.

Co-registered perfusion SPECT/CT: Utility for prediction of improved postoperative outcome in lung volume reduction surgery candidates

International Nuclear Information System (INIS)

Takenaka, Daisuke; Ohno, Yoshiharu; Koyama, Hisanobu; Nogami, Munenobu; Onishi, Yumiko; Matsumoto, Keiko; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro

2010-01-01

Purpose: To directly compare the capabilities of perfusion scan, SPECT, co-registered SPECT/CT, and quantitatively and qualitatively assessed MDCT (i.e. quantitative CT and qualitative CT) for predicting postoperative clinical outcome for lung volume reduction surgery (LVRS) candidates. Materials and methods: Twenty-five consecutive candidates (19 men and six women, age range: 42-72 years) for LVRS underwent preoperative CT and perfusion scan with SPECT. Clinical outcome of LVRS for all subjects was also assessed by determining the difference between pre- and postoperative forced expiratory volume in 1 s (FEV 1 ) and 6-min walking distance (6MWD). All SPECT examinations were performed on a SPECT scanner, and co-registered to thin-section CT by using commercially available software. On planar imaging, SPECT and SPECT/CT, upper versus lower zone or lobe ratios (U/Ls) were calculated from regional uptakes between upper and lower lung fields in the operated lung. On quantitatively assessed CT, U/L for all subjects was assessed from regional functional lung volumes. On qualitatively assessed CT, planar imaging, SPECT and co-registered SPECT/CT, U/Ls were assessed with a 4-point visual scoring system. To compare capabilities of predicting clinical outcome, each U/L was statistically correlated with the corresponding clinical outcome. Results: Significantly fair or moderate correlations were observed between quantitatively and qualitatively assessed U/Ls obtained with all four methods and clinical outcomes (-0.60 ≤ r ≤ -0.42, p < 0.05). Conclusion: Co-registered perfusion SPECT/CT has better correlation with clinical outcome in LVRS candidates than do planar imaging, SPECT or qualitatively assessed CT, and is at least as valid as quantitatively assessed CT.

Co-registered perfusion SPECT/CT: Utility for prediction of improved postoperative outcome in lung volume reduction surgery candidates

Energy Technology Data Exchange (ETDEWEB)

Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.j [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Division of Image-Based Medicine, Institute of Biomedical Research and Innovation, 2-2, Minatojima Minamimachi Chuo-ku, Kobe, Hyogo, 650-0047 (Japan); Onishi, Yumiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Matsumoto, Keiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Department of Radiology, University of Yamanashi, 1110 Shimogato, Chuo, Yamanashi, 409-3898 (Japan); Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan)

2010-06-15

Purpose: To directly compare the capabilities of perfusion scan, SPECT, co-registered SPECT/CT, and quantitatively and qualitatively assessed MDCT (i.e. quantitative CT and qualitative CT) for predicting postoperative clinical outcome for lung volume reduction surgery (LVRS) candidates. Materials and methods: Twenty-five consecutive candidates (19 men and six women, age range: 42-72 years) for LVRS underwent preoperative CT and perfusion scan with SPECT. Clinical outcome of LVRS for all subjects was also assessed by determining the difference between pre- and postoperative forced expiratory volume in 1 s (FEV{sub 1}) and 6-min walking distance (6MWD). All SPECT examinations were performed on a SPECT scanner, and co-registered to thin-section CT by using commercially available software. On planar imaging, SPECT and SPECT/CT, upper versus lower zone or lobe ratios (U/Ls) were calculated from regional uptakes between upper and lower lung fields in the operated lung. On quantitatively assessed CT, U/L for all subjects was assessed from regional functional lung volumes. On qualitatively assessed CT, planar imaging, SPECT and co-registered SPECT/CT, U/Ls were assessed with a 4-point visual scoring system. To compare capabilities of predicting clinical outcome, each U/L was statistically correlated with the corresponding clinical outcome. Results: Significantly fair or moderate correlations were observed between quantitatively and qualitatively assessed U/Ls obtained with all four methods and clinical outcomes (-0.60 {<=} r {<=} -0.42, p < 0.05). Conclusion: Co-registered perfusion SPECT/CT has better correlation with clinical outcome in LVRS candidates than do planar imaging, SPECT or qualitatively assessed CT, and is at least as valid as quantitatively assessed CT.

Method and timing of tumor volume measurement for outcome prediction in cervical cancer using magnetic resonance imaging

International Nuclear Information System (INIS)

Mayr, Nina A.; Taoka, Toshiaki; Yuh, William T.C.; Denning, Leah M.; Zhen, Weining K.; Paulino, Arnold C.; Gaston, Robert C.; Sorosky, Joel I.; Meeks, Sanford L.; Walker, Joan L.; Mannel, Robert S.; Buatti, John M.

2002-01-01

Purpose: Recently, imaging-based tumor volume before, during, and after radiation therapy (RT) has been shown to predict tumor response in cervical cancer. However, the effectiveness of different methods and timing of imaging-based tumor size assessment have not been investigated. The purpose of this study was to compare the predictive value for treatment outcome derived from simple diameter-based ellipsoid tumor volume measurement using orthogonal diameters (with ellipsoid computation) with that derived from more complex contour tracing/region-of-interest (ROI) analysis 3D tumor volumetry. Methods and Materials: Serial magnetic resonance imaging (MRI) examinations were prospectively performed in 60 patients with advanced cervical cancer (Stages IB 2 -IVB/recurrent) at the start of RT, during early RT (20-25 Gy), mid-RT (45-50 Gy), and at follow-up (1-2 months after RT completion). ROI-based volumetry was derived by tracing the entire tumor region in each MR slice on the computer work station. For the diameter-based surrogate ''ellipsoid volume,'' the three orthogonal diameters (d 1 , d 2 , d 3 ) were measured on film hard copies to calculate volume as an ellipsoid (d 1 x d 2 x d 3 x π/6). Serial tumor volumes and regression rates determined by each method were correlated with local control, disease-free and overall survival, and the results were compared between the two measuring methods. Median post-therapy follow-up was 4.9 years (range, 2.0-8.2 years). Results: The best method and time point of tumor size measurement for the prediction of outcome was the tumor regression rate in the mid-therapy MRI examination (at 45-50 Gy) using 3D ROI volumetry. For the pre-RT measurement both the diameter-based method and ROI volumetry provided similar predictive accuracy, particularly for patients with small ( 3 ) and large (≥100 cm 3 ) pre-RT tumor size. However, the pre-RT tumor size measured by either method had much less predictive value for the intermediate-size (40

ICPP calcined solids storage facility closure study. Volume II: Cost estimates, planning schedules, yearly cost flowcharts, and life-cycle cost estimates

International Nuclear Information System (INIS)

1998-02-01

This document contains Volume II of the Closure Study for the Idaho Chemical Processing Plant Calcined Solids Storage Facility. This volume contains draft information on cost estimates, planning schedules, yearly cost flowcharts, and life-cycle costs for the four options described in Volume I: (1) Risk-Based Clean Closure; NRC Class C fill, (2) Risk-Based Clean Closure; Clean fill, (3) Closure to landfill Standards; NRC Class C fill, and (4) Closure to Landfill Standards; Clean fill

ICPP calcined solids storage facility closure study. Volume II: Cost estimates, planning schedules, yearly cost flowcharts, and life-cycle cost estimates

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-02-01

This document contains Volume II of the Closure Study for the Idaho Chemical Processing Plant Calcined Solids Storage Facility. This volume contains draft information on cost estimates, planning schedules, yearly cost flowcharts, and life-cycle costs for the four options described in Volume I: (1) Risk-Based Clean Closure; NRC Class C fill, (2) Risk-Based Clean Closure; Clean fill, (3) Closure to landfill Standards; NRC Class C fill, and (4) Closure to Landfill Standards; Clean fill.

Sodium fast reactor safety and licensing research plan - Volume II

International Nuclear Information System (INIS)

Ludewig, H.; Powers, D.A.; Hewson, John C.; LaChance, Jeffrey L.; Wright, A.; Phillips, J.; Zeyen, R.; Clement, B.; Garner, Frank; Walters, Leon; Wright, Steve; Ott, Larry J.; Suo-Anttila, Ahti Jorma; Denning, Richard; Ohshima, Hiroyuki; Ohno, S.; Miyhara, S.; Yacout, Abdellatif; Farmer, M.; Wade, D.; Grandy, C.; Schmidt, R.; Cahalen, J.; Olivier, Tara Jean; Budnitz, R.; Tobita, Yoshiharu; Serre, Frederic; Natesan, Ken; Carbajo, Juan J.; Jeong, Hae-Yong; Wigeland, Roald; Corradini, Michael; Thomas, Justin; Wei, Tom; Sofu, Tanju; Flanagan, George F.; Bari, R.; Porter D.

2012-01-01

Expert panels comprised of subject matter experts identified at the U.S. National Laboratories (SNL, ANL, INL, ORNL, LBL, and BNL), universities (University of Wisconsin and Ohio State University), international agencies (IRSN, CEA, JAEA, KAERI, and JRC-IE) and private consultation companies (Radiation Effects Consulting) were assembled to perform a gap analysis for sodium fast reactor licensing. Expert-opinion elicitation was performed to qualitatively assess the current state of sodium fast reactor technologies. Five independent gap analyses were performed resulting in the following topical reports: (1) Accident Initiators and Sequences (i.e., Initiators/Sequences Technology Gap Analysis), (2) Sodium Technology Phenomena (i.e., Advanced Burner Reactor Sodium Technology Gap Analysis), (3) Fuels and Materials (i.e., Sodium Fast Reactor Fuels and Materials: Research Needs), (4) Source Term Characterization (i.e., Advanced Sodium Fast Reactor Accident Source Terms: Research Needs), and (5) Computer Codes and Models (i.e., Sodium Fast Reactor Gaps Analysis of Computer Codes and Models for Accident Analysis and Reactor Safety). Volume II of the Sodium Research Plan consolidates the five gap analysis reports produced by each expert panel, wherein the importance of the identified phenomena and necessities of further experimental research and code development were addressed. The findings from these five reports comprised the basis for the analysis in Sodium Fast Reactor Research Plan Volume I.

Sodium fast reactor safety and licensing research plan. Volume II.

Energy Technology Data Exchange (ETDEWEB)

Ludewig, H. (Brokhaven National Laboratory, Upton, NY); Powers, D. A.; Hewson, John C.; LaChance, Jeffrey L.; Wright, A. (Argonne National Laboratory, Argonne, IL); Phillips, J.; Zeyen, R. (Institute for Energy Petten, Saint-Paul-lez-Durance, France); Clement, B. (IRSN/DPAM.SEMIC Bt 702, Saint-Paul-lez-Durance, France); Garner, Frank (Radiation Effects Consulting, Richland, WA); Walters, Leon (Advanced Reactor Concepts, Los Alamos, NM); Wright, Steve; Ott, Larry J. (Oak Ridge National Laboratory, Oak Ridge, TN); Suo-Anttila, Ahti Jorma; Denning, Richard (Ohio State University, Columbus, OH); Ohshima, Hiroyuki (Japan Atomic Energy Agency, Ibaraki, Japan); Ohno, S. (Japan Atomic Energy Agency, Ibaraki, Japan); Miyhara, S. (Japan Atomic Energy Agency, Ibaraki, Japan); Yacout, Abdellatif (Argonne National Laboratory, Argonne, IL); Farmer, M. (Argonne National Laboratory, Argonne, IL); Wade, D. (Argonne National Laboratory, Argonne, IL); Grandy, C. (Argonne National Laboratory, Argonne, IL); Schmidt, R.; Cahalen, J. (Argonne National Laboratory, Argonne, IL); Olivier, Tara Jean; Budnitz, R. (Lawrence Berkeley National Laboratory, Berkeley, CA); Tobita, Yoshiharu (Japan Atomic Energy Agency, Ibaraki, Japan); Serre, Frederic (Centre d' %C3%94etudes nucl%C3%94eaires de Cadarache, Cea, France); Natesan, Ken (Argonne National Laboratory, Argonne, IL); Carbajo, Juan J. (Oak Ridge National Laboratory, Oak Ridge, TN); Jeong, Hae-Yong (Korea Atomic Energy Research Institute, Daejeon, Korea); Wigeland, Roald (Idaho National Laboratory, Idaho Falls, ID); Corradini, Michael (University of Wisconsin-Madison, Madison, WI); Thomas, Justin (Argonne National Laboratory, Argonne, IL); Wei, Tom (Argonne National Laboratory, Argonne, IL); Sofu, Tanju (Argonne National Laboratory, Argonne, IL); Flanagan, George F. (Oak Ridge National Laboratory, Oak Ridge, TN); Bari, R. (Brokhaven National Laboratory, Upton, NY); Porter D. (Idaho National Laboratory, Idaho Falls, ID); Lambert, J. (Argonne National Laboratory, Argonne, IL); Hayes, S. (Idaho National Laboratory, Idaho Falls, ID); Sackett, J. (Idaho National Laboratory, Idaho Falls, ID); Denman, Matthew R.

2012-05-01

Expert panels comprised of subject matter experts identified at the U.S. National Laboratories (SNL, ANL, INL, ORNL, LBL, and BNL), universities (University of Wisconsin and Ohio State University), international agencies (IRSN, CEA, JAEA, KAERI, and JRC-IE) and private consultation companies (Radiation Effects Consulting) were assembled to perform a gap analysis for sodium fast reactor licensing. Expert-opinion elicitation was performed to qualitatively assess the current state of sodium fast reactor technologies. Five independent gap analyses were performed resulting in the following topical reports: (1) Accident Initiators and Sequences (i.e., Initiators/Sequences Technology Gap Analysis), (2) Sodium Technology Phenomena (i.e., Advanced Burner Reactor Sodium Technology Gap Analysis), (3) Fuels and Materials (i.e., Sodium Fast Reactor Fuels and Materials: Research Needs), (4) Source Term Characterization (i.e., Advanced Sodium Fast Reactor Accident Source Terms: Research Needs), and (5) Computer Codes and Models (i.e., Sodium Fast Reactor Gaps Analysis of Computer Codes and Models for Accident Analysis and Reactor Safety). Volume II of the Sodium Research Plan consolidates the five gap analysis reports produced by each expert panel, wherein the importance of the identified phenomena and necessities of further experimental research and code development were addressed. The findings from these five reports comprised the basis for the analysis in Sodium Fast Reactor Research Plan Volume I.

Ocean Thermal Energy Converstion (OTEC) test facilities study program. Final report. Volume II. Part B

Energy Technology Data Exchange (ETDEWEB)

None

1977-01-17

Results are presented of an 8-month study to develop alternative non-site-specific OTEC facilities/platform requirements for an integrated OTEC test program which may include land and floating test facilities. Volume II--Appendixes is bound in three parts (A, B, and C) which together comprise a compendium of the most significant detailed data developed during the study. Part B provides an annotated test list and describes component tests and system tests.

Structure-volume relationships: singular volume effects produced by cupric ion-globular protein interaction.

Science.gov (United States)

Katz, S; Shinaberry, G; Heck, E L; Squire, W

1980-08-05

The nature of the volume isotherms produced by the coordination of Cu(II) with ovalbumin and bovine serum albumin differs substantially from the adsorption isotherms produced by these systems. Whereas there was increased binding of Cu(II) associated with a pH increase from pH 5.3 to pH 7.4, the volume isotherms for these systems did not exhibit this type of pH dependence. The volume changes were determined at 30.0 +/- 0.001 degrees C with microdilatometers which could be read to 0.01 muL. The binding isotherms for ovalbumin at pH 5.3 and 7.4 and for bovine serum albumin at pH 5.3 was resolved by a Scatchard plot to yield the appropriate thermodynamic parameters. An algorithm was derived to calculate the distribution of the individual PMi complexes, i.e., PMi-1 + M in equilibrium (Ki) PMi where i equals 1, 2, 3, ..., n moles of cation, M, bound per mole of protein, P, for the above systems. The volume isotherms were then resolved in terms of the constituent delta Vi terms, i.e., the volume change produced by the formation of the individual PMi complexes. These values were verified by an independent graphical differentiation procedure. The coordination of Cu(II) to BSA at pH 7.4 produced a cooperative adsorption isotherm which was not amenable to a Scatchard analysis. The resultant anomalous volume isotherm was resolved into a component related to Cu(II)-site interaction and a negative volume effect attributable to a conformational change induced by complex formation. This structural transition which occurs at physiological pH may constitute a control mechanism for regulating the serum level of Cu(II) and possibly other divalent ions.

Fukushima Daiichi Unit 1 Uncertainty Analysis-Exploration of Core Melt Progression Uncertain Parameters-Volume II.

Energy Technology Data Exchange (ETDEWEB)

Denman, Matthew R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brooks, Dusty Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-08-01

Sandia National Laboratories (SNL) has conducted an uncertainty analysi s (UA) on the Fukushima Daiichi unit (1F1) accident progression wit h the MELCOR code. Volume I of the 1F1 UA discusses the physical modeling details and time history results of the UA. Volume II of the 1F1 UA discusses the statistical viewpoint. The model used was developed for a previous accident reconstruction investigation jointly sponsored by the US Department of Energy (DOE) and Nuclear Regulatory Commission (NRC). The goal of this work was to perform a focused evaluation of uncertainty in core damage progression behavior and its effect on key figures - of - merit (e.g., hydrogen production, fraction of intact fuel, vessel lower head failure) and in doing so assess the applicability of traditional sensitivity analysis techniques .

Reforming Agricultural Trade for Developing Countries : Volume 1. Key Issues for a Pro-Development Outcome of the Doha Round

OpenAIRE

McCalla, Alex F.; Nash, John

2007-01-01

Reforming agricultural trade for developing countries is a two-volume set. The first volume is subtitled Key issues for a pro- development outcome of the Doha Round, and it is focused on specific concerns that are being encountered in the agricultural negotiations, and on strategies for dealing with them to arrive at a final agreement that will significantly spur growth and reduce poverty in developing countries. The companion volume is subtitled Quantifying the impact of multilateral trade r...

The clinical-familial correlates and naturalistic outcome of panic-disorder-agoraphobia with and without lifetime bipolar II comorbidity

Directory of Open Access Journals (Sweden)

Toni Cristina

2008-11-01

Full Text Available Abstract Background Much of the literature on panic disorder (PD-bipolar disorder (BP cormorbidity concerns BP-I. This literature emphasizes the difficulties encountered in pharmacologic treatment and outcome when such comorbidity is present. The present report explores these issues with respect to BP-II. Methods The sample comprised 326 outpatients (aged 34.5 ± 11.5 years old; 222 females with Diagnostic and Statistical Manual of Mental Disorders 3rd edn, revised (DSM-III-R PD-agoraphobia; among them 52 subjects (16% were affected by lifetime comorbidity with BP-II. Patients were evaluated by means of the Structured Clinical Interview for DSM-IV (SCID, the Panic-Agoraphobia Interview, and the Longitudinal Interview Follow-up Examination (Life-Up and treated according to routine clinical practice at the University of Pisa, Italy, for a period of 3 years. Clinical and course features were compared between subjects with and without BP-II. All patients received the clinicians' choice of antidepressants and, in the case of the subsample with BP-II, mood stabilizers (for example, valproate, lithium were among the mainstays of treatment. Results In comparison to patients without bipolar comorbidity, those with BP-II showed a significantly greater frequency of social phobia, obsessive-compulsive disorder, alcohol-related disorders, and separation anxiety during childhood and adolescence. Regarding family history, a significantly greater frequency of PD and mood disorders was present among the BP-II. No significant differences were observed in the long-term course of PD or agoraphobic symptoms under pharmacological treatment or the likelihood of spontaneous pharmacological treatment interruptions. Conclusion Although the severity and outcome of panic-agoraphobic symptomatology appear to be similar in patients with and without lifetime bipolar comorbidity, the higher number of concomitant disorders in our PD patients with BP-II does indicate a greater

Best-practices guidelines for L2PSA development and applications. Volume 2 - Best practices for the Gen II PWR, Gen II BWR L2PSAs. Extension to Gen III reactors

International Nuclear Information System (INIS)

Raimond, E.; Durin, T.; Rahni, N.; Meignen, R.; Cranga, M.; Pichereau, F.; Bentaib, A.; Guigueno, Y.; Loeffler, H.; Mildenberger, O.; Lajtha, G.; Santamaria, C.S.; Dienstbier, J.; Rydl, A.; Holmberg, J.E.; Lindholm, I.; Maennistoe, I.; Pauli, E.M.; Dirksen, G.; Grindon, L.; Peers, K.; Hulqvist, G.; Parozzi, F.; Polidoro, F.; Cazzoli, E.; Vitazkova, J.; Burgazzi, L.; Oury, L.; Ngatchou, C.; Siltanen, S.; Niemela, I.; Routamo, T.; Helstroem, P.; Bassi, C.; Brinkman, H.; Seidel, A.; Schubert, B.; Wohlstein, R.; Guentay, S.; Vincon, L.

2010-01-01

The objective of this coordinated action was to develop best practice guidelines for the performance of Level 2 PSA methodologies with a view of harmonisation at EU level and to allow meaningful and practical uncertainty evaluations in a Level 2 PSA. Specific relationships with community in charge of nuclear reactor safety (utilities, safety authorities, vendors, and research or services companies) have been established in order to define the current needs in terms of guidelines for level 2 PSA development and applications. An international workshop was organised in Hamburg, with the support of VATTENFALL, in November 2008. The level 2 PSA experts from the ASAMPSA2 project partners have proposed some guidelines for the development and application of L2PSA based on their experience and on information available from international cooperation (EC Severe Accident network of Excellence - SARNET, IAEA standards, OECD-NEA publications and workshop) or open literature. The number of technical issues addressed in the guideline is very large and all are not covered with the same relevancy in the first version of the guideline. This version is submitted for external review in November 2010 by severe accident experts and PSA, especially, from SARNET and OECD-NEA members. The feedback of the external review will be dis cussed during an international open works hop planned in March 2011 and all outcomes will be taken into consideration in the final version of this guideline (June 2011). The guideline includes 3 volumes: - Volume 1 - General considerations on L2PSA. - Volume 2 - Technical recommendations for Gen II and III reactors. - Volume 3 - Specific considerations for future reactor (Gen IV). The recommendations formulated in the guideline should not be considered as 'mandatory' but should help the L2PSA developers to achieve high quality studies with limited time and resources. It may also help the L2PSA reviewers by positioning one specific study in comparison with some

Solid Waste Operations Complex W-113, Detail Design Report (Title II). Volume 1: Title II design report

International Nuclear Information System (INIS)

1995-09-01

The Solid Waste Retrieval Facility--Phase 1 (Project W113) will provide the infrastructure and the facility required to retrieve from Trench 04, Burial ground 4C, contact handled (CH) drums and boxes at a rate that supports all retrieved TRU waste batching, treatment, storage, and disposal plans. This includes (1) operations related equipment and facilities, viz., a weather enclosure for the trench, retrieval equipment, weighing, venting, obtaining gas samples, overpacking, NDE, NDA, shipment of waste and (2) operations support related facilities, viz., a general office building, a retrieval staff change facility, and infrastructure upgrades such as supply and routing of water, sewer, electrical power, fire protection, roads, and telecommunication. Title I design for the operations related equipment and facilities was performed by Raytheon/BNFL, and that for the operations support related facilities including infrastructure upgrade was performed by KEH. These two scopes were combined into an integrated W113 Title II scope that was performed by Raytheon/BNFL. Volume 1 provides a comprehensive narrative description of the proposed facility and systems, the basis for each of the systems design, and the engineering assessments that were performed to support the technical basis of the Title II design. The intent of the system description presented is to provide WHC an understanding of the facilities and equipment provided and the A/E's perspective on how these systems will operate

The correlation between hematoma volume and outcome in ruptured posterior fossa arteriovenous malformations indicates the importance of surgical evacuation of hematomas.

Science.gov (United States)

Yilmaz, Adem; Musluman, Ahmet Murat; Kanat, Ayhan; Cavusoglu, Halit; Terzi, Yuksel; Aydin, Yunus

2011-01-01

The correlation between hematoma volume and outcome in ruptured arteriovenous malformations (AVM) with accompanying posterior fossa hematoma was retrospectively evaluated. Microsurgery operations were performed on 127 patients with intracranial AVM between January 1998 and January 2009 at our clinic. Fifteen (11.8%) patients were identified as suffering from posterior fossa AVM, and twelve of these patients presented with a cerebellar hematoma. All patients were clinically evaluated according to the following criteria: modified Rankin Scale (mRS) prior to surgery, Spetzler-Martin grade (SMG) of the AVMs, hematoma volume prior to surgery, and mRS following surgery. Postoperative mRS scores were significantly lower than preoperative scores (p=0.0001). Postoperative outcomes were concordant with the SMG of the AVMs (r=0.67, p=0.033), hematoma volume (r=0.537, p=0.072) and preoperative mRS scores (r=0.764, p=0.004). These analyses show that the postoperative mRS score is strongly correlated with a preoperative mRS score, hematoma volume and SMG. Posterior fossa AVMs present an increased risk for hemorrhage and for increased morbidity and mortality. Cases with hematoma should be operated on an urgent basis. We conclude that hematoma volume is a factor that impacts postoperative results and prognosis. SMG and preoperative mRS scores were also correlated with outcome.

IGF-II transgenic mice display increased aberrant colon crypt multiplicity and tumor volume after 1,2-dimethylhydrazine treatment

Directory of Open Access Journals (Sweden)

Oesterle Doris

2006-01-01

Full Text Available Abstract In colorectal cancer insulin-like growth factor II (IGF-II is frequently overexpressed. To evaluate, whether IGF-II affects different stages of tumorigenesis, we induced neoplastic alterations in the colon of wild-type and IGF-II transgenic mice using 1,2-dimethylhydrazine (DMH. Aberrant crypt foci (ACF served as markers of early lesions in the colonic mucosa, whereas adenomas and carcinomas characterized the endpoints of tumor development. DMH-treatment led initially to significantly more ACF in IGF-II transgenic than in wild-type mice. This increase in ACF was especially prominent for those consisting of ≥three aberrant crypts (AC. Nevertheless, adenomas and adenocarcinomas of the colon, present after 34 weeks in both genetic groups, were not found at different frequency. Tumor volumes, however, were significantly higher in IGF-II transgenic mice and correlated with serum IGF-II levels. Immunohistochemical staining for markers of proliferation and apoptosis revealed increased cell proliferation rates in tumors of IGF-II transgenic mice without significant affection of apoptosis. Increased proliferation was accompanied by elevated localization of β-catenin in the cytosol and cell nuclei and reduced appearance at the inner plasma membrane. In conclusion, we provide evidence that IGF-II, via activation of the β-catenin signaling cascade, promotes growth of ACF and tumors without affecting tumor numbers.

Impact of removed tumor volume and location on patient outcome in glioblastoma.

Science.gov (United States)

Awad, Al-Wala; Karsy, Michael; Sanai, Nader; Spetzler, Robert; Zhang, Yue; Xu, Yizhe; Mahan, Mark A

2017-10-01

locations). OS significantly improved with EOR in univariate analysis, averaging 22.3, 19.7, and 13.2 months for >90, 80-90, and 70-80% resection, respectively. Survival was 22.8, 19.0, and 12.7 months for 0, 0-5, and 5-10 ml postoperative residual, respectively. A hazard model showed that larger preoperative tumor volume [hazard ratio (HR) 1.05, 95% CI 1.02-1.07], greater age (HR 1.02, 95% CI 1.01-1.03), multifocality (HR 1.44, 95% CI 1.01-2.04), and deep nuclei/basal ganglia (HR 2.05, CI 1.27-3.3) were the most predictive of poor survival after adjusting for KPS and tumor location. There was a negligible but significant interaction between EOR and preoperative tumor volume (HR 0.9995, 95% CI 0.9993-0.9998), but EOR alone did not correlate with OS after adjusting for other factors. The interaction between EOR and preoperative tumor volume represented tumor volume removed during surgery. In conclusion, EOR alone was not an important predictor of outcome during GBM treatment once preoperative tumor volume, age, and deep nuclei/basal ganglia location were factored. Instead, the interaction between EOR and preoperative volume, representing reduced disease burden, was an important predictor of reducing OS. Removal of tumor from eloquent cortex did not impact postoperative KPS. These results suggest aggressive surgical treatment to reduce postoperative residual while maintaining postoperative KPS may aid patient survival outcomes for a given tumor size and location.

II-VI semiconductor compounds

CERN Document Server

1993-01-01

For condensed matter physicists and electronic engineers, this volume deals with aspects of II-VI semiconductor compounds. Areas covered include devices and applications of II-VI compounds; Co-based II-IV semi-magnetic semiconductors; and electronic structure of strained II-VI superlattices.

Aerial radiometric and magnetic survey; Brushy Basin detail survey: Price/Salina national topographic map sheets, Utah. Volume III. Area II: graphic data, Section I-II. Final report

International Nuclear Information System (INIS)

1981-01-01

This volume contains all of the graphic data for Area II which consists of map lines 1660 to 3400 and 5360 to 5780, and tie lines 6100, 6120, and 6160. Due to the large map scale of the presented data (1:62,500), this sub-section was divided into eleven 7-1/2 min quadrant sheets

Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes

Directory of Open Access Journals (Sweden)

Ha Na Lee

2014-06-01

Full Text Available Purpose To evaluate the association between prostatic inflammation and lower urinary tract symptoms (LUTS, and to identify the effects of prostatic inflammation on the treatment with an alpha blocker. Materials and Methods 111 Participants who were aged ≥ 50 years, the presence of LUTS (maximal flow rate < 20 m/s, IPSS ≥ 11, and an elevated PSA level (3-20ng/mL were treated with tamsulosin 0.2mg once daily for 3 months after prostate biopsies. Prostatic inflammation was scored as none (0, mild (I, moderate (II, or marked (III. LUTS parameters including urine flow rates, IPSS, PSA, and prostate volume were evaluated. Results Inflammation grading resulted in 25, 60, and 26 patients that were grade 0, I, and II, respectively. Lower grade inflammation was related to higher urine flow rate at baseline. Patients with higher inflammation grades had larger prostate volumes, larger total and transitional zone volumes, and higher PSA levels. Overall, urine flow rates and residual urine volume were improved after 3 months of alpha blocker therapy. Eighty percent of patients with grade 0 inflammation, 73% of patients with grade I inflammation, and 92.3% of patients with grade II inflammation showed improvement of LUTS after treatment. Longer duration of treatment was related to a decreased chance of improvement of LUTS. Patients with increased IPSS voiding subscales could be predictive of improvement of LUTS. Conclusions Patients with high grade inflammation had lower flow rates and higher prostatic volumes than patients with low grade inflammation. Inflammation grade did not affect the outcomes of alpha blocker treatment.

AJER VOLUME II-JULY 2014

African Journals Online (AJOL)

user

African Journal of Economic Review, Volume 1I, Issue 2, July 2014 ..... This paper also carries out the Chow-break point test (stability test) to test .... Unlike other East African countries, Rwanda has had a lot of political instabilities characterized.

Outcome and patterns of failure following limited-volume irradiation for malignant astrocytomas

Energy Technology Data Exchange (ETDEWEB)

Garden, A.S.; Maor, M.H.; Yung, W.K.A.; Bruner, J.M.; Woo, Shiao Y.; Moser, R.P.; Lee, Ya-Yen (Anderson (M.D.) Hospital and Tumor Inst., Houston, TX (USA))

1991-02-01

Between January 1982 and June 1986, 60 consecutive patients with high-grade astrocytomas (39 glioblastoma multiforme (GBM), 21 anaplastic astrocytoma (AA)) were treated with radiation therapy after biopsy (13 patients) or resection (47 patients). 53 patients were treated with limited-volume irradiation, 7 received whole-brain irradiation. The mean tumor dose was 65.4 Gy. In 35 patients, chemotherapy was given as part of their initial treatment. The 1- and 2-year survivals for GBM patients were 40 and 14 percent, respectively. Survival figures for AA patients were 76 and 52 percent at 1 and 2 years, respectively. The progression-free rate at 1 year was 13 percent in GBM and 29 percent in AA patients. 34 of 48 patients who received limited-volume irradiation had evidence of progression on postirradiation CT scans. 6 patients (3 GBM, 3 AA) had evidence of a new intracranial metastatic site on CT scan. In 3 patients the metastasis was within the previously irradiated volume, and in 3 other patients, it was outside this volume. All 6 had evidence of progression of their primary tumor at the original location on CT scan prior to the discovery of the metastatic site. 21 patients (15 GBM, 6 AA) had at least 1 postirradiation reoperation for a recurrent mass. 19 patients had recurrent tumors in the primary site, and 2 patients had necrosis but no tumor. Patients who received limited-volume irradiation for high-grade astrocytomas achieved the same survival results as patients treated previously with whole brain irradiation. New intra-cranial metastases did not influence the outcome, since these were always antedated by tumor progression at the primary site. (author). 16 refs.; 8 figs.; 2 tabs.

Impact of surgical experience on management and outcome of pancreatic surgery performed in high- and low-volume centers.

Science.gov (United States)

Stella, Marco; Bissolati, Massimiliano; Gentile, Daniele; Arriciati, Alessandro

2017-09-01

Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume. 124 pancreatic resections (98 PD) were conducted by a single surgeon from 2004 to 2014 in two different Italian hospitals with different PS volumes as well as in general surgical activities. The results were retrospectively analyzed. All data regarding demographics, oncological characteristics, surgical parameters and post-operative outcomes were compared between patients operated on in the HV (group A) and LV hospital (group B). The surgical experience in the LV hospital has been then divided into a first period (group B1) and in a second period (group B2). χ 2 test or Fisher's exact test (when variables were dichotomous) was used. The unpaired t test was used to compare continuous data between the two groups. Values are expressed as n. of cases (percent) for categorical data or as mean (standard deviation) for continuous data. A p value less than 0.05 was considered as significant. From 2004 to 2014, 124 patients underwent pancreatic resection by the same surgeon: 69 in an HV hospital (group A) and 55 in an LV hospital (group B). We focused our attention on PD outcomes, 54 in group A and 44 in group B (22 in group B1 and 22 in group B2, accordingly to the aforementioned criteria). A higher incidence of ASA 3 patients, although not statistically significant, was found in group B than in group A (34 vs. 18%; p

Preliminary evaluation of alternative waste form solidification processes. Volume II. Evaluation of the processes

International Nuclear Information System (INIS)

1980-08-01

This Volume II presents engineering feasibility evaluations of the eleven processes for solidification of nuclear high-level liquid wastes (HHLW) described in Volume I of this report. Each evaluation was based in a systematic assessment of the process in respect to six principal evaluation criteria: complexity of process; state of development; safety; process requirements; development work required; and facility requirements. The principal criteria were further subdivided into a total of 22 subcriteria, each of which was assigned a weight. Each process was then assigned a figure of merit, on a scale of 1 to 10, for each of the subcriteria. A total rating was obtained for each process by summing the products of the subcriteria ratings and the subcriteria weights. The evaluations were based on the process descriptions presented in Volume I of this report, supplemented by information obtained from the literature, including publications by the originators of the various processes. Waste form properties were, in general, not evaluated. This document describes the approach which was taken, the developent and application of the rating criteria and subcriteria, and the evaluation results. A series of appendices set forth summary descriptions of the processes and the ratings, together with the complete numerical ratings assigned; two appendices present further technical details on the rating process

The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease)

Energy Technology Data Exchange (ETDEWEB)

Kim, Sang Won; Chun, Misun; Kim, Myung Wook; Kim, Wook Hwan; Kang, Seok Yun; Kang, Seung Hee; Oh, Young Taek; Lee, Sunyoung; Yang, Juno [Ajou University School of Medicine, Suwon (Korea, Republic of)

2007-12-15

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1- and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2- and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.

The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease)

International Nuclear Information System (INIS)

Kim, Sang Won; Chun, Misun; Kim, Myung Wook; Kim, Wook Hwan; Kang, Seok Yun; Kang, Seung Hee; Oh, Young Taek; Lee, Sunyoung; Yang, Juno

2007-01-01

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1- and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2- and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer

Effect of lung-protective ventilation with lower tidal volumes on clinical outcomes among patients undergoing surgery: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Gu, Wan-Jie; Wang, Fei; Liu, Jing-Chen

2015-02-17

In anesthetized patients undergoing surgery, the role of lung-protective ventilation with lower tidal volumes is unclear. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of this ventilation strategy on postoperative outcomes. We searched electronic databases from inception through September 2014. We included RCTs that compared protective ventilation with lower tidal volumes and conventional ventilation with higher tidal volumes in anesthetized adults undergoing surgery. We pooled outcomes using a random-effects model. The primary outcome measures were lung injury and pulmonary infection. We included 19 trials (n=1348). Compared with patients in the control group, those who received lung-protective ventilation had a decreased risk of lung injury (risk ratio [RR] 0.36, 95% confidence interval [CI] 0.17 to 0.78; I2=0%) and pulmonary infection (RR 0.46, 95% CI 0.26 to 0.83; I2=8%), and higher levels of arterial partial pressure of carbon dioxide (standardized mean difference 0.47, 95% CI 0.18 to 0.75; I2=65%). No significant differences were observed between the patient groups in atelectasis, mortality, length of hospital stay, length of stay in the intensive care unit or the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen. Anesthetized patients who received ventilation with lower tidal volumes during surgery had a lower risk of lung injury and pulmonary infection than those given conventional ventilation with higher tidal volumes. Implementation of a lung-protective ventilation strategy with lower tidal volumes may lower the incidence of these outcomes. © 2015 Canadian Medical Association or its licensors.

Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, Michael J; Joe, Alexius Y; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger [Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Brink, Ingo [Department of Nuclear Medicine, University Hospital of Freiburg (Germany); Krause, Thomas M [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

2002-09-01

This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15{+-}9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256{+-}80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses. (orig.)

Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

International Nuclear Information System (INIS)

Reinhardt, Michael J.; Joe, Alexius Y.; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger; Brink, Ingo; Krause, Thomas M.

2002-01-01

This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15±9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256±80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses. (orig.)

Final report of the Multiprogram Laboratory Panel Energy Research Advisory Board. Volume II. Support studies

International Nuclear Information System (INIS)

Spiewak, I.; Guthrie, M.P.; Nichols, J.P.; Preston, E.L.; West, C.D.; Wilbanks, T.J.; Wilkes, B.Y.; Zerby, A.C.

1982-09-01

Volume II - support studies for nine national laboratories include: report of statistical data on the multiprogram laboratories; examples of national laboratory use in foreign countries; domestic models for national laboratory utilization; relationships of laboratories with industry and universities; uses of laboratories for training industrial R and D personnel; legal mandates and constraints on the national laboratories; with appendices on facts about Harwell, CEN-Saclay, TNO, Studsvik, and JAERI-Tokai; the Requirements Boards of the United Kingdom Department of Industry; impact of President's FY 1983 budget; and the PNL experiment

Journal of Sustainable Development of Energy, Water and Environment Systems - Volume II

Directory of Open Access Journals (Sweden)

Neven Duić

2014-12-01

Full Text Available The Journal of Sustainable Development of Energy, Water and Environment Systems – JSDEWES is an international journal dedicated to the improvement and dissemination of knowledge on methods, policies and technologies for increasing the sustainability of development by de-coupling growth from natural resources and replacing them with knowledge based economy, taking into account its economic, environmental and social pillars, as well as methods for assessing and measuring sustainability of development, regarding energy, transport, water, environment and food production systems and their many combinations. In total 32 manuscripts were published in Volume II, all of them reviewed by at least two reviewers. The Journal of Sustainable Development of Energy, Water and Environment Systems would like to thank reviewers for their contribution to the quality of the published manuscripts.

Basic Quechua. Volume I: Quechua Reader. Volume II: Quechua Grammar and Dictionary.

Science.gov (United States)

Aitken-Soux, Percy G.; Crapo, Richley H.

Volume I, the reader, has 86 lessons consisting of short passages and vocabulary lists. The language and the stories presented were learned and collected at the Indian community and Hacienda of Cayara near Potosi, Bolivia. Translations of the passages are provided in a separate section. The second volume presents the grammar and phonology of the…

Effect of timing on the outcomes of 1-phase nonextraction therapy of Class II malocclusion.

Science.gov (United States)

Baccetti, Tiziano; Franchi, Lorenzo; Kim, Ludia H

2009-10-01

The aim of this cephalometric study was to evaluate the role of timing in relation to skeletal maturity on the outcomes of nonextraction comprehensive Class II therapy. Three samples of patients with Class II Division 1 malocclusion were treated with headgear combined with fixed appliances and Class II elastics. Lateral cephalograms were taken of all subjects before therapy (T1) and at an average interval of 6 months after therapy (T2). The first sample (23 subjects) was treated before the pubertal growth spurt, the second sample (24 subjects) received therapy during the pubertal growth spurt, and the third sample (13 subjects) was treated at a postpubertal stage of development. The average T1 to T2 interval was approximately 30 months for all patients, with an average treatment duration of 24 months. Longitudinal observations of a group of 17 subjects with untreated Class II malocclusions were compared with the treated groups at the 3 skeletal maturation intervals with nonparametric statistics. Class II treatment before or during the pubertal growth spurt induced significant favorable skeletal changes (restricted maxillary advancement in prepubertal patients and enhanced mandibular growth in pubertal patients). Patients treated after the pubertal growth spurt had only significant dentoalveolar changes. The greatest amount of dentoskeletal correction of Class II malocclusion with 1-phase nonextraction treatment occurred in patients treated during the pubertal growth spurt.

Aerial radiometric and magnetic survey; Brushy Basin detail survey: Price/Salina national topographic map sheets, Utah. Volume III. Area II: graphic data, Section III-IX Final report

International Nuclear Information System (INIS)

1981-01-01

This volume contains all of the graphic data for Area II, which include map lines 1660 to 3400 and 5360 to 5780 and tie lines 6100, 6120, and 6160. Due to the large map scale of the data presented (1:62,500), this area was further subdivided into eleven 7-1/2 min quadrant sheets. It should be noted that TL6100 resides in both Areas II and III. The graphic data for TL6100 are presented in Volume IV - Area III - Graphic Data of this report

Environmental control implications of generating electric power from coal. Technology status report. Volume II

Energy Technology Data Exchange (ETDEWEB)

None

1976-12-01

This is the first in a series of reports evaluating environmental control technologies applicable to the coal-to-electricity process. The technologies are described and evaluated from an engineering and cost perspective based upon the best available information obtained from utility experience and development work in progress. Environmental control regulations and the health effects of pollutants are also reviewed. Emphasis is placed primarily upon technologies that are now in use. For SO/sub 2/ control, these include the use of low sulfur coal, cleaned coal, or flue-gas desulfurization systems. Electrostatic precipitators and fabric filters used for the control of particulate matter are analyzed, and combustion modifications for NO/sub x/ control are described. In each area, advanced technologies still in the development stage are described briefly and evaluated on the basis of current knowledge. Fluidized-bed combustion (FBC) is a near-term technology that is discussed extensively in the report. The potential for control of SO/sub 2/ and NO/sub x/ emissions by use of FBC is analyzed, as are the resulting solid waste disposal problems, cost estimates, and its potential applicability to electric utility systems. Volume II presents the detailed technology analyses complete with reference citations. This same material is given in condensed form in Volume I without references. A brief executive summary is also given in Volume I.

Volume I. Environmental effects on contents of Cs-137 and Sr-90 in milk. Volume II. Appendices

International Nuclear Information System (INIS)

1981-01-01

Milk, animal fodders, soils, humans, livestock, and wildlife on or near 55 dairy farms in Utah were assayed for radionuclide content. Effects of soil chemistry, water supply, plant type, farming practices, geographic location, altitude, rainfall, and other ecological differences were sought by intensive analysis. Although many analyses have not been completed, several cause-effect relationships have been defined. Wet-lands yield more 137 Cs, 131 I, or 90 Sr to milk under like conditions of fallout intensity than dry-lands. In most cases, the station with the highest yield is also practicing wet grazing. 90 Sr and 137 Cs content of milk is enhanced by sandy soils. Increased altitude and higher rainfall lead to higher yields of 90 Sr and 137 Cs in milk. Levels of 137 Cs in milk increase from south to north, and Utah can be divided into several regions, each having a characteristic level of 90 Sr and 137 Cs in milk, meat, and fodders. Poor pastures (over-grazed to the extent that stem bases are eaten and much soil is exposed) yield more 137 Cs and 90 Sr than improved pastures. Feeding green chop alfalfa or putting the animals on the meadows causes marked but temporary increases in the 90 Sr and 137 Cs content of the milk. However, the annual yield for two stations of similar ecology in the same geographic area is essentially the same. Experimental details are presented in Volume I. The appendices in Volume II are made up primarily of the data compiled at the 78 stations

Separation and preconcentration of lead(II), cobalt(II), and nickel(II) on EDTA immobilized activated carbon cloth prior to flame atomic absorption spectrometric determination in environmental samples

OpenAIRE

ALOTHMAN, ZEID ABDULLAH; YILMAZ, ERKAN; HABİLA, MOHAMED; SOYLAK, MUSTAFA

2015-01-01

The synthesis and characterization of ethylenediaminetetraacetic acid immobilized activated carbon cloth was performed in the present work. It was used for preconcentration-separation of lead(II), cobalt(II), and nickel(II) at trace levels as an adsorbent. Factors including pH, concentration and volume of eluent, sample and eluent flow rates, sample volume, and effect of coexisting ions on the solid phase extraction of analytes were examined. The preconcentration factor was 50. The detection ...

Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

International Nuclear Information System (INIS)

La Roca, Ricardo L.R. Felts de; Fonseca, Francisco Paula da; Cunha, Isabela Werneck da; Bezerra, Stephania Martins

2013-01-01

Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA ≥ 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

Energy Technology Data Exchange (ETDEWEB)

La Roca, Ricardo L.R. Felts de, E-mail: Ricardo@delarocaurologia.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil); Fonseca, Francisco Paula da, E-mail: fpf@uol.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Divisao de Urologia. Dept. de Cirurgia Pelvica; Cunha, Isabela Werneck da; Bezerra, Stephania Martins, E-mail: iwerneck@gmail.com, E-mail: stephaniab@gmail.com [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Patologia

2013-07-01

Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA {>=} 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

Intraoperative Magnetic-Resonance Tomography and Neuronavigation During Resection of Focal Cortical Dysplasia Type II in Adult Epilepsy Surgery Offers Better Seizure Outcomes.

Science.gov (United States)

Roessler, Karl; Kasper, Burkhard S; Heynold, Elisabeth; Coras, Roland; Sommer, Björn; Rampp, Stefan; Hamer, Hajo M; Blümcke, Ingmar; Buchfelder, Michael

2018-01-01

Focal cortical dysplasia (FCD) is one important cause of drug-resistant epilepsy potentially curable by epilepsy surgery. We investigated the options of using neuronavigation and intraoperative magnetic-resonance tomographical imaging (MRI) to avoid residual epileptogenic tissue during resection of patients with FCD II to improve seizure outcome. Altogether, 24 patients with FCD II diagnosed by MRI (16 female, 8 male; mean age 34 ± 10 years) suffered from drug-resistant electroclinical and focal epilepsy for a mean of 20.7 ± 5 years. Surgery was performed with preoperative stereoelectroencephalography (in 15 patients), neuronavigation, and intraoperative 1.5T-iopMRI in all 24 investigated patients. In 75% of patients (18/24), a complete resection was performed. In 89% (16/18) of completely resected patients, we documented an Engel I seizure outcome after a mean follow-up of 42 months. All incompletely resected patients had a worse outcome (Engel II-III, P < 0.0002). Patients with FCD IIB had also significant better seizure outcome compared with patients diagnosed as having FCD IIA (82% vs. 28%, P < 0.02). In 46% (11/24) of patients, intraoperative second-look surgeries due to residual lesions detected during the intraoperative MRI were performed. In these 11 patients, there were significant more completely seizure free patients (73% vs. 38% Engel IA), compared with 13 patients who finished surgery after the first intraoperative MRI (P < 0.05). Excellent seizure outcome after surgery of patients with FCD II positively correlated with the amount of resection, histologic subtype, and the use of intraoperative MRI, especially when intraoperative second-look surgeries were performed. Copyright © 2017 Elsevier Inc. All rights reserved.

Possible interrelationship between changes in F-actin and myosin II, protein phosphorylation, and cell volume regulation in Ehrlich ascites tumor cells

DEFF Research Database (Denmark)

Pedersen, S F; Hoffmann, E K

2002-01-01

effects on F-actin. The subsequent F-actin depolymerization, however, appeared MLCK- and PKC-dependent, and the initial swelling-induced F-actin depolymerization was MLCK-dependent; both effects were apparently secondary to kinase-mediated effects on cell volume changes. NHE1 in EATC is activated both....... Moreover, Rho kinase inhibition did not significantly affect NHE1 activation, neither by shrinkage nor by CL-A. Implications for the possible interrelationship between changes in F-actin and myosin II, protein phosphorylation, and cell volume regulation are discussed....

Adaptive/Nonadaptive Proton Radiation Planning and Outcomes in a Phase II Trial for Locally Advanced Non-small Cell Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Koay, Eugene J.; Lege, David [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y., E-mail: jychang@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2012-12-01

Purpose: To analyze dosimetric variables and outcomes after adaptive replanning of radiation therapy during concurrent high-dose protons and chemotherapy for locally advanced non-small cell lung cancer (NSCLC). Methods and Materials: Nine of 44 patients with stage III NSCLC in a prospective phase II trial of concurrent paclitaxel/carboplatin with proton radiation [74 Gy(RBE) in 37 fractions] had modifications to their original treatment plans after re-evaluation revealed changes that would compromise coverage of the target volume or violate dose constraints; plans for the other 35 patients were not changed. We compared patients with adaptive plans with those with nonadaptive plans in terms of dosimetry and outcomes. Results: At a median follow-up of 21.2 months (median overall survival, 29.6 months), no differences were found in local, regional, or distant failure or overall survival between groups. Adaptive planning was used more often for large tumors that shrank to a greater extent (median, 107.1 cm{sup 3} adaptive and 86.4 cm{sup 3} nonadaptive; median changes in volume, 25.3% adaptive and 1.2% nonadaptive; P<.01). The median number of fractions delivered using adaptive planning was 13 (range, 4-22). Adaptive planning generally improved sparing of the esophagus (median absolute decrease in V{sub 70}, 1.8%; range, 0%-22.9%) and spinal cord (median absolute change in maximum dose, 3.7 Gy; range, 0-13.8 Gy). Without adaptive replanning, target coverage would have been compromised in 2 cases (57% and 82% coverage without adaptation vs 100% for both with adaptation); neither patient experienced local failure. Radiation-related grade 3 toxicity rates were similar between groups. Conclusions: Adaptive planning can reduce normal tissue doses and prevent target misses, particularly for patients with large tumors that shrink substantially during therapy. Adaptive plans seem to have acceptable toxicity and achieve similar local, regional, and distant control and overall

Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, Michael J.; Joe, Alexius Y.; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger [Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Brink, Ingo [Department of Nuclear Medicine, University Hospital of Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

2002-09-01

This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15{+-}9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256{+-}80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses

Coal liquefaction: A research and development needs assessment: Final report, Volume II

Energy Technology Data Exchange (ETDEWEB)

Schindler, H.D.; Burke, F.P.; Chao, K.C.; Davis, B.H.; Gorbaty, M.L.; Klier, K.; Kruse, C.W.; Larsen, J.W.; Lumpkin, R.E.; McIlwain, M.E.; Wender, I.; Stewart, N.

1989-03-01

Volume II of this report on an assessment of research needs for coal liquefaction contains reviews of the five liquefaction technologies---direct, indirect, pyrolysis, coprocessing, and bioconversion. These reviews are not meant to be encyclopedic; several outstanding reviews of liquefaction have appeared in recent years and the reader is referred to these whenever applicable. Instead, these chapters contain reviews of selected topics that serve to support the panel's recommendations or to illustrate recent accomplishments, work in progress, or areas of major research interest. At the beginning of each of these chapters is a brief introduction and a summary of the most important research recommendations brought out during the panel discussions and supported by the material presented in the review. A review of liquefaction developments outside the US is included. 594 refs., 100 figs., 60 tabs.

Brain Volumes at Term-Equivalent Age in Preterm Infants : Imaging Biomarkers for Neurodevelopmental Outcome through Early School Age

NARCIS (Netherlands)

Keunen, Kristin; Išgum, Ivana; van Kooij, Britt J M; Anbeek, Petronella; van Haastert, Ingrid C; Koopman-Esseboom, Corine; van Stam, Petronella C; Nievelstein, Rutger A J; Viergever, Max A; de Vries, Linda S; Groenendaal, Floris; Benders, Manon J N L

OBJECTIVE: To evaluate the relationship between brain volumes at term and neurodevelopmental outcome through early school age in preterm infants. STUDY DESIGN: One hundred twelve preterm infants (born mean gestational age 28.6 ± 1.7 weeks) were studied prospectively with magnetic resonance imaging

High clusterin expression correlates with a poor outcome in stage II colorectal cancers.

LENUS (Irish Health Repository)

Kevans, David

2012-02-01

The role of clusterin in tumor growth and progression remains unclear. Overexpression of cytoplasmic clusterin has been studied in aggressive colon tumors; however, no correlation between clusterin expression and survival in colorectal cancer has been identified to date. We assessed levels of clusterin expression in a group of stage II colorectal cancer patients to assess its utility as a prognostic marker. The study included 251 patients with stage II colorectal cancer. Tissue microarrays were constructed and immunohistochemistry done and correlated with clinical features and long term outcome. Dual immunofluorescence and confocal microscopy were used with terminal deoxynucleotidyl-transferase-mediated dUTP nick-end labeling probes and clusterin antibody to assess the degree of co localization. Percentage epithelial cytoplasmic staining was higher in tumor compared with nonadjacent normal mucosa (P < 0.001). Within the stromal compartment, percentage cytoplamic staining and intensity was lower in tumor tissue compared with normal nonadjacent mucosa (P < or = 0.001). Survival was significantly associated with percentage epithelial cytoplasmic staining (P < 0.001), epithelial cytoplasmic staining intensity (P < 0.001), percentage stromal cytoplasmic staining (P = 0.002), and stromal cytoplasmic staining intensity (P < 0.001). Clusterin levels are associated with poor survival in stage II colorectal cancer.

Solid-phase extraction of Mn(II), Co(II), Ni(II), Cu(II), Cd(II) and Pb(II) ions from environmental samples by flame atomic absorption spectrometry (FAAS)

Energy Technology Data Exchange (ETDEWEB)

Duran, Celal [Department of Chemistry, Faculty of Art and Science, Karadeniz Technical University, 61080 Trabzon (Turkey); Gundogdu, Ali [Department of Chemistry, Faculty of Art and Science, Karadeniz Technical University, 61080 Trabzon (Turkey); Bulut, Volkan Numan [Department of Chemistry, Giresun Faculty of Art and Science, Karadeniz Technical University, 28049 Giresun (Turkey); Soylak, Mustafa [Department of Chemistry, Faculty of Art and Science, Erciyes University, 38039 Kayseri (Turkey)]. E-mail: soylak@erciyes.edu.tr; Elci, Latif [Department of Chemistry, Faculty of Art and Science, Pamukkale University, 20020 Denizli (Turkey); Sentuerk, Hasan Basri [Department of Chemistry, Faculty of Art and Science, Karadeniz Technical University, 61080 Trabzon (Turkey); Tuefekci, Mehmet [Department of Chemistry, Faculty of Art and Science, Karadeniz Technical University, 61080 Trabzon (Turkey)

2007-07-19

A new method using a column packed with Amberlite XAD-2010 resin as a solid-phase extractant has been developed for the multi-element preconcentration of Mn(II), Co(II), Ni(II), Cu(II), Cd(II), and Pb(II) ions based on their complex formation with the sodium diethyldithiocarbamate (Na-DDTC) prior to flame atomic absorption spectrometric (FAAS) determinations. Metal complexes sorbed on the resin were eluted by 1 mol L{sup -1} HNO{sub 3} in acetone. Effects of the analytical conditions over the preconcentration yields of the metal ions, such as pH, quantity of Na-DDTC, eluent type, sample volume and flow rate, foreign ions etc. have been investigated. The limits of detection (LOD) of the analytes were found in the range 0.08-0.26 {mu}g L{sup -1}. The method was validated by analyzing three certified reference materials. The method has been applied for the determination of trace elements in some environmental samples.

Comparing acquired angioedema with hereditary angioedema (types I/II): findings from the Icatibant Outcome Survey.

Science.gov (United States)

Longhurst, H J; Zanichelli, A; Caballero, T; Bouillet, L; Aberer, W; Maurer, M; Fain, O; Fabien, V; Andresen, I

2017-04-01

Icatibant is used to treat acute hereditary angioedema with C1 inhibitor deficiency types I/II (C1-INH-HAE types I/II) and has shown promise in angioedema due to acquired C1 inhibitor deficiency (C1-INH-AAE). Data from the Icatibant Outcome Survey (IOS) were analysed to evaluate the effectiveness of icatibant in the treatment of patients with C1-INH-AAE and compare disease characteristics with those with C1-INH-HAE types I/II. Key medical history (including prior occurrence of attacks) was recorded upon IOS enrolment. Thereafter, data were recorded retrospectively at approximately 6-month intervals during patient follow-up visits. In the icatibant-treated population, 16 patients with C1-INH-AAE had 287 attacks and 415 patients with C1-INH-HAE types I/II had 2245 attacks. Patients with C1-INH-AAE versus C1-INH-HAE types I/II were more often male (69 versus 42%; P = 0·035) and had a significantly later mean (95% confidence interval) age of symptom onset [57·9 (51·33-64·53) versus 14·0 (12·70-15·26) years]. Time from symptom onset to diagnosis was significantly shorter in patients with C1-INH-AAE versus C1-INH-HAE types I/II (mean 12·3 months versus 118·1 months; P = 0·006). Patients with C1-INH-AAE showed a trend for higher occurrence of attacks involving the face (35 versus 21% of attacks; P = 0·064). Overall, angioedema attacks were more severe in patients with C1-INH-HAE types I/II versus C1-INH-AAE (61 versus 40% of attacks were classified as severe to very severe; P types I/II, respectively. © 2016 British Society for Immunology.

Understanding the relationship between the Centers for Medicare and Medicaid Services' Hospital Compare star rating, surgical case volume, and short-term outcomes after major cancer surgery.

Science.gov (United States)

Kaye, Deborah R; Norton, Edward C; Ellimoottil, Chad; Ye, Zaojun; Dupree, James M; Herrel, Lindsey A; Miller, David C

2017-11-01

Both the Centers for Medicare and Medicaid Services' (CMS) Hospital Compare star rating and surgical case volume have been publicized as metrics that can help patients to identify high-quality hospitals for complex care such as cancer surgery. The current study evaluates the relationship between the CMS' star rating, surgical volume, and short-term outcomes after major cancer surgery. National Medicare data were used to evaluate the relationship between hospital star ratings and cancer surgery volume quintiles. Then, multilevel logistic regression models were fit to examine the association between cancer surgery outcomes and both star rankings and surgical volumes. Lastly, a graphical approach was used to compare how well star ratings and surgical volume predicted cancer surgery outcomes. This study identified 365,752 patients undergoing major cancer surgery for 1 of 9 cancer types at 2,550 hospitals. Star rating was not associated with surgical volume (P cancer surgery outcomes (mortality, complication rate, readmissions, and prolonged length of stay). The adjusted predicted probabilities for 5- and 1-star hospitals were 2.3% and 4.5% for mortality, 39% and 48% for complications, 10% and 15% for readmissions, and 8% and 16% for a prolonged length of stay, respectively. The adjusted predicted probabilities for hospitals with the highest and lowest quintile cancer surgery volumes were 2.7% and 5.8% for mortality, 41% and 55% for complications, 12.2% and 11.6% for readmissions, and 9.4% and 13% for a prolonged length of stay, respectively. Furthermore, surgical volume and the star rating were similarly associated with mortality and complications, whereas the star rating was more highly associated with readmissions and prolonged length of stay. In the absence of other information, these findings suggest that the star rating may be useful to patients when they are selecting a hospital for major cancer surgery. However, more research is needed before these ratings can

Proposed Tenaska Washington II Generation Project : Final Environmental Impact Statement. Volume 2: Public Involvement.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1994-01-01

In regard to the proposed Tenaska Washington II Generation Project, the goal of the Bonneville Power Administration`s (BPA) Environmental Impact Statement (EIS) public involvement process is to determine the issues to be examined and pertinent analyses to be conducted and to solicit comments on the content and quality of information presented in the Draft Environmental Impact Statement (DEIS). Comments and questions are solicited from the public and government agencies during the scoping process and during the comment period and public hearing on the DEIS, to find out what is of most concern to them. The end product of the public involvement process is the Comment Report which follows in part of this volume on Public Involvement.

Characterizing Tumor Heterogeneity With Functional Imaging and Quantifying High-Risk Tumor Volume for Early Prediction of Treatment Outcome: Cervical Cancer as a Model

International Nuclear Information System (INIS)

Mayr, Nina A.; Huang Zhibin; Wang, Jian Z.; Lo, Simon S.; Fan, Joline M.; Grecula, John C.; Sammet, Steffen; Sammet, Christina L.; Jia Guang; Zhang Jun; Knopp, Michael V.; Yuh, William T.C.

2012-01-01

Purpose: Treatment response in cancer has been monitored by measuring anatomic tumor volume (ATV) at various times without considering the inherent functional tumor heterogeneity known to critically influence ultimate treatment outcome: primary tumor control and survival. This study applied dynamic contrast-enhanced (DCE) functional MRI to characterize tumors' heterogeneous subregions with low DCE values, at risk for treatment failure, and to quantify the functional risk volume (FRV) for personalized early prediction of treatment outcome. Methods and Materials: DCE-MRI was performed in 102 stage IB 2 –IVA cervical cancer patients to assess tumor perfusion heterogeneity before and during radiation/chemotherapy. FRV represents the total volume of tumor voxels with critically low DCE signal intensity ( 20, >13, and >5 cm 3 , respectively, significantly predicted unfavorable 6-year primary tumor control (p = 0.003, 7.3 × 10 −8 , 2.0 × 10 −8 ) and disease-specific survival (p = 1.9 × 10 −4 , 2.1 × 10 −6 , 2.5 × 10 −7 , respectively). The FRVs were superior to the ATVs as early predictors of outcome, and the differentiating power of FRVs increased during treatment. Discussion: Our preliminary results suggest that functional tumor heterogeneity can be characterized by DCE-MRI to quantify FRV for predicting ultimate long-term treatment outcome. FRV is a novel functional imaging heterogeneity parameter, superior to ATV, and can be clinically translated for personalized early outcome prediction before or as early as 2–5 weeks into treatment.

The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation

International Nuclear Information System (INIS)

Leonard, Kara Lynne; Hepel, Jaroslaw T.; Hiatt, Jessica R.; Dipetrillo, Thomas A.; Price, Lori Lyn; Wazer, David E.

2013-01-01

Purpose: To evaluate dose-volume parameters and the interfraction interval (IFI) as they relate to cosmetic outcome and normal tissue effects of 3-dimensional conformal radiation therapy (3D-CRT) for accelerated partial breast irradiation (APBI). Methods and Materials: Eighty patients were treated by the use of 3D-CRT to deliver APBI at our institutions from 2003-2010 in strict accordance with the specified dose-volume constraints outlined in the National Surgical Adjuvant Breast and Bowel Project B39/Radiation Therapy Oncology Group 0413 (NSABP-B39/RTOG 0413) protocol. The prescribed dose was 38.5 Gy in 10 fractions delivered twice daily. Patients underwent follow-up with assessment for recurrence, late toxicity, and overall cosmetic outcome. Tests for association between toxicity endpoints and dosimetric parameters were performed with the chi-square test. Univariate logistic regression was used to evaluate the association of interfraction interval (IFI) with these outcomes. Results: At a median follow-up time of 32 months, grade 2-4 and grade 3-4 subcutaneous fibrosis occurred in 31% and 7.5% of patients, respectively. Subcutaneous fibrosis improved in 5 patients (6%) with extended follow-up. Fat necrosis developed in 11% of women, and cosmetic outcome was fair/poor in 19%. The relative volume of breast tissue receiving 5%, 20%, 50%, 80%, and 100% (V5-V100) of the prescribed dose was associated with risk of subcutaneous fibrosis, and the volume receiving 50%, 80%, and 100% (V50-V100) was associated with fair/poor cosmesis. The mean IFI was 6.9 hours, and the minimum IFI was 6.2 hours. The mean and minimum IFI values were not significantly associated with late toxicity. Conclusions: The incidence of moderate to severe late toxicity, particularly subcutaneous fibrosis and fat necrosis and resulting fair/poor cosmesis, remains high with continued follow-up. These toxicity endpoints are associated with several dose-volume parameters. Minimum and mean IFI values were

Portable microcomputer for the analysis of plutonium gamma-ray spectra. Volume II. Software description and listings

International Nuclear Information System (INIS)

Ruhter, W.D.

1984-05-01

A portable microcomputer has been developed and programmed for the International Atomic Energy Agency (IAEA) to perform in-field analysis of plutonium gamma-ray spectra. The unit includes a 16-bit LSI-11/2 microprocessor, 32-K words of memory, a 20-character display for user prompting, a numeric keyboard for user responses, and a 20-character thermal printer for hard-copy output of results. The unit weights 11 kg and has dimensions of 33.5 x 30.5 x 23.0 cm. This compactness allows the unit to be stored under an airline seat. Only the positions of the 148-keV 241 Pu and 208-keV 237 U peaks are required for spectral analysis that gives plutonium isotopic ratios and weight percent abundances. Volume I of this report provides a detailed description of the data analysis methodology, operation instructions, hardware, and maintenance and troubleshooting. Volume II describes the software and provides software listings

NURE aerial gamma-ray and magnetic reconnaissance survey, Colorado-Arizona area: Salton Sea NI II-9, Phoenix NI 12-7, El Centro NI II-12, AJO NI 12-10, Lukeville NH 12-1 quadrangles. Volume I. Narrative report

International Nuclear Information System (INIS)

1979-11-01

A rotary-wing reconnaissance high sensitivity radiometric and magnetic survey, encompassing several 1:250,000 quadrangles in southwestern Arizona and southeastern California, was performed. The surveyed area consisted of approximately 9300 line miles. The radiometric data were corrected and normalized to 400 feet terrain clearance. The data were identified as to rock type by correlating the data samples with existing geologic maps. Statistics defining the mean and standard deviation of each rock type are presented as listings in Volume I of this report. The departure of the data from its corresponding mean rock type is computed in terms of standard deviation units and is presented graphically as anomaly maps in Volume II and as computer listings in microfiche form in Volume I. Profiles of the normalized averaged data are contained in Volume II and include traces of the potassium, uranium and thorium count rates, corresponding ratios, and several ancilliary sensor data traces, magnetometer, radio altimeter and barometric pressure height. A description of the local geology is provided, and a discussion of the magnetic and radiometric data is presented together with an evaluation of selected uranium anomalies

Association of Mean Platelet Volume with Severity, Serology & Treatment Outcome in Dengue Fever: Prognostic Utility.

Science.gov (United States)

Sharma, Kritika; Yadav, Ajay

2015-11-01

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Dengue fever (DF) with its severe manifestations such as dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) has emerged as a major public health problem of international concern. Thrombocytopenia and bleeding are common complications of dengue fever, hence besides platelet counts, there is a need to assess the role of mean platelet volume. Studying association of mean platelet volume (MPV) with severity, serology & treatment outcome to assess its prognostic utility, which can be of great help in limiting morbidity & mortality associated with dengue fever. The present study was conducted in Central Pathology Lab of SMS Medical College & Hospital, Jaipur, Rajasthan from the period of March 2013 till October 2013. Blood samples were collected from 200 patients with NS 1 Antigen positivity experiencing febrile illness, clinically consistent with dengue infection. Evaluation of platelet counts, MPV, IgM and IgG antibodies was done in all these cases. Categorical data were presented as numbers (percent) and were compared among groups using Chi-square test. Groups compared for demographic data were presented as mean and standard deviation and were compared using student t-test, ANOVA and Post-Hoc Test, Tukey Test using SPSS, version 20 for Windows. A total of 200 Dengue fever cases were studied. Out of which, 68% cases were of DF, 23% DHF & 9% DSS i.e. classical dengue fever was most common presentation. Maximum (44%) cases were in age group of 15-24 years. Fever was the presenting complaint in all cases (100%). 98% cases of dengue had thrombocytopenia. MPV showed no significant correlation with severity, serology & treatment outcome, thus excluding its role in dengue cases. Mean platelet volume is not important as prognostic parameter in dengue fever.

The Effects of World War II on Economic and Health Outcomes across Europe

Science.gov (United States)

Kesternich, Iris; Siflinger, Bettina; Smith, James P.; Winter, Joachim K.

2013-01-01

We investigate long-run effects of World War II on socio-economic status and health of older individuals in Europe. We analyze data from SHARELIFE, a retrospective survey conducted as part of SHARE in Europe in 2009. SHARELIFE provides detailed data on events in childhood during and after the war for over 20,000 individuals in 13 European countries. We construct several measures of war exposure—experience of dispossession, persecution, combat in local areas, and hunger periods. Exposure to war and more importantly to individual-level shocks caused by the war significantly predicts economic and health outcomes at older ages. PMID:24850973

Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

Science.gov (United States)

Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

2015-08-01

When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

Small Lesion Size Is Associated with Sleep-Related Epilepsy in Focal Cortical Dysplasia Type II

Directory of Open Access Journals (Sweden)

Bo Jin

2018-02-01

Full Text Available ObjectiveTo investigate the neuroimaging and clinical features associated with sleep-related epilepsy (SRE in patients with focal cortical dysplasia (FCD type II.MethodsPatients with histopathologically proven FCD type II were included from three epilepsy centers. SRE was defined according to the video EEG findings and seizure history. Cortical surface reconstruction and volume calculation were performed using FreeSurfer. The lesions were manually delineated on T1 volumetric MRI using the ITK-SNAP software. The lesion volumes were normalized by the intracranial volume of each patient. The lesions were classified as small or large by placing a threshold based on quantitative (whether the lesion was detected on MRI report and qualitative (volume criteria.ResultsA total of 77 consecutive patients were included. Of them, 36 had SRE and 41 had non-SRE. An earlier age of epilepsy onset, high seizure frequency, regional interictal EEG findings, and favorable surgical outcome were characteristic in both groups. Small lesions were defined as those having a volume <3,217 mm3. In total, 60.9% of the patients with SRE (25/41 had small FCD lesion, which was significantly higher than the non-SRE group (9/34, 26.5%, p = 0.005. Small lesion size was the only predictor significantly associated with SRE in the overall type II group by multivariate analyses (p = 0.016. Although the proportion of patients who had frontal FCD and SRE was higher than non-frontal FCD (54.5 vs. 27.3%, p = 0.043, the relationship between SRE and lesion location was not confirmed by multivariate analysis. Thalamic volume and seizure semiology were not statistically different between the SRE and non-SRE group. The significant association between lesion size and SRE was reproducible in type IIb and IIa subgroups.SignificanceSRE is common in patients with FCD type II. Small FCD type II lesions are significantly associated with SRE. Although our findings cannot be applied to

Association Between Use of Lung-Protective Ventilation With Lower Tidal Volumes and Clinical Outcomes Among Patients Without Acute Respiratory Distress Syndrome A Meta-analysis

NARCIS (Netherlands)

Serpa Neto, Ary; Cardoso, Sérgio Oliveira; Manetta, José Antônio; Pereira, Victor Galvão Moura; Espósito, Daniel Crepaldi; Pasqualucci, Manoela de Oliveira Prado; Damasceno, Maria Cecília Toledo; Schultz, Marcus J.

2012-01-01

Context Lung-protective mechanical ventilation with the use of lower tidal volumes has been found to improve outcomes of patients with acute respiratory distress syndrome (ARDS). It has been suggested that use of lower tidal volumes also benefits patients who do not have ARDS. Objective To determine

Clinical and radiological outcome following pneumothorax after endoscopic lung volume reduction with valves.

Science.gov (United States)

Gompelmann, D; Benjamin, N; Kontogianni, K; Herth, Fjf; Heussel, C P; Hoffmann, H; Eberhardt, R

2016-01-01

Valve implantation has evolved as a therapy for patients with advanced emphysema. Although it is a minimally invasive treatment, it is associated with complications, the most common being pneumothorax. Pneumothorax occurs due to the rapid target lobe volume reduction and may be a predictor of clinical benefit despite this complication. The objective of this study was to conduct an exploratory data analysis of patients who developed a pneumothorax following endoscopic valve therapy for emphysema. This study performed a retrospective evaluation of pneumothorax management and the impact of pneumothorax on clinical outcomes in 70 patients following valve therapy in 381 consecutive patients. Pneumothorax rate following valve therapy was 18%. Pneumothorax management consisted of chest tube insertion, valve removal, and surgical intervention in 87% (61/70), 44% (31/70), and 19% (13/70) of the patients, respectively. Despite pneumothorax, patients experienced modest but significant improvements in lung function parameters (forced expiratory volume in 1 second: 55±148 mL, residual volume: -390±964 mL, total lung capacity: -348±876; all P pneumothorax, which was associated with relevant clinical improvement, was observed in only 21% (15/70) of the patients. Pneumothorax is a frequent severe complication following valve therapy that requires further intervention. Nevertheless, the pneumothorax does not impair the clinical status in the majority of patients. Patients with lobar atelectasis benefit after recovering from pneumothorax in terms of lung function parameters.

Outcome of radiotherapy for localized stage I E and II E nasal NK/T cell lymphoma

International Nuclear Information System (INIS)

Jin Jing; Li Yexiong; Yao Bo; Fang Hui; Liu Xinfan; Zhou Liqiang; Lv Ning; Yu Zihao

2006-01-01

Objective: With the optimal therapy remains unclear for nasal NK/T cell lymphoma, the aim of this study is to analyze the outcome of radiotherapy as primary treatment for localized stage I E and II E diseases. Methods: Between January. 1983 and December 2003, 105 patients with stage I E and II E primary nasal NK/T cell lymphoma were retrospectively reviewed. According to the Ann Arbor Staging System, there were 83 stage I E and 22 stage II E. Stage I E was subdivided into limited stage I E confined to the nasal cavity (37 patients), or extensive stage I E with an extension beyond the nasal cavity (46 patients). Thirty-one patients received radiotherapy alone. Thirty-four patients were treated with radiotherapy followed by 2-4 cycles of chemotherapy. Thirty-seven patients were treated with chemotherapy followed by radiotherapy and 3 with chemotherapy alone. Of 83 patients with stage I E disease, 26 were primarily treated with radiotherapy alone, 30 with. radiotherapy followed by chemotherapy, and 27 with chemotherapy followed by radiotherapy. Results: The five-year overall survival (OS) and progression-free survival rates (PIS) for all patients was 71% and 59%, respectively. The 5-year OS for stage I E and stage II E was 78% and 46% (P<0.01), while the 5-year PFS for stage I E and stage II E was 63% and 40%, respectively (P<0.01). Patients with limited stage I E had a better OS and PFS than those with extensive stage I E, with 5-year OS and PFS of 82% and 80% versus 75% and 45%, respectively. Complete response (CR) was achieved in 91 (87%) patients after radiotherapy and/or chemotherapy. Initial radiotherapy resulted in a superior CR as compared to initial chemotherapy, with 54 of 65 (83%) patients achieving CR with initial radiotherapy, versus only 8 of 40 (20%) with initial chemotherapy. For 102 patients who received radiotherapy with or without chemotherapy, the outcome of primary, treatment with radiotherapy alone was compared to that of CMT. Five-year OS and

GENII [Generation II]: The Hanford Environmental Radiation Dosimetry Software System: Volume 3, Code maintenance manual: Hanford Environmental Dosimetry Upgrade Project

International Nuclear Information System (INIS)

Napier, B.A.; Peloquin, R.A.; Strenge, D.L.; Ramsdell, J.V.

1988-09-01

The Hanford Environmental Dosimetry Upgrade Project was undertaken to incorporate the internal dosimetry models recommended by the International Commission on Radiological Protection (ICRP) in updated versions of the environmental pathway analysis models used at Hanford. The resulting second generation of Hanford environmental dosimetry computer codes is compiled in the Hanford Environmental Dosimetry System (Generation II, or GENII). This coupled system of computer codes is intended for analysis of environmental contamination resulting from acute or chronic releases to, or initial contamination of, air, water, or soil, on through the calculation of radiation doses to individuals or populations. GENII is described in three volumes of documentation. This volume is a Code Maintenance Manual for the serious user, including code logic diagrams, global dictionary, worksheets to assist with hand calculations, and listings of the code and its associated data libraries. The first volume describes the theoretical considerations of the system. The second volume is a Users' Manual, providing code structure, users' instructions, required system configurations, and QA-related topics. 7 figs., 5 tabs

GENII (Generation II): The Hanford Environmental Radiation Dosimetry Software System: Volume 3, Code maintenance manual: Hanford Environmental Dosimetry Upgrade Project

Energy Technology Data Exchange (ETDEWEB)

Napier, B.A.; Peloquin, R.A.; Strenge, D.L.; Ramsdell, J.V.

1988-09-01

The Hanford Environmental Dosimetry Upgrade Project was undertaken to incorporate the internal dosimetry models recommended by the International Commission on Radiological Protection (ICRP) in updated versions of the environmental pathway analysis models used at Hanford. The resulting second generation of Hanford environmental dosimetry computer codes is compiled in the Hanford Environmental Dosimetry System (Generation II, or GENII). This coupled system of computer codes is intended for analysis of environmental contamination resulting from acute or chronic releases to, or initial contamination of, air, water, or soil, on through the calculation of radiation doses to individuals or populations. GENII is described in three volumes of documentation. This volume is a Code Maintenance Manual for the serious user, including code logic diagrams, global dictionary, worksheets to assist with hand calculations, and listings of the code and its associated data libraries. The first volume describes the theoretical considerations of the system. The second volume is a Users' Manual, providing code structure, users' instructions, required system configurations, and QA-related topics. 7 figs., 5 tabs.

High School and Beyond. 1980 Senior Coort. Third-Follow-Up (1986). Data File User's Manual. Volume II: Survey Instruments. Contractor Report.

Science.gov (United States)

Sebring, Penny; And Others

Survey instruments used in the collection of data for the High School and Beyond base year (1980) through the third follow-up surveys (1986) are provided as Volume II of a user's manual for the senior cohort data file. The complete user's manual is designed to provide the extensive documentation necessary for using the cohort data files. Copies of…

PATRAM '80. Proceedings. Volume 2

International Nuclear Information System (INIS)

Huebner, H.W.

1980-01-01

Volume 2 contains papers from the following sessions: Safeguards-Related Problems; Neutronics and Criticality; Operations and Systems Experience II; Plutonium Systems; Intermediate Storage in Casks; Operations and Systems Planning; Institutional Issues; Structural and Thermal Evaluation I; Poster Session B; Extended Testing I; Structural and Thermal Evaluation II; Extended Testing II; and Emergency Preparedness and Response. Individual papers were processed. (LM)

Characterizing Tumor Heterogeneity With Functional Imaging and Quantifying High-Risk Tumor Volume for Early Prediction of Treatment Outcome: Cervical Cancer as a Model

Energy Technology Data Exchange (ETDEWEB)

Mayr, Nina A., E-mail: Nina.Mayr@osumc.edu [Department of Radiation Oncology, Ohio State University, Columbus, OH (United States); Huang Zhibin [Department of Radiation Oncology and Department of Physics, East Carolina University, Greenville, NC (United States); Wang, Jian Z. [Department of Radiation Oncology, Ohio State University, Columbus, OH (United States); Lo, Simon S. [Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH (United States); Fan, Joline M. [Department of Molecular Biology, Stanford University, Stanford, CA (United States); Grecula, John C. [Department of Radiation Oncology, Ohio State University, Columbus, OH (United States); Sammet, Steffen [Department of Radiology, University of Chicago, Chicago, IL (United States); Department of Radiology, Ohio State University, Columbus, OH (United States); Sammet, Christina L. [Department of Radiology, University of Chicago, Chicago, IL (United States); Jia Guang; Zhang Jun; Knopp, Michael V.; Yuh, William T.C. [Department of Radiology, Ohio State University, Columbus, OH (United States)

2012-07-01

Purpose: Treatment response in cancer has been monitored by measuring anatomic tumor volume (ATV) at various times without considering the inherent functional tumor heterogeneity known to critically influence ultimate treatment outcome: primary tumor control and survival. This study applied dynamic contrast-enhanced (DCE) functional MRI to characterize tumors' heterogeneous subregions with low DCE values, at risk for treatment failure, and to quantify the functional risk volume (FRV) for personalized early prediction of treatment outcome. Methods and Materials: DCE-MRI was performed in 102 stage IB{sub 2}-IVA cervical cancer patients to assess tumor perfusion heterogeneity before and during radiation/chemotherapy. FRV represents the total volume of tumor voxels with critically low DCE signal intensity (<2.1 compared with precontrast image, determined by previous receiver operator characteristic analysis). FRVs were correlated with treatment outcome (follow-up: 0.2-9.4, mean 6.8 years) and compared with ATVs (Mann-Whitney, Kaplan-Meier, and multivariate analyses). Results: Before and during therapy at 2-2.5 and 4-5 weeks of RT, FRVs >20, >13, and >5 cm{sup 3}, respectively, significantly predicted unfavorable 6-year primary tumor control (p = 0.003, 7.3 Multiplication-Sign 10{sup -8}, 2.0 Multiplication-Sign 10{sup -8}) and disease-specific survival (p = 1.9 Multiplication-Sign 10{sup -4}, 2.1 Multiplication-Sign 10{sup -6}, 2.5 Multiplication-Sign 10{sup -7}, respectively). The FRVs were superior to the ATVs as early predictors of outcome, and the differentiating power of FRVs increased during treatment. Discussion: Our preliminary results suggest that functional tumor heterogeneity can be characterized by DCE-MRI to quantify FRV for predicting ultimate long-term treatment outcome. FRV is a novel functional imaging heterogeneity parameter, superior to ATV, and can be clinically translated for personalized early outcome prediction before or as early as 2

Pulmonary function testing in HTLV-I and HTLV-II infected humans: a cohort study

Directory of Open Access Journals (Sweden)

Garratty George

2003-07-01

Full Text Available Abstract Background HTLV-I infection has been linked to lung pathology and HTLV-II has been associated with an increased incidence of pneumonia and acute bronchitis. However it is unknown whether HTLV-I or -II infection alters pulmonary function. Methods We performed pulmonary function testing on HTLV-I, HTLV-II and HTLV seronegative subjects from the HTLV outcomes study (HOST, including vital capacity (VC, forced expiratory volume in one second (FEV1, and diffusing lung capacity for carbon monoxide (DLCO corrected for hemoglobin and lung volume. Multivariable analysis adjusted for differences in age, gender, race/ethnicity, height and smoking history. Results Mean (standard deviation pulmonary function values among the 257 subjects were as follows: FVC = 3.74 (0.89 L, FEV1 = 2.93 (0.67 L, DLCOcorr = 23.82 (5.89 ml/min/mmHg, alveolar ventilation (VA = 5.25 (1.20 L and DLCOcorr/VA = 4.54 (0.87 ml/min/mmHg/L. There were no differences in FVC, FEV1 and DLCOcorr/VA by HTLV status. For DLCOcorr, HTLV-I and HTLV-II subjects had slightly lower values than seronegatives, but neither difference was statistically significant after adjustment for confounding. Conclusions There was no difference in measured pulmonary function and diffusing capacity in generally healthy HTLV-I and HTLV-II subjects compared to seronegatives. These results suggest that previously described HTLV-associated abnormalities in bronchoalveolar cells and fluid may not affect pulmonary function.

TIBER II/ETR final design report: Volume 3, 5.0 Radiation safety and environment; 6.0 Physics and technology R and D needs

International Nuclear Information System (INIS)

Lee, J.D.

1987-09-01

This paper discusses the design of the TIBER II Tokamak. This particular volume discusses: safety and environmental requirements and design targets; accident analyses; personnel safety and maintenance exposure; effluent control; waste management and decommissioning; safety considerations in building design; and safety and environmental conclusions and recommendations

Mg II ABSORPTION CHARACTERISTICS OF A VOLUME-LIMITED SAMPLE OF GALAXIES AT z ∼ 0.1

International Nuclear Information System (INIS)

Barton, Elizabeth J.; Cooke, Jeff

2009-01-01

We present an initial survey of Mg II absorption characteristics in the halos of a carefully constructed, volume-limited subsample of galaxies embedded in the spectroscopic part of the Sloan Digital Sky Survey (SDSS). We observed quasars near sightlines to 20 low-redshift (z ∼ 0.1), luminous (M r + 5log h ≤-20.5) galaxies in SDSS DR4 and DR6 with the LRIS-B spectrograph on the Keck I telescope. The primary systematic criteria for the targeted galaxies are a redshift z ∼> 0.1 and the presence of an appropriate bright background quasar within a projected 75 h -1 kpc of its center, although we preferentially sample galaxies with lower impact parameters and slightly more star formation within this range. Of the observed systems, six exhibit strong (W eq (2796) ≥ 0.3 A) Mg II absorption at the galaxy's redshift, six systems have upper limits which preclude strong Mg II absorption, while the remaining observations rule out very strong (W eq (2796) ≥ 1-2 A) absorption. The absorbers fall at higher impact parameters than many non-absorber sightlines, indicating a covering fraction f c ∼ -1 kpc (f c ∼ 0.25). The data are consistent with a possible dependence of covering fraction and/or absorption halo size on the environment or star-forming properties of the central galaxy.

Long-term outcomes of mandibular kinematics following class II malocclusion therapy with removable functional appliance therapy.

Science.gov (United States)

Linsen, Sabine S; Wolf, Michael; Müßig, Dieter

2016-11-01

To evaluate mandibular kinematics in class I adults following class II therapy with removable functional appliances (RFAs) during the growth period in comparison with orthodontically untreated class I and II individuals. Condylar (CRoM) and incisal range of motion (InRoM), velocity during opening and closing, and the mandibular rotation angle were recorded using an ultrasound-based jaw-tracking system in 36 test patients (mean age = 28.03 ± 6.58 years). Significant group effects were found for CRoM towards the posterior in the right joint (p = 0.002) and InRoM towards the anterior (p = 0.043). The post hoc Tukey test indicates a significantly longer CRoM (posterior) for the right condyle in class II (p = 0.003) and RFA individuals (p = 0.023). The kinematic data imply greater dentoalveolar effects due to RFA therapy than adaptive remodeling of the temporomandibular joint. The class I relationship in the RFA group following treatment indicates stable long-term outcomes.

Comparative ranking of 0. 1-10 MW/sub e/ solar thermal electric power systems. Volume II. Supporting data. Final report

Energy Technology Data Exchange (ETDEWEB)

Thornton, J.P.; Brown, K.C.; Finegold, J.G.; Gresham, J.B.; Herlevich, F.A.; Kriz, T.A.

1980-07-01

This report is part of a two-volume set summarizing the results of a comparative ranking of generic solar thermal concepts designed specifically for electric power generation. The original objective of the study was to project the mid-1990 cost and performance of selected generic solar thermal electric power systems for utility applications and to rank these systems by criteria that reflect their future commercial acceptance. This study considered plants with rated capacities of 1-10 MW/sub e/, operating over a range of capacity factors from the no-storage case to 0.7 and above. Later, the study was extended to include systems with capacities from 0.1 to 1 MW/sub e/, a range that is attractive to industrial and other nonutility applications. Volume I summarizes the results for the full range of capacities from 0.1 to 1.0 MW/sub e/. Volume II presents data on the performance and cost and ranking methodology.

International Linear Collider Technical Design Report (Volumes 1 through 4)

Energy Technology Data Exchange (ETDEWEB)

Harrison M.

2013-03-27

The design report consists of four volumes: Volume 1, Executive Summary; Volume 2, Physics; Volume 3, Accelerator (Part I, R and D in the Technical Design Phase, and Part II, Baseline Design); and Volume 4, Detectors.

Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study.

LENUS (Irish Health Repository)

Good, Daniel W

2012-08-01

Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate.

Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

International Nuclear Information System (INIS)

Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M.; Renker, Matthias; Ackermann, Hanns; Schoepf, U.J.

2011-01-01

To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p 5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

The association between brain volumes, delirium duration, and cognitive outcomes in intensive care unit survivors: the VISIONS cohort magnetic resonance imaging study*.

Science.gov (United States)

Gunther, Max L; Morandi, Alessandro; Krauskopf, Erin; Pandharipande, Pratik; Girard, Timothy D; Jackson, James C; Thompson, Jennifer; Shintani, Ayumi K; Geevarghese, Sunil; Miller, Russell R; Canonico, Angelo; Merkle, Kristen; Cannistraci, Christopher J; Rogers, Baxter P; Gatenby, J Chris; Heckers, Stephan; Gore, John C; Hopkins, Ramona O; Ely, E Wesley

2012-07-01

Delirium duration is predictive of long-term cognitive impairment in intensive care unit survivors. Hypothesizing that a neuroanatomical basis may exist for the relationship between delirium and long-term cognitive impairment, we conducted this exploratory investigation of the associations between delirium duration, brain volumes, and long-term cognitive impairment. A prospective cohort of medical and surgical intensive care unit survivors with respiratory failure or shock. Quantitative high resolution 3-Tesla brain magnetic resonance imaging was used to calculate brain volumes at discharge and 3-month follow-up. Delirium was evaluated using the confusion assessment method for the intensive care unit; cognitive outcomes were tested at 3- and 12-month follow-up. Linear regression was used to examine associations between delirium duration and brain volumes, and between brain volumes and cognitive outcomes. A total of 47 patients completed the magnetic resonance imaging protocol. Patients with longer duration of delirium displayed greater brain atrophy as measured by a larger ventricle-to-brain ratio at hospital discharge (0.76, 95% confidence intervals [0.10, 1.41]; p = .03) and at 3-month follow-up (0.62 [0.02, 1.21], p = .05). Longer duration of delirium was associated with smaller superior frontal lobe (-2.11 cm(3) [-3.89, -0.32]; p = .03) and hippocampal volumes at discharge (-0.58 cm(3) [-0.85, -0.31], p Battery for the Assessment of Neuropsychological Status score -11.17 [-21.12, -1.22], p = .04). Smaller superior frontal lobes, thalamus, and cerebellar volumes at 3 months were associated with worse executive functioning and visual attention at 12 months. These preliminary data show that longer duration of delirium is associated with smaller brain volumes up to 3 months after discharge, and that smaller brain volumes are associated with long-term cognitive impairment up to 12 months. We cannot, however, rule out that smaller preexisting brain volumes explain

Draft Site Treatment Plan (DSTP), Volumes I and II

International Nuclear Information System (INIS)

D'Amelio, J.

1994-01-01

Site Treatment Plans (STP) are required for facilities at which the DOE generates or stores mixed waste. This Draft Site Treatment Plan (DSTP) the second step in a three-phase process, identifies the currently preferred options for treating mixed waste at the Savannah River Site (SRS) or for developing treatment technologies where technologies do not exist or need modification. The DSTP reflects site-specific preferred options, developed with the state's input and based on existing available information. To the extent possible, the DSTP identifies specific treatment facilities for treating the mixed waste and proposes schedules. Where the selection of specific treatment facilities is not possible, schedules for alternative activities such as waste characterization and technology assessment are provided. All schedule and cost information presented is preliminary and is subject to change. The DSTP is comprised of two volumes: this Compliance Plan Volume and the Background Volume. This Compliance Plan Volume proposes overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) of RCRA and procedures for converting the target dates into milestones to be enforced under the Order. The more detailed discussion of the options contained in the Background Volume is provided for informational purposes only

Plasma uric acid and tumor volume are highly predictive of outcome in nasopharyngeal carcinoma patients receiving intensity modulated radiotherapy

International Nuclear Information System (INIS)

Lin, Hui; Lin, Huan-Xin; Ge, Nan; Wang, Hong-Zhi; Sun, Rui; Hu, Wei-Han

2013-01-01

The combined predictive value of plasma uric acid and primary tumor volume in nasopharyngeal carcinoma (NPC) patients receiving intensity modulated radiation therapy (IMRT) has not yet been determined. In this retrospective study, plasma uric acid level was measured after treatment in 130 histologically-proven NPC patients treated with IMRT. Tumor volume was calculated from treatment planning CT scans. Overall (OS), progression-free (PFS) and distant metastasis-free (DMFS) survival were compared using Kaplan-Meier analysis and the log rank test, and Cox multivariate and univariate regression models were created. Patients with a small tumor volume (<27 mL) had a significantly better DMFS, PFS and OS than patients with a large tumor volume. Patients with a high post-treatment plasma uric acid level (>301 μmol/L) had a better DMFS, PFS and OS than patients with a low post-treatment plasma uric acid level. Patients with a small tumor volume and high post-treatment plasma uric acid level had a favorable prognosis compared to patients with a large tumor volume and low post-treatment plasma uric acid level (7-year overall OS, 100% vs. 48.7%, P <0.001 and PFS, 100% vs. 69.5%, P <0.001). Post-treatment plasma uric acid level and pre-treatment tumor volume have predictive value for outcome in NPC patients receiving IMRT. NPC patients with a large tumor volume and low post-treatment plasma uric acid level may benefit from additional aggressive treatment after IMRT

Cranial vault remodeling in microcephalic osteodysplastic primordial dwarfism type II and craniosynostosis.

Science.gov (United States)

Engel, Michael; Castrillon-Oberndorfer, Gregor; Hoffmann, Jürgen; Egermann, Marcus; Freudlsperger, Christian; Thiele, Oliver Christian

2012-09-01

This is a survey of the long-term result after various surgical treatments in a child with microcephalic osteodysplastic primordial dwarfism type II (MOPD II) and craniosynostosis. We report a 17-year-old patient with MOPD II but some unusual clinical signs including bilateral knee dislocation, a misplaced upper lobe bronchus, and hypoplasia of the anterior corpus callosum. Because of premature fusion of several cranial sutures, the child developed signs of increased intracranial pressure with somnolence and papilledema. Cranial vault remodeling with fronto-orbital advancement was performed twice at the age of 16 and 21 months to open the abnormally closed suture, increase the intracranial volume, and relieve the elevated intracranial pressure. Following this procedure, the child's neurologic situation recovered significantly. Surgical procedure of fronto-orbital advancement and the performed reoperation in our patient were safe with no major complications intraoperatively and postoperatively with good functional and satisfying aesthetic outcomes in the long-term follow-up, expressed by the patient, his parents, and the surgeons.

Grading of vestibular schwannomas and corresponding tumor volumes: ramifications for radiosurgery.

Science.gov (United States)

Mindermann, T; Schlegel, I

2013-01-01

Patients with vestibular schwannomas (VS) are either assigned to watchful waiting, microsurgical resection, or radiosurgery. Decision making on how to proceed is based on parameters such as age, tumor growth, loss of hearing, and the tumor's Koos grading. In order to correlate Koos grading with tumor volume, patient records of 235 patients with VS who underwent Gamma Knife radiosurgery (GKRS) were retrospectively reviewed. From 1994 to 2009, 235 consecutive patients underwent GKRS for sporadic VS at the Zurich Gamma Knife Center. Median follow up was 62.8 ± 33.0 months. Of the 235 tumors, 32 (13.6 %) were graded Koos I with a volume of 0.25 ± 0.3 cc; 71 (30.2 %) were graded Koos II with a volume of 0.57 ± 0.54 cc; 70 (29.8 %) were graded Koos III with a volume of 1.82 ± 1.88 cc; and 62 (26.4 %) were graded Koos IV with a volume of 4.17 ± 2.75 cc. Tumor progression was defined as a volume increase > 20 % at 2 years or later following GKRS. Overall tumor progression occurred in 21/235 (8.9 %) patients at 3.4 ± 0.9 years. Tumor progression did not differ statistically significantly in the various Koos grades: 1/32 (3.1 %) patients with VS Koos Grade I, 7/71 (9.8 %) patients with VS Koos Grade II, 6/70 (8.6 %) patients with VS Koos Grade III, and 7/62 (11.3 %) patients with VS Koos Grade IV. To our knowledge, this is the first work correlating the various Koos grades of VS to their respective tumor volumes. In our patients, tumor volumes of VS Koos Grade IV were limited because all of our patients were eligible for radiosurgery. In our series, the outcome following GKRS for patients with VS Koos Grade IV tumors did not differ from patients with VS Koos Grades I-III. We therefore suggest to limit Koos Grade IV VS to tumor volumes 6 cc that may not be eligible for radiosurgery.

Bibliography of mass spectroscopy literature for 1972 compiled by a computer method. Volume II. Key Word Out of Context (KWOC) Index

International Nuclear Information System (INIS)

Capellen, J.; Svec, H.J.; Sage, C.R.; Sun, R.

1975-08-01

This report covers the year 1972, and lists approximately 10,000 articles of interest to mass spectroscopists. This two-volume report consists of three sections. Vol. II contains the Key Word Out of Context Index (KWOC Index) section. The KWOC Index lists the key words, the reference numbers of the articles in which the key word appears, and the first 100 characters of the title

Do time of birth, unit volume, and staff seniority affect neonatal outcome in deliveries at ≥34+0 weeks of gestation?

Science.gov (United States)

Reif, P; Pichler, G; Griesbacher, A; Lehner, G; Schöll, W; Lang, U; Hofmann, H; Ulrich, D

2018-06-01

We investigated whether time of birth, unit volume, and staff seniority affect neonatal outcome in neonates born at ≥34 +0 weeks of gestation. Population-based prospective cohort study. Ten public hospitals in the Austrian province of Styria. A total of 87 065 neonates delivered in the period 2004-2015. Based on short-term outcome data, generalised linear mixed models were used to calculate the risk for adverse and severely adverse neonatal outcomes according to time of birth, unit volume, and staff seniority. Neonatal composite adverse and severely adverse outcome measures. The odds ratio for severely adverse events during the night-time (22:01-07:29 hours) compared with the daytime (07:30-15:00 hours) was 1.35 (95% confidence interval, 95% CI 1.13-1.61). There were no significant differences in neonatal outcome comparing weekdays and weekends, and comparing office hours and shifts. Units with 500-1000 deliveries per year had the lowest risk for adverse events. Adverse and severely adverse neonatal outcomes were least common for midwife-guided deliveries, and became more frequent with the level of experience of the doctors attending the delivery. With increasing pregnancy risks, senior staff attending delivery and delivering in a tertiary centre reduce the odds ratio for adverse events. Different times of delivery were associated with increased adverse neonatal outcomes. The management of uncomplicated deliveries by less experienced staff showed no negative impact on perinatal outcome. In contrast, riskier pregnancies delivered by senior staff in a tertiary centre favour a better outcome. Achieving a better balance in the total number of labour ward staff during the day and the night appears to be a greater priority than increasing the continuous presence of senior obstetrical staff on the labour ward during the out-of-hours period. Deliveries during night time lead to a greater number of neonates experiencing severely adverse events. © 2017 Royal College of

Patient satisfaction: does surgical volume matter?

Science.gov (United States)

Tevis, Sarah E; Kennedy, Gregory D

2015-06-01

Patient satisfaction is an increasing area of interest due to implications of pay for performance and public reporting of results. Although scores are adjusted for patient factors, little is known about the relationship between hospital structure, postoperative outcomes, and patient satisfaction with the hospital experience. Hospitals participating in the University HealthSystem Consortium database from 2011-2012 were included. Patients were restricted to those discharged by general surgeons to isolate surgical patients. Hospital data were paired with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results from the Hospital Compare website. Postoperative outcomes were dichotomized based on the median for all hospitals and stratified based on surgical volume. The primary outcome of interest was high on overall patient satisfaction, whereas other HCAHPS domains were assessed as secondary outcomes. Chi square and binary logistic regression analyses were performed to evaluate whether postoperative outcomes or surgical volume more significantly influenced high patient satisfaction. The study population consisted of 171 hospitals from the University HealthSystem Consortium database. High surgical volume was a more important predictor of overall patient satisfaction regardless of hospital complication (P patient satisfaction on the HCAHPS survey than postoperative outcomes, whereas volume was less predictive in other HCAHPS domains. Patients may require more specific questioning to identify high quality, safe hospitals. Copyright © 2015 Elsevier Inc. All rights reserved.

Intensity-Modulated Radiation Therapy in Oropharyngeal Carcinoma: Effect of Tumor Volume on Clinical Outcomes

International Nuclear Information System (INIS)

Lok, Benjamin H.; Setton, Jeremy; Caria, Nicola; Romanyshyn, Jonathan; Wolden, Suzanne L.; Zelefsky, Michael J.; Park, Jeffery; Rowan, Nicholas; Sherman, Eric J.; Fury, Matthew G.; Ho, Alan; Pfister, David G.; Wong, Richard J.; Shah, Jatin P.; Kraus, Dennis H.; Zhang, Zhigang; Schupak, Karen D.; Gelblum, Daphna Y.; Rao, Shyam D.; Lee, Nancy Y.

2012-01-01

Purpose: To analyze the effect of primary gross tumor volume (pGTV) and nodal gross tumor volume (nGTV) on treatment outcomes in patients treated with definitive intensity-modulated radiation therapy (IMRT) for oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, a total of 442 patients with squamous cell carcinoma of the oropharynx were treated with IMRT with curative intent at our center. Thirty patients treated postoperatively and 2 additional patients who started treatment more than 6 months after diagnosis were excluded. A total of 340 patients with restorable treatment plans were included in this present study. The majority of the patients underwent concurrent platinum-based chemotherapy. The pGTV and nGTV were calculated using the original clinical treatment plans. Cox proportional hazards models and log-rank tests were used to evaluate the correlation between tumor volumes and overall survival (OS), and competing risks analysis tools were used to evaluate the correlation between local failure (LF), regional failure (RF), distant metastatic failure (DMF) vs. tumor volumes with death as a competing risk. Results: Median follow-up among surviving patients was 34 months (range, 5-67). The 2-year cumulative incidence of LF, RF and DF in this cohort of patients was 6.1%, 5.2%, and 12.2%, respectively. The 2-year OS rate was 88.6%. Univariate analysis determined pGTV and T-stage correlated with LF (p < 0.0001 and p = 0.004, respectively), whereas nGTV was not associated with RF. On multivariate analysis, pGTV and N-stage were independent risk factors for overall survival (p = 0.0003 and p = 0.0073, respectively) and distant control (p = 0.0008 and p = 0.002, respectively). Conclusions: In this cohort of patients with OPC treated with IMRT, pGTV was found to be associated with overall survival, local failure, and distant metastatic failure.

Safety Specialist Manpower, Manpower Resources. Volumes II and III.

Science.gov (United States)

Booz Allen and Hamilton, Inc., Washington, DC.

These second and third volumes of a four-volume study of manpower in state highway safety programs over the next decade estimate manpower resources by state and in national aggregate and describe present and planned training programs for safety specialists. For each educational level, both total manpower and manpower actually available for…

INTRA/Mod3.2. Manual and code description. Volume 2 - User's manual

International Nuclear Information System (INIS)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the physical modelling of INTRA and the ruling numerics, and volume II, the User's Manual is an input description. This document, the User's Manual, Volume II, contains a detailed description of how to use INTRA, how to set up an input file, how to run INTRA and also post-processing

Adaptive designs for dose-finding in non-cancer phase II trials: influence of early unexpected outcomes.

Science.gov (United States)

Resche-Rigon, Matthieu; Zohar, Sarah; Chevret, Sylvie

2008-01-01

In non-cancer phase II trials, dose-finding trials are usually carried out using fixed designs, in which several doses including a placebo are randomly distributed to patients. However, in certain vulnerable populations, such as neonates or infants, there is an heightened requirement for safety, precluding randomization. To estimate the minimum effective dose of a new drug from a non-cancer phase II trial, we propose the use of adaptive designs like the Continual Reassessment Method (CRM). This approach estimates the dose closest to some target response, and has been shown to be unbiased and efficient in cancer phase I trials. Based on a motivating example, we point out the individual influence of first outliers in this setting. A weighted version of the CRM is proposed as a theoretical benchmark to control for these outliers. Using simulations, we illustrate how this approach provides further insight into the behavior of the CRM. When dealing with low targets like a 10% failure rate, the CRM appears unable to rapidly overcome an early unexpected outcome. This behavior persisted despite changing the inference (Bayesian or likelihood), underlying dose-response model (though slightly improved using the power model), and the number of patients enrolled at each dose level. The choices for initial guesses of failure rates, the vague prior for the model parameter, and the log-log shape of weights can appear somewhat arbitrary. In phase II dose-finding studies in which failure targets are below 20%, the CRM appears quite sensitive to first unexpected outcomes. Using a power model for dose-response improves some behavior if the trial is started at the first dose level and includes at least three to five patients at the starting dose before applying the CRM allocation rule.

Oral HPV infection and MHC class II deficiency (A study of two cases with atypical outcome

Directory of Open Access Journals (Sweden)

Guirat-Dhouib Naouel

2012-04-01

Full Text Available Abstract Background Major histocompatibility complex class II deficiency, also referred to as bare lymphocyte syndrome is a rare primary Immunodeficiency disorder characterized by a profondly deficient human leukocyte antigen class II expression and a lack of cellular and humoral immune responses to foreign antigens. Clinical manifestations include extreme susceptibility to viral, bacterial, and fungal infections. The infections begin in the first year of life and involve usually the respiratory system and the gastrointestinal tract. Severe malabsorption with failure to thrive ensues, often leading to death in early childhood. Bone marrow transplantation is the curative treatment. Case reports Here we report two cases with a late outcome MHC class II deficiency. They had a long term history of recurrent bronchopulmonary and gastrointestinal infections. Bone marrow transplantation could not be performed because no compatible donor had been identified. At the age of 12 years, they developed oral papillomatous lesions related to HPV (human papillomavirus. The diagnosis of HPV infection was done by histological examination. HPV typing performed on the tissue obtained at biopsy showed HPV type 6. The lesions were partially removed after two months of laser treatment. Conclusions Viral infections are common in patients with MHC class II and remain the main cause of death. Besides warts caused by HPV infection do not exhibit a propensity for malignant transformation; they can cause great psychosocial morbidity.

Heater test planning for the Near Surface Test Facility at the Hanford reservation. Volume II. Appendix

International Nuclear Information System (INIS)

DuBois, A.; Binnall, E.; Chan, T.; McEvoy, M.; Nelson, P.; Remer, J.

1979-04-01

Volume II contains the following information: theoretical support for radioactive waste storage projects - development of data analysis methods and numerical models; injectivity temperature profiling as a means of permeability characterization; geophysical holes at the Near Surface Test Facility (NSTF), Hanford; proposed geophysical and hydrological measurements at NSTF; suggestions for characterization of the discontinuity system at NSTF; monitoring rock property changes caused by radioactive waste storage using the electrical resistivity method; microseismic detection system for heated rock; Pasco Basin groundwater contamination study; a letter to Mark Board on Gable Mountain Faulting; report on hydrofracturing tests for in-situ stress measurement, NSTF, Hole DC-11, Hanford Reservation; and borehole instrumentation layout for Hanford Near Surface Test Facility

Direct liquid content measurement applicable for He II space cryostats

International Nuclear Information System (INIS)

Wanner, M.

1988-01-01

A direct calorimetric method for content measurement in the He II cryostat ISO was assessed. A well defined heat pulse into the He II bath causes a small temperature increase which can be measured and directly correlated to the liquid mass through the He II specific heat. To study this method under the potential zero gravity constraints of disconnected liquid volumes a setup was established for investigating heat transfer between separated liquid volumes. The results for different fluid configurations confirm that even for completely disconnected volumes the heat is almost immediately distributed throughout the whole liquid by evaporation and recondensation

An Independent Scientific Assessment of Well Stimulation in California Volume III

Energy Technology Data Exchange (ETDEWEB)

Long, Jane C.S. [California Council on Science and Technology, Sacramento, CA (United States); Feinstein, Laura C. [California Council on Science and Technology, Sacramento, CA (United States); Birkholzer, Jens [California Council on Science and Technology, Sacramento, CA (United States); Foxall, William [California Council on Science and Technology, Sacramento, CA (United States); Houseworth, James [California Council on Science and Technology, Sacramento, CA (United States); Jordan, Preston [California Council on Science and Technology, Sacramento, CA (United States); Lindsey, Nathaniel [California Council on Science and Technology, Sacramento, CA (United States); Maddalena, Randy [California Council on Science and Technology, Sacramento, CA (United States); McKone, Thomas [California Council on Science and Technology, Sacramento, CA (United States); Stringfellow, William [California Council on Science and Technology, Sacramento, CA (United States); Ulrich, Craig [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heberger, Matthew [Pacific Inst., Oakland, CA (United States); Shonkoff, Seth [PSE Healthy Energy, Berkeley, CA (United States); Brandt, Adam [Stanford Univ., CA (United States); Ferrar, Kyle [The FracTracker Alliance, Oakland, CA (United States); Gautier, Donald [DonGautier LLC., Palo Alto, CA (United States); Phillips, Scott [California State Univ. Stanislaus, Turlock, CA (United States); Greenfield, Ben [Univ. of California, Berkeley, CA (United States); Jerrett, Michael L.B. [Univ. of California, Los Angeles, CA (United States)

2015-07-01

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, issued in July 2015, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, this volume, presents case studies that assess environmental issues and qualitative risks for specific geographic regions. The Summary Report summarizes key findings, conclusions and recommendations of all three volumes.

Hearing Outcomes After Stereotactic Radiosurgery for Unilateral Intracanalicular Vestibular Schwannomas: Implication of Transient Volume Expansion

Energy Technology Data Exchange (ETDEWEB)

Kim, Young-Hoon [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Gyu, E-mail: gknife@plaza.snu.ac.kr [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, Jung Ho [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chung, Hyun-Tai; Kim, In Kyung; Song, Sang Woo [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Jeong-Hoon [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Jin Wook; Kim, Yong Hwy; Park, Chul-Kee [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Chae-Yong [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Paek, Sun Ha; Jung, Hee-Won [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of)

2013-01-01

Purpose: We evaluated the prognostic factors for hearing outcomes after stereotactic radiosurgery (SRS) for unilateral sporadic intracanalicular vestibular schwannomas (IC-VSs) as a clinical homogeneous group of VSs. Methods and Materials: Sixty consecutive patients with unilateral sporadic IC-VSs, defined as tumors in the internal acoustic canal, and serviceable hearing (Gardner-Roberson grade 1 or 2) were treated with SRS as an initial treatment. The mean tumor volume was 0.34 {+-} 0.03 cm{sup 3} (range, 0.03-1.00 cm{sup 3}), and the mean marginal dose was 12.2 {+-} 0.1 Gy (range, 11.5-13.0 Gy). The median follow-up duration was 62 months (range, 36-141 months). Results: The actuarial rates of serviceable hearing preservation were 70%, 63%, and 55% at 1, 2, and 5 years after SRS, respectively. In multivariate analysis, transient volume expansion of {>=}20% from initial tumor size was a statistically significant risk factor for loss of serviceable hearing and hearing deterioration (increase of pure tone average {>=}20 dB) (odds ratio = 7.638; 95% confidence interval, 2.317-25.181; P=.001 and odds ratio = 3.507; 95% confidence interval, 1.228-10.018; P=.019, respectively). The cochlear radiation dose did not reach statistical significance. Conclusions: Transient volume expansion after SRS for VSs seems to be correlated with hearing deterioration when defined properly in a clinically homogeneous group of patients.

Environmental Pollution: Noise Pollution - Sonic Boom. Volume I.

Science.gov (United States)

Defense Documentation Center, Alexandria, VA.

The unclassified, annotated bibliography is Volume I of a two-volume set on Noise Pollution - Sonic Boom in a series of scheduled bibliographies on Environmental Pollution. Volume II is Confidential. Corporate author-monitoring agency, subject, title, contract, and report number indexes are included. (Author/JR)

Assessment of the health and environmental effects of power generation in the Midwest. Volume II. Ecological effects

Energy Technology Data Exchange (ETDEWEB)

Dvorak, A J; Pentecost, E D

1977-04-01

This report presents an initial evaluation of the major health and environmental issues associated with increased coal use in the six Midwestern states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Using an integrated assessment approach, the evaluation proceeds from a base-line scenario of energy demand and facility siting for the period 1975 to 2020. Emphasis is placed on impacts from coal extraction, land reclamation, coal combustion for electrical generation, and coal gasification. The range of potential impacts and constraints is illustrated by a second scenario that represents an expected upper limit for coal utilization in Illinois. Volume I of the report includes a characterization of the energy demand and siting scenarios, coal related technologies, and coal resources, and the related impacts on air quality, water quality, and human health. Volume II includes background information on the native ecosystems, climate, soils, and agricultural land use and a description of the ecological impacts expected from coal utilization in southern Illinois, which as ecosystems representative of a large segment of the six-state area.

Stream II-V5: Revision Of Stream II-V4 To Account For The Effects Of Rainfall Events

International Nuclear Information System (INIS)

Chen, K.

2010-01-01

STREAM II-V4 is the aqueous transport module currently used by the Savannah River Site emergency response Weather Information Display (WIND) system. The transport model of the Water Quality Analysis Simulation Program (WASP) was used by STREAM II to perform contaminant transport calculations. WASP5 is a US Environmental Protection Agency (EPA) water quality analysis program that simulates contaminant transport and fate through surface water. STREAM II-V4 predicts peak concentration and peak concentration arrival time at downstream locations for releases from the SRS facilities to the Savannah River. The input flows for STREAM II-V4 are derived from the historical flow records measured by the United States Geological Survey (USGS). The stream flow for STREAM II-V4 is fixed and the flow only varies with the month in which the releases are taking place. Therefore, the effects of flow surge due to a severe storm are not accounted for by STREAM II-V4. STREAM II-V4 has been revised to account for the effects of a storm event. The steps used in this method are: (1) generate rainfall hyetographs as a function of total rainfall in inches (or millimeters) and rainfall duration in hours; (2) generate watershed runoff flow based on the rainfall hyetographs from step 1; (3) calculate the variation of stream segment volume (cross section) as a function of flow from step 2; (4) implement the results from steps 2 and 3 into the STREAM II model. The revised model (STREAM II-V5) will find the proper stream inlet flow based on the total rainfall and rainfall duration as input by the user. STREAM II-V5 adjusts the stream segment volumes (cross sections) based on the stream inlet flow. The rainfall based stream flow and the adjusted stream segment volumes are then used for contaminant transport calculations.

The effect of post-wash total progressive motile sperm count and semen volume on pregnancy outcomes in intrauterine insemination cycles: a retrospective study.

Science.gov (United States)

Ok, Elvan Koyun; Doğan, Omer Erbil; Okyay, Recep Emre; Gülekli, Bülent

2013-01-01

The purpose of this study was to determine the impact of post-wash total progressive motile sperm count (TPMSC) and semen volume on pregnancy outcomes in intrauterine insemination (IUI) cycles. The retrospective study included a total of 156 cycles (141 couples) and was performed in our center over a 24-month period. The semen parameters were recorded for each man and each insemination. The semen samples were re-evaluated after the preparation process. Post-wash TPMSC values were divided into four groups; Group 1: 10×10(6). Post-wash inseminated semen volume was divided into three groups; Group 1: 0.3 mL; Group 2: 0.4 mL; Group 3: 0.5 mL. The effect of post-wash total progressive motile sperm and semen volume on pregnancy outcomes was evaluated. The pregnancy rates per cycle and per couple were 27.56% and 30.49%, respectively. There was not a significant relationship between the inseminated semen volume and pregnancy rate (p>0.05). However, a significant linear-by-linear association was documented between the TPMSC and pregnancy rate (p=0.042). Our findings suggest that the post-wash inseminated semen volume should be between 0.3-0.5 mL. An average post-wash total motile sperm count of 10×10(6) may be a useful threshold value for IUI success, but more studies are needed to determine a cut-off value for TPMSC.

Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia.

LENUS (Irish Health Repository)

Sweeney, Kieron J

2013-02-01

McLone and Knepper\\'s unified theory of Chiari malformation Type II (CM-II) describes how the loss of CSF via the open posterior neuropore fails to create adequate distending pressure for the developing rhomboencephalic vesicle. The authors of the present article describe the relationship between the posterior fossa volume and intracranial cerebellar volume as being related to the distance from the obex of the fourth ventricle to the myelomeningocele lesion using a common mathematical model, the Hagen-Poiseuille law.

Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

Energy Technology Data Exchange (ETDEWEB)

Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Renker, Matthias [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States)

2011-09-15

To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

Demonstration, testing, & evaluation of in situ heating of soil. Draft final report, Volume II: Appendices A to E

Energy Technology Data Exchange (ETDEWEB)

Dev, H.; Enk, J.; Jones, D.; Saboto, W.

1996-02-12

This document is a draft final report for US DOE contract entitled, {open_quotes}Demonstration Testing and Evaluation of In Situ Soil Heating,{close_quotes} Contract No. DE-AC05-93OR22160, IITRI Project No. C06787. This report is presented in two volumes. Volume I contains the technical report This document is Volume II, containing appendices with background information and data. In this project approximately 300 cu. yd. of clayey soil containing a low concentration plume of volatile organic chemicals was heated in situ by the application of electrical energy. It was shown that as a result of heating the effective permeability of soil to air flow was increased such that in situ soil vapor extraction could be performed. The initial permeability of soil was so low that the soil gas flow rate was immeasurably small even at high vacuum levels. When scaled up, this process can be used for the environmental clean up and restoration of DOE sites contaminated with VOCs and other organic chemicals boiling up to 120{degrees}to 130{degrees}C in the vadose zone. Although it may applied to many types of soil formations, it is particularly attractive for low permeability clayey soil where conventional in situ venting techniques are limited by low air flow.

Treatment outcome for a sample of patients with Class II division 1 malocclusion treated at a regional hospital orthodontic department.

LENUS (Irish Health Repository)

Burden, D J

1998-01-01

This retrospective study assessed the outcome of orthodontic treatment of 264 patients with Class II division 1 malocclusion (overjet greater than 6 mm). The sample comprised patients who had completed their fixed appliance orthodontic treatment at a regional hospital orthodontic unit in the Republic of Ireland. The PAR Index (Peer Assessment Rating) was used to evaluate treatment outcome using before and after treatment study casts. The results revealed that treatment for this particular type of malocclusion was highly effective with a very few patients failing to benefit from their orthodontic treatment.

Bibliography of Utah radioactive occurrences. Volume II

International Nuclear Information System (INIS)

Doelling, H.H.

1983-07-01

The references in this bibliography were assembled by reviewing published bibliographies of Utah geology, unpublished reports of the US Geological Survey and the Department of Energy, and various university theses. Each of the listings is cross-referenced by location and subject matter. This report is published in two volumes

High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 2

International Nuclear Information System (INIS)

Cunnane, J.C.

1994-03-01

The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion.This document is organized into three volumes. Volumes I and II represent a tiered set of information intended for somewhat different audiences. Volume I is intended to provide an overview of waste glass corrosion, and Volume 11 is intended to provide additional experimental details on experimental factors that influence waste glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II. Volume I is intended for managers, decision makers, and modelers, the combined set of Volumes I, II, and III is intended for scientists and engineers working in the field of high-level waste

High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 2

Energy Technology Data Exchange (ETDEWEB)

Cunnane, J.C. [comp.; Bates, J.K.; Bradley, C.R. [Argonne National Lab., IL (United States)] [and others

1994-03-01

The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion.This document is organized into three volumes. Volumes I and II represent a tiered set of information intended for somewhat different audiences. Volume I is intended to provide an overview of waste glass corrosion, and Volume 11 is intended to provide additional experimental details on experimental factors that influence waste glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II. Volume I is intended for managers, decision makers, and modelers, the combined set of Volumes I, II, and III is intended for scientists and engineers working in the field of high-level waste.

Hanford spent nuclear fuel project recommended path forward, volume III: Alternatives and path forward evaluation supporting documentation

International Nuclear Information System (INIS)

Fulton, J.C.

1994-10-01

Volume I of the Hanford Spent Nuclear Fuel Project - Recommended Path Forward constitutes an aggressive series of projects to construct and operate systems and facilities to safely retrieve, package, transport, process, and store K Basins fuel and sludge. Volume II provided a comparative evaluation of four Alternatives for the Path Forward and an evaluation for the Recommended Path Forward. Although Volume II contained extensive appendices, six supporting documents have been compiled in Volume III to provide additional background for Volume II

Assessment of tidal volume and thoracoabdominal motion using volume and flow-oriented incentive spirometers in healthy subjects

Directory of Open Access Journals (Sweden)

V.F. Parreira

2005-07-01

Full Text Available The objective of the present study was to evaluate incentive spirometers using volume- (Coach and Voldyne and flow-oriented (Triflo II and Respirex devices. Sixteen healthy subjects, 24 ± 4 years, 62 ± 12 kg, were studied. Respiratory variables were obtained by respiratory inductive plethysmography, with subjects in a semi-reclined position (45º. Tidal volume, respiratory frequency, minute ventilation, inspiratory duty cycle, mean inspiratory flow, and thoracoabdominal motion were measured. Statistical analysis was performed with Kolmogorov-Smirnov test, t-test and ANOVA. Comparison between the Coach and Voldyne devices showed that larger values of tidal volume (1035 ± 268 vs 947 ± 268 ml, P = 0.02 and minute ventilation (9.07 ± 3.61 vs 7.49 ± 2.58 l/min, P = 0.01 were reached with Voldyne, whereas no significant differences in respiratory frequency were observed (7.85 ± 1.24 vs 8.57 ± 1.89 bpm. Comparison between flow-oriented devices showed larger values of inspiratory duty cycle and lower mean inspiratory flow with Triflo II (0.35 ± 0.05 vs 0.32 ± 0.05 ml/s, P = 0.00, and 531 ± 137 vs 606 ± 167 ml/s, P = 0.00, respectively. Abdominal motion was larger (P < 0.05 during the use of volume-oriented devices compared to flow-oriented devices (52 ± 11% for Coach and 50 ± 9% for Voldyne; 43 ± 13% for Triflo II and 44 ± 14% for Respirex. We observed that significantly higher tidal volume associated with low respiratory frequency was reached with Voldyne, and that there was a larger abdominal displacement with volume-oriented devices.

J-ACT II. Differences in rate of valid recanalization and of a favorable outcome by site of MCA occlusion

International Nuclear Information System (INIS)

Hirano, Teruyuki

2010-01-01

The background and purpose of this study was to elucidate whether the effects of alteplase differ with occlusion site of the middle cerebral artery (MCA). An exploratory analysis was made of 57 patients enrolled on the Japan Alteplase Clinical Trial II (J-ACT II). The residual vessel length (mm), determined on pretreatment MR angiography (MRA), was used to reflect the occluded site. The proportions of patients with valid recanalization (modified Mori grade 2-3) at 6 and 24 hours, and a favorable outcome (modified Rankin scale 0-1 at 3 months) were compared between the groups dichotomized according to their lengths of residual vessel. Multiple logistic regression models were generated to elucidate the predictors of valid recanalization and a favorable outcome. Receiver operating characteristic (ROC) analysis revealed that 5 mm was the practical cutoff length for the dichotomization. In patients with M1 length <5 mm (n=12), the frequencies of valid recanalization at 6/24 hours (16.6%/25.0%) were significantly low compared with those (62.2%/82.2%) of 45 patients with a residual M1 length of ≥5 mm and M2 occlusions (p=0.008 for 6 hours, p<0.001 for 24 hours). The proportion of a favorable outcome was also small in patients with M1 length <5 mm (8.3%), as compared to the others (57.8%, p=0.004). In logistic regression models, the site of MCA occlusion (<5 mm) was the significant predictor of valid recanalization at 6/24 hours and of a favorable outcome. In patients with acute MCA occlusion, residual vessel length <5 mm on MRA can identify poor responders. (author)

Association Between Use of Traditional Chinese Medicine Herbal Therapy and Survival Outcomes in Patients With Stage II and III Colorectal Cancer: A Multicenter Prospective Cohort Study.

Science.gov (United States)

Xu, Yun; Mao, Jun J; Sun, Lingyun; Yang, Lin; Li, Jie; Hao, Yingxu; Li, Huashan; Hou, Wei; Chu, Yuping; Bai, Yu; Jia, Xiaoqiang; Wang, Jinwan; Shen, Lin; Zhang, Ying; Wang, Jianbin; Liu, Jianping; Yang, Yufei

2017-11-01

Chinese cancer patients often use Traditional Chinese Medicine (TCM) herbal medicine during or after active cancer treatments. However, little is known about how TCM herbal medicine impacts cancer outcomes. This study aimed to evaluate the association between TCM herbal therapy and survival outcomes in patients with stage II or III colorectal cancer. We conducted an eight-center prospective cohort study in China among patients who had undergone radical resection for stage II and III colorectal cancer. All patients received comprehensive conventional treatments according to National Comprehensive Cancer Network (NCCN) guidelines, and follow-up visits were conducted over five years. We defined high exposure as a patient's use of TCM individualized herbs for more than one year, ascertained via clinical interviews. The primary outcome was disease-free survival (DFS), with overall survival (OS) as a secondary outcome. Between April 2007 and February 2009, we enrolled 312 patients into the cohort; 166 (53.2%) met the definition of high exposure to TCM herbs. Adjusting for covariates, high exposure to TCM was associated with both better DFS (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = 0.39 to 0.98) and OS (HR = 0.31, 95% CI = 0.14 to 0.68). In subgroup exploratory analysis, the effects demonstrated that the differences in outcomes were statistically significant in patients who had received chemotherapy. Longer duration of TCM herbal use is associated with improved survival outcomes in stage II and III colorectal cancer patients in China. More research is needed to evaluate the effects and underlying mechanisms of herbal medicine on colorectal cancer outcomes. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

INTRA/Mod3.2. Manual and code description. Volume 2 - User`s manual

Energy Technology Data Exchange (ETDEWEB)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the physical modelling of INTRA and the ruling numerics, and volume II, the User`s Manual is an input description. This document, the User`s Manual, Volume II, contains a detailed description of how to use INTRA, how to set up an input file, how to run INTRA and also post-processing

Draft Strategic Laboratory Missions Plan. Volume II

International Nuclear Information System (INIS)

1996-03-01

This volume described in detail the Department's research and technology development activities and their funding at the Department's laboratories. It includes 166 Mission Activity Profiles, organized by major mission area, with each representing a discrete budget function called a Budget and Reporting (B ampersand R) Code. The activities profiled here encompass the total research and technology development funding of the laboratories from the Department. Each profile includes a description of the activity and shows how the funding for that activity is distributed among the DOE laboratories as well as universities and industry. The profiles also indicate the principal laboratories for each activity, as well as which other laboratories are involved. The information in this volume is at the core of the Strategic Laboratory Mission Plan. It enables a reader to follow funds from the Department's appropriation to a specific activity description and to specific R ampersand D performing institutions. This information will enable the Department, along with the Laboratory Operations Board and Congress, to review the distribution of R ampersand D performers chosen to execute the Department's missions

Draft Strategic Laboratory Missions Plan. Volume II

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-03-01

This volume described in detail the Department`s research and technology development activities and their funding at the Department`s laboratories. It includes 166 Mission Activity Profiles, organized by major mission area, with each representing a discrete budget function called a Budget and Reporting (B & R) Code. The activities profiled here encompass the total research and technology development funding of the laboratories from the Department. Each profile includes a description of the activity and shows how the funding for that activity is distributed among the DOE laboratories as well as universities and industry. The profiles also indicate the principal laboratories for each activity, as well as which other laboratories are involved. The information in this volume is at the core of the Strategic Laboratory Mission Plan. It enables a reader to follow funds from the Department`s appropriation to a specific activity description and to specific R & D performing institutions. This information will enable the Department, along with the Laboratory Operations Board and Congress, to review the distribution of R & D performers chosen to execute the Department`s missions.

Is orbital volume associated with eyeball and visual cortex volume in humans?

Science.gov (United States)

Pearce, Eiluned; Bridge, Holly

2013-01-01

In humans orbital volume increases linearly with absolute latitude. Scaling across mammals between visual system components suggests that these larger orbits should translate into larger eyes and visual cortices in high latitude humans. Larger eyes at high latitudes may be required to maintain adequate visual acuity and enhance visual sensitivity under lower light levels. To test the assumption that orbital volume can accurately index eyeball and visual cortex volumes specifically in humans. Structural Magnetic Resonance Imaging (MRI) techniques are employed to measure eye and orbit (n = 88) and brain and visual cortex (n = 99) volumes in living humans. Facial dimensions and foramen magnum area (a proxy for body mass) were also measured. A significant positive linear relationship was found between (i) orbital and eyeball volumes, (ii) eyeball and visual cortex grey matter volumes and (iii) different visual cortical areas, independently of overall brain volume. In humans the components of the visual system scale from orbit to eye to visual cortex volume independently of overall brain size. These findings indicate that orbit volume can index eye and visual cortex volume in humans, suggesting that larger high latitude orbits do translate into larger visual cortices.

Hearing Outcomes After Stereotactic Radiosurgery for Unilateral Intracanalicular Vestibular Schwannomas: Implication of Transient Volume Expansion

International Nuclear Information System (INIS)

Kim, Young-Hoon; Kim, Dong Gyu; Han, Jung Ho; Chung, Hyun-Tai; Kim, In Kyung; Song, Sang Woo; Park, Jeong-Hoon; Kim, Jin Wook; Kim, Yong Hwy; Park, Chul-Kee; Kim, Chae-Yong; Paek, Sun Ha; Jung, Hee-Won

2013-01-01

Purpose: We evaluated the prognostic factors for hearing outcomes after stereotactic radiosurgery (SRS) for unilateral sporadic intracanalicular vestibular schwannomas (IC-VSs) as a clinical homogeneous group of VSs. Methods and Materials: Sixty consecutive patients with unilateral sporadic IC-VSs, defined as tumors in the internal acoustic canal, and serviceable hearing (Gardner-Roberson grade 1 or 2) were treated with SRS as an initial treatment. The mean tumor volume was 0.34 ± 0.03 cm 3 (range, 0.03-1.00 cm 3 ), and the mean marginal dose was 12.2 ± 0.1 Gy (range, 11.5-13.0 Gy). The median follow-up duration was 62 months (range, 36-141 months). Results: The actuarial rates of serviceable hearing preservation were 70%, 63%, and 55% at 1, 2, and 5 years after SRS, respectively. In multivariate analysis, transient volume expansion of ≥20% from initial tumor size was a statistically significant risk factor for loss of serviceable hearing and hearing deterioration (increase of pure tone average ≥20 dB) (odds ratio = 7.638; 95% confidence interval, 2.317-25.181; P=.001 and odds ratio = 3.507; 95% confidence interval, 1.228-10.018; P=.019, respectively). The cochlear radiation dose did not reach statistical significance. Conclusions: Transient volume expansion after SRS for VSs seems to be correlated with hearing deterioration when defined properly in a clinically homogeneous group of patients.

Primary Tumor Volume Is an Important Predictor of Clinical Outcomes Among Patients With Locally Advanced Squamous Cell Cancer of the Head and Neck Treated With Definitive Chemoradiotherapy

International Nuclear Information System (INIS)

Strongin, Anna; Yovino, Susannah; Taylor, Rodney; Wolf, Jeffrey; Cullen, Kevin; Zimrin, Ann; Strome, Scott; Regine, William; Suntharalingam, Mohan

2012-01-01

Purpose: The tumor volume has been established as a significant predictor of outcomes among patients with head-and-neck cancer undergoing radiotherapy alone. The present study attempted to add to the existing data on tumor volume as a prognostic factor among patients undergoing chemoradiotherapy. Methods and Materials: A total of 78 patients who had undergone definitive chemoradiotherapy for Stage III-IV squamous cell cancer of the hypopharynx, oropharynx, and larynx were identified. The primary tumor volumes were calculated from the treatment planning computed tomography scans, and these were correlated to the survival and tumor control data obtained from the retrospective analysis. Results: The interval to progression correlated with the primary tumor volume (p = .007). The critical cutoff point for the tumor volume was identified as 35 cm 3 , and patients with a tumor volume 3 had a significantly better prognosis than those with a tumor volume >35 cm 3 at 5 years (43% vs. 71%, p = .010). Longer survival was also correlated with smaller primary tumor volumes (p = .022). Similarly, patients with a primary tumor volume 3 had a better prognosis in terms of both progression-free survival (61% vs. 33%, p = .004) and overall survival (84% vs. 41%, p = 3 larger than tumors without locoregional failure (p = .028) and 27.1-cm 3 larger than tumors that recurred as distant metastases (p = .020). Conclusion: The results of our study have shown that the primary tumor volume is a significant prognostic factor in patients with advanced cancer of the head and neck undergoing definitive chemoradiotherapy and correlated with the treatment outcomes better than the T or N stage.

Methods of Celestial Mechanics Volume II: Application to Planetary System, Geodynamics and Satellite Geodesy

CERN Document Server

Beutler, Gerhard

2005-01-01

G. Beutler's Methods of Celestial Mechanics is a coherent textbook for students as well as an excellent reference for practitioners. Volume II is devoted to the applications and to the presentation of the program system CelestialMechanics. Three major areas of applications are covered: (1) Orbital and rotational motion of extended celestial bodies. The properties of the Earth-Moon system are developed from the simplest case (rigid bodies) to more general cases, including the rotation of an elastic Earth, the rotation of an Earth partly covered by oceans and surrounded by an atmosphere, and the rotation of an Earth composed of a liquid core and a rigid shell (Poincaré model). (2) Artificial Earth Satellites. The oblateness perturbation acting on a satellite and the exploitation of its properties in practice is discussed using simulation methods (CelestialMechanics) and (simplified) first order perturbation methods. The perturbations due to the higher-order terms of the Earth's gravitational potential and reso...

Early Prediction of Outcome in Advanced Head-and-Neck Cancer Based on Tumor Blood Volume Alterations During Therapy: A Prospective Study

International Nuclear Information System (INIS)

Cao Yue; Popovtzer, Aron; Li, Diana; Chepeha, Douglas B.; Moyer, Jeffrey S.; Prince, Mark E.; Worden, Francis; Teknos, Theodoros; Bradford, Carol; Mukherji, Suresh K.; Eisbruch, Avraham

2008-01-01

Purpose: To assess whether alterations in tumor blood volume (BV) and blood flow (BF) during the early course of chemo-radiotherapy (chemo-RT) for head-and-neck cancer (HNC) predict treatment outcome. Methods and Materials: Fourteen patients receiving concomitant chemo-RT for nonresectable, locally advanced HNC underwent dynamic contrast-enhanced (DCE) MRI scans before therapy and 2 weeks after initiation of chemo-RT. The BV and BF were quantified from DCE MRI. Preradiotherapy BV and BF, as well as their changes during RT, were evaluated separately in the primary gross tumor volume (GTV) and nodal GTV for association with outcomes. Results: At a median follow-up of 10 months (range, 5-27 months), 9 patients had local-regional controlled disease. One patient had regional failure, 3 had local failures, and 1 had local-regional failure. Reduction in tumor volume after 2 weeks of chemo-RT did not predict for local control. In contrast, the BV in the primary GTV after 2 weeks of chemo-RT was increased significantly in the local control patients compared with the local failure patients (p < 0.03). Conclusions: Our data suggest that an increase in available primary tumor blood for oxygen extraction during the early course of RT is associated with local control, thus yielding a predictor with potential to modify treatment. These findings require validation in larger studies

Atlas of total body radionuclide imaging. Volume I and II

International Nuclear Information System (INIS)

Fordham, E.W.; Ali, A.; Turner, D.A.; Charters, J.

1982-01-01

This two-volume work on total body imaging may well be regarded by future historians of nuclear medicine as representing the high points in the art of total body imaging in clinical nuclear medicine. With regard to information content and volume, it is the largest collection of well-interpreted, beautifully reproduced, total body images available to date. The primary goal of this atlas is to demonstrate patterns of abnormality in both typical and less typical variations. This goal is accomplished with many well-described examples of technical artifacts, of normal variants, of common and of rare diseases, and of pitfalls in interpretations. Volume I is entirely dedicated to skeletal imaging with Tc-99m labeled phosphates or phosphonates. The volume is divided into 22 chapters, which include chapters on methodology and instrumentation, chapters on the important bone diseases and other topics such as a treatise on false-negative and false-positive scans, and soft tissue and urinary tract abnormalities recognizable on bone scintigrams

Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis.

Science.gov (United States)

Serpa Neto, Ary; Cardoso, Sérgio Oliveira; Manetta, José Antônio; Pereira, Victor Galvão Moura; Espósito, Daniel Crepaldi; Pasqualucci, Manoela de Oliveira Prado; Damasceno, Maria Cecília Toledo; Schultz, Marcus J

2012-10-24

Lung-protective mechanical ventilation with the use of lower tidal volumes has been found to improve outcomes of patients with acute respiratory distress syndrome (ARDS). It has been suggested that use of lower tidal volumes also benefits patients who do not have ARDS. To determine whether use of lower tidal volumes is associated with improved outcomes of patients receiving ventilation who do not have ARDS. MEDLINE, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials up to August 2012. Eligible studies evaluated use of lower vs higher tidal volumes in patients without ARDS at onset of mechanical ventilation and reported lung injury development, overall mortality, pulmonary infection, atelectasis, and biochemical alterations. Three reviewers extracted data on study characteristics, methods, and outcomes. Disagreement was resolved by consensus. Twenty articles (2822 participants) were included. Meta-analysis using a fixed-effects model showed a decrease in lung injury development (risk ratio [RR], 0.33; 95% CI, 0.23 to 0.47; I2, 0%; number needed to treat [NNT], 11), and mortality (RR, 0.64; 95% CI, 0.46 to 0.89; I2, 0%; NNT, 23) in patients receiving ventilation with lower tidal volumes. The results of lung injury development were similar when stratified by the type of study (randomized vs nonrandomized) and were significant only in randomized trials for pulmonary infection and only in nonrandomized trials for mortality. Meta-analysis using a random-effects model showed, in protective ventilation groups, a lower incidence of pulmonary infection (RR, 0.45; 95% CI, 0.22 to 0.92; I2, 32%; NNT, 26), lower mean (SD) hospital length of stay (6.91 [2.36] vs 8.87 [2.93] days, respectively; standardized mean difference [SMD], 0.51; 95% CI, 0.20 to 0.82; I2, 75%), higher mean (SD) PaCO2 levels (41.05 [3.79] vs 37.90 [4.19] mm Hg, respectively; SMD, -0.51; 95% CI, -0.70 to -0.32; I2, 54%), and lower mean (SD) pH values (7.37 [0.03] vs 7.40 [0

Free radicals in biology. Volume II

International Nuclear Information System (INIS)

Pryor, W.A.

1976-01-01

This volume continues the treatment of topics in free radical biology and free radical pathology from Volume I. In the first chapter, pyridinyl radicals, radicals which are models for those derived from NAD, are discussed. Pyridinyl radicals can be synthesized and isolated and directly studied in a number of chemical systems. The next chapter treats the role of glutathione in the cell. It is becoming even more apparent that this vital thiol controls a large number of important cellular functions. The GSH/GSSG balance has recently been implicated as a control for cellular development; this balance also may be important in relaying the effects of oxidants from one site to another in the body. The next chapter outlines the reactions of singlet oxygen; some of these involve free radicals and some do not. This reactive intermediate appears to be important both in photochemical smog and in cellular chemistry where singlet oxygen is produced by nonphotochemical processes. The production of free radicals from dry tissues, a controversial area with conflicting claims is reviewed. The next chapter outlines the current status of the studies of photochemical smog. The next two chapters treat specific reactive materials which are present in smog. The first discusses the chemistry of nitrogen oxides and ozone. The second chapter treats the chemistry of the peroxyacyl nitrites. These compounds, although present in only small concentration, are among the most toxic components of smog. The last two chapters treat radiation damage to proteins and radiation protection and radical reactions produced by radiation in nucleic acids

Apparent molar volumes and compressibilities of alkaline earth metal ions in methanol and dimethylsulfoxide

International Nuclear Information System (INIS)

Warminska, Dorota; Wawer, Jaroslaw; Grzybkowski, Waclaw

2010-01-01

Temperature dependencies of density of magnesium (II), calcium (II), strontium (II), barium (II) perchlorates as well as beryllium (II), and sodium trifluoromethanesulfonates in methanol and dimethylsulfoxide have been determined over the composition range studied. From density data the apparent molar volumes and partial molar volumes of the salts at infinite dilution as well as the expansibilities have been evaluated. The apparent molar isentropic compressibilities of alkaline earth metal perchlorates and beryllium (II) and sodium triflates in methanol and DMSO have been calculated from sound speed data obtained at T = 298.15 K.

Clinical Course and Outcomes of Small Supratentorial Intracerebral Hematomas.

Science.gov (United States)

Behrouz, Réza; Misra, Vivek; Godoy, Daniel A; Topel, Christopher H; Masotti, Luca; Klijn, Catharina J M; Smith, Craig J; Parry-Jones, Adrian R; Slevin, Mark A; Silver, Brian; Willey, Joshua Z; Masjuán Vallejo, Jaime; Nzwalo, Hipólito; Popa-Wagner, Aurel; Malek, Ali R; Hafeez, Shaheryar; Di Napoli, Mario

2017-06-01

Intracerebral hemorrhage (ICH) volume, particularly if ≥30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes hematoma expansion, Glasgow Outcome Scale (GOS), and in-hospital death. Poor outcome was defined as composite of in-hospital death and severe disability (GOS ≤ 3). Comparison was conducted based on hemorrhage location. Logistic regression using dichotomized outcome scales was applied to determine predictors of poor outcome. Among 375 cases of supratentorial ICH with volumes hematomas <30 mL expands, leading to END or death. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Blanket comparison and selection study. Volume II

International Nuclear Information System (INIS)

1983-10-01

This volume contains extensive data for the following chapters: (1) solid breeder tritium recovery, (2) solid breeder blanket designs, (3) alternate blanket concept screening, and (4) safety analysis. The following appendices are also included: (1) blanket design guidelines, (2) power conversion systems, (3) helium-cooled, vanadium alloy structure blanket design, (4) high wall loading study, and (5) molten salt safety studies

Demonstration, testing, ampersand evaluation of in situ heating of soil. Draft final report, Volume II: Appendices A to E

International Nuclear Information System (INIS)

Dev, H.; Enk, J.; Jones, D.; Saboto, W.

1996-01-01

This document is a draft final report for US DOE contract entitled, open-quotes Demonstration Testing and Evaluation of In Situ Soil Heating,close quotes Contract No. DE-AC05-93OR22160, IITRI Project No. C06787. This report is presented in two volumes. Volume I contains the technical report This document is Volume II, containing appendices with background information and data. In this project approximately 300 cu. yd. of clayey soil containing a low concentration plume of volatile organic chemicals was heated in situ by the application of electrical energy. It was shown that as a result of heating the effective permeability of soil to air flow was increased such that in situ soil vapor extraction could be performed. The initial permeability of soil was so low that the soil gas flow rate was immeasurably small even at high vacuum levels. When scaled up, this process can be used for the environmental clean up and restoration of DOE sites contaminated with VOCs and other organic chemicals boiling up to 120 degrees to 130 degrees C in the vadose zone. Although it may applied to many types of soil formations, it is particularly attractive for low permeability clayey soil where conventional in situ venting techniques are limited by low air flow

Fixed site neutralization model programmer's manual. Volume II

International Nuclear Information System (INIS)

Engi, D.; Chapman, L.D.; Judnick, W.; Blum, R.; Broegler, L.; Lenz, J.; Weinthraub, A.; Ballard, D.

1979-12-01

This report relates to protection of nuclear materials at nuclear facilities. This volume presents the source listings for the Fixed Site Neutralization Model and its supporting modules, the Plex Preprocessor and the Data Preprocessor

TECHNICAL REPORT ON TECHNOLOGICALLY ENHANCED NATURALLY OCCURRING RADIOACTIVE MATERIALS FROM URANIUM MINING, VOLUME II: INVESTIGATION OF POTENTIAL HEALTH, GEOGRAPHIC, AND ENVIRONMENTAL ISSUES OF ABANDONED URANIUM MINES

Science.gov (United States)

Volume II investigates the potential radiogenic risks from abandoned uranium mines and evaluates which may pose the greatest hazards to members of the public and to the environment. The intent of this report is to identify who may be most likely to be exposed to wastes at small a...

Interim report on the development and application of environmental mapped data digitization, encoding, analysis, and display software for the ALICE system. Volume II. [MAP, CHAIN, FIX, and DOUT, in FORTRAN IV for PDP-10

Energy Technology Data Exchange (ETDEWEB)

Amiot, L.W.; Lima, R.J.; Scholbrock, S.D.; Shelman, C.B.; Wehman, R.H.

1979-06-01

Volume I of An Interim Report on the Development and Application of Environmental Mapped Data Digitization, Encoding, Analysis, and Display Software for the ALICE System provided an overall description of the software developed for the ALICE System and presented an example of its application. The scope of the information presented in Volume I was directed both to the users and developers of digitization, encoding, analysis, and display software. Volume II presents information which is directly related to the actual computer code and operational characteristics (keys and subroutines) of the software. Volume II will be of more interest to developers of software than to users of the software. However, developers of software should be aware that the code developed for the ALICE System operates in an environment where much of the peripheral hardware to the PDP-10 is ANL/AMD built. For this reason, portions of the code may have to be modified for implementation on other computer system configurations. 11 tables.

Principles of quantum computation and information volume II

International Nuclear Information System (INIS)

Kok, P

2007-01-01

Any new textbook in quantum information has some pretty strong competition to contend with. Not only is there the classic text by Nielsen and Chuang from 2000, but also John Preskill's lecture notes, available for free online. Nevertheless, a proper textbook seems more enduring than online notes, and the field has progressed considerably in the seven years since Nielsen and Chuang was published. A new textbook is a great opportunity to give a snapshot of our current state of knowledge in quantum information. Therein also lies a problem: The field has expanded so much that it is impossible to cover everything at the undergraduate level. Quantum information theory is relevant to an extremely large portion of physics, from solid state and condensed matter physics to particle physics. Every discipline that has some relation to quantum mechanics is affected by our understanding of quantum information theory. Those who wish to write a book on quantum information therefore have to make some profound choices: Do you keep the ultimate aim of a quantum computer in mind, or do you focus on quantum communication and precision measurements as well? Do you describe how to build a quantum computer with all possible physical systems or do you present only the underlying principles? Do you include only the tried and tested ideas, or will you also explore more speculative directions? You don't have to take a black-or-white stance on these questions, but how you approach them will profoundly determine the character of your book. The authors of 'Principles of Quantum Computation and Information (Volume II: Basic Tools and Special Topics)' have chosen to focus on the construction of quantum computers, but restrict themselves mainly to general techniques. Only in the last chapter do they explicitly address the issues that arise in the different implementations. The book is the second volume in a series, and consists of four chapters (labelled 5 to 8) called 'Quantum Information Theory

Outcome Mapping Virtual Learning Community - Phase II | IDRC ...

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

The first phase of the project (103520) focused on developing the Outcome ... as distance learning) and strategically communicating Outcome Mapping to key ... an organization based in India with South Asian reach, to facilitate exchange ...

Environmental law and climate change : Volumes I & II

NARCIS (Netherlands)

Verschuuren, Jonathan

Two volume set that brings together 54 of the most influential and important scientific journal articles in the field of climate law, thematically grouped together as follows: introducing climate law, theories and approaches, climate change mitigation, climate change adaptation, climate justice,

Fiber, Fabric and Fashion. Environment II.

Science.gov (United States)

Arizona State Univ., Tempe.

A competency-based instructional guide for grades 7-14, this volume is one of three parts, each of which focuses on a different environment (psychomotor, cognitive, or affective), and each of which includes competencies and learning activities for each of three instructional levels. The topics for this volume (Environment II--cognitive) are…

Clinical and radiological outcome following pneumothorax after endoscopic lung volume reduction with valves

Directory of Open Access Journals (Sweden)

Gompelmann D

2016-12-01

Full Text Available D Gompelmann,1,2 N Benjamin,1 K Kontogianni,1 FJF Herth,1,2 CP Heussel,2–4 H Hoffmann,2,5 R Eberhardt1,2 1Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, 2German Center for Lung Research, 3Diagnostic and Interventional Radiology, Thoraxklinik at University of Heidelberg, 4Diagnostic and Interventional Radiology, University Hospital Heidelberg, 5Thoracic Surgery, Thoraxklinik at University of Heidelberg, Heidelberg, Germany Introduction: Valve implantation has evolved as a therapy for patients with advanced emphysema. Although it is a minimally invasive treatment, it is associated with complications, the most common being pneumothorax. Pneumothorax occurs due to the rapid target lobe volume reduction and may be a predictor of clinical benefit despite this complication. Objective: The objective of this study was to conduct an exploratory data analysis of patients who developed a pneumothorax following endoscopic valve therapy for emphysema. Materials and methods: This study performed a retrospective evaluation of pneumothorax management and the impact of pneumothorax on clinical outcomes in 70 patients following valve therapy in 381 consecutive patients. Results: Pneumothorax rate following valve therapy was 18%. Pneumothorax management consisted of chest tube insertion, valve removal, and surgical intervention in 87% (61/70, 44% (31/70, and 19% (13/70 of the patients, respectively. Despite pneumothorax, patients experienced modest but significant improvements in lung function parameters (forced expiratory volume in 1 second: 55±148 mL, residual volume: -390±964 mL, total lung capacity: -348±876; all P<0.05. Persistent lobar atelectasis 3 months after recovering from pneumothorax, which was associated with relevant clinical improvement, was observed in only 21% (15/70 of the patients. Conclusion: Pneumothorax is a frequent severe complication following valve therapy that requires further intervention

The relationship of the emotional climate of work and threat to patient outcome in a high-volume thoracic surgery operating room team.

Science.gov (United States)

Nurok, Michael; Evans, Linda A; Lipsitz, Stuart; Satwicz, Paul; Kelly, Andrea; Frankel, Allan

2011-03-01

It is widely believed that the emotional climate of surgical team's work may affect patient outcome. To analyse the relationship between the emotional climate of work and indices of threat to patient outcome. Interventional study. Operating rooms in a high-volume thoracic surgery centre from September 2007 to June 2008. Thoracic surgery operating room teams. Two 90 min team-skills training sessions focused on findings from a standardised safety-culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication and leadership. Relationship of functional or less functional emotional climates of work to indices of threat to patient outcome. A less functional emotional climate corresponded to more threat to outcome in the sterile surgical environment in the pre-intervention period (pwork in the sterile surgical environment appeared to be related to threat to patient outcome prior to, but not after, a team-training intervention. Further study of the relationship between the emotional climate of work and threat to patient outcome using reproducible methods is required.

Influence of endoleaks on aneurysm volume and hemodynamics after endovascular aneurysm repair

International Nuclear Information System (INIS)

Pitton, M.B.; Welter, B.; Schmenger, P.; Thelen, M.; Dueber, C.; Neufang, A.

2003-01-01

Purpose: To evaluate the aneurysm volume and the intra-aneurysmatic pressure and maximal pressure pulse (dp/dtmax) in completely excluded aneurysms and cases with endoleaks. Materials and Methods: In 36 mongrel dogs, experimental autologous aneurysms were treated with stent-grafts. All aortic side branches were ligated in 18 cases (group I) but were preserved in group II (n=18). Aneurysm volumes were calculated from CT scans before and after intervention, and from follow-up CT scans at 1 week, 6 weeks and 6 months. Finally, for hemodynamic measurements, manometer-tipped catheters were introduced into the excluded aneurysm sac (group I and II), selectively in endoleaks (group II), and intraluminally for aortic reference measurement. Systemic hypertension was induced by volume load and pharmacologic stress. Pressure curves and dp/dt were simultaneously recorded and the ratios of aneurysm pressure to systemic reference pressure calculated. Results: At follow-up, type-II, endoleaks were excluded in all cases of group I by selective angiography. In contrast, endoleaks were evident in all cases of group II. Volumetric analysis of the aneurysms showed a benefit for group I with an improved aneurysm shrinkage: ΔVolume +0.08%, -1.62% and -9.76% at 1 week, 6 weeks and 6 months follow-up (median, group I), compared to +1.43%, +0.67%, and -4.04% (group II), p [de

Does Categorization Method Matter in Exploring Volume-Outcome Relation? A Multiple Categorization Methods Comparison in Coronary Artery Bypass Graft Surgery Surgical Site Infection.

Science.gov (United States)

Yu, Tsung-Hsien; Tung, Yu-Chi; Chung, Kuo-Piao

2015-08-01

Volume-infection relation studies have been published for high-risk surgical procedures, although the conclusions remain controversial. Inconsistent results may be caused by inconsistent categorization methods, the definitions of service volume, and different statistical approaches. The purpose of this study was to examine whether a relation exists between provider volume and coronary artery bypass graft (CABG) surgical site infection (SSI) using different categorization methods. A population-based cross-sectional multi-level study was conducted. A total of 10,405 patients who received CABG surgery between 2006 and 2008 in Taiwan were recruited. The outcome of interest was surgical site infection for CABG surgery. The associations among several patient, surgeon, and hospital characteristics was examined. The definition of surgeons' and hospitals' service volume was the cumulative CABG service volumes in the previous year for each CABG operation and categorized by three types of approaches: Continuous, quartile, and k-means clustering. The results of multi-level mixed effects modeling showed that hospital volume had no association with SSI. Although the relation between surgeon volume and surgical site infection was negative, it was inconsistent among the different categorization methods. Categorization of service volume is an important issue in volume-infection study. The findings of the current study suggest that different categorization methods might influence the relation between volume and SSI. The selection of an optimal cutoff point should be taken into account for future research.

Lawrence Berkeley National Laboratory 1995 site environmental report: Volume 2, Data appendix

International Nuclear Information System (INIS)

1996-07-01

Ernest Orlando Lawrence Berkeley National Laboratory presents Volume II, Data Appendix as a reference document to supplement the 1995 Site Environmental Report. Volume II contains the raw environmental monitoring and sampling data used to generate many of the summary results included in the main report. Supplemental data is provided for sitewide activities involving the media of stack and ambient air quality, rainwater, surface water, stormwater, wastewater, and soil and sediment. Volume II also contains supplemental data on the special preoperational monitoring study for the new Hazardous Waste Handling Facility. The Table of Contents provides a cross-reference to the data tables of the main report and this appendix. Data are given in System International (SI) units

Adsorption efficiencies of calcium (II ion and iron (II ion on activated carbon obtained from pericarp of rubber fruit

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Orawan Sirichote

2008-03-01

Full Text Available Determination of adsorption efficiencies of activated carbon from pericarp of rubber fruit for calcium (II ion and iron (II ion has been performed by flowing the solutions of these ions through a column of activated carbon. The weights of activated carbon in 500 mL buret column (diameter 3.2 cm for flowing calcium (II ion and iron (II ion solutions were 15 g and 10 g, respectively. The initial concentration of calcium ion was prepared to be about eight times more diluted than the true concentration found in the groundwater from the lower part of southern Thailand. Calcium (II ion concentrations were analysed by EDTA titration and its initial concentration was found to be 23.55 ppm. With a flow rate of 26 mL/min, the adsorption efficiency was 11.4 % with passed through volume 4.75 L. Iron (II ion concentrations were analysed by spectrophotometric method; its initial concentration was found to be 1.5565 ppm. At a flow rate of 22 mL/min, the adsorption efficiency was 0.42 % with passed through volume of 34.0 L.

Comparison of treatment outcome using two definitions of rapid cycling in subjects with bipolar II disorder.

Science.gov (United States)

Amsterdam, Jay D; Lorenzo-Luaces, Lorenzo; DeRubeis, Robert J

2017-02-01

We examined differences in treatment outcome between Diagnostic and Statistical Manual Fourth Edition (DSM-IV)-defined rapid cycling and average lifetime-defined rapid cycling in subjects with bipolar II disorder. We hypothesized that, compared with the DSM-IV definition, the average lifetime definition of rapid cycling may better identify subjects with a history of more mood lability and a greater likelihood of hypomanic symptom induction during long-term treatment. Subjects ≥18 years old with a bipolar II major depressive episode (n=129) were categorized into DSM-IV- and average lifetime-defined rapid cycling and prospectively treated with either venlafaxine or lithium monotherapy for 12 weeks. Responders (n=59) received continuation monotherapy for six additional months. These exploratory analyses found moderate agreement between the two rapid-cycling definitions (κ=0.56). The lifetime definition captured subjects with more chronic courses of bipolar II depression, whereas the DSM-IV definition captured subjects with more acute symptoms of hypomania. There was no difference between rapid-cycling definitions with respect to the response to acute venlafaxine or lithium monotherapy. However, the lifetime definition was slightly superior to the DSM-IV definition in identifying subjects who went on to experience hypomanic symptoms during continuation therapy. Although sample sizes were limited, the findings suggest that the lifetime definition of rapid cycling may identify individuals with a chronic rapid-cycling course and may also be slightly superior to the DSM-IV definition in identifying individuals with hypomania during relapse-prevention therapy. These findings are preliminary in nature and need replication in larger, prospective, bipolar II studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury; a randomized double-blind placebo-controlled clinical trial.

Science.gov (United States)

Farzanegan, Gholam Reza; Derakhshan, Nima; Khalili, Hosseinali; Ghaffarpasand, Fariborz; Paydar, Shahram

2017-10-01

The aim of the current study was to investigate the effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury (TBI). The study was conducted as a randomized clinical trial during a 16-month period from May 2015 and August 2016 in a level I trauma center in Shiraz, Southern Iran. We included 65 patients with moderate (GCS: 9-13) to severe (GCS: 5-8) TBI who had brain contusions of less than 30cc volume. We excluded those who required surgical intervention. Patients were randomly assigned to receive daily 20mg atorvastatin for 10days (n=21) or placebo in the same dosage (n=23). The brain contusion volumetry was performed on days 0, 3 and 7 utilizing spiral thin-cut brain CT-Scan (1-mm thickness). The outcome measured included modified Rankin scale (MRS), Glasgow Outcome Scale (GOS) and Disability rating Scale (DRS) which were all evaluated 3months post-injury. There was no significant difference between two study group regarding the baseline, 3rd day and 7th day of the contusion volume and the rate of contusion expansion. However, functional outcome scales of GOS, MRS and DRS at 3-months post-injury were significantly better in atorvastatin arm of the study compared to placebo (p values of 0.043, 0.039 and 0.030 respectively). Even though atorvastatin was not found to be more effective than placebo in reducing contusion expansion rate, it was associated with improved functional outcomes at 3-months following moderate to severe TBI. Copyright © 2017 Elsevier Ltd. All rights reserved.

Seymour Benzer and T4 rII

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 13; Issue 10. Seymour Benzer and T4 rII - Running the Map into the Ground. R Jayaraman. General Article Volume 13 Issue 10 October 2008 pp 898-908. Fulltext. Click here to view fulltext PDF. Permanent link:

Variation in critical care unit admission rates and outcomes for patients with acute coronary syndromes or heart failure among high- and low-volume cardiac hospitals.

Science.gov (United States)

van Diepen, Sean; Bakal, Jeffrey A; Lin, Meng; Kaul, Padma; McAlister, Finlay A; Ezekowitz, Justin A

2015-02-27

Little is known about cross-hospital differences in critical care units admission rates and related resource utilization and outcomes among patients hospitalized with acute coronary syndromes (ACS) or heart failure (HF). Using a population-based sample of 16,078 patients admitted to a critical care unit with a primary diagnosis of ACS (n=14,610) or HF (n=1467) between April 1, 2003 and March 31, 2013 in Alberta, Canada, we stratified hospitals into high (>250), medium (200 to 250), or low (<200) volume based on their annual volume of all ACS and HF hospitalization. The percentage of hospitalized patients admitted to critical care units varied across low, medium, and high-volume hospitals for both ACS and HF as follows: 77.9%, 81.3%, and 76.3% (P<0.001), and 18.0%, 16.3%, and 13.0% (P<0.001), respectively. Compared to low-volume units, critical care patients with ACS and HF admitted to high-volume hospitals had shorter mean critical care stays (56.6 versus 95.6 hours, P<0.001), more critical care procedures (1.9 versus 1.2 per patient, <0.001), and higher resource-intensive weighting (2.8 versus 1.5, P<0.001). No differences in in-hospital mortality (5.5% versus 6.2%, adjusted odds ratio 0.93; 95% CI, 0.61 to 1.41) were observed between high- and low-volume hospitals; however, 30-day cardiovascular readmissions (4.6% versus 6.8%, odds ratio 0.77; 95% CI, 0.60 to 0.99) and cardiovascular emergency-room visits (6.6% versus 9.5%, odds ratio 0.80; 95% CI, 0.69 to 0.94) were lower in high-volume compared to low-volume hospitals. Outcomes stratified by ACS or HF admission diagnosis were similar. Cardiac patients hospitalized in low-volume hospitals were more frequently admitted to critical care units and had longer hospitals stays despite lower resource-intensive weighting. These findings may provide opportunities to standardize critical care utilization for ACS and HF patients across high- and low-volume hospitals. © 2015 The Authors. Published on behalf of the American

Association of HY-restricting HLA class II alleles with pregnancy outcome in patients with recurrent miscarriage subsequent to a firstborn boy

DEFF Research Database (Denmark)

Nielsen, Henriette Svarre; Steffensen, Rudi; Varming, Kim

2009-01-01

and in 203 of their children born prior to the miscarriages. The subsequent live birth in women with boys prior to the miscarriages compared with girls is lower in women with HY-restricting HLA class II alleles [odds ratio (OR): 0.17 (0.1-0.4), P = 0.0001]. One HY-restricting HLA class II allele in women...... with firstborn boys significantly reduces the chances of a live birth [OR: 0.46 (0.2-0.9), P = 0.02]. Two HY-restricting HLA class II alleles further reduced this chance [OR: 0.21 (0.1-0.7), P = 0.02]. HY-restricting HLA class II did not reduce the chances of a live birth in SRM women with firstborn girls. HY-restricting...... birth. This study explores the putative impact of known HY-presenting HLA alleles on future pregnancy outcome in women with at least three consecutive miscarriages following a birth [secondary recurrent miscarriage (SRM)]. HLA-A, -B, -DRB1, DRB3-5 and DQB1 genotyping was performed in 358 SRM patients...

Assessment of perinatal outcome after sustained tocolysis in early labour (APOSTEL-II trial

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Scherjon Sicco A

2009-09-01

Full Text Available Abstract Background Preterm labour is the main cause of perinatal morbidity and mortality in the Western world. At present, there is evidence that tocolysis for 48 hours is useful in women with threatened preterm labour at least before 32 weeks. This allows transfer of the patient to a perinatal centre, and maximizes the effect of corticosteroids for improved neonatal survival. It is questionable whether treatment with tocolytics should be maintained after 48 hours. Methods/Design The APOSTEL II trial is a multicentre placebo-controlled study. Pregnant women admitted for threatened preterm labour who have been treated with 48 hours corticosteroids and tocolysis will be eligible to participate in the trial between 26+0 and 32+2 weeks gestational age. They will be randomly allocated to nifedipine (intervention or placebo (control for twelve days or until delivery, whatever comes first. Primary outcome is a composite of perinatal death, and severe neonatal morbidity up to evaluation at 6 months after birth. Secondary outcomes are gestational age at delivery, number of days in neonatal intensive care and total days of the first 6 months out of hospital. In addition a cost-effectiveness analysis will be performed. Analysis will be by intention to treat. The power calculation is based on an expected 11% difference in adverse neonatal outcome. This implies that 406 women have to be randomised (two sided test, β 0.2 at alpha 0.05. Discussion This trial will provide evidence as to whether maintenance tocolysis reduces severe perinatal morbidity and mortality in women with threatened preterm labour before 32 weeks. Trial Registration Clinical trial registration: http://www.trialregister.nl, NTR 1336, date of registration: June 3rd 2008.

Cardiac Magnetic Resonance Imaging Predictors of Short-Term Outcomes after High Risk Coronary Surgery.

Science.gov (United States)

Sheriff, Mohammed J; Mouline, Omar; Hsu, Chijen; Grieve, Stuart M; Wilson, Michael K; Bannon, Paul G; Vallely, Michael P; Puranik, Rajesh

2016-06-01

The euroSCORE II is a widely used pre-coronary artery bypass graft surgery (CAGS) risk score, but its predictive power lacks the specificity to predict outcomes in high-risk patients (surgery case mix, revascularisation techniques and related outcomes in recent years. We investigated the utility of Cardiac Magnetic Resonance Imaging (CMRI) in predicting immediate and six-week outcomes after CAGS. Fifty-two consecutive patients with high euroSCORE II (>16) and left ventricular (LV) dysfunction (magnetic resonance imaging parameters were assessed in patients who either had complications immediately post-surgery (n=35), six weeks post-surgery (n=20) or were uncomplicated. The average age of patients recruited was 69±5 years with high euroSCORE II (22±4) and low 2D-echocardiography LV ejection fraction (38%±2%). Cardiac magnetic resonance imaging results demonstrated that those with immediate complications had higher LV scar/infarct burden as a proportion of LV mass (17±3% vs 10±3%; p=0.04) with lower circumferential relaxation index (2.5±0.46 vs 2.8±0.56; p=0.05) compared to those with no complications. Early mortality from surgery was 17% (n=9) and was associated with lower RV stroke volume (55±12 vs 68±18; p=0.03) and higher LV infarct scar/burden (18±2% vs 10±2%, p=0.04). Cardiac magnetic resonance imaging showed patients with complications at six weeks post-surgery had higher LV scar/infarct burden (14.5±2% vs 6.8±2%, p=0.03) compared to those without complications. Cardiac magnetic resonance imaging preoperative LV and RV parameters are valuable in assessing the likelihood of successful outcomes from CAGS in high-risk patients with LV dysfunction. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

The impact of written information and counseling (WOMAN-PRO II Program) on symptom outcomes in women with vulvar neoplasia: A multicenter randomized controlled phase II study.

Science.gov (United States)

Raphaelis, Silvia; Mayer, Hanna; Ott, Stefan; Mueller, Michael D; Steiner, Enikö; Joura, Elmar; Senn, Beate

2017-07-01

To determine whether written information and/or counseling based on the WOMAN-PRO II Program decreases symptom prevalence in women with vulvar neoplasia by a clinically relevant degree, and to explore the differences between the 2 interventions in symptom prevalence, symptom distress prevalence, and symptom experience. A multicenter randomized controlled parallel-group phase II trial with 2 interventions provided to patients after the initial diagnosis was performed in Austria and Switzerland. Women randomized to written information received a predefined set of leaflets concerning wound care and available healthcare services. Women allocated to counseling were additionally provided with 5 consultations by an Advanced Practice Nurse (APN) between the initial diagnosis and 6months post-surgery that focused on symptom management, utilization of healthcare services, and health-related decision-making. Symptom outcomes were simultaneously measured 5 times to the counseling time points. A total of 49 women with vulvar neoplasia participated in the study. Symptom prevalence decreased in women with counseling by a clinically relevant degree, but not in women with written information. Sporadically, significant differences between the 2 interventions could be observed in individual items, but not in the total scales or subscales of the symptom outcomes. The results indicate that counseling may reduce symptom prevalence in women with vulvar neoplasia by a clinically relevant extent. The observed group differences between the 2 interventions slightly favor counseling over written information. The results justify testing the benefit of counseling thoroughly in a comparative phase III trial. Copyright © 2017 Elsevier Inc. All rights reserved.

Large volume unresectable locally advanced non-small cell lung cancer: acute toxicity and initial outcome results with rapid arc

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Fogliata Antonella

2010-10-01

Full Text Available Abstract Background To report acute toxicity, initial outcome results and planning therapeutic parameters in radiation treatment of advanced lung cancer (stage III with volumetric modulated arcs using RapidArc (RA. Methods Twenty-four consecutive patients were treated with RA. All showed locally advanced non-small cell lung cancer with stage IIIA-IIIB and with large volumes (GTV:299 ± 175 cm3, PTV:818 ± 206 cm3. Dose prescription was 66Gy in 33 fractions to mean PTV. Delivery was performed with two partial arcs with a 6 MV photon beam. Results From a dosimetric point of view, RA allowed us to respect most planning objectives on target volumes and organs at risk. In particular: for GTV D1% = 105.6 ± 1.7%, D99% = 96.7 ± 1.8%, D5%-D95% = 6.3 ± 1.4%; contra-lateral lung mean dose resulted in 13.7 ± 3.9Gy, for spinal cord D1% = 39.5 ± 4.0Gy, for heart V45Gy = 9.0 ± 7.0Gy, for esophagus D1% = 67.4 ± 2.2Gy. Delivery time was 133 ± 7s. At three months partial remission > 50% was observed in 56% of patients. Acute toxicities at 3 months showed 91% with grade 1 and 9% with grade 2 esophageal toxicity; 18% presented grade 1 and 9% with grade 2 pneumonia; no grade 3 acute toxicity was observed. The short follow-up does not allow assessment of local control and progression free survival. Conclusions RA proved to be a safe and advantageous treatment modality for NSCLC with large volumes. Long term observation of patients is needed to assess outcome and late toxicity.

Variation in Annual Volume at a University Hospital Does Not Predict Mortality for Pancreatic Resections

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Rita A. Mukhtar

2008-01-01

Full Text Available Annual volume of pancreatic resections has been shown to affect mortality rates, prompting recommendations to regionalize these procedures to high-volume hospitals. Implementation has been difficult, given the paucity of high-volume centers and the logistical hardships facing patients. Some studies have shown that low-volume hospitals achieve good outcomes as well, suggesting that other factors are involved. We sought to determine whether variations in annual volume affected patient outcomes in 511 patients who underwent pancreatic resections at the University of California, San Francisco between 1990 and 2005. We compared postoperative mortality and complication rates between low, medium, or high volume years, designated by the number of resections performed, adjusting for patient characteristics. Postoperative mortality rates did not differ between high volume years and medium/low volume years. As annual hospital volume of pancreatic resections may not predict outcome, identification of actual predictive factors may allow low-volume centers to achieve excellent outcomes.

Does Certification as Bariatric Surgery Center and Volume Influence the Outcome in RYGB-Data Analysis of German Bariatric Surgery Registry.

Science.gov (United States)

Stroh, Christine; Köckerling, F; Lange, V; Wolff, S; Knoll, C; Bruns, C; Manger, Th

2017-02-01

To examine the association between the certification as bariatric surgery center and volume and patient outcome, data collected in the German Bariatric Surgery Registry were evaluated. All data were registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg. Data collection began in 2005 for all bariatric procedures in an online database. Participation in the quality assurance study is required for all certified bariatric surgery centers in Germany. Descriptive evaluation and matched pairs analysis were performed. Patients were matched via propensity score taking into account BMI, age, and incidence of comorbidities. During the period from 2005 to 2013, 3083 male and 10,639 female patients were operated on with the RYGB primary approach. In Centers of Competence (77.2 %) and non-accredited hospitals (76.3 %), the proportion of female patients was significantly lower than in Centers of Reference/Excellence (78.7 %; p = 0.002). The mean age in Centers of Reference/Excellence (41.2 years) was significantly lower than in Centers of Competence (43.2 years; p bariatric surgery centers with higher volume. The study supports the concept of certification. There are different factors which can and cannot be preoperatively modified and influence the perioperative outcome.

Lanchester-Type Models of Warfare. Volume II

Science.gov (United States)

1980-10-01

ii7 L HOWES and THRALL (1972) ,HT n HTY HT m HTX jini ijl HOLTER (1973) and ANDERSON (1979) CHA HAx Y tAs in the preceding table, SPUDICH (1968) - the...detail can one afford? A recent U. S. General Accounting Office ( GAO ) report [150, pp. 28-29] points out that there is a strong inconsistency between...further details). 65. A recent U. S. Getueral Accounting Office ( GAO ) [1501 study has emphasized that empirical study is necessary to strengthen the

Increased mean platelet volume in type 2 diabetes mellitus

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Ezgi Coşkun Yenigün

2014-03-01

Full Text Available Objective: Platelet functions have important roles in the development of vascular complications in diabetic patients. Platelets with increased volume have increased activity compared to smaller ones; therefore, mean platelet volume (MPV is used as a marker for platelet activity. In the present study, we evaluated MPV in patients with type II diabetes mellitus (DM and its associations with diabetic microvascular and macrovascular complications. Methods: Consecutive type II diabetic patients were screened from outpatient clinic of Internal Medicine Department of Diskapı Yıldırım Beyazıt Education and Researsch Hospital, Ankara, Turkey. A total of 48 patients with type II DM and 30 age and gender matched healthy subjects constituted the study population. For all subjects a complete blood count including MPV, fasting blood glucose level and lipid parameters were studied. In diabetic patients, duration of diabetes and HbA1C level, presence of microvascular and macrovascular complications were noted additively. Mean platelet volume was compared between diabetic patients and healthy counterparents. Then, among diabetic patients, MPV was compared between the ones with and without microvascular and macrovascular complications. Results: Mean platelet volume was found significantly higher in diabetic patients compared to non-diabetic healthy subjects. Diabetic patients with at least one of the microvascular complications had significantly higher MPV than those without microvascular damage.Higher MPV levels have also been shown in diabetics with macrovascular complications compared to the ones without macrovascular disease. Conclusion: Mean platelet volume was found to be higher in type II diabetics and those having any of microvascular or macrovascular diabetic complications.

TBscore II

DEFF Research Database (Denmark)

Rudolf, Frauke; Lemvik, Grethe; Abate, Ebba

2013-01-01

Abstract Background: The TBscore, based on simple signs and symptoms, was introduced to predict unsuccessful outcome in tuberculosis patients on treatment. A recent inter-observer variation study showed profound variation in some variables. Further, some variables depend on a physician assessing...... them, making the score less applicable. The aim of the present study was to simplify the TBscore. Methods: Inter-observer variation assessment and exploratory factor analysis were combined to develop a simplified score, the TBscore II. To validate TBscore II we assessed the association between start...

Electric power annual 1994. Volume 2, Operational and financial data

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-11-28

This year, the annual is published in two volumes. Volume I focused on US electric utilities and contained final 1994 data on net generation, fossil fuel consumption, stocks, receipts, and cost. This Volume II presents annual 1994 summary statistics for the electric power industry, including information on both electric utilities and nonutility power producers. Included are preliminary data for electric utility retail sales of electricity, associated revenue, and average revenue per kilowatthour of electricity sold (based on form EIA-861) and for electric utility financial statistics, environmental statistics, power transactions, and demand- side management. Final 1994 data for US nonutility power producers on installed capacity and gross generation, as well as supply and disposition information, are also provided in Volume II. Technical notes and a glossary are included.

Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades.

Science.gov (United States)

Fischer, Joern; Joern, Fischer; Hellmich, Gunter; Gunter, Hellmich; Jackisch, Thomas; Thomas, Jackisch; Puffer, Erik; Erik, Puffer; Zimmer, Jörg; Jörg, Zimmer; Bleyl, Dorothea; Dorothea, Bleyl; Kittner, Thomas; Thomas, Kittner; Witzigmann, Helmut; Helmut, Witzigmann; Stelzner, Sigmar; Sigmar, Stelzner

2015-06-01

This study aimed to investigate the outcome for stage II and III rectal cancer patients compared to stage II and III colonic cancer patients with regard to 5-year cause-specific survival (CSS), overall survival, and local and combined recurrence rates over time. This prospective cohort study identified 3,355 consecutive patients with adenocarcinoma of the colon or rectum and treated in our colorectal unit between 1981 and 2011, for investigation. The study was restricted to International Union Against Cancer (UICC) stages II and III. Postoperative mortality and histological incomplete resection were excluded, which left 995 patients with colonic cancer and 726 patients with rectal cancer for further analysis. Five-year CSS rates improved for colonic cancer from 65.0% for patients treated between 1981 and 1986 to 88.1% for patients treated between 2007 and 2011. For rectal cancer patients, the respective 5-year CSS rates improved from 53.4% in the first observation period to 89.8% in the second one. The local recurrence rate for rectal cancer dropped from 34.2% in the years 1981-1986 to 2.1% in the years 2007-2011. In the last decade of observation, prognosis for rectal cancer was equal to that for colon cancer (CSS 88.6 vs. 86.7%, p = 0.409). Survival of patients with colon and rectal cancer has continued to improve over the last three decades. After major changes in treatment strategy including introduction of total mesorectal excision and neoadjuvant (radio)chemotherapy, prognosis for stage II and III rectal cancer is at least as good as for stage II and III colonic cancer.

Clinical Course and Outcomes of Small Supratentorial Intracerebral Hematomas

NARCIS (Netherlands)

Behrouz, R.; Misra, V.; Godoy, D.A.; Topel, C.H.; Masotti, L.; Klijn, C.J.M.; Smith, C.J.; Parry-Jones, A.R.; Slevin, M.A.; Silver, B.; Willey, J.Z.; Vallejo, J. Masjuan; Nzwalo, H.; Popa-Wagner, A.; Malek, A.R.; Hafeez, S.; Napoli, M. Di

2017-01-01

BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) volume, particularly if >/=30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes <30 mL. METHODS: Basic

Brookhaven National Laboratory 2008 Site Environment Report Volume 1

Energy Technology Data Exchange (ETDEWEB)

Brookhaven National Laboratory

2009-10-01

Brookhaven National Laboratory (BNL) prepares an annual Site Environmental Report (SER) in accordance with DOE Order 231.1A, Environment, Safety and Health Reporting of the U.S. Department of Energy. The report is written to inform the public, regulators, employees, and other stakeholders of the Laboratory's environmental performance during the calendar year in review. Volume I of the SER summarizes environmental data; environmental management performance; compliance with applicable DOE, federal, state, and local regulations; and performance in restoration and surveillance monitoring programs. BNL has prepared annual SERs since 1971 and has documented nearly all of its environmental history since the Laboratory's inception in 1947. Volume II of the SER, the Groundwater Status Report, also is prepared annually to report on the status of and evaluate the performance of groundwater treatment systems at the Laboratory. Volume II includes detailed technical summaries of groundwater data and its interpretation, and is intended for internal BNL users, regulators, and other technically oriented stakeholders. A brief summary of the information contained in Volume II is included in this volume in Chapter 7, Groundwater Protection. Both reports are available in print and as downloadable files on the BNL web page at http://www.bnl.gov/ewms/ser/. An electronic version on compact disc is distributed with each printed report. In addition, a summary of Volume I is prepared each year to provide a general overview of the report, and is distributed with a compact disc containing the full report.

International Best Practice Basis for Assessing Recovery Operations. Annex II of Technical Volume 5

International Nuclear Information System (INIS)

2015-01-01

This volume seeks to identify lessons learned related to post-accident recovery that may further improve preparedness worldwide. This objective assessment of the recovery programme is made according to international best practice. In the practice and assessment of radiation and nuclear safety, international best practice is a process or technique that is likely to consistently produce superior results. An important principle is that a ‘best’ practice can evolve to become better as improvements are discovered and lessons are learned from past experience. The lessons to be learned from the recovery programme as it unfolds in Japan will feed back into improving international best practice in post-accident recovery worldwide. Best practice is used to maintain quality and is a component of quality management systems and standards, such as ISO 9000. It is generally regarded as being the most efficient and effective way to accomplish desired outcomes. The body of best practice is used as a benchmark and for self assessment

Trends of Heller myotomy hospitalizations for achalasia in the United States, 1993-2005: effect of surgery volume on perioperative outcomes.

Science.gov (United States)

Wang, Y Richard; Dempsey, Daniel T; Friedenberg, Frank K; Richter, Joel E

2008-10-01

Achalasia is a rare chronic disorder of esophageal motor function. Single-center reports suggest that there has been greater use of laparoscopic Heller myotomy for achalasia in the United States since its introduction in 1992. We aimed to study the trends of Heller myotomy and the relationship between surgery volume and perioperative outcomes. The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) is a 20% stratified sample of all hospitalizations in the United States. It was used to study the macro-trends of Heller myotomy hospitalizations during 1993-2005. We also used the NIS 2003-2005 micro-data to study the perioperative outcomes of Heller myotomy hospitalizations, using other achalasia and laparoscopic cholecystectomy hospitalizations as control groups. The generalized linear model with repeated observations from the same unit was used to adjust for multiple hospitalizations from the same hospital. The national estimate of Heller myotomy hospitalizations increased from 728 to 2,255 during 1993-2005, while its mean length of stay decreased from 9.9 to 4.3 days. Of the 1,117 Heller myotomy hospitalizations in the NIS 2003-2005, 10 (0.9%) had the diagnosis of esophageal perforation at discharge. Length of stay was negatively correlated with a hospital's number of Heller myotomy per year (correlation coefficient -0.171, P Heller myotomy per year was negatively associated with length of stay (coefficient -0.215 to -0.119, both P Heller myotomy for achalasia was associated with greater use of surgery and shorter length of stay. A larger volume of Heller myotomy in a hospital was associated with better perioperative outcomes in terms of shorter length of stay and lower total charges.

Comprehensive Cooling Water Study. Volume 1. Summary of environmental effects, Savannah River Plant. Annual report

International Nuclear Information System (INIS)

Gladden, J.B.; Lower, M.W.; Mackey, H.E.; Specht, W.L.; Wilde, E.W.

1985-07-01

This volume summarizes the technical content of Volumes II through XI of the annual report. Volume II provides a description of the SRP environment, facilities, and operation, and presents the objectives and design for the CCWS. Volume III presents information on water quality of SRP surface waters. Results of radionuclide and heavy metal transport studies are presented in Volume IV. Volume V contains findings from studies of wetland plant communities. Volume VI presents findings from studies of the lower food chain components of SRP aquatic habitats. The results of fisheries studies are reported in Volume VII. Studies of semi-aquatic vertebrate populations are reported in Volume VIII. Water-fowl utilization of SRP habitats is discussed in Volume IX. The status of endangered species that utilize SRP aquatic habitats is presented in Volume X. The findings from studies of Parr Pond ecosystem are presented in Volume XI

SLSF loop handling system. Volume I. Structural analysis

International Nuclear Information System (INIS)

Ahmed, H.; Cowie, A.; Ma, D.

1978-10-01

SLSF loop handling system was analyzed for deadweight and postulated dynamic loading conditions, identified in Chapters II and III in Volume I of this report, using a linear elastic static equivalent method of stress analysis. Stress analysis of the loop handling machine is presented in Volume I of this report. Chapter VII in Volume I of this report is a contribution by EG and G Co., who performed the work under ANL supervision

Cacotheline as an oxidimetric reagent. Determination of Sn(II), Cu(I), Ti(III), Fe(II), V(II) and V(III)

International Nuclear Information System (INIS)

Nemani Murty, K.; Yedluri Rao, P.; Geddada Chalam, K.

1982-01-01

Sn(II), Ti(III), Cu(I),Fe(II), V(III) and V(II) can be titrated potentiometrically with cacotheline in 1-4 M hydrochloric acid, 0.5-2 M hydrochloric acid, 0.5-1.5 M sulphuric acid in presence of 4 ml of 10% EDTA solution in a total volume of 50 ml, 9-10 M phosphoric acid, 4-8 M acetic acid and 3-8 M acetic acid respectively. Cacotheline can be used for the assay of tin plate and solder. The cacotheline undergoes a 2-electron reduction reaction. A cacotheline solution (0.005 M) in 0.02 M hydrochloric acid is fairly stable for several months. The conditional redox potentials of cacotheline have been determined in sulphuric, phosphoric and acetic acid medium. (Author)

C-Band Airport Surface Communications System Standards Development. Phase II Final Report. Volume 2: Test Bed Performance Evaluation and Final AeroMACS Recommendations

Science.gov (United States)

Hall, Edward; Magner, James

2011-01-01

This report is provided as part of ITT s NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: New ATM Requirements-Future Communications, C-Band and L-Band Communications Standard Development and was based on direction provided by FAA project-level agreements for New ATM Requirements-Future Communications. Task 7 included two subtasks. Subtask 7-1 addressed C-band (5091- to 5150-MHz) airport surface data communications standards development, systems engineering, test bed and prototype development, and tests and demonstrations to establish operational capability for the Aeronautical Mobile Airport Communications System (AeroMACS). Subtask 7-2 focused on systems engineering and development support of the L-band digital aeronautical communications system (L-DACS). Subtask 7-1 consisted of two phases. Phase I included development of AeroMACS concepts of use, requirements, architecture, and initial high-level safety risk assessment. Phase II builds on Phase I results and is presented in two volumes. Volume I is devoted to concepts of use, system requirements, and architecture, including AeroMACS design considerations. Volume II (this document) describes an AeroMACS prototype evaluation and presents final AeroMACS recommendations. This report also describes airport categorization and channelization methodologies. The purposes of the airport categorization task were (1) to facilitate initial AeroMACS architecture designs and enable budgetary projections by creating a set of airport categories based on common airport characteristics and design objectives, and (2) to offer high-level guidance to potential AeroMACS technology and policy development sponsors and service providers. A channelization plan methodology was developed because a common global methodology is needed to assure seamless interoperability among diverse AeroMACS services potentially supplied by multiple service providers.

Assessment and management of ageing of major nuclear power plant components important to safety: In-containment instrumentation and control cables. Volume II

International Nuclear Information System (INIS)

2000-12-01

and technical support organizations dealing with specific plant components addressed in the reports. The component addressed in the present report is the in-containment instrumentation and control (I and C) cables. The report presents, in two volumes, results of a Co-ordinated Research Project (CRP) on the Management of Ageing of In-containment Instrumentation and Control cables. Part I, Volume 1 presents information on current methods for assessing and managing ageing degradation of Instrumentation and Control cables in real NPP environments prepared by the CRP team. An important complement of this information is user perspectives on the application of these methods which are presented in Part II, Volume 1. Volume 2 contains annexes supporting the guidance of Volume 1 with more detailed information and examples provided by individual CRP participants. For a quick overview, readers should see Section 8 of Part I, Volume 1, which describes a systematic ageing management programme for Instrumentation and Control cables utilizing methods presented in the report; Section 9 of Part I, Volume 1, which presents CRP conclusions and recommendations; and Part II providing the application guidance from the user's perspective

Severe and fatal obstetric injury claims in relation to labor unit volume

DEFF Research Database (Denmark)

Milland, Maria; Mikkelsen, Kim L; Christoffersen, Jens K

2015-01-01

with decreasing annual delivery volume. Face value incidence rate ratios of approved severe injuries increased with decreasing labor unit volume, but the association did not reach statistical significance. CONCLUSION: High volume labor units appear associated with fewer approved and fewer fatal injury claims...... in labor units in 1995-2012. METHODS: Exposure information regarding the annual number of deliveries per labor unit was retrieved from the Danish National Birth Register. Outcome information was retrieved from the Danish Patient Compensation Association. Exposure was categorized in delivery volume...... quintiles as annual volume per labor unit: (10-1377), (1378-2016), (2017-2801), (2802-3861), (3862-6659). MAIN OUTCOME MEASURES: Five primary measures of outcome were used. Incidence rate ratios of (A) Submitted claims, (B) Approved claims, (C) Approved severe injury claims (120% degree of disability), (D...

Clinical Outcomes of Volume-Modulated Arc Therapy in 205 Patients with Nasopharyngeal Carcinoma: An Analysis of Survival and Treatment Toxicities.

Directory of Open Access Journals (Sweden)

Rui Guo

Full Text Available To investigate the clinical efficacy and treatment toxicity of volume-modulated arc therapy (VMAT for nasopharyngeal carcinoma (NPC.205 VMAT-treated NPC patients from our cancer center were prospectively entrolled. All patients received 68-70 Gy irradiation based on the planning target volume of the primary gross tumor volume. Acute and late toxicities were graded according to the Common Terminology Criteria for Adverse Events v3.0 and Radiation Therapy Oncology Group Late Radiation Morbidity Scoring Criteria.The median follow-up period was 37.3 months (range, 6.3-45.1 months. The 3-year estimated local failure-free survival, regional failure-free survival, locoregional failure-free survival, distant metastasis-free survival, disease-free survival and overall survival were 95.5%, 97.0%, 94.0%, 92.1%, 86.8% and 97.0%, respectively. Cox regression analysis showed primary gross tumor volume, N stage and EBV-DNA to be independent predictors of VMAT outcomes (P < 0.05. The most common acute and late side effects were grade 2-3 mucositis (78% and xerostomia (83%, 61%, 34%, and 9% at 3, 6, 12 and 24 months after VMAT, respectively.VMAT for the primary treatment of NPC achieved very high locoregional control with a favorable toxicity profile. The time-saving benefit of VMAT will enable more patients to receive precision radiotherapy.

International Photovoltaic Program Plan. Volume II. Appendices

Energy Technology Data Exchange (ETDEWEB)

Costello, D.; Koontz, R.; Posner, D.; Heiferling, P.; Carpenter, P.; Forman, S.; Perelman, L.

1979-12-01

This second volume of a two-part report on the International Photovoltaic Program Plan contains appendices summarizing the results of analyses conducted in preparation of the plan. These analyses include compilations of relevant statutes and existing Federal programs; strategies designed to expand the use of photovoltaics abroad; information on the domestic photovoltaic plan and its impact on the proposed international plan; perspectives on foreign competition; industry views on the international photovoltaic market and ideas about how US government actions could affect this market; international financing issues; and information on issues affecting foreign policy and developing countries.

Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome.

Science.gov (United States)

Sökeland, J

2000-09-01

To test the hypothesis that in patients with benign prostatic hyperplasia (BPH), the outcome of drug therapy with finasteride may be predictable from the baseline prostate volume and that positive clinical effects might be expected only in patients with prostate volumes of > 40 mL, using a subgroup analysis of results from a previously reported clinical trial of finasteride and phytotherapy. A subgroup of 431 patients was analysed from a randomized, multicentre, double-blind clinical trial involving 543 patients with the early stages of BPH. Patients received a fixed combination of extracts of saw palmetto fruit (Serenoa repens) and nettle root (Urtica dioica) (PRO 160/120) or the synthetic 5alpha-reductase inhibitor finasteride. The patients assessed had valid ultrasonographic measurements and baseline prostate volumes of either 40 mL. All 516 patients were included in the safety analysis. The results of the original trial showed equivalent efficacy for both treatments. The mean (SD) maximum urinary flow (the main outcome variable) increased (from baseline values) after 24 weeks by 1.9 (5.6) mL/s with PRO 160/120 and by 2.4 (6.3) mL/s with finasteride. There were no statistically significant group differences (P = 0.52). The subgroups with small prostates ( 40 mL were similar, at 2.3 (6.1) and 2. 2 (5.3) mL/s, respectively. There were improvements in the International Prostate Symptom Score in both treatment groups, with no statistically significant differences. The subgroup analysis showed slightly better results for voiding symptoms in the patients with prostates of > 40 mL, but there were also improvements in the subgroup with smaller prostates. The safety analysis showed that more patients in the finasteride group reported adverse events and also there were more adverse events in this group than in patients treated with PRO 160/120. The present analysis showed that the efficacy of both PRO 160/120 and finasteride was equivalent and unrelated to prostate volume

Energy Extension Service Pilot Program: evaluation report after two years. Volume II. State reports

Energy Technology Data Exchange (ETDEWEB)

None

1980-04-01

This report, Vol. II, presents a discussion of the operations of the ten EES pilot state programs during the period from October 1, 1977 through September 30, 1979. Each of the ten pilot states - Alabama, Connecticut, Michigan, New Mexico, Pennsylvania, Tennessee, Texas, Washington, Wisconsin, and Wyoming - received a grant of approximately $1.1 million to develop and implement an 18-month program beginning on October 1, 1977. In September 1978, each State received an additional $370,000 for service-delivery programs for the extension of the pilot program, April 1979 through September 1979. A case-study description of the operations of the pilot program in each State is provided here, with special attention given to the two programs selected in each State for more-detailed study and survey research. Although the thrust of this volume is descriptive, some survey data and analyses are presented for the emphasis programs. Two telephone surveys of clients and a non-client sample were conducted, one at the end of the first year of the pilot program (October 1977 - September 1978) and one at the end of the second year (October 1978 - September 1979).

The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 2, Summary of technical input and model implementation

Energy Technology Data Exchange (ETDEWEB)

Prindle, N.H.; Mendenhall, F.T.; Trauth, K.; Boak, D.M. [Sandia National Labs., Albuquerque, NM (United States); Beyeler, W. [Science Applications International Corp., Albuquerque, NM (United States); Hora, S. [Hawaii Univ., Hilo, HI (United States); Rudeen, D. [New Mexico Engineering Research Inst., Albuquerque, NM (United States)

1996-05-01

The Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories (SNL). SPM provides an analytical basis for supporting programmatic decisions for the Waste Isolation Pilot Plant (WIPP) to meet selected portions of the applicable US EPA long-term performance regulations. The first iteration of SPM (SPM-1), the prototype for SPM< was completed in 1994. It served as a benchmark and a test bed for developing the tools needed for the second iteration of SPM (SPM-2). SPM-2, completed in 1995, is intended for programmatic decision making. This is Volume II of the three-volume final report of the second iteration of the SPM. It describes the technical input and model implementation for SPM-2, and presents the SPM-2 technical baseline and the activities, activity outcomes, outcome probabilities, and the input parameters for SPM-2 analysis.

The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 2, Summary of technical input and model implementation

International Nuclear Information System (INIS)

Prindle, N.H.; Mendenhall, F.T.; Trauth, K.; Boak, D.M.; Beyeler, W.; Hora, S.; Rudeen, D.

1996-05-01

The Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories (SNL). SPM provides an analytical basis for supporting programmatic decisions for the Waste Isolation Pilot Plant (WIPP) to meet selected portions of the applicable US EPA long-term performance regulations. The first iteration of SPM (SPM-1), the prototype for SPM< was completed in 1994. It served as a benchmark and a test bed for developing the tools needed for the second iteration of SPM (SPM-2). SPM-2, completed in 1995, is intended for programmatic decision making. This is Volume II of the three-volume final report of the second iteration of the SPM. It describes the technical input and model implementation for SPM-2, and presents the SPM-2 technical baseline and the activities, activity outcomes, outcome probabilities, and the input parameters for SPM-2 analysis

Postoperative Clinical Outcome and Risk Factors for Poor Outcome of Foraminal and Extraforaminal Lumbar Disc Herniation.

Science.gov (United States)

Bae, Jung Sik; Kang, Kyung Hee; Park, Jeong Hyun; Lim, Jae Hyeon; Jang, Il Tae

2016-03-01

We evaluated postoperative outcomes in patients who have lumbar foraminal or extraforaminal disc herniation (FELDH) and suggested the risk factors for poor outcomes. A total of 234 patients were selected for this study. Pre- and post-operative Visual Analogue Scale (VAS) and Korean version Oswestry Disability Index (KODI) were evaluated and the changes of both score were calculated. Outcome was defined as excellent, good, fair, and poor based on Mcnab classification. The percentage of superior facetectomy was calculated by using the Maro-view 5.4 Picture Archiving Communication System (PACS). Paramedian lumbar discectomy was performed in 180 patients and combined lumbar discectomy was performed in 54 patients. Paramedian lumbar discectomy group showed better outcome compared with combined discectomy group. p value of VAS change was 0.009 and KODI was 0.013. The average percentage of superior facetectomy was 33% (range, 0-79%) and it showed negative correlation with VAS and KODI changes (Pearson coefficient : -0.446 and -0.498, respectively). Excellent or good outcome cases (Group I) were 136 (58.1%) and fair or poor outcome cases (Group II) were 98 (41.9%). The percentage of superior facetectomy was 26.5% at Group I and 42.5% at Group II. There was significant difference in superior facetectomy percentage between Group I and II (p=0.000). This study demonstrated that paramedian lumbar discectomy with preservation of facet joints is an effective and good procedure for FELDH. At least 60% of facet should be preserved for excellent or good outcomes.

SEPARATION OF Fe (III, Cr(III, Cu(II, Ni(II, Co(II, AND Pb(II METAL IONS USING POLY(EUGENYL OXYACETIC ACID AS AN ION CARRIER BY A LIQUID MEMBRANE TRANSPORT METHOD

Directory of Open Access Journals (Sweden)

La Harimu

2010-06-01

Full Text Available Fe (III, Cr(III, Cu(II, Ni(II, Co(II, and Pb(II  metal ions had been separated using poly(eugenyl oxyacetic acid as an ion carrier by bulk liquid membrane transport method. The effect of pH, polyeugenyl oxyacetic acid ion carrier concentration, nitric acid concentration in the stripping solution, transport time, and metal concentration were optimized. The result showed that the optimum condition for transport of metal ions was at pH 4 for ion Fe(III and at pH 5 for Cr(III, Cu(II, Ni(II, Co(II, and Pb(II ions. The carrier volumes were optimum with concentration of 1 x 10-3 M at 7.5 mL for Cr(III, Cu (II,  Ni(II, Co(II ions and at 8.5 mL for Fe(III and Pb(II ions. The concentration of HNO3 in stripping phase was optimum at 2 M for Fe(III and Cu(II ions, 1 M for Cr(III, Ni(II and Co(II ions, and 0.5 M for Pb(II ion. The optimum transport times were 36 h for Fe(III and Co(II ions, and 48 h for Cr(III, Cu (II, Ni(II, and Pb(II ions. The concentration of metal ions accurately transported were 2.5 x 10-4 M for Fe(III and Cr(III ions, and 1 M for Cu (II, Ni(II, Co(II, and Pb(II ions. Compared to other metal ions the transport of Fe(III was the highest with selectivity order of Fe(III > Cr(III > Pb(II > Cu(II > Ni(II > Co(II. At optimum condition, Fe(III ion was transported through the membrane at 46.46%.   Keywords: poly(eugenyl oxyacetic acid, transport, liquid membrane, Fe (III, Cr(III, Cu(II, Ni(II, Co(II, and Pb(II ions

Percutaneous Image-Guided Cryoablation of Challenging Mediastinal Lesions Using Large-Volume Hydrodissection: Technical Considerations and Outcomes

Energy Technology Data Exchange (ETDEWEB)

Garnon, Julien, E-mail: juliengarnon@gmail.com; Koch, Guillaume, E-mail: Guillaume.koch@gmail.com; Caudrelier, Jean, E-mail: caudjean@yahoo.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France); Ramamurthy, Nitin, E-mail: Nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Rao, Pramod, E-mail: pramodrao@me.com [University of Strasbourg, ICube (France); Tsoumakidou, Georgia, E-mail: Georgia.tsoumakidou@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: cazzatorobertoluigi@gmail.com; Gangi, Afshin, E-mail: Afshin.gangi@chru-strasbourg.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France)

2016-11-15

ObjectiveThis study was designed to describe the technique of percutaneous image-guided cryoablation with large-volume hydrodissection for the treatment of challenging mediastinal lesions.MethodsBetween March 2014 and June 2015, three patients (mean age 62.7 years) with four neoplastic anterior mediastinal lesions underwent five cryoablation procedures using large-volume hydrodissection. Procedures were performed under general anaesthesia using CT guidance. Lesion characteristics, hydrodissection and cryoablation data, technical success, complications, and clinical outcomes were assessed using retrospective chart review.ResultsLesions (mean size 2.7 cm; range 2–4.3 cm) were in contact with great vessels (n = 13), trachea (n = 3), and mediastinal nerves (n = 6). Hydrodissection was performed intercostally (n = 4), suprasternally (n = 2), transsternally (n = 1), or via the sternoclavicular joint (n = 1) using 1–3 spinal needles over 13.4 (range 7–26) minutes; 450 ml of dilute contrast was injected (range 300–600 ml) and increased mean lesion-collateral structure distance from 1.9 to 7.7 mm. Vulnerable mediastinal nerves were identified in four of five procedures. Technical success was 100 %, with one immediate complication (recurrent laryngeal nerve injury). Mean follow-up period was 15 months. One lesion demonstrated residual disease on restaging PET-CT and was retreated to achieve complete ablation. At last follow-up, two patients remained disease-free, and one patient developed distant disease after 1 year without local recurrence.ConclusionsCryoablation using large-volume hydrodissection is a feasible technique, enabling safe and effective treatment of challenging mediastinal lesions.

Cardiac resynchronization induces major structural and functional reverse remodeling in patients with New York Heart Association class I/II heart failure

DEFF Research Database (Denmark)

St John Sutton, Martin; Ghio, Stefano; Plappert, Ted

2009-01-01

BACKGROUND: Cardiac resynchronization therapy (CRT) improves LV structure, function, and clinical outcomes in New York Heart Association class III/IV heart failure with prolonged QRS. It is not known whether patients with New York Heart Association class I/II systolic heart failure exhibit left...... ventricular (LV) reverse remodeling with CRT or whether reverse remodeling is modified by the cause of heart failure. METHODS AND RESULTS: Six hundred ten patients with New York Heart Association class I/II heart failure, QRS duration > or =120 ms, LV end-diastolic dimension > or =55 mm, and LV ejection...... reduction in LV end-diastolic and end-systolic volume indexes and a 3-fold greater increase in LV ejection fraction in patients with nonischemic causes of heart failure. CONCLUSIONS: CRT in patients with New York Heart Association I/II resulted in major structural and functional reverse remodeling at 1 year...

Self-dual nonsupersymmetric Type II String Compactifications

International Nuclear Information System (INIS)

Kachru, Shamit; Silverstein, Eva

1998-01-01

It has recently been proposed that certain nonsupersymmetric type II orbifolds have vanishing perturbative contributions to the cosmological constant. We show that techniques of Sen and Vafa allow one to construct dual type II descriptions of these models (some of which have no weakly coupled heterotic dual). The dual type II models are given by the same orbifolds with the string coupling S and a T 2 volume T exchanged. This allows us to argue that in various strongly coupled limits of the original type II models, there are weakly coupled duals which exhibit the same perturbative cancellations as the original models

Fusion Engineering Device. Volume II. Design description

International Nuclear Information System (INIS)

1981-10-01

This volume summarizes the design of the FED. It includes a description of the major systems and subsystems, the supporting plasma design analysis, a projected device cost and associated construction schedule, and a description of the facilities to house and support the device. This effort represents the culmination of the FY81 studies conducted at the Fusion Engineering Design Center (FEDC). Unique in these design activities has been the collaborative involvement of the Design Center personnel and numerous resource physicists from the fusion community who have made significant contributions in the physics design analysis as well as the physics support of the engineering design of the major FED systems and components

Volume changes and electrostriction in the primary photoreactions of various photosynthetic systems: estimation of dielectric coefficient in bacterial reaction centers and of the observed volume changes with the Drude-Nernst equation.

Science.gov (United States)

Mauzerall, David; Hou, Jian-Min; Boichenko, Vladimir A

2002-01-01

Photoacoustics (PA) allows the determination of enthalpy and volume changes of photoreactions in photosynthetic reaction centers on the 0.1-10 mus time scale. These include the bacterial centers from Rb. sphaeroides, PS I and PS II centers from Synechocystis and in whole cells. In vitro and in vivo PA data on PS I and PS II revealed that both the volume change (-26 A(3)) and reaction enthalpy (-0.4 eV) in PS I are the same as those in the bacterial centers. However the volume change in PS II is small and the enthalpy far larger, -1 eV. Assigning the volume changes to electrostriction allows a coherent explanation of these observations. One can explain the large volume decrease in the bacterial centers with an effective dielectric coefficient of approximately 4. This is a unique approach to this parameter so important in estimation of protein energetics. The value of the volume contraction for PS I can only be explained if the acceptor is the super- cluster (Fe(4)S(4))(Cys(4)) with charge change from -1 to -2. The small volume change in PS II is explained by sub-mus electron transfer from Y(Z) anion to P(680) cation, in which charge is only moved from the Y(Z) anion to the Q(A) with no charge separation or with rapid proton transfer from oxidized Y(Z) to a polar region and thus very little change in electrostriction. At more acid pH equally rapid proton transfer from a neighboring histidine to a polar region may be caused by the electric field of the P(680) cation.

SU-E-T-72: A Retrospective Correlation Analysis On Dose-Volume Control Points and Treatment Outcomes

Energy Technology Data Exchange (ETDEWEB)

Roy, A; Nohadani, O [Northwestern University, Evanston, IL (United States); Refaat, T; Bacchus, I; Cutright, D; Sathiaseelan, V; Mittal, B [Northwestern University, Chicago, IL (United States)

2015-06-15

Purpose: To quantify correlation between dose-volume control points and treatment outcomes. Specifically, two outcomes are analyzed: occurrence of radiation induced dysphagia and target complications. The results inform the treatment planning process when competing dose-volume criteria requires relaxations. Methods: 32 patients, treated with whole-field sequential intensity modulated radiation therapy during 2009–2010 period, are considered for this study. Acute dysphagia that is categorized into 3 grades is observed on all patients. 3 patients are observed in grade 1, 17 patients in grade 2, and 12 patients in grade 3. Ordinal logistic regression is employed to establish correlations between grades of dysphagia and dose to cervico-thoracic esophagus. Particularly, minimum (Dmin), mean (Dmean), and maximum (Dmax) dose control points are analyzed. Additionally, target complication, which includes local-regional recurrence and/or distant metastasis, is observed on 4 patients. Binary logistic regression is used to quantify correlation between target complication and four dose control points. Namely, ICRU recommended dose control points, D2, D50, D95, and D98 are analyzed. Results: For correlation with dysphagia, Dmin on cervico-thoracic esophagus is statistically significant (p-value = 0.005). Additionally, Dmean on cervico-thoracic esophagus is also significant in association with dysphagia (p-value = 0.012). However, no correlation was observed between Dmax and dysphagia (p-value = 0.263). For target complications, D50 on the target is a statistically significant dose control point (p-value = 0.032). No correlations were observed between treatment complications and D2 (p-value = 0.866), D95 (p-value = 0.750), and D98 (p-value = 0.710) on the target. Conclusion: Significant correlations are observed between radiation induced dysphagia and Dmean (and Dmin) to cervico-thoracic esophagus. Additionally, correlation between target complications and median dose to target

SU-E-T-72: A Retrospective Correlation Analysis On Dose-Volume Control Points and Treatment Outcomes

International Nuclear Information System (INIS)

Roy, A; Nohadani, O; Refaat, T; Bacchus, I; Cutright, D; Sathiaseelan, V; Mittal, B

2015-01-01

Purpose: To quantify correlation between dose-volume control points and treatment outcomes. Specifically, two outcomes are analyzed: occurrence of radiation induced dysphagia and target complications. The results inform the treatment planning process when competing dose-volume criteria requires relaxations. Methods: 32 patients, treated with whole-field sequential intensity modulated radiation therapy during 2009–2010 period, are considered for this study. Acute dysphagia that is categorized into 3 grades is observed on all patients. 3 patients are observed in grade 1, 17 patients in grade 2, and 12 patients in grade 3. Ordinal logistic regression is employed to establish correlations between grades of dysphagia and dose to cervico-thoracic esophagus. Particularly, minimum (Dmin), mean (Dmean), and maximum (Dmax) dose control points are analyzed. Additionally, target complication, which includes local-regional recurrence and/or distant metastasis, is observed on 4 patients. Binary logistic regression is used to quantify correlation between target complication and four dose control points. Namely, ICRU recommended dose control points, D2, D50, D95, and D98 are analyzed. Results: For correlation with dysphagia, Dmin on cervico-thoracic esophagus is statistically significant (p-value = 0.005). Additionally, Dmean on cervico-thoracic esophagus is also significant in association with dysphagia (p-value = 0.012). However, no correlation was observed between Dmax and dysphagia (p-value = 0.263). For target complications, D50 on the target is a statistically significant dose control point (p-value = 0.032). No correlations were observed between treatment complications and D2 (p-value = 0.866), D95 (p-value = 0.750), and D98 (p-value = 0.710) on the target. Conclusion: Significant correlations are observed between radiation induced dysphagia and Dmean (and Dmin) to cervico-thoracic esophagus. Additionally, correlation between target complications and median dose to target

HIBAL Program. Preliminary Warhead-Design. Volume II. Appendices.

Science.gov (United States)

1980-09-15

Mild Steel (iAi i018). ............. 11-2 B. SAE 4130 .. .. .. .... ...... ....... 11-3 C. SAE 4140 ......... .... .... ......... 11-3 D, SAE 4340...11-7 - Test Data for SAE 4140 Steel Frag- ments ...... ................ 11-14 Figure II-7A - 4142 ... .............. 11-15 Figure 11-8 - Test Data...included the following types of steel: SAE 1018, 4130, 4140 and 4340; 5-317 and 5-876 Carpenter tool steel; Anico HY-80 and SSS-100 steel; AISI-S7

Fiscal year 1985 Department of Energy authorization (high-energy and nuclear physics). Volume II-B. Hearing before the Subcommittee on Energy Development and Applications of the Committee on Science and Technology, US House of Representatives, Ninety-Eighth Congress, Second Session, February 22, 1984

International Nuclear Information System (INIS)

Anon.

1984-01-01

Volume II-B of the DOE authorization hearings for fiscal year 1985 covers testimony on high-energy and nuclear physics programs. The volume opens with a continuation of Appendix I, which contains questions directed at Dr. Alvin Trivelpiece and his responses on research at several laboratories and four construction projects. The latter include general plant projects, the Continuous Electron Beam Accelerator Facility, the Tandem/AGS Heavy Ion Transfer Line, and the University Accelerator Upgrade at the University of Washington and Yale. Two 1983 DOE/National Science Foundation reports make up Appendix II. The volume concludes with the text of the 1985 budget request for $746,105,000 and a breakdown of line item expenditures

The outcome of critical illness in decompensated alcoholic liver cirrhosis

DEFF Research Database (Denmark)

Kavli, M; Strøm, T; Carlsson, M

2012-01-01

physiology and chronic health evaluation II (APACHE II) and simplified organ failure assessment (SOFA) in predicting outcome. We hypothesized that in a Scandinavian cohort of ICU patients, APACHE II, SOFA, and simplified acute physiology score (SAPS II) were superior to predict outcome compared...... with the Child-Pugh score. METHODS: A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. Eighty-seven adult patients with decompensated liver alcoholic cirrhosis were admitted from January 2007 to January 2010. RESULTS: The patients were severely ill with median scores...... alcoholic liver disease should be revised....

Retrospective Methods Analysis of Semiautomated Intracerebral Hemorrhage Volume Quantification From a Selection of the STICH II Cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas).

Science.gov (United States)

Haley, Mark D; Gregson, Barbara A; Mould, W Andrew; Hanley, Daniel F; Mendelow, Alexander David

2018-02-01

The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective analysis of a selection of the STICH II cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas). From 390 patients, 739 scans were selected from the STICH II image archive based on the availability of a CT scan compatible with OsiriX DICOM viewer. ICH volumes were calculated by the reference standard semiautomatic segmentation in OsiriX software and compared with calculated arithmetic methods (ABC/2, ABC/2.4, ABC/3, and 2/3SC) volumes. Volumes were compared by difference plots for specific groups: randomization ICH (n=374), 3- to 7-day postsurgical ICH (n=206), antithrombotic-associated ICH (n=79), irregular-shape ICH (n=703) and irregular-density ICH (n=650). Density and shape were measured by the Barras ordinal shape and density groups (1-5). The ABC/2.4 method had the closest agreement to the semiautomatic segmentation volume in all groups, except for the 3- to 7-day postsurgical ICH group where the ABC/3 method was superior. Although the ABC/2 formula for calculating elliptical ICH is well validated, it must be used with caution in ICH scans where the elliptical shape of ICH is a false assumption. We validated the adjustment of the ABC/2.4 method in randomization, antithrombotic-associated, heterogeneous-density, and irregular-shape ICH. URL: http://www.isrctn.com/ISRCTN22153967. Unique identifier: ISRCTN22153967. © 2018 American Heart Association, Inc.

Chemically modified activated carbon with 1-acylthiosemicarbazide for selective solid-phase extraction and preconcentration of trace Cu(II), Hg(II) and Pb(II) from water samples.

Science.gov (United States)

Gao, Ru; Hu, Zheng; Chang, Xijun; He, Qun; Zhang, Lijun; Tu, Zhifeng; Shi, Jianping

2009-12-15

A new sorbent 1-acylthiosemicarbazide-modified activated carbon (AC-ATSC) was prepared as a solid-phase extractant and applied for removing of trace Cu(II), Hg(II) and Pb(II) prior to their determination by inductively coupled plasma optical emission spectrometry (ICP-OES). The separation/preconcentration conditions of analytes were investigated, including effects of pH, the shaking time, the sample flow rate and volume, the elution condition and the interfering ions. At pH 3, the maximum static adsorption capacity of Cu(II), Hg(II) and Pb(II) onto the AC-ATSC were 78.20, 67.80 and 48.56 mg g(-1), respectively. The adsorbed metal ions were quantitatively eluted by 3.0 mL of 2% CS(NH2)2 and 2.0 mol L(-1) HCl solution. Common coexisting ions did not interfere with the separation. According to the definition of IUPAC, the detection limits (3sigma) of this method for Cu(II), Hg(II) and Pb(II) were 0.20, 0.12 and 0.45 ng mL(-1), respectively. The relative standard deviation under optimum conditions is less than 4.0% (n=8). The prepared sorbent was applied for the preconcentration of trace Cu(II), Hg(II) and Pb(II) in certified and water samples with satisfactory results.

Very Low Cerebral Blood Volume Predicts Parenchymal Hematoma in Acute Ischemic Stroke

DEFF Research Database (Denmark)

Hermitte, Laure; Cho, Tae-Hee; Ozenne, Brice

2013-01-01

BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to exp......BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective...

Kempe's engineers year-book for 1977. Volume II

Energy Technology Data Exchange (ETDEWEB)

Prockter, C.E. (ed.)

1977-01-01

The second volume of this two-volume yearbook contains data on: electrical and electronic engineering; aerodynamics and aircraft propulsion; gas turbines; internal combustion engines; motor vehicles; fuels; fluidics; nuclear energy; gas and gas engineering; steam engineering and steam turbines; marine diesel engines; naval architecture; mining engineering; industrial explosives; air compression, pneumatic equipment, etc.; refrigeration, heating, ventilation and air conditioning; lighting; industrial safety and protection; fire protection; highway engineering; surveying; foundation and earthwork; cements, mortars and clay products; buildings; public health engineering; concretes; design of steel structures; bridges and bridgework; paints and coatings; patents, designs and trade marks; depreciation; legal notes for engineers; factory planning and layout; and agricultural engineering. (1325p.) A subject index is provided. (LCL)

First plasmas in the TJ-II flexible Heliac

International Nuclear Information System (INIS)

Alejaldre, C.; Alonso, J.; Almoguera, L.

1999-01-01

First plasmas have been successfully achieved in the TJ-II stellarator using electron cyclotron resonance heating (f = 53.2 GHz, P ECRH = 250 kW). Initial experiments have explored the TJ-II flexibility in a wide range of plasma volumes, different rotational transform and magnetic well values. In this paper, the main results of this campaign are presented and, in particular, the influence of plasma wall interaction phenomena on TJ-II operation is discussed briefly. (author)

Nuclear proliferation and civilian nuclear power: report of the Nonproliferation Alternative Systems Assessment Program. Volume 1. Program summary

Energy Technology Data Exchange (ETDEWEB)

1979-12-01

This report summarizes the Nonproliferation Alternative Systems Assessment Program (NASAP): its background, its studies, and its results. This introductory chapter traces the growth of the issue of nuclear weapons proliferation and the organization and objectives of NASAP. Chapter 2 summarizes the program's assessments, findings and recommendations. Each of Volumes II-VII reports on an individual assessment (Volume II: Proliferation Resistance; Volume III: Resources and Fuel Cycle Facilities; Volume IV: Commercial Potential; Volume V: Economics and Systems Analysis; Volume VI: Safety and Environmental Considerations for Licensing; Volume VII: International Perspectives). Volume VIII (Advanced Concepts) presents a combined assessment of several less fully developed concepts, and Volume IX (Reactor and Fuel Cycle Descriptions) provides detailed descriptions of the reactor and fuel-cycle systems studied by NASAP.

Nuclear proliferation and civilian nuclear power: report of the Nonproliferation Alternative Systems Assessment Program. Volume 1. Program summary

International Nuclear Information System (INIS)

1979-12-01

This report summarizes the Nonproliferation Alternative Systems Assessment Program (NASAP): its background, its studies, and its results. This introductory chapter traces the growth of the issue of nuclear weapons proliferation and the organization and objectives of NASAP. Chapter 2 summarizes the program's assessments, findings and recommendations. Each of Volumes II-VII reports on an individual assessment (Volume II: Proliferation Resistance; Volume III: Resources and Fuel Cycle Facilities; Volume IV: Commercial Potential; Volume V: Economics and Systems Analysis; Volume VI: Safety and Environmental Considerations for Licensing; Volume VII: International Perspectives). Volume VIII (Advanced Concepts) presents a combined assessment of several less fully developed concepts, and Volume IX (Reactor and Fuel Cycle Descriptions) provides detailed descriptions of the reactor and fuel-cycle systems studied by NASAP

Colorado Conference on iterative methods. Volume 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

The conference provided a forum on many aspects of iterative methods. Volume I topics were:Session: domain decomposition, nonlinear problems, integral equations and inverse problems, eigenvalue problems, iterative software kernels. Volume II presents nonsymmetric solvers, parallel computation, theory of iterative methods, software and programming environment, ODE solvers, multigrid and multilevel methods, applications, robust iterative methods, preconditioners, Toeplitz and circulation solvers, and saddle point problems. Individual papers are indexed separately on the EDB.

Beneficiation-hydroretort processing of US oil shales: Volume 2

Energy Technology Data Exchange (ETDEWEB)

None

1989-01-01

This report has been divided into three volumes. Volume I describes the MRI beneficiation work. In addition, Volume I presents the results of joint beneficiation-hydroretorting studies and provides an economic analysis of the combined beneficiation-hydroretorting approach for processing Eastern oil shales. Volume II presents detailed results of hydroretorting tests made by HYCRUDE/IGT on raw and beneficiated oil shales prepared by MRI. Volume III comprises detailed engineering design drawings and supporting data developed by the Roberts and Schaefer Company, Engineers and Contractors, Salt Lake City, Utah, in support of the capital and operating costs for a conceptual beneficiation plant processing an Alabama oil shale.

Two cycles of cisplatin-based chemotherapy for low-volume stage II seminoma: results of a retrospective, single-center case series.

Science.gov (United States)

Pichler, Renate; Leonhartsberger, Nicolai; Stöhr, Brigitte; Horninger, Wolfgang; Steiner, Hannes

2012-01-01

To report on the oncological outcome and toxicity of patients treated with 2 cycles of cisplatin-based chemotherapy for low-volume metastatic stage II seminoma. We retrospectively identified a case series of 15 patients with seminoma stage IIA (26.7%) and IIB (73.3%) who underwent chemotherapy consisting of 2 cycles of cisplatin, etoposide and bleomycin (PEB) (cisplatin 20 mg/m(2) on days 1-5, etoposide 100 mg/m(2) on days 1-5, bleomycin 30 mg on days 1, 8 and 15) according to patient preference (refusing a 3rd cycle of PEB) or institutional practice in the last decades. Complete staging before chemotherapy was available in all patients. Patient age, the side and diameter of the primary tumor, the size of the lymph nodes before and after chemotherapy, acute and late toxicity of chemotherapy, the incidence of second malignancies, the relapse-free rate and cancer-specific mortality were recorded. Chemotherapy was well tolerated and no episode of febrile neutropenia occurred. Thrombocytopenia grade 4 was not seen in any patient, while leukopenia grade 4 was observed in 4 (26.6%) patients. The mean (range) lymph node size decreased significantly from 2.54 cm (1.1-4.0) before chemotherapy to 0.75 cm (0.4-2.2) after chemotherapy (p < 0.001). After a median (range) follow-up of 60 (13-185) months, no patient had relapsed, no patient had died as a result of seminoma and second malignancy was seen in only 1 (6.6%) patient. These excellent long-term results from a retrospective case series of 2 cycles of PEB in stage IIA/IIB seminoma patients represent a hint for further research with a view to reducing treatment burden. However, these incidental findings should be studied in prospective trials prior to drawing any conclusions. Copyright © 2013 S. Karger AG, Basel.

Do high-volume hospitals and surgeons provide better care in urologic oncology?

Science.gov (United States)

Eastham, James A

2009-01-01

Studies focusing primarily on hospital or surgical volume as a surrogate for surgical experience have found substantial variations in outcomes. Increasing surgical experience has been shown to improve outcomes after multiple procedures, including esophagectomy, pancreatectomy, and primary surgery for colon and breast cancer. More recently, evidence has been presented that surgical volume/experience affects quality of life and cancer control outcomes after urologic oncology procedures. Although most of these data pertain to radical prostatectomy, similar conclusions have been reached for radical cystectomy, retroperitoneal lymph node dissection, and management of renal cell carcinoma. This review highlights data indicating that high-volume surgeons and hospitals provide better care for radical prostatectomy.

Mapping the brain in type II diabetes: Voxel-based morphometry using DARTEL

International Nuclear Information System (INIS)

Chen, Zhiye; Li, Lin; Sun, Jie; Ma, Lin

2012-01-01

Purpose: To investigate the pattern of brain volume changes of the brain in patients with type II diabetes mellitus using voxel-based morphometry. Material and methods: Institutional ethics approval and informed consent were obtained. VBM based on the high resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images was obtained from 16 type II diabetes patients (mean age 61.2 years) and 16 normal controls (mean age 59.6 years). All images were spatially preprocessed using Diffeomorphic Anatomical Registration using Exponentiated Lie algebra (DARTEL) algorithm, and the DARTEL templates were made from 100 normal subjects. Statistical parametric mapping was generated using analysis of covariance (ANCOVA). Results: An atrophy pattern of gray matter was seen in type II diabetes patients compared with controls that involved the right superior, middle, and inferior temporal gyri, right precentral gyrus, and left rolandic operculum region. The loss of white matter volume in type II diabetes mellitus was observed in right temporal lobe and left inferior frontal triangle region. ROI analysis revealed that the gray and white matter volume of right temporal lobe were significant lower in type II diabetes mellitus than that in controls (P < 0.05). Conclusion: This work demonstrated that type II diabetes mellitus patients mainly exhibited gray and white matter atrophy in right temporal lobe, and this finding supported that type II diabetes mellitus could lead to subtle diabetic brain structural changes in patients without dementia or macrovascular complications.

Mapping the brain in type II diabetes: Voxel-based morphometry using DARTEL

Energy Technology Data Exchange (ETDEWEB)

Chen, Zhiye [Department of Radiology, PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Li, Lin [Department of Geriatric Endocrinology, PLA General Hospital, Beijing 100853 (China); Sun, Jie [Department of Endocrinology, PLA General Hospital, Beijing 100853 (China); Ma, Lin, E-mail: cjr.malin@vip.163.com [Department of Radiology, PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

2012-08-15

Purpose: To investigate the pattern of brain volume changes of the brain in patients with type II diabetes mellitus using voxel-based morphometry. Material and methods: Institutional ethics approval and informed consent were obtained. VBM based on the high resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images was obtained from 16 type II diabetes patients (mean age 61.2 years) and 16 normal controls (mean age 59.6 years). All images were spatially preprocessed using Diffeomorphic Anatomical Registration using Exponentiated Lie algebra (DARTEL) algorithm, and the DARTEL templates were made from 100 normal subjects. Statistical parametric mapping was generated using analysis of covariance (ANCOVA). Results: An atrophy pattern of gray matter was seen in type II diabetes patients compared with controls that involved the right superior, middle, and inferior temporal gyri, right precentral gyrus, and left rolandic operculum region. The loss of white matter volume in type II diabetes mellitus was observed in right temporal lobe and left inferior frontal triangle region. ROI analysis revealed that the gray and white matter volume of right temporal lobe were significant lower in type II diabetes mellitus than that in controls (P < 0.05). Conclusion: This work demonstrated that type II diabetes mellitus patients mainly exhibited gray and white matter atrophy in right temporal lobe, and this finding supported that type II diabetes mellitus could lead to subtle diabetic brain structural changes in patients without dementia or macrovascular complications.

Eddy current manual, volume 2

International Nuclear Information System (INIS)

Cecco, V.S.; Van Drunen, G.; Sharp, F.L.

1984-09-01

This report on eddy current testing is divided into three sections: (a) Demonstration of Basic Principles, (b) Practical (Laboratory) Tests and, (c) Typical Certification Questions. It is intended to be used as a supplement to ΣEddy Current Manual, Volume 1Σ (AECL-7523) during CSNDT Foundation Level II and III courses

INTRA/Mod3.2. Manual and Code Description. Volume I - Physical Modelling

International Nuclear Information System (INIS)

Andersson, Jenny; Edlund, O.; Hermann, J.; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the Physical modelling of INTRA and the ruling numerical methods and volume II, the User's Manual is an input description. This document, the Physical modelling of INTRA, contains code characteristics, integration methods and applications

INTRA/Mod3.2. Manual and Code Description. Volume I - Physical Modelling

Energy Technology Data Exchange (ETDEWEB)

Andersson, Jenny; Edlund, O; Hermann, J; Johansson, Lise-Lotte

1999-01-01

The INTRA Manual consists of two volumes. Volume I of the manual is a thorough description of the code INTRA, the Physical modelling of INTRA and the ruling numerical methods and volume II, the User`s Manual is an input description. This document, the Physical modelling of INTRA, contains code characteristics, integration methods and applications

Nuclear proliferation and civilian nuclear power. Report of the Nonproliferation Alternative Systems Assessment Program. Volume I. Program summary

International Nuclear Information System (INIS)

1980-06-01

This report summarizes the Nonproliferation Alternative Systems Assessment Program (NASAP): its background, its studies, and its results. The introductory chapter traces the growth of the issue of nuclear weapons proliferation and the organization and objectives of NASAP. Chapter 2 summarizes the program's assessments, findings, and recommendations. Each of Volumes II-VII reports on an individual assessment (Volumn II: Proliferation Resistance; Volume III: Resources and Fuel Cycle Facilities; Volume IV: Commercial Potential; Volume V: Economics and Systems Analysis; Volume VI: Safety and Environmental Considerations for Licensing; Volume VII: International Perspectives). Volume VIII (Advanced Concepts) presents a combined assessment of several less fully developed concepts, and Volume IX (Reactor and Fuel Cycle Descriptions) provides detailed descriptions of the reactor and fuel-cycle systems studied by NASAP

Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma

Energy Technology Data Exchange (ETDEWEB)

Sasanelli, Myriam; Meignan, Michel; Haioun, Corinne; Itti, Emmanuel [Paris-Est University, Nuclear Medicine and Lymphoid Malignancies Unit, Henri Mondor Hospital, Creteil (France); Berriolo-Riedinger, Alina; Casasnovas, Rene-Olivier [Nuclear Medicine and Hematology, Georges-Francois Leclerc Center, Le Bocage Hospital, Dijon (France); Biggi, Alberto; Gallamini, Andrea [Nuclear Medicine and Hematology, Santa Croce e Carle Hospital, Cuneo (Italy); Siegel, Barry A.; Cashen, Amanda F. [Washington University School of Medicine, Nuclear Medicine and Oncology, Siteman Cancer Center, St. Louis, MO (United States); Vera, Pierre; Tilly, Herve [Nuclear Medicine and Hematology, Henri Becquerel Center, Rouen (France); Versari, Annibale [Nuclear Medicine, Santa Maria Nuova Hospital-IRCCS, Reggio Emilia (Italy)

2014-11-15

We investigated the prognostic value of total metabolic tumour volume (TMTV) in diffuse large B-cell lymphoma (DLBCL). TMTV was measured in 114 patients with newly diagnosed DLBCL who underwent {sup 18}F-FDG PET/CT at baseline before immunochemotherapy. TMTV was computed by summing the volumes of all lymphomatous lesions after applying the local SUVmax threshold of 41 % using semiautomatic software. Prognostic value was assessed by Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS). Median follow-up was 39 months. Average pretherapy TMTV was 509 ± 568 cm{sup 3}. The 3-year estimates of PFS were 77 % in the low metabolic burden group (TMTV ≤550 cm{sup 3}) and 60 % in the high metabolic burden group (TMTV >550 cm{sup 3}, p = 0.04), and prediction of OS was even better (87 % vs. 60 %, p = 0.0003). Cox regression showed independence of TMTV for OS prediction (p = 0.002) compared with other pretherapy indices of tumour burden, such as tumour bulk and the International Prognostic Index. Pretherapy TMTV is an independent predictor of outcome in patients with DLBCL. (orig.)

Final programmatic environmental impact statement for the uranium mill tailings remedial action ground water project. Volume II

Energy Technology Data Exchange (ETDEWEB)

None

1996-10-01

Volume II of the programmatic environmental impact statement (PElS) is a comment and response document; it is the collection of the comments received on the draft PElS. The U.S. Department of Energy's (DOE) response to each comment is provided after each comment. If the comment resulted in a change to the PElS, the affected section number of the PElS is provided in the response. Comments 1 through 259 were received at public hearings. The name of the hearing at which the comment was received is listed after each comment. Comments were recorded on flip charts and by notetakers. DOE representatives were present to hear the comments and respond to them. The DOE's written response is provided after each comment. Comments 260 through 576 were received in writing at the hearings, and from various federal, tribal, and state agencies and from individuals during the public comment period. Copies of the written comments follow the comments and responses.

Final programmatic environmental impact statement for the uranium mill tailings remedial action ground water project. Volume II

International Nuclear Information System (INIS)

1996-01-01

Volume II of the programmatic environmental impact statement (PElS) is a comment and response document; it is the collection of the comments received on the draft PElS. The U.S. Department of Energy's (DOE) response to each comment is provided after each comment. If the comment resulted in a change to the PElS, the affected section number of the PElS is provided in the response. Comments 1 through 259 were received at public hearings. The name of the hearing at which the comment was received is listed after each comment. Comments were recorded on flip charts and by notetakers. DOE representatives were present to hear the comments and respond to them. The DOE's written response is provided after each comment. Comments 260 through 576 were received in writing at the hearings, and from various federal, tribal, and state agencies and from individuals during the public comment period. Copies of the written comments follow the comments and responses

Survival in pediatric lung transplantation: The effect of center volume and expertise.

Science.gov (United States)

Khan, Muhammad S; Zhang, Wei; Taylor, Rachel A; Dean McKenzie, E; Mallory, George B; Schecter, Marc G; Morales, David L S; Heinle, Jeffrey S; Adachi, Iki

2015-08-01

Institutional operative volume has been shown to impact outcomes of various procedures including lung transplantation (LTx). We sought to determine whether this holds true with pediatric LTx by comparing outcomes of adult centers (with larger overall volume) to those of pediatric centers (with smaller volume but more pediatric-specific experience). A retrospective analysis of the Organ Procurement and Transplant Network data was performed. Centers were categorized as either adult (LTx volume predominantly in adult patients), high-volume pediatric (HVP, ≥4 LTxs/year), or low-volume pediatric (LVP, HVP 3 [5%], LVP 8 [13%]). Although adult centers had larger overall LTx volume, their pediatric experiences were severely limited (median 1/year). In younger children, HVP centers were significantly better than LVP centers for patient survival (half-life: 7.3 vs 2.9 years, p = 0.002). Similarly, in older children and adolescents, HVP centers were significantly better than adult centers for patient survival (half-life: 4.6 vs 2.5 years, p = 0.001). Of note, even LVP centers tended to have longer patient survival than adult centers (p = 0.064). Multivariable analysis identified adult centers as an independent risk factor for graft failure (hazard ratio: 1.5, p < 0.001) as with LVP (hazard ratio: 1.3, p = 0.0078). Despite larger overall clinical volume, outcomes among pediatric LTx recipients in adult centers are not superior to those of pediatric centers. Not only center volume but pediatric-specific experience has an impact on outcomes in pediatric LTx. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure

OpenAIRE

Guldager, Henrik; Nielsen, Soeren L; Carl, Peder; Soerensen, Mogens B

1997-01-01

Background: The aim of this study was to test the hypothesis that a new mode of ventilation (pressure-regulated volume control; PRVC) is associated with improvements in respiratory mechanics and outcome when compared with conventional volume control (VC) ventilation in patients with acute respiratory failure. We conducted a randomised, prospective, open, cross over trial on 44 patients with acute respiratory failure in the general intensive care unit of a university hospital. After a stabiliz...

Improvements in 5-year outcomes of stage II/III rectal cancer relative to colon cancer.

Science.gov (United States)

Renouf, Daniel J; Woods, Ryan; Speers, Caroline; Hay, John; Phang, P Terry; Fitzgerald, Catherine; Kennecke, Hagen

2013-12-01

Stage for stage, rectal cancer has historically been associated with inferior survival compared with colon cancer. Randomized trials of rectal cancer have generally demonstrated improvements in locoregional relapse but not survival. We compared therapy and outcomes of colon versus rectal cancer in 2 time cohorts to determine if relative improvements have occurred. Patients with resected stage II/III colorectal cancer referred to the British Columbia Cancer Agency in 1989/1990 and 2001/2002 were identified. The higher of clinical or pathologic stage was used for patients receiving preoperative chemoradiation. Disease-specific survival (DSS) and overall survival (OS) were compared for rectal and colon cancer between the 2 cohorts. Kaplan-Meier method was used for survival analysis. A total of 1427 patients were included, with 375 from 1989/1990 and 1052 from 2001/2002. Between 1989/1990 and 2001/2002 there were significant increases in the use of perioperative chemotherapy for both rectal and colon cancer (Prectal cancer. DSS significantly improved for rectal (Pcolon cancer (P=0.069). Five-year OS was significantly inferior for rectal versus colon cancer in 1989/1990 (46.1% vs. 57.2%, P=0.023) and was similar to that of colon cancer in 2001/2002 (63.7% vs. 66.2%, P=0.454). Advances in locoregional and systemic therapy significantly improved survival among patients with rectal cancer. DSS and OS are now similar between colon and rectal cancer for both stage II and III disease.

Relations between brain volumes, neuropsychological assessment and parental questionnaire in prematurely born children.

Science.gov (United States)

Lind, Annika; Haataja, Leena; Rautava, Liisi; Väliaho, Anniina; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Korkman, Marit

2010-05-01

The objective of this study is to assess the relationship between brain volumes at term equivalent age and neuropsychological functions at 5 years of age in very low birth weight (VLBW) children, and to compare the results from a neuropsychological assessment and a parental questionnaire at 5 years of age. The study group included a regional cohort of 97 VLBW children and a control group of 161 children born at term. At term equivalent age, brain magnetic resonance imaging (MRI) was performed on the VLBW children, and analysed for total and regional brain volumes. At 5 years of age, a psychologist assessed the neuropsychological performance with NEPSY II, and parents completed the Five to fifteen (FTF) questionnaire on development and behaviour. The results of the control group were used to give the age-specific reference values. No significant associations were found between the brain volumes and the NEPSY II domains. As for the FTF, significant associations were found between a smaller total brain tissue volume and poorer executive functions, between a smaller cerebellar volume and both poorer executive functions and motor skills, and, surprisingly, between a larger volume of brainstem and poorer language functions. Even after adjustment for total brain tissue volume, the two associations between the cerebellar volume and the FTF domains remained borderline significant (P = 0.05). The NEPSY II domains Executive Functioning, Language and Motor Skills were significantly associated with the corresponding FTF domains. In conclusion, altered brain volumes at term equivalent age appear to affect development still at 5 years of age. The FTF seems to be a good instrument when used in combination with other neuropsychological assessment.

Selective removal of cesium from aqueous solutions with nickel (II) hexacyanoferrate (III) functionalized agricultural residue–walnut shell

International Nuclear Information System (INIS)

Ding, Dahu; Lei, Zhongfang; Yang, Yingnan; Feng, Chuanping; Zhang, Zhenya

2014-01-01

Highlights: • Novel biosorbent for cesium removal was derived from agricultural residue. • It could remove cesium effectively from aqueous solution. • Large size of granules makes it easy to be separated from solutions. • The volume of used biosorbent could be significantly reduced after incineration. • Incinerated biosorbent has a low volume and a low cost final disposal. - Abstract: A novel nickel (II) hexacyanoferrate (III) functionalized agricultural residue-walnut shell (Ni II HCF III -WS) was developed to selectively remove cesium ion (Cs + ) from aqueous solutions. This paper showed the first integral study on Cs + removal behavior and waste reduction analysis by using biomass adsorption material. The results indicated that the removal process was rapid and reached saturation within 2 h. As a special characteristic of Ni II HCF III -WS, acidic condition was preferred for Cs + removal, which was useful for extending the application scope of the prepared biomass material in treating acidic radioactive liquid waste. The newly developed Ni II HCF III -WS could selectively remove Cs + though the coexisting ions (Na + and K + in this study) exhibited negative effects. In addition, approximately 99.8% (in volume) of the liquid waste was reduced by using Ni II HCF III -WS and furthermore 91.9% (in volume) of the spent biomass material (Cs-Ni II HCF III -WS) was reduced after incineration (at 500 °C for 2 h). Due to its relatively high distribution coefficient and significant volume reduction, Ni II HCF III -WS is expected to be a promising material for Cs + removal in practice

Acculturation level and caregiver outcomes from a randomized intervention trial to enhance caregivers' health: evidence from REACH II.

Science.gov (United States)

Meyer, Oanh L; Liu, Xiaoyan Lucia; Tancredi, Daniel; Ramirez, A Susana; Schulz, Richard; Hinton, Ladson

2018-06-01

Latinos comprise a growing segment of the caregiver population and vary widely in acculturation, yet little is known regarding how acculturation might affect caregiver stress or intervention outcomes. This study examined the relationship between acculturation and burden, bother, and depression in Latino dementia caregivers at baseline and following an intervention. This was a secondary data analysis of 211 Latino caregivers of older adults with dementia from Resources for Enhancing Alzheimer's Caregiver Health (REACH) II, a multisite randomized trial of caregiver interventions. Baseline and follow-up data were used to run mixed-effects models examining the main and moderating effect of acculturation on caregiver stress. No significant main effect of acculturation was found for any of the outcome measures, controlling for demographic covariates. Acculturation moderated the effect of the intervention on caregiver burden: those who were more acculturated benefited more from the intervention. Differential acculturation for Latino caregivers was not directly associated with caregiver burden, bother, or depression, but was associated with reducing burden from the intervention. Future research should explore by what mechanism acculturation influences caregiver burden following an intervention.

USAF Logistics Process Optimization Study for the Aircraft Asset Sustainment Process. Volume 2

National Research Council Canada - National Science Library

Adamson, Anthony

1998-01-01

.... It is published as three separate volumes. Volume I, USAF Logistics Process Optimization Study for the Aircraft Asset Sustainment Process -- Phase II Report, discusses the result and cost/benefit analysis of testing three initiatives...

USAF Logistics Process Optimization Study for the Aircraft Asset Sustainment Process. Volume 1

National Research Council Canada - National Science Library

Adamson, Anthony

1998-01-01

.... It is published as three separate volumes. Volume I, USAF Logistics Process Optimization Study for the Aircraft Asset Sustainment Process -- Phase II Report, discusses the result and cost/benefit analysis of testing three initiatives...

No-migration variance petition. Volume 3, Revision 1: Appendix B, Attachments A through D

Energy Technology Data Exchange (ETDEWEB)

1990-03-01

Volume III contains the following attachments: TRUPACT-II content codes (TRUCON); TRUPACT-II chemical list; chemical compatibility analysis for Rocky Flats Plant waste forms (Appendix 2.10.12 of TRUPACT-II safety analysis report); and chemical compatibility analyses for waste forms across all sites.

Analysis of the permitting processes associated with exploration of Federal OCS leases. Final report. Volume II. Appendices

Energy Technology Data Exchange (ETDEWEB)

1980-11-01

Under contract to the Office of Leasing Policy Development (LPDO), Jack Faucett Associates is currently undertaking the description and analysis of the Outer Continental Shelf (OCS) regulatory process to determine the nature of time delays that affect OCS production of oil and gas. This report represents the results of the first phase of research under this contract, the description and analysis of regulatory activity associated with exploration activities on the Federal OCS. Volume 1 contains the following three sections: (1) study results; (2) Federal regulatory activities during exploration of Federal OCS leases which involved the US Geological Survey, Environmental Protection Agency, US Coast Guard, Corps of Engineers, and National Ocean and Atmospheric Administration; and (3) state regulatory activities during exploration of Federal OCS leases of Alaska, California, Louisiana, Massachusetts, New Jersey, North Carolina and Texas. Volume II contains appendices of US Geological Survey, Environmental Protection Agency, Coast Guard, Corps of Engineers, the Coastal Zone Management Act, and Alaska. The major causes of delay in the regulatory process governing exploration was summarized in four broad categories: (1) the long and tedious process associated with the Environmental Protection Agency's implementation of the National Pollutant Discharge Elimination System Permit; (2) thelack of mandated time periods for the completion of individual activities in the permitting process; (3) the lack of overall coordination of OCS exploratory regulation; and (4) the inexperience of states, the Federal government and industry relating to the appropriate level of regulation for first-time lease sale areas.

Pleural subxyphoid drain confers better pulmonary function and clinical outcomes in chronic obstructive pulmonary disease after off-pump coronary artery bypass grafting: a randomized controlled trial.

Science.gov (United States)

Guizilini, Solange; Viceconte, Marcela; Esperança, Gabriel Tavares da M; Bolzan, Douglas W; Vidotto, Milena; Moreira, Rita Simone L; Câncio, Andréia Azevedo; Gomes, Walter J

2014-01-01

To evaluate the lung function and clinical outcome in severe chronic obstructive pulmonary disease in patients undergoing off-pump coronary artery bypass grafting with left internal thoracic artery graft, comparing the pleural drain insertion in the intercostal versus subxyphoid region. A randomized controlled trial. Chronic obstructive pulmonary disease patients were randomized into two groups according pleural drain site: II group (n=27) - pleural drain in intercostal space; SI group (n=29) - pleural drain in the subxyphoid region. Spirometry values (Forced Vital Capacity - and Forced expiratory volume in 1 second) were obtained on preoperative and 1, 3 and 5 postoperative days. Chest x-ray from preoperative until postoperative day 5 (POD5) was performed for monitoring respiratory events, such as atelectasis and pleural effusion. Pulmonary shunt fraction and pain score was evaluate preoperatively and on postoperative day 1. In both groups there was a significant decrease of the spirometry values (Forced Vital Capacity and Forced expiratory volume in 1 second) until POD5 (Ppleural drainage in severe Chronic obstructive pulmonary disease patients determined better preservation and recovery of pulmonary capacity and volumes with lower pulmonary shunt fraction and better clinical outcomes on early postoperative off-pump coronary artery bypass grafting.

SU-E-T-170: Characterization of the Location, Extent, and Proximity to Critical Structures of Target Volumes Provides Detail for Improved Outcome Predictions Among Pancreatic Cancer Patients

International Nuclear Information System (INIS)

Cheng, Z; Moore, J; Rosati, L; Mian, O; Narang, A; Herman, J; McNutt, T

2015-01-01

Purpose: In radiotherapy, size, location and proximity of the target to critical structures influence treatment decisions. It has been shown that proximity of the target predicts dosimetric sparing of critical structures. In addition to dosimetry, precise location of disease has further implications such as tumor invasion, or proximity to major arteries that inhibit surgery. Knowledge of which patients can be converted to surgical candidates by radiation may have high impact on future treat/no-treat decisions. We propose a method to improve our characterization of the location of pancreatic cancer and treatment volume extent with respect to nearby arteries with the goal of developing features to improve clinical predictions and decisions. Methods: Oncospace is a local learning health system that systematically captures clinical outcomes and all aspects of radiotherapy treatment plans, including overlap volume histograms (OVH) – a measure of spatial relationships between two structures. Minimum and maximum distances of PTV and OARs based on OVH, PTV volume, anatomic location by ICD-9 code, and surgical outcome were queried. Normalized distance to center from the left and right kidney was calculated to indicate tumor location and laterality. Distance to critical arteries (celiac, superior mesenteric, common hepatic) is validated by surgical status (borderline resectable, locally advanced converted to resectable). Results: There were 205 pancreas stereotactic body radiotherapy patients treated from 2009–2015 queried. Location/laterality of tumor based on kidney OVH show strong trends between location by OVH and by ICD-9. Compared to the locally advanced group, the borderline resectable group showed larger geometrical distance from critical arteries (p=0.03). Conclusion: Our platform enabled analysis of shape/size-location relationships. These data suggest that PTV volume and attention to distance between PTVs and surrounding OARs and major arteries may be

SU-E-T-170: Characterization of the Location, Extent, and Proximity to Critical Structures of Target Volumes Provides Detail for Improved Outcome Predictions Among Pancreatic Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

Cheng, Z; Moore, J; Rosati, L; Mian, O; Narang, A; Herman, J; McNutt, T [Johns Hopkins University, Baltimore, MD (United States)

2015-06-15

Purpose: In radiotherapy, size, location and proximity of the target to critical structures influence treatment decisions. It has been shown that proximity of the target predicts dosimetric sparing of critical structures. In addition to dosimetry, precise location of disease has further implications such as tumor invasion, or proximity to major arteries that inhibit surgery. Knowledge of which patients can be converted to surgical candidates by radiation may have high impact on future treat/no-treat decisions. We propose a method to improve our characterization of the location of pancreatic cancer and treatment volume extent with respect to nearby arteries with the goal of developing features to improve clinical predictions and decisions. Methods: Oncospace is a local learning health system that systematically captures clinical outcomes and all aspects of radiotherapy treatment plans, including overlap volume histograms (OVH) – a measure of spatial relationships between two structures. Minimum and maximum distances of PTV and OARs based on OVH, PTV volume, anatomic location by ICD-9 code, and surgical outcome were queried. Normalized distance to center from the left and right kidney was calculated to indicate tumor location and laterality. Distance to critical arteries (celiac, superior mesenteric, common hepatic) is validated by surgical status (borderline resectable, locally advanced converted to resectable). Results: There were 205 pancreas stereotactic body radiotherapy patients treated from 2009–2015 queried. Location/laterality of tumor based on kidney OVH show strong trends between location by OVH and by ICD-9. Compared to the locally advanced group, the borderline resectable group showed larger geometrical distance from critical arteries (p=0.03). Conclusion: Our platform enabled analysis of shape/size-location relationships. These data suggest that PTV volume and attention to distance between PTVs and surrounding OARs and major arteries may be

PATRAM '80. Proceedings. Volume 1

International Nuclear Information System (INIS)

Huebner, H.W.

1980-01-01

Volume 1 contains papers from the following sessions: Plenary Session; Regulations, Licensing and Standards; LMFBR Systems Concepts; Risk/Safety Assessment I; Systems and Package Design; US Institutional Issues; Risk/Safety Assessment II; Leakage, Leak Rate and Seals; Poster Session A; Operations and Systems Experience I; Manufacturing Processes and Materials; and Quality Assurance and Maintenance. Individual papers were processed. (LM)

Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.

Science.gov (United States)

Liotta, Eric M; Prabhakaran, Shyam; Sangha, Rajbeer S; Bush, Robin A; Long, Alan E; Trevick, Stephen A; Potts, Matthew B; Jahromi, Babak S; Kim, Minjee; Manno, Edward M; Sorond, Farzaneh A; Naidech, Andrew M; Maas, Matthew B

2017-08-22

We tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Patients presenting with spontaneous ICH were enrolled in an observational cohort study that prospectively collected demographic, clinical, laboratory, radiographic, and outcome data. We performed univariate and adjusted multivariate analyses to assess for associations between serum magnesium levels and initial hematoma volume, final hematoma volume, and in-hospital hematoma growth as radiographic measures of hemostasis, and functional outcome measured by the modified Rankin Scale (mRS) at 3 months. We included 290 patients for analysis. Admission serum magnesium was 2.0 ± 0.3 mg/dL. Lower admission magnesium levels were associated with larger initial hematoma volumes on univariate ( p = 0.02), parsimoniously adjusted ( p = 0.002), and fully adjusted models ( p = 0.006), as well as greater hematoma growth ( p = 0.004, p = 0.005, and p = 0.008, respectively) and larger final hematoma volumes ( p = 0.02, p = 0.001, and p = 0.002, respectively). Lower admission magnesium level was associated with worse functional outcomes at 3 months (i.e., higher mRS; odds ratio 0.14, 95% confidence interval 0.03-0.64, p = 0.011) after adjustment for age, admission Glasgow Coma Scale score, initial hematoma volume, time from symptom onset to initial CT, and hematoma growth, with evidence that the effect of magnesium is mediated through hematoma growth. These data support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH. © 2017 American Academy of Neurology.

Fiscal Year 1986 Department of Energy authorization (basic research programs). Volume II-B. Hearing before the Subcommittee on Energy Development and Applications of the Committee on Science and Technology, US House of Representatives, Ninety-Ninth Congress, First Session, February 28, 1985

International Nuclear Information System (INIS)

Anon.

1985-01-01

Volume II-B of the hearing record contains Appendix 3 and Appendix 4 of Volume II-A. Appendix 3 provides supporting materials on the accomplishments and project summaries of the various departments under the Office of Basic Energy Sciences. This includes DOE supported work in engineering, chemistry, biology, mathematics, geology, and the energy sciences. Appendix 4 provides summaries of DOE supported work on high energy physics, which investigates the nature of matter and the behavior of matter and energy. Over 90% of the funding for this work comes from DOE, which is responsible for national planning in the effort to develop accelerator facilities, the superconducting super collider, and other physics programs

Controlled synthesized natroalunite microtubes applied for cadmium(II) and phosphate co–removal

Energy Technology Data Exchange (ETDEWEB)

Xu, Huan [School of Physics and Materials Science, Anhui University, Hefei 230601 (China); Institute of Plasma Physics, Chinese Academy of Sciences, P.O. Box 1126, Hefei 230031 (China); Zhu, Baisheng [University of Science and Technology of China, Hefei 230026 (China); Ren, Xuemei, E-mail: renxm1985@163.com [Institute of Plasma Physics, Chinese Academy of Sciences, P.O. Box 1126, Hefei 230031 (China); Shao, Dadong; Tan, Xiaoli; Chen, Changlun [Institute of Plasma Physics, Chinese Academy of Sciences, P.O. Box 1126, Hefei 230031 (China)

2016-08-15

Highlights: • Five natroalunite samples with different morphologies were synthesized. • EG: water ratio controls the morphology and adsorption performance of natroalunite. • NMs show the best performance in Cd(II) and phosphate co-uptake. • Phosphate bridges NMs and Cd(II) in co–removal process and enhances Cd(II) uptake. - Abstract: Treatment of wastewater containing several kinds of contaminants poses great challenges, because heavy metal and inorganic anion contaminants possess different fate and transport mechanisms. Individual adsorption of Cd(II)/phosphate on clay or metallic oxides has been extensively investigated, but the mutual effects of these two species in co–existing systems have received little attention. In this study, five natroalunite samples with different morphologies were synthesized by a simple hydrothermal method with appropriate volume ratio of ethylene glycol (EG) to water. The volume ratio of EG to water plays a key role in the formation of natroalunite samples, and dramatically affects their adsorption capacities. The mutual effects of Cd(II) and phosphate on their interaction with natroalunite microtubes (NMs) were investigated by varying experimental conditions, such as pH, temperature and addition sequences. The results demonstrate that highly efficient co–removal of Cd(II) and phosphate can be accomplished using NMs, and the process is strongly dependent on solution pH and temperature via the formation of ternary surface complexes. This study implies that the hydrothermally synthesized NMs can be regarded as a potential promising material for the co–removal of Cd(II) and phosphate from large volumes of aqueous solutions in pollution management.

Treatment outcome, body image, and sexual functioning after orchiectomy and radiotherapy for Stage I-II testicular seminoma

International Nuclear Information System (INIS)

Incrocci, Luca; Hop, Wim C.J.; Wijnmaalen, Arendjan; Slob, A. Koos

2002-01-01

Purpose: Orchiectomy followed by infradiaphragmatic irradiation is the standard treatment for Stage I-II testicular seminoma in The Netherlands. Because body image and sexual functioning can be affected by treatment, a retrospective study was carried out to assess treatment outcome, body image, and changes in sexuality after orchiectomy and radiotherapy. Methods and Materials: The medical charts of 166 patients with Stage I-II testicular seminoma were reviewed. A questionnaire on body image and current sexual functioning regarding the frequency and quality of erections, sexual activity, significance of sex, and changes in sexuality was sent to 157 patients (at a mean of 51 months after treatment). Results: Seventy-eight percent (n=123, mean age 42 years) completed the questionnaire. During irradiation, almost half of patients experienced nausea and 19% nausea and vomiting. Only 3 patients had disease relapse. After treatment, about 20% reported less interest and pleasure in sex and less sexual activity. Interest in sex, erectile difficulties, and satisfaction with sexual life did not differ from age-matched healthy controls. At the time of the survey, 17% of patients had erectile difficulties, a figure that was significantly higher than before treatment, but which correlated also with age. Twenty percent expressed concerns about fertility, and 52% found their body had changed after treatment. Cancer treatment had negatively influenced sexual life in 32% of the patients. Conclusions: Orchiectomy with radiotherapy is an effective and well-tolerated treatment for Stage I-II testicular seminoma. Treatment-induced changes in body image and concerns about fertility were detected, but the sexual problems encountered did not seem to differ from those of healthy controls, although baseline data are lacking

Mid-Term Outcomes of Endovascular Treatment for TASC-II D Femoropopliteal Occlusive Disease with Critical Limb Ischemia

Energy Technology Data Exchange (ETDEWEB)

Torres-Blanco, Álvaro, E-mail: atorres658@yahoo.es; Edo-Fleta, Gemma; Gómez-Palonés, Francisco; Molina-Nácher, Vicente; Ortiz-Monzón, Eduardo [Hospital Universitario Dr. Peset, Department of Angiology, Endovascular and Vascular Surgery (Spain)

2016-03-15

PurposeThe purpose of the study was to assess the safety and midterm effectiveness of endovascular treatment in Trans-Atlantic Inter-Society Consensus II (TASC-II) D femoropopliteal occlusions in patients with critical limb ischemia (CLI).MethodsPatients with CLI who underwent endovascular treatment for TASC-D de novo femoropopliteal occlusive disease between September 2008 and December 2013 were selected. Data included anatomic features, pre- and postprocedure ankle-brachial index, duplex ultrasound, and periprocedural complications. Sustained clinical improvement, limb salvage rate, freedom from target lesion revascularization (TLR), and freedom from target extremity revascularization (TER) were assessed by Kaplan–Meier estimation and predictors of restenosis/occlusion with Cox analysis.ResultsThirty-two patients underwent treatment of 35 TASC-D occlusions. Mean age was 76 ± 9. Mean lesion length was 23 ± 5 cm. Twenty-eight limbs (80 %) presented tissue loss. Seventeen limbs underwent treatment by stent, 13 by stent-graft, and 5 by angioplasty. Mean follow-up was 29 ± 20 months. Seven patients required major amputation and six patients died during follow-up. Eighteen endovascular and three surgical TLR procedures were performed due to restenosis or occlusion. Estimated freedom from TLR and TER rates at 2 years were 41 and 76 %, whereas estimated primary and secondary patency rates were 41 and 79 %, respectively.ConclusionsEndovascular treatment for TASC II D lesions is safe and offers satisfying outcomes. This patient subset would benefit from a minimally invasive approach. Follow-up is advisable due to a high rate of restenosis. Further follow-up is necessary to know the long-term efficacy of these procedures.

MANAJEMEN KULTUR ROTIFER DENGAN TANGKI VOLUME KECIL

Directory of Open Access Journals (Sweden)

Philip Teguh Imanto

2009-04-01

Full Text Available Keberhasilan pembenihan ikan sangat dipengaruhi keberhasilan produksi jasad pakan rotifer secara tepat dan efisien. Penelitian kultur rotifer dengan tangki volume kecil bertujuan untuk mendapatkan efisiensi produksi yang paling optimal dan memenuhi prinsip dasar akuakultur low volume high density. Penelitian menggunakan tangki polyethylene dengan volume 500 L dan volume media awal 100 L, padat tebar awal 200 ind. rotifer per mL dengan sediaan pakan dasar fitoplankton Nannocloropsis occulata, ragi roti (0,05 g/mio.rot./feeding dan suplemen Scott emulsion (0,005 g/mio.rot./feeding. Penelitian dilakukan secara bertahap; tahap pertama (I tanpa penambahan air laut, peningkatan volume hanya dari penambahan 15 L Nannochloropsis tiap hari sampai hari kelima, tahap kedua (II dengan penambahan alga 40 L dan air laut 40 L; serta tahap ketiga (III dengan menggandakan pemberian ragi roti. Hasil penelitian menunjukkan bahwa pada percobaan tahap I: total produksi rata-rata 122,37 x 106 ind. rotifer, pada tahap II: 97,67 x 106 ind. rotifer, dan pada tahap III: dicapai rata-rata total produksi tertinggi dengan 187,17 x 106 ind. rotifer per tanki kultur 500 L. Pengelolaan kultur pada tahap III memberikan hasil terbaik dengan simpangan terkecil antar tangki kultur ulangan, dan membuktikan sebagai pengelolaan terbaik untuk kultur rotifer dengan tangki volume kecil.  Success of marine seed production is highly influenced by effective and efficient production performance of life food rotifer. Observation on rotifer culture using small volume tank was aimed to get the optimum production and efficiency, to fulfill the basic principle of aquaculture “low volume high density”. Polyethylene tanks of 500 L. were used as culture container, with initial 100 liter sea water as culture medium and initial density of 200 ind. rotifer per mL. N. occulata, baker yeast (0.05 g/mio.rotifer/feeding and Scott emulsion (0.005 g/mio.rotifer/feeding were used as basic feed, and

Adsorption behavior of multiwall carbon nanotube/iron oxide magnetic composites for Ni(II) and Sr(II)

International Nuclear Information System (INIS)

Chen Changlun; Hu Jun; Shao Dadong; Li Jiaxing; Wang Xiangke

2009-01-01

Multiwall carbon nanotube (MWCNT)/iron oxide magnetic composites were prepared, and were characterized by scan electron microscopy using a field emission scanning electron microscope, X-ray diffraction and vibrating sample magnetometer. The adsorptions of Ni(II) and Sr(II) onto MWCNT/iron oxide magnetic composites were studied as a function of pH and ionic strength. The results show that the adsorptions of Ni(II) and Sr(II) on the magnetic composites is strongly dependent on pH and ionic strength. The adsorption capacity of the magnetic composites is much higher than that of MWCNTs and iron oxides. The solid magnetic composites can be separated from the solution by a magnetic process. The Langmuir model fits the adsorption isotherm data of Ni(II) better than the Freundlich model. Results of desorption study shows that Ni(II) adsorbed onto the magnetic composites can be easily desorbed at pH < 2.0. MWCNT/iron oxide magnetic composites may be a promising candidate for pre-concentration and solidification of heavy metal ions and radionuclides from large volumes of aqueous solution, as required for remediation purposes.

FIX-II/3025, BWR FIX-II Pump Trip Experiment 3025, Immediate Split Size Break

International Nuclear Information System (INIS)

NILSSON, Lars; GUSTAFSSON, Per-Ake; GUSTAFSON, Lennart; JANCZAK, Rajmund; OESTERLUNDH, Ingrid

1992-01-01

1 - Description of test facility: The FIX-II facility is a volume scaled 1:777 representation of a Swedish BWR with external pumps. The pressure vessel contains a 36 rod full length bundle and a spray condenser at the top to allow steady state operation. The downcomer, bypass channels and guide tube volumes are represented by external piping. The intact loop represents three of the four external reactor loops. The broken loop is constructed such that both guillotine breaks and split breaks may be simulated. The facility is equipped with ADS-simulation, but no ECCS injection are included. The FIX-II loop is also suited to investigate response of pump trips and MSIV closures in internal pump reactors. 2 - Description of test: Test 3025 simulates an intermediate size split break in one of the four main recirculation lines. The break area was 31 per cent of the scaled down pipe area of the reactor. The initial power of the 36-rod bundle was 3.38 MW, corresponding to the hot channel power of the reactor

1987 Oak Ridge model conference: Proceedings: Volume 2, Environmental protection

Energy Technology Data Exchange (ETDEWEB)

1987-01-01

See the abstract for Volume I for general information on the conference. Topics discussed in Volume II include data management techiques for environmental protection efforts, the use of models in environmental auditing, in emergency plans, chemical accident emergency response, risk assessment, monitoring of waste sites, air and water monitoring of waste sites, and in training programs. (TEM)

1987 Oak Ridge model conference: Proceedings: Volume 2, Environmental protection

International Nuclear Information System (INIS)

1987-01-01

See the abstract for Volume I for general information on the conference. Topics discussed in Volume II include data management techiques for environmental protection efforts, the use of models in environmental auditing, in emergency plans, chemical accident emergency response, risk assessment, monitoring of waste sites, air and water monitoring of waste sites, and in training programs

Site Environmental Report for 2012, Volumes 1& 2

Energy Technology Data Exchange (ETDEWEB)

Pauer, Ron; Baskin, David; Bauters, Tim; Borglin, Ned; Fox, Robert; Horst, Blair; Jelinski, John; Lackner, Ginny; Philliber, Jeff; Thorson, Patrick; Wahl, Linnea; Wehle, Petra; Xu, Suying; None

2013-09-30

This report provides a comprehensive summary of the environmental program activities at LBNL for the calendar year 2012. Volume I is organized into an executive summary followed by six chapters that include an overview of LBNL, a discussion of its Environmental Management System (EMS), the status of environmental programs, summarized results from surveillance and monitoring activities, and quality assurance (QA) measures. Volume II contains individual data results from surveillance and monitoring activities.

Australia; Basel II Implementation Assessment

OpenAIRE

International Monetary Fund

2010-01-01

The key findings of Australia’s BASEL II implementation assessment are presented. The Australian Prudential Regulation Authority (APRA) allocated sufficient resources, including highly skilled staff, prior to the Basel II start date, and the outcome has been a robust and high-quality implementation that has built upon and substantially strengthened the risk-management capabilities of major banks. The quality of leadership and commitment by all involved has been instrumental in the success of ...

Outcome of Mainz II Pouch Urinary Diversion after Radical ...

African Journals Online (AJOL)

bladder cancer is one of the options of continent urinary diversion following radical ... II pouch urinary diversion for muscle‑invasive bladder cancer in our institution ... immunotherapy.[2]. Following RC, there is a need for urinary diversion. Internal urinary diversion by ureterosigmoidostomy was introduced decades ago,.

Selective removal of cesium from aqueous solutions with nickel (II) hexacyanoferrate (III) functionalized agricultural residue–walnut shell

Energy Technology Data Exchange (ETDEWEB)

Ding, Dahu, E-mail: dingdahu@gmail.com [Graduate School of Life and Environmental Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8572 (Japan); Lei, Zhongfang; Yang, Yingnan [Graduate School of Life and Environmental Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8572 (Japan); Feng, Chuanping [School of Water Resources and Environment, China University of Geosciences (Beijing), Key Laboratory of Groundwater Circulation and Evolution, Ministry of Education, Beijing 100083 (China); Zhang, Zhenya, E-mail: zhang.zhenya.fu@u.tsukuba.ac.jp [Graduate School of Life and Environmental Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8572 (Japan)

2014-04-01

Highlights: • Novel biosorbent for cesium removal was derived from agricultural residue. • It could remove cesium effectively from aqueous solution. • Large size of granules makes it easy to be separated from solutions. • The volume of used biosorbent could be significantly reduced after incineration. • Incinerated biosorbent has a low volume and a low cost final disposal. - Abstract: A novel nickel (II) hexacyanoferrate (III) functionalized agricultural residue-walnut shell (Ni{sup II}HCF{sup III}-WS) was developed to selectively remove cesium ion (Cs{sup +}) from aqueous solutions. This paper showed the first integral study on Cs{sup +} removal behavior and waste reduction analysis by using biomass adsorption material. The results indicated that the removal process was rapid and reached saturation within 2 h. As a special characteristic of Ni{sup II}HCF{sup III}-WS, acidic condition was preferred for Cs{sup +} removal, which was useful for extending the application scope of the prepared biomass material in treating acidic radioactive liquid waste. The newly developed Ni{sup II}HCF{sup III}-WS could selectively remove Cs{sup +} though the coexisting ions (Na{sup +} and K{sup +} in this study) exhibited negative effects. In addition, approximately 99.8% (in volume) of the liquid waste was reduced by using Ni{sup II}HCF{sup III}-WS and furthermore 91.9% (in volume) of the spent biomass material (Cs-Ni{sup II}HCF{sup III}-WS) was reduced after incineration (at 500 °C for 2 h). Due to its relatively high distribution coefficient and significant volume reduction, Ni{sup II}HCF{sup III}-WS is expected to be a promising material for Cs{sup +} removal in practice.

Evaluasi Risiko Keterlambatan Pekerjaan Pembangunan Apron Baru Bandara Sultan Syarif Kasim II, Pekanbaru

OpenAIRE

Yulita, Syifa; Sandhyavitri, Ari; Malik, Alfian

2017-01-01

Implementation of the project of New Apron Development Workshop of Sultan Syarif Kasim II Airport, Pekanbaru from initial observations of previous authors poses a risk during the construction period of unpredictable events by civil engineer is a force majure condition such as unpredictable volume during interim planning The time set does not include unexpected or over volume work. The delay that occurred in the project of Advanced Construction Work of New Apron Sultan Syarif Kasim II Airport,...

Vitamin E alters alveolar type II cell phospholipid synthesis in oxygen and air

International Nuclear Information System (INIS)

Kennedy, K.A.; Snyder, J.M.; Stenzel, W.; Saito, K.; Warshaw, J.B.

1990-01-01

Newborn rats were injected with vitamin E or placebo daily until 6 days after birth. The effect of vitamin E pretreatment on in vitro surfactant phospholipid synthesis was examined in isolated type II cells exposed to oxygen or air form 24 h in vitro. Type II cells were also isolated from untreated 6-day-old rats and cultured for 24 h in oxygen or air with control medium or vitamin E supplemented medium. These cells were used to examine the effect of vitamin E exposure in vitro on type II cell phospholipid synthesis and ultrastructure. Phosphatidylcholine (PC) synthesis was reduced in cells cultured in oxygen as compared with air. This decrease was not prevented by in vivo pretreatment or in vitro supplementation with vitamin E. Vitamin E pretreatment increased the ratio of disaturated PC to total PC and increased phosphatidylglycerol synthesis. The volume density of lamellar bodies in type II cells was increased in cells maintained in oxygen. Vitamin E did not affect the volume density of lamellar bodies. We conclude that in vitro hyperoxia inhibits alveolar type II cell phosphatidylcholine synthesis without decreasing lamellar body volume density and that supplemental vitamin E does not prevent hyperoxia-induced decrease in phosphatidylcholine synthesis

C-Band Airport Surface Communications System Standards Development. Phase II Final Report. Volume 1: Concepts of Use, Initial System Requirements, Architecture, and AeroMACS Design Considerations

Science.gov (United States)

Hall, Edward; Isaacs, James; Henriksen, Steve; Zelkin, Natalie

2011-01-01

This report is provided as part of ITT s NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: New ATM Requirements-Future Communications, C-Band and L-Band Communications Standard Development and was based on direction provided by FAA project-level agreements for New ATM Requirements-Future Communications. Task 7 included two subtasks. Subtask 7-1 addressed C-band (5091- to 5150-MHz) airport surface data communications standards development, systems engineering, test bed and prototype development, and tests and demonstrations to establish operational capability for the Aeronautical Mobile Airport Communications System (AeroMACS). Subtask 7-2 focused on systems engineering and development support of the L-band digital aeronautical communications system (L-DACS). Subtask 7-1 consisted of two phases. Phase I included development of AeroMACS concepts of use, requirements, architecture, and initial high-level safety risk assessment. Phase II builds on Phase I results and is presented in two volumes. Volume I (this document) is devoted to concepts of use, system requirements, and architecture, including AeroMACS design considerations. Volume II describes an AeroMACS prototype evaluation and presents final AeroMACS recommendations. This report also describes airport categorization and channelization methodologies. The purposes of the airport categorization task were (1) to facilitate initial AeroMACS architecture designs and enable budgetary projections by creating a set of airport categories based on common airport characteristics and design objectives, and (2) to offer high-level guidance to potential AeroMACS technology and policy development sponsors and service providers. A channelization plan methodology was developed because a common global methodology is needed to assure seamless interoperability among diverse AeroMACS services potentially supplied by multiple service providers.

Exploiting the potential of free software to evaluate root canal biomechanical preparation outcomes through micro-CT images.

Science.gov (United States)

Neves, A A; Silva, E J; Roter, J M; Belladona, F G; Alves, H D; Lopes, R T; Paciornik, S; De-Deus, G A

2015-11-01

To propose an automated image processing routine based on free software to quantify root canal preparation outcomes in pairs of sound and instrumented roots after micro-CT scanning procedures. Seven mesial roots of human mandibular molars with different canal configuration systems were studied: (i) Vertucci's type 1, (ii) Vertucci's type 2, (iii) two individual canals, (iv) Vertucci's type 6, canals (v) with and (vi) without debris, and (vii) canal with visible pulp calcification. All teeth were instrumented with the BioRaCe system and scanned in a Skyscan 1173 micro-CT before and after canal preparation. After reconstruction, the instrumented stack of images (IS) was registered against the preoperative sound stack of images (SS). Image processing included contrast equalization and noise filtering. Sound canal volumes were obtained by a minimum threshold. For the IS, a fixed conservative threshold was chosen as the best compromise between instrumented canal and dentine whilst avoiding debris, resulting in instrumented canal plus empty spaces. Arithmetic and logical operations between sound and instrumented stacks were used to identify debris. Noninstrumented dentine was calculated using a minimum threshold in the IS and subtracting from the SS and total debris. Removed dentine volume was obtained by subtracting SS from IS. Quantitative data on total debris present in the root canal space after instrumentation, noninstrumented areas and removed dentine volume were obtained for each test case, as well as three-dimensional volume renderings. After standardization of acquisition, reconstruction and image processing micro-CT images, a quantitative approach for calculation of root canal biomechanical outcomes was achieved using free software. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Defining a Hospital Volume Threshold for Minimally Invasive Pancreaticoduodenectomy in the United States

Science.gov (United States)

Adam, Mohamed Abdelgadir; Thomas, Samantha; Youngwirth, Linda; Pappas, Theodore; Roman, Sanziana A.

2016-01-01

Importance There is increasing interest in expanding use of minimally invasive pancreaticoduodenectomy (MIPD). This procedure is complex, with data suggesting a significant association between hospital volume and outcomes. Objective To determine whether there is an MIPD hospital volume threshold for which patient outcomes could be optimized. Design, Setting, and Participants Adult patients undergoing MIPD were identified from the Healthcare Cost and Utilization Project National Inpatient Sample from 2000 to 2012. Multivariable models with restricted cubic splines were used to identify a hospital volume threshold by plotting annual hospital volume against the adjusted odds of postoperative complications. The current analysis was conducted on August 16, 2016. Main Outcomes and Measures Incidence of any complication. Results Of the 865 patients who underwent MIPD, 474 (55%) were male and the median patient age was 67 years (interquartile range, 59-74 years). Among the patients, 747 (86%) had cancer and 91 (11%) had benign conditions/pancreatitis. Overall, 410 patients (47%) had postoperative complications and 31 (4%) died in-hospital. After adjustment for demographic and clinical characteristics, increasing hospital volume was associated with reduced complications (overall association P < .001); the likelihood of experiencing a complication declined as hospital volume increased up to 22 cases per year (95% CI, 21-23). Median hospital volume was 6 cases per year (range, 1-60). Most patients (n = 717; 83%) underwent the procedure at low-volume (≤22 cases per year) hospitals. After adjustment for patient mix, undergoing MIPD at low- vs high-volume hospitals was significantly associated with increased odds for postoperative complications (odds ratio, 1.74; 95% CI, 1.03-2.94; P = .04). Conclusions and Relevance Hospital volume is significantly associated with improved outcomes from MIPD, with a threshold of 22 cases per year. Most patients undergo MIPD at low-volume

Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II Protocol

Directory of Open Access Journals (Sweden)

Rowan Elise N

2011-05-01

Full Text Available Abstract Background Within the spectrum of spontaneous intracerebral haemorrhage there are some patients with large or space occupying haemorrhage who require surgery for neurological deterioration and others with small haematomas who should be managed conservatively. There is equipoise about the management of patients between these two extremes. In particular there is some evidence that patients with lobar haematomas and no intraventricular haemorrhage might benefit from haematoma evacuation. The STICH II study will establish whether a policy of earlier surgical evacuation of the haematoma in selected patients will improve outcome compared to a policy of initial conservative treatment. Methods/Design an international multicentre randomised parallel group trial. Only patients for whom the treating neurosurgeon is in equipoise about the benefits of early craniotomy compared to initial conservative treatment are eligible. All patients must have a CT scan confirming spontaneous lobar intracerebral haemorrhage (≤1 cm from the cortex surface of the brain and 10-100 ml in volume. Any clotting or coagulation problems must be corrected and randomisation must take place within 48 hours of ictus. With 600 patients, the study will be able to demonstrate a 12% benefit from surgery (2p Stratified randomisation is undertaken using a central 24 hour randomisation service accessed by telephone or web. Patients randomised to early surgery should have the operation within 12 hours. Information about the status (Glasgow Coma Score and focal signs of all patients through the first five days of their trial progress is also collected in addition to another CT scan at about five days (+/- 2 days. Outcome is measured at six months via a postal questionnaire to the patient. Primary outcome is death or severe disability defined using a prognosis based 8 point Glasgow Outcome Scale. Secondary outcomes include: Mortality, Rankin, Barthel, EuroQol, and Survival. Trial

Coal slurry combustion and technology. Volume 2

Energy Technology Data Exchange (ETDEWEB)

1983-01-01

Volume II contains papers presented at the following sessions of the Coal Slurry Combustion and Technology Symposium: (1) bench-scale testing; (2) pilot testing; (3) combustion; and (4) rheology and characterization. Thirty-three papers have been processed for inclusion in the Energy Data Base. (ATT)

Site Environmental Report for 2008, Volume 1

Energy Technology Data Exchange (ETDEWEB)

Lackner, Regina; Baskin, David; Fox, Robert; Jelinski, John; Pauer, Ron; Thorson, Patrick; Wahl, Linnea; Xu, Suying

2009-09-21

The Site Environmental Report for 2008 is an integrated report on the environmental programs at Lawrence Berkeley National Laboratory and satisfies the requirements of DOE order 231.1A, Environment, Safety, and Health Reporting. Volume II contains individual data results from surveillance and monitoring activities

IMAGE information monitoring and applied graphics software environment. Volume 4. Applications description

International Nuclear Information System (INIS)

Hallam, J.W.; Ng, K.B.; Upham, G.L.

1986-09-01

The EPRI Information Monitoring and Applied Graphics Environment (IMAGE) system is designed for 'fast proto-typing' of advanced concepts for computer-aided plant operations tools. It is a flexible software system which can be used for rapidly creating, dynamically driving and evaluating advanced operator aid displays. The software is written to be both host computer and graphic device independent. This four volume report includes an Executive Overview of the IMAGE package (Volume 1), followed by Software Description (Volume II), User's Guide (Volume III), and Description of Example Applications (Volume IV)

Clinical effectiveness of decongestive treatments on excess arm volume and patient-centered outcomes in women with early breast cancer-related arm lymphedema: a systematic review

Science.gov (United States)

Jeffs, Eunice; Ream, Emma; Taylor, Cath; Bick, Debra

2018-01-01

ABSTRACT Objective: To identify the effect of decongestive lymphedema treatment on excess arm volume or patient-centered outcomes in women presenting within either 12 months or a mean nine months of developing arm lymphedema following breast cancer treatment. Introduction: Lymphedema is a common consequence of breast cancer treatment requiring life-long treatment to reduce symptoms and prevent complications. Currently, evidence to inform the optimal decongestive lymphedema treatment package is lacking. Inclusion criteria: The review included studies on women who received lymphedema treatment within either 12 months or a mean of nine months of developing unilateral breast cancer-related arm lymphedema. The intervention was any decongestive lymphedema treatment delivered with the purpose of reducing arm lymphedema, compared to another form of lymphedema treatment (whether self or practitioner-administered), placebo or no treatment. The clinical outcome was excess arm volume; patient-centered outcomes were health-related quality of life, arm heaviness, arm function, patient-perceived benefit and satisfaction with treatment. Experimental study designs were eligible, including randomized and non-randomized controlled trials, quasi-experimental, prospective and retrospective before and after studies were considered. Methods: A three-step search strategy was utilized to find published and unpublished studies. The search identified studies published from the inception of each database to July 6, 2016. Reference lists were scanned to identify further eligible studies. Studies were critically appraised using appropriate standardized critical appraisal instruments from the Joanna Briggs Institute. Details describing each study and treatment results regarding outcomes of interest were extracted from papers included in the review using appropriate standardized data extraction tools from the Joanna Briggs Institute. Due to heterogeneity in included studies, results for similar

Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes.

Science.gov (United States)

Murawski, Christopher D; Kennedy, John G

2011-06-01

Internal fixation is a popular first-line treatment method for proximal fifth metatarsal Jones fractures in athletes; however, nonunions and screw breakage can occur, in part because of nonspecific fixation hardware and poor blood supply. To report the results from 26 patients who underwent percutaneous internal fixation with a specialized screw system of a proximal fifth metatarsal Jones fracture (zones II and III) and bone marrow aspirate concentrate. Case series; Level of evidence, 4. Percutaneous internal fixation for a proximal fifth metatarsal Jones fracture (zones II and III) was performed on 26 athletic patients (mean age, 27.47 years; range, 18-47). All patients were competing at some level of sport and were assessed preoperatively and postoperatively using the Foot and Ankle Outcome Score and SF-12 outcome scores. The mean follow-up time was 20.62 months (range, 12-28). Of the 26 fractures, 17 were traditional zone II Jones fractures, and the remaining 9 were zone III proximal diaphyseal fractures. The mean Foot and Ankle Outcome Score significantly increased, from 51.15 points preoperatively (range, 14-69) to 90.91 at final follow-up (range, 71-100; P fracture healing on standard radiographs was 5 weeks after surgery (range, 4-24). Two patients did not return to their previous levels of sporting activity. One patient experienced a delayed union, and 1 healed but later refractured. Percutaneous internal fixation of proximal fifth metatarsal Jones fractures, with a Charlotte Carolina screw and bone marrow aspirate concentrate, provides more predictable results while permitting athletes a return to sport at their previous levels of competition, with few complications.

A randomized clinical multicentre trial comparing enamel matrix derivative and membrane treatment of buccal class II furcation involvement in mandibular molars. Part III: patient factors and treatment outcome.

NARCIS (Netherlands)

Hoffmann, T.; Richter, S; Meyle, J.; Gonzales, J.R.; Heinz, B.; Arjomand, M.; Sculean, A.; Reich, E.; Jepsen, K.J.; Jepsen, S.; Boedeker, R.H.

2006-01-01

OBJECTIVE: Evaluation of effects of patient factors on the outcome of regenerative treatment of buccal mandibular class II furcation defects. MATERIAL AND METHODS: Fifty-one patients were recruited. In the intention-to-treat population 21 patients were allocated into the sequence left treatment with

INEL environmental characterization report. Volume II. Appendices A-D

International Nuclear Information System (INIS)

1984-09-01

This volume contains appendices: (1) a socioeconomic data base for southeastern Idaho; (2) an ecological characterization of the INEL; (3) site-specific climatology summary, NPR primary and alternate sites; (4) NPR site borehole completion; (5) an investigation of the principal lineament at the INEL; (6) an investigation of Clay Butte, Idaho; (7) Arco and Howe fault study; (8) seismology of the INEL; (9) geologic map of the INEL; and (1) geologic ages of the INEL

Methadone and perinatal outcomes: a prospective cohort study.

LENUS (Irish Health Repository)

Cleary, Brian J

2012-08-01

  Methadone use in pregnancy has been associated with adverse perinatal outcomes and neonatal abstinence syndrome (NAS). This study aimed to examine perinatal outcomes and NAS in relation to (i) concomitant drug use and (ii) methadone dose.

Photo-Geomorphology of Coastal Landforms, Cat Island, Bahamas. Volume II,

Science.gov (United States)

The report provides the aerial imagery used in the analysis of the coastal landforms of Cat Island in the east-central Bahama Islands. Interpretive...published volume Coastal Landform of Cat Island, Bahamas: A Study of Holocene Accretionary Topography and Sea-Level Change but may also serve as an

Atlas of Ohio Aquatic Insects: Volume II, Plecoptera.

Science.gov (United States)

DeWalt, R Edward; Grubbs, Scott A; Armitage, Brian J; Baumann, Richard W; Clark, Shawn M; Bolton, Michael J

2016-01-01

We provide volume II of a distributional atlas of aquatic insects for the eastern USA state of Ohio. This treatment of stoneflies (Plecoptera) is companion to Armitage et al. (2011) on caddisflies (Trichoptera). We build on a recent analysis of Ohio stonefly diversity patterns based on large drainages (DeWalt et al. 2012), but add 3717 new records to the data set. We base most analyses on the United States Geological Survey Hierarchical Unit Code eight (HUC8) drainage scale. In addition to distributional maps for each species, we provide analyses of species richness versus HUC8 drainage area and the number of unique locations in a HUC8 drainage, species richness versus Ohio counties, analyze adult presence phenology throughout the year, and demonstrate stream size range affiliation for each species. This work is based on a total of 7797 specimen records gathered from 21 regional museums, agency data, personal collections, and from the literature Table 1. To our knowledge this is the largest stonefly data set available for a similarly sized geopolitical area anywhere in the world. These data are made available as a Darwin Core Archive supported by the Pensoft Integrated Publishing Toolkit (DeWalt et al. 2016b). All known published papers reporting stoneflies from Ohio are detailed in Suppl. material 1. We recovered 102 species from Ohio, including all nine Nearctic families Table 2​. Two species were removed from the DeWalt et al. (2012) list and two new state records added. Perlidae (32 spp.) was most speciose, compared to the low diversity Pteronarcyidae (2 spp.) and Peltoperlidae (1 sp.). The richest HUC8 drainages occurred in northeastern, south-central, and southern regions of the state where drainages were heavily forested, had the highest slopes, and were contained within or adjacent to the unglaciated Allegheny and Appalachian Plateaus. Species poor drainages occurred mainly in the northwestern region where Wisconsinan aged lake plains climaxed to an

Central receiver solar thermal power system. Phase 1. CDRL item 2; Pilot Plant preliminary design report. Volume II. System decription and system analysis

Energy Technology Data Exchange (ETDEWEB)

Hallet, Jr., R. W.; Gervais, R. L.

1977-10-01

An active system analysis and integration effort has been maintained. These activities have included the transformation of initial program requirements into a preliminary system design, the evolution of subsystem requirements which lay the foundation for subsystem design and test activity, and the overseeing of the final preliminary design effort to ensure that the subsystems are operationally compatible and capable of producing electricity at the lowest possible cost per unit of energy. Volume II of the Preliminary Design Report presents the results of the overall system effort that went on during this contract. The effort is assumed to include not only the total system definition and design but also all subsystem interactions.

Site Environmental Report for 2002, Volume 1

Energy Technology Data Exchange (ETDEWEB)

Pauer, Ron

2003-07-01

Each year, Ernest Orlando Lawrence Berkeley National Laboratory prepares an integrated report on its environmental programs to satisfy the requirements of United States Department of Energy Order 231.1. The ''Site Environmental Report for 2002'' summarizes Berkeley Lab's compliance with environmental standards and requirements, characterizes environmental management efforts through surveillance and monitoring activities, and highlights significant programs and efforts for calendar year 2002. Throughout this report, Ernest Orlando Lawrence Berkeley National Laboratory is referred to as ''Berkeley Lab,'' ''the Laboratory,'' ''Lawrence Berkeley National Laboratory,'' and ''LBNL.'' The report is separated into two volumes. Volume I contains a general overview of the Laboratory, the status of environmental programs, and summarized results from surveillance and monitoring activities. Volume II contains individual data results from the monitoring programs. This year, the ''Site Environmental Report'' was distributed on a CD in PDF format that includes Volume I, Volume II, and related documents. The report is also available on the Web at http://www.lbl.gov/ehs/esg/. The report follows the Laboratory's policy of using the International System of Units (SI), also known as the metric system of measurements. Whenever possible, results are additionally reported using the more conventional (non-SI) system of measurements because this system is referenced by some current regulatory standards and is more familiar to some readers. The tables included at the end of the Glossary are intended to help readers understand the various prefixes used with SI units of measurement and convert these units from one system to the other.

The European Dioxin Emission Inventory. Stage II. Final report

Energy Technology Data Exchange (ETDEWEB)

Quass, U.; Fermann, M.; Broeker, G.

2001-07-01

For Stage II of the European Dioxin Project the following objectives were set: - Amendment of existing emission data collected for most relevant emission sources in order to reduce uncertainties of emission estimates. Collecting first emission data from countries not yet performing dioxin emission measurement programs. Extending the inventory of dioxin emissions to ambient air produced in Stage I by a complementary study on emissions to land and water. Extending the regional scope of data collection to countries in Central Europe. The report of Stage II of the European Dioxin Project is presented in 3 Volumes. Volume 1 contains an overview on the background and approach of different activities carried out and on the results obtained. These results are put into a broader view regarding the dioxin reduction measures in Europe leading to conclusions and recommendation for future work. Volume 2 of the report contains a detailed presentation of the sub-projects carried out. The chapters of Volume 2 are structured in a similar manner and start with a short summary in order to allow for a fast cross-reading. In the case of the desk-top studies an overview of the main results or statements is given. Regarding emission measurements details on the experimental set-up and the facilities being investigated are presented. Volume 3 contains a re-evaluation of the dioxin emission inventory presented for the most relevant sources types in the Stage I report. New data gathered from the projects of Stage II as well as from independent activities in the European countries are considered for a revision of the 1995 emission estimates. Additionally, based on current trends and activities the PCDD/F emissions for the years 2000 and 2005 are estimated. Finally, an attempt is made to evaluate the PCDD/F emission reduction rates which might be possible to achieve by the year 2005 compared to 1985. (orig.)

Commingled uranium-tailings study. Volume II. Technical report

Energy Technology Data Exchange (ETDEWEB)

None

1982-06-30

Public Law 96-540, Section 213, directs the Secretary of Energy to develop a plan for a cooperative program to provide assistance in the stabilization and management of defense-related uranium mill tailings commingled with other tailings. In developing the plan, the Secretary is further directed to: (1) establish the amount and condition of tailings generated under federal contracts; (2) examine appropriate methodologies for establishing the extent of federal assistance; and (3) consult with the owners and operators of each site. This technical report summarizes US Department of Energy (DOE) and contractor activities in pursuit of items (1), (2), and (3) above. Recommendations regarding policy and a cooperative plan for federal assistance are under separate cover as Volume I.

Adding a PECS II block for proximal arm arteriovenous access - a randomised study.

Science.gov (United States)

Quek, K H; Low, E Y; Tan, Y R; Ong, A S C; Tang, T Y; Kam, J W; Kiew, A S C

2018-05-01

Brachial plexus block is often utilised for proximal arm arteriovenous access creation. However, the medial upper arm and axilla are often inadequately anaesthetised, requiring repeated, intraoperative local anaesthetic supplementation, or conversion into general anaesthesia. We hypothesised that the addition of a PECS II block would improve anaesthesia and analgesia for proximal arm arteriovenous access surgery. In this prospective, double-blinded, randomised proof-of-concept study, 36 consenting adults with end-stage renal disease aged between 21 and 90 years received either a combined supraclavicular and PECS II block (Group PECS, n = 18), or combined supraclavicular and sham block (Group SCB, n = 18) for proximal arm arteriovenous access surgery. Primary outcome was whether patients required intraoperative local anaesthetic supplementation by the surgeon. In Group PECS, 33.3% (6/18) needed local anaesthetic supplementation vs. 100% (18/18) in Group SCB. Group SCB had three times (RR 3.0, 95% CI 1.6-5.8; P PECS required lower volume of supplemental local anaesthetic compared to Group SCB (0.0 ml, IQR 0.0-6.3 ml vs. 15.0 ml, IQR 7.4-17.8 ml; P PECS II block to a supraclavicular block improves regional anaesthesia for patients with end-stage renal disease undergoing proximal arm arteriovenous access surgery. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Safety analysis report for the TRUPACT-II shipping package (condensed version). Volume 1, Rev. 14

International Nuclear Information System (INIS)

1994-10-01

The condensed version of the TRUPACT-II Contact Handled Transuranic Waste Safety Analysis Report for Packaging (SARP) contains essential material required by TRUPACT-II users, plus additional contents (payload) information previously submitted to the U.S. Nuclear Regulatory Commission. All or part of the following sections, which are not required by users of the TRUPACT-II, are deleted from the condensed version: (i) structural analysis, (ii) thermal analysis, (iii) containment analysis, (iv) criticality analysis, (v) shielding analysis, and (vi) hypothetical accident test results

Safety analysis report for the TRUPACT-II shipping package (condensed version). Volume 1, Rev. 14

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-10-01

The condensed version of the TRUPACT-II Contact Handled Transuranic Waste Safety Analysis Report for Packaging (SARP) contains essential material required by TRUPACT-II users, plus additional contents (payload) information previously submitted to the U.S. Nuclear Regulatory Commission. All or part of the following sections, which are not required by users of the TRUPACT-II, are deleted from the condensed version: (i) structural analysis, (ii) thermal analysis, (iii) containment analysis, (iv) criticality analysis, (v) shielding analysis, and (vi) hypothetical accident test results.

Doubtful outcome of the validation of the Rome II questionnaire: validation of a symptom based diagnostic tool

Directory of Open Access Journals (Sweden)

Nylin Henry BO

2009-12-01

the Rome II is of doubtful value for clinical practice and research. The results for reproducibility and reliability were acceptable but the outcome of the predictability test was poor with IBS as an exception. The agreement between the digital and the paper questionnaire was good.

Selective removal of cesium from aqueous solutions with nickel (II) hexacyanoferrate (III) functionalized agricultural residue-walnut shell.

Science.gov (United States)

Ding, Dahu; Lei, Zhongfang; Yang, Yingnan; Feng, Chuanping; Zhang, Zhenya

2014-04-15

A novel nickel (II) hexacyanoferrate (III) functionalized agricultural residue-walnut shell (Ni(II)HCF(III)-WS) was developed to selectively remove cesium ion (Cs(+)) from aqueous solutions. This paper showed the first integral study on Cs(+) removal behavior and waste reduction analysis by using biomass adsorption material. The results indicated that the removal process was rapid and reached saturation within 2h. As a special characteristic of Ni(II)HCF(III)-WS, acidic condition was preferred for Cs(+) removal, which was useful for extending the application scope of the prepared biomass material in treating acidic radioactive liquid waste. The newly developed Ni(II)HCF(III)-WS could selectively remove Cs(+) though the coexisting ions (Na(+) and K(+) in this study) exhibited negative effects. In addition, approximately 99.8% (in volume) of the liquid waste was reduced by using Ni(II)HCF(III)-WS and furthermore 91.9% (in volume) of the spent biomass material (Cs-Ni(II)HCF(III)-WS) was reduced after incineration (at 500°C for 2h). Due to its relatively high distribution coefficient and significant volume reduction, Ni(II)HCF(III)-WS is expected to be a promising material for Cs(+) removal in practice. Copyright © 2014 Elsevier B.V. All rights reserved.

Adverse Outcome Pathway Networks II: Network Analytics.

Science.gov (United States)

Villeneuve, Daniel L; Angrish, Michelle M; Fortin, Marie C; Katsiadaki, Ioanna; Leonard, Marc; Margiotta-Casaluci, Luigi; Munn, Sharon; O'Brien, Jason M; Pollesch, Nathan L; Smith, L Cody; Zhang, Xiaowei; Knapen, Dries

2018-02-28

Toxicological responses to stressors are more complex than the simple one biological perturbation to one adverse outcome model portrayed by individual adverse outcome pathways (AOPs). Consequently, the AOP framework was designed to facilitate de facto development of AOP networks that can aid understanding and prediction of pleiotropic and interactive effects more common to environmentally realistic, complex exposure scenarios. The present paper introduces nascent concepts related to the qualitative analysis of AOP networks. First, graph theory-based approaches for identifying important topological features are illustrated using two example AOP networks derived from existing AOP descriptions. Second, considerations for identifying the most significant path(s) through an AOP network from either a biological or risk assessment perspective are described. Finally, approaches for identifying interactions among AOPs that may result in additive, synergistic, or antagonistic responses, or previously undefined emergent patterns of response, are introduced. Along with a companion article (Knapen et al. part I), these concepts set the stage for development of tools and case studies that will facilitate more rigorous analysis of AOP networks, and the utility of AOP network-based predictions, for use in research and regulatory decision-making. Collectively, this work addresses one of the major themes identified through a SETAC Horizon Scanning effort focused on advancing the AOP framework. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Relationships between volume, efficiency, and quality in surgery--a delicate balance from managerial perspectives.

Science.gov (United States)

Kraus, Thomas W; Büchler, Markus W; Herfarth, Christian

2005-10-01

Volume, efficiency, and quality in hospital care are often mixed in debate. We analyze how these dimensions are interrelated in surgical hospital management, with particular focus on volume effects: under financial constraints, efficiency is the best form of cost control. External perception of quality is important to attract patients and gain volumes. There are numerous explicit and implicit notions of surgical quality. The relevance of implicit criteria (functionality, reliability, consistency, customaziability, convenience) can change in the time course of hospital competition. Outcome data theoretically are optimal measures of quality, but surgical quality is multifactorially influenced by case mix, surgical technique, indication, process designs, organizational structures, and volume. As quality of surgery is hard to grade, implicit criteria such as customizability currently often overrule functionality (outcome) as the dominant market driver. Activities and volumes are inputs to produce quality. Capability does not translate to ability in a linear function. Adequate process design is important to realize efficiency and quality. Volumes of activities, degree of standardization, specialization, and customer involvement are relevant estimates for process design in services. Flow-orientated management focuses primarily on resource utilization and efficiency, not on surgical quality. The relationship between volume and outcome in surgery is imperfectly understood. Factors involve learning effects both on process efficiency and quality, increased standardization and task specialization, process flow homogeneity, and potential for process integration. Volume is a structural component to develop efficiency and quality. The specific capabilities and process characteristics that contribute to surgical outcome improvement should be defined and exported. Adequate focus should allow even small institutions to benefit from volume-associated effects. All volumes

Modification of cell volume and proliferative capacity of Pseudokirchneriella subcapitata cells exposed to metal stress

International Nuclear Information System (INIS)

Machado, Manuela D.; Soares, Eduardo V.

2014-01-01

Highlights: •Metals induce morphological alterations on P. subcapitata. •Algal cell cycle consists: mother cell growth; cell division, with two nucleus divisions; release of four autospores. •Cu(II) and Cr(VI) arrest cell growth before the first nuclear division. •Cd(II) arrests cell growth after the second nuclear division but before the cytokinesis. •The approach used can be useful in the elucidation of different modes of action of pollutants. -- Abstract: The impact of metals (Cd, Cr, Cu and Zn) on growth, cell volume and cell division of the freshwater alga Pseudokirchneriella subcapitata exposed over a period of 72 h was investigated. The algal cells were exposed to three nominal concentrations of each metal: low (closed to 72 h-EC 10 values), intermediate (closed to 72 h-EC 50 values) and high (upper than 72 h-EC 90 values). The exposure to low metal concentrations resulted in a decrease of cell volume. On the contrary, for the highest metal concentrations an increase of cell volume was observed; this effect was particularly notorious for Cd and less pronounced for Zn. Two behaviours were found when algal cells were exposed to intermediate concentrations of metals: Cu(II) and Cr(VI) induced a reduction of cell volume, while Cd(II) and Zn(II) provoked an opposite effect. The simultaneous nucleus staining and cell image analysis, allowed distinguishing three phases in P. subcapitata cell cycle: growth of mother cell; cell division, which includes two divisions of the nucleus; and, release of four autospores. The exposure of P. subcapitata cells to the highest metal concentrations resulted in the arrest of cell growth before the first nucleus division [for Cr(VI) and Cu(II)] or after the second nucleus division but before the cytokinesis (release of autospores) when exposed to Cd(II). The different impact of metals on algal cell volume and cell-cycle progression, suggests that different toxicity mechanisms underlie the action of different metals

Procedural Experience for Transcatheter Aortic Valve Replacement and Relation to Outcomes: The STS/ACC TVT Registry.

Science.gov (United States)

Carroll, John D; Vemulapalli, Sreekanth; Dai, Dadi; Matsouaka, Roland; Blackstone, Eugene; Edwards, Fred; Masoudi, Frederick A; Mack, Michael; Peterson, Eric D; Holmes, David; Rumsfeld, John S; Tuzcu, E Murat; Grover, Frederick

2017-07-04

Transcatheter aortic valve replacement (TAVR) has been introduced into U.S. clinical practice with efforts to optimize outcomes and minimize the learning curve. The goal of this study was to assess the degree to which increasing experience during the introduction of this procedure, separated from other outcome determinants including patient and procedural characteristics, is associated with outcomes. The authors evaluated the association of hospital TAVR volume and patient outcomes for TAVR by using data from 42,988 commercial procedures conducted at 395 hospitals submitting to the Transcatheter Valve Therapy Registry from 2011 through 2015. Outcomes assessed included adjusted and unadjusted in-hospital major adverse events. Increasing site volume was associated with lower in-hospital risk-adjusted outcomes, including mortality (p < 0.02), vascular complications (p < 0.003), and bleeding (p < 0.001) but was not associated with stroke (p = 0.14). From the first case to the 400th case in the volume-outcome model, risk-adjusted adverse outcomes declined, including mortality (3.57% to 2.15%), bleeding (9.56% to 5.08%), vascular complications (6.11% to 4.20%), and stroke (2.03% to 1.66%). Vascular and bleeding volume-outcome associations were nonlinear with a higher risk of adverse outcomes in the first 100 cases. An association of procedure volume with risk-adjusted outcomes was also seen in the subgroup having transfemoral access. The initial adoption of TAVR into practice in the United States showed that increasing experience was associated with better outcomes. This association, whether deemed a prolonged learning curve or a manifestation of a volume-outcome relationship, suggested that concentrating experience in higher volume heart valve centers might be a means of improving outcomes. (STS/ACC Transcatheter Valve Therapy Registry [TVT Registry]; NCT01737528). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All

Examination of the Pattern of Growth of Cerebral Tissue Volumes From Hospital Discharge to Early Childhood in Very Preterm Infants.

Science.gov (United States)

Monson, Brian B; Anderson, Peter J; Matthews, Lillian G; Neil, Jeffrey J; Kapur, Kush; Cheong, Jeanie L Y; Doyle, Lex W; Thompson, Deanne K; Inder, Terrie E

2016-08-01

Smaller cerebral volumes at hospital discharge in very preterm (VPT) infants are associated with poor neurobehavioral outcomes. Brain growth from the newborn period to middle childhood has not been explored because longitudinal data have been lacking. To examine the pattern of growth of cerebral tissue volumes from hospital discharge to childhood in VPT infants and to determine perinatal risk factors for impaired brain growth and associations with neurobehavioral outcomes at 7 years. Prospective cohort study of VPT infants (childhood and outcomes in VPT infants. Low brain volumes observed in VPT infants are exaggerated at 7 years. Low brain volume in infancy is associated with long-term functional outcomes, emphasizing the persisting influence of early brain development on subsequent growth and outcomes.

Prognostic role of tumor volume for radiotherapy outcome in patient with T2 laryngeal cancer

International Nuclear Information System (INIS)

Rutkowski, T.; Wygoda, A.; Skladowski, K.; Rutkowski, R.; Maciejewski, B.; Hejduk, B.; Kolosza, Z.

2013-01-01

Background and purpose: Tumor volume (TV) is recognized as a prognostic factor of treatment outcome for head and neck tumors but is not routinely included in the treatment decision-making process. The purpose of the study was to define its prognostic role for patients with T2 laryngeal cancer. Material and methods: TV of 160 patients who underwent RT between 2002 and 2006 for T2 laryngeal squamous cell carcinoma were reviewed. The tumor was located in the glottis and epiglottis in 82 (51 %) and 78 (49 %) patients, respectively. TV was manually contoured on pretreatment, planning, contrast-enhanced CT scans and the volumetric measurement (cm 3 ) was calculated by the volume algorithm. Results: The median TV value was 2.01 cm 3 (range 0.15-21.68 cm 3 ). The median TV was significantly lower in patients with glottic tumors (p < 0.0001), N0 (p < 0.001), or well histopatologically differentiated tumors (p = 0.01). A significant correlation between TV, hemoglobin concentration (p < 0.01), and total dose (TD; p < 0.001) was observed. On univariate analyses, TV influenced local control (LC; p = 0.02) and overall survival (OS, p < 0.001). On multivariate analysis, both age (HR 1.038, p = 0.03) and TV (HR = 1.075, p = 0.01) remained significantly related to LC and OS (age: HR 1.038, p = 0.005; TV: HR 1.097, p = 0.0001). Conclusion: Large TV worsen prognosis of patients with T2 laryngeal cancer. A large TV is more common for supraglottic, poorly differentiated tumors and may suggest higher risk of nodal spread. The routine estimation of TV prior to therapy may be essential in order to select the best treatment option for patients with T2 laryngeal cancer. (orig.)

Removal of Ni(II), Zn(II) and Pb(II) ions from single metal aqueous solution using rice husk-based activated carbon

Energy Technology Data Exchange (ETDEWEB)

Taha, Mohd F., E-mail: faisalt@petronas.com.my; Shaharun, Maizatul S. [Fundamental and Applied Sciences Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, 31750, Perak Darul Ridzuan (Malaysia); Shuib, Anis Suhaila, E-mail: anisuha@petronas.com.my; Borhan, Azry [Chemical Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, 31750, Perak Darul Ridzuan (Malaysia)

2014-10-24

An attempt was made to investigate the potential of rice husk-based activated carbon as an alternative low-cost adsorbent for the removal of Ni(II), Zn(II) and Pb(II) ions from single aqueous solution. Rice husk-based activated carbon was prepared via treatment of rice husk with NaOH followed by the carbonization process at 400°C for 2 hours. Three samples, i.e. raw rice husk, rice husk treated with NaOH and rice husk-based activated carbon, were analyzed for their morphological characteristics using field-emission scanning electron microscope/energy dispersive X-ray (FESEM/EDX). These samples were also analyzed for their carbon, hydrogen, nitrogen, oxygen and silica contents using CHN elemental analyzer and FESEM/EDX. The porous properties of rice husk-based activated carbon were determined by Brunauer-Emmett-Teller (BET) surface area analyzer, and its surface area and pore volume were 255 m{sup 2}/g and 0.17 cm{sup 2}/g, respectively. The adsorption studies for the removal of Ni(II), Zn(II) and Pb(II) ions from single metal aqueous solution were carried out at a fixed initial concentration of metal ion (150 ppm) with variation amount of adsorbent (rice husk-based activated carbon) as a function of varied contact time at room temperature. The concentration of each metal ion was analyzed using atomic absorption spectrophotometer (AAS). The results obtained from adsorption studies indicate the potential of rice husk as an economically promising precursor for the preparation of activated carbon for removal of Ni(II), Zn(II) and Pb(II) ions from single aqueous solution. Isotherm and kinetic model analyses suggested that the experimental data of adsorption studies fitted well with Langmuir, Freundlich and second-order kinetic models.

The Influence of Hospital Volume on Circumferential Resection Margin Involvement: Results of the Dutch Surgical Colorectal Audit.

Science.gov (United States)

Gietelink, Lieke; Henneman, Daniel; van Leersum, Nicoline J; de Noo, Mirre; Manusama, Eric; Tanis, Pieter J; Tollenaar, Rob A E M; Wouters, Michel W J M

2016-04-01

This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (risk of CRM involvement (odds ratio=1.54; 95% CI: 1.12-2.11). To evaluate the association between hospital volume and CRM (circumferential resection margin) involvement in rectal cancer surgery. To guarantee the quality of surgical treatment of rectal cancer, the Association of Surgeons of the Netherlands has stated a minimal annual volume standard of 20 procedures per hospital. The influence of hospital volume has been examined for different outcome variables in rectal cancer surgery. Its influence on the pathological outcome (CRM) however remains unclear. As long-term outcomes are best predicted by the CRM status, this parameter is of essential importance in the debate on the justification of minimal volume standards in rectal cancer surgery. Data from the Dutch Surgical Colorectal Audit (2011-2012) were used. Hospital volume was divided into 3 groups, and baseline characteristics were described. The influence of hospital volume on CRM involvement was analyzed, in a multivariate model, between low- and high-volume hospitals, according to the minimal volume standards. This study included 5161 patients. CRM was recorded in 86% of patients. CRM involvement was 11% in low-volume group versus 7.7% and 7.9% in the medium- and high-volume group (P≤0.001). After adjustment for relevant confounders, the influence of hospital volume on CRM involvement was still significant odds ratio (OR) = 1.54; 95% CI: 1.12-2.11). The outcomes of this pooled analysis support minimal volume standards in rectal cancer surgery. Low hospital volume was independently associated with a higher risk of CRM involvement (OR = 1.54; 95% CI: 1.12-2.11).

Pregnancy outcomes after assisted human reproduction.

Science.gov (United States)

Okun, Nanette; Sierra, Sony

2014-01-01

independent risk factor for obstetrical complications and adverse perinatal outcomes, even without the addition of assisted human reproduction. (II-2) 2. The relative risk for an imprinting phenotype such as Silver-Russell syndrome, Beckwith-Wiedemann syndrome, or Angelman syndrome is increased in the assisted reproduction population, but the actual risk for one of these phenotypes to occur in an assisted pregnancy is estimated to be low, at less than 1 in 5000. The exact biological etiology for this increased imprinting risk is likely heterogeneous and requires more research. (II-2) Recommendations 1. All men with severe oligozoospermia or azoospermia (sperm count assisted human reproductive treatments. (II-2A) 4. The benefits and cumulative pregnancy rates of elective single embryo transfer support a policy of using this protocol in couples with good prognosis for success, and elective single embryo transfer should be strongly encouraged in this population. (II-2A) 5. To reduce the incidence of multiple pregnancy, health care policies that support public funding for assisted human reproduction, with regulations promoting best practice regarding elective single embryo transfer, should be strongly encouraged. (II-2A) 6. Among singleton pregnancies, assisted reproductive technology is associated with increased risks of preterm birth and low birth weight infants, and ovulation induction is associated with an increased risk of low birth weight infants. Until sufficient research has clarified the independent roles of infertility and treatment for infertility, couples should be counselled about the risks associated with treatment. (II-2B) There is a role for closer obstetric surveillance of women who conceive with assisted human reproduction. (III-L) 7. There is growing evidence that pregnancy outcomes are better for cryopreserved embryos fertilized in vitro than for fresh embryo transfers. This finding supports a policy of elective single embryo transfer for women with a good

Mathematics for natural scientists II advanced methods

CERN Document Server

Kantorovich, Lev

2016-01-01

This book covers the advanced mathematical techniques useful for physics and engineering students, presented in a form accessible to physics students, avoiding precise mathematical jargon and laborious proofs. Instead, all proofs are given in a simplified form that is clear and convincing for a physicist. Examples, where appropriate, are given from physics contexts. Both solved and unsolved problems are provided in each chapter. Mathematics for Natural Scientists II: Advanced Methods is the second of two volumes. It follows the first volume on Fundamentals and Basics.

Confinement studies in the TJ-II stellarator

International Nuclear Information System (INIS)

Alejaldre, C.; Alonso, J.; Almoguera, L.; Ascasibar, E.; Baciero, A.; Balbin, R.; Blaumoser, M.; Botija, J.; Branas, B.; Cal, E. de la; Cappa, A.; Carrasco, R.; Castejon, F.; Cepero, J.R.; Cremy, C.; Delgado, J.M.; Doncel, J.; Dulya, C.; Estrada, T.; Fernandez, A.; Fuentes, C.; Garcia, A.; Garcia-Cortes, I.; Guasp, J.; Herranz, J.; Hidalgo, C.; Jimenez, J.A.; Kirpitchev, I.; Krivenski, V.; Labrador, I.; Lapayese, F.; Likin, K.; Linier, M.; Lopez-Fraguas, A.; Lopez-Sanchez, A.; Luna, E. de la; Martin, R.; Martinez, A.; Martinez-Laso, L.; Medrano, M.; Mendez, P.; McCarthy, K.J.; Medina, F.; Milligen, B. van; Ochando, M.; Pacios, L.; Pastor, I.; Pedrosa, M.A.; Pena, A. de la; Portas, A.; Qin, J.; Rodriguez-Rodrigo, L.; Salas, A.; Sanchez, E.; Sanchez, J.; Tabares, F.; Tafalla, D.; Tribaldos, V.; Vega, J.; Zurro, B.; Akulina, D.; Fedyanin, O.I.; Grebenshchikov, S.; Kharchev, N.; Meshcheryakov, A.; Sarksian, K.A.; Barth, R.; Dijk, G. van; Meiden, H. van der

1999-01-01

ECR (electron cyclotron resonance) heated plasmas have been studied in the low magnetic shear TJ-II stellarator (R = 1.5 m, a ECRH = 300 kW, power density = 1-25 W cm -3 ). Recent experiments have explored the flexibility of the TJ-II across a wide range of plasma volumes with different rotational transforms and rational surface densities. In this paper, the main results of this campaign are presented and, in particular, the influence of iota and rational surfaces on plasma profiles is discussed. (author)

Validation of CRIB II for prediction of mortality in premature babies.

Science.gov (United States)

Rastogi, Pallav Kumar; Sreenivas, V; Kumar, Nirmal

2010-02-01

Validation of Clinical Risk Index for Babies (CRIB II) score in predicting the neonatal mortality in preterm neonates < or = 32 weeks gestational age. Prospective cohort study. Tertiary care neonatal unit. 86 consecutively born preterm neonates with gestational age < or = 32 weeks. The five variables related to CRIB II were recorded within the first hour of admission for data analysis. The receiver operating characteristics (ROC) curve was used to check the accuracy of the mortality prediction. HL Goodness of fit test was used to see the discrepancy between observed and expected outcomes. A total of 86 neonates (males 59.6% mean birthweight: 1228 +/- 398 grams; mean gestational age: 28.3 +/- 2.4 weeks) were enrolled in the study, of which 17 (19.8%) left hospital against medical advice (LAMA) before reaching the study end point. Among 69 neonates completing the study, 24 (34.8%) had adverse outcome during hospital stay and 45 (65.2%) had favorable outcome. CRIB II correctly predicted adverse outcome in 90.3% (Hosmer Lemeshow goodness of fit test P=0.6). Area under curve (AUC) for CRIB II was 0.9032. In intention to treat analysis with LAMA cases included as survivors, the mortality prediction was 87%. If these were included as having died then mortality prediction was 83.1%. The CRIB II score was found to be a good predictive instrument for mortality in preterm infants < or = 32 weeks gestation.

Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.

LENUS (Irish Health Repository)

2012-01-31

OBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.

ICU Telemedicine Program Financial Outcomes.

Science.gov (United States)

Lilly, Craig M; Motzkus, Christine; Rincon, Teresa; Cody, Shawn E; Landry, Karen; Irwin, Richard S

2017-02-01

ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge. Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars using Producer Price Index for Health-Care Facilities. Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The annual direct contribution margin improved from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) to $60,586,397 (logistic center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay. The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

RTNS-II utilization

International Nuclear Information System (INIS)

Doran, D.G.; Panayotou, N.F.; Powell, R.W.

1979-12-01

The objective of the several RTNS-II irradation programs is to maximize information gained from the small test volume available in this unique irradiation facility for application in the fusion materials program. While this facility provides the highest 14 MeV neutron flux available, the flux is generally too low and the irradiation volume too small for testing of engineering materials. Emphasis, therefore, is on identifying damage mechanisms of high energy neutrons and correlating them quantitatively with effects produced by fission neutrons. The information gained will be used to evaluate and calibrate damage and correlation models under development. The scope of the program includes in-situ experiments, postirradiation experiments, irradiation temperatures ranging from 4 0 K to 1,000 0 K, and fluences ranging from 3 x 10 16 to about 3 x 10 19 n/cm 2

Inductively coupled plasma emission spectroscopy. Part II: applications and fundamentals. Volume 2

International Nuclear Information System (INIS)

Boumans, P.W.J.M.

1987-01-01

This is the second part of the two-volume treatise by this well-known and respected author. This volume reviews applications of inductively coupled plasma atomic emission spectroscopy (ICP-AES), summarizes fundamental studies, and compares ICP-AES methods with other methods of analysis. The first six chapters are devoted to specific fields of application, including the following: metals and other industrial materials, geology, the environment, agriculture and food, biology and clinical analysis, and organic materials. The chapter on the analysis of organic materials also covers the special instrumental considerations required when organic solvents are introduced into an inductively coupled plasma. A chapter on the direct analysis of solids completes the first part of this volume. Each of the applications chapters begins with a summary of the types of samples that are encountered in that field, and the kinds of problems that an elemental analysis can help to solve. This is followed by a tutorial approach covering applicability, advantages, and limitations of the methods. The coverage is thorough, including sample handling, storage, and preparation, acid, and fusion dissolution, avoiding contamination, methods of preconcentration, the types of interferences that can be expected and ways to reduce them, and the types of ICP plasmas that are used. The second half of the volume covers fundamental studies of ICP-AES: basic processes of aerosol generation, plasma modeling and computer simulation, spectroscopic diagnostics, excitation mechanisms, and discharge characteristics. This section introduces the experimental and modeling methods that have been used to obtain fundamental information about ICPs

Intravascular volume after aneurysmal subarachnoid hemorrhage

NARCIS (Netherlands)

Hoff, R.G.

2009-01-01

Intravascular volume after aneurysmal subarachnoid hemorrhage A subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disorder with an often poor prognosis. The occurrence of delayed cerebral ischemia (DCI) is one of the most important factors determining outcome in

Ocean Thermal Energy Conservation (OTEC) power system development (PDS) II. Preliminary design report

Energy Technology Data Exchange (ETDEWEB)

1979-08-10

This report documents the results and conclusions of the PDS II, Phase I, preliminary design of a 10 MWe OTEC power system, using enhanced plate type heat exchangers, and of representative 0.2 MWe test articles. It further provides the documentation (specifications, drawings, trade studies, etc.) resulting from the design activities. The data and discussions of the technical concepts are organized to respond to the PDS II, Phase II proposal evaluation criteria. This volume, which specifically addresses the three evaluation categories (heat exchangers, rotating machinery, and power system configuration and performance) is an integral part of the Phase II plans (proposal) which describe the technical approach to delivering test articles to OTEC-1. In addition, there is a section which addresses power system cost and net energy analysis and another which discusses the results of stainless steel feasibility studies. Supporting documentation is contained in two appendix volumes.

The theoretical and computational models of the GASFLOW-II code

International Nuclear Information System (INIS)

Travis, J.R.

1999-01-01

GASFLOW-II is a finite-volume computer code that solves the time-dependent compressible Navier-Stokes equations for multiple gas species in a dispersed liquid water two-phase medium. The fluid-dynamics algorithm is coupled to the chemical kinetics of combusting gases to simulate diffusion or propagating flames in complex geometries of nuclear containments. GASFLOW-II is therefore able to predict gaseous distributions and thermal and pressure loads on containment structures and safety related equipment in the event combustion occurs. Current developments of GASFLOW-II are focused on hydrogen distribution, mitigation measures including carbon dioxide inerting, and possible combustion events in nuclear reactor containments. Fluid turbulence is calculated to enhance the transport and mixing of gases in rooms and volumes that may be connected by a ventilation system. Condensation, vaporization, and heat transfer to walls, floors, ceilings, internal structures, and within the fluid are calculated to model the appropriate mass and energy sinks. (author)

TRU Waste Sampling Program: Volume I. Waste characterization

International Nuclear Information System (INIS)

Clements, T.L. Jr.; Kudera, D.E.

1985-09-01

Volume I of the TRU Waste Sampling Program report presents the waste characterization information obtained from sampling and characterizing various aged transuranic waste retrieved from storage at the Idaho National Engineering Laboratory and the Los Alamos National Laboratory. The data contained in this report include the results of gas sampling and gas generation, radiographic examinations, waste visual examination results, and waste compliance with the Waste Isolation Pilot Plant-Waste Acceptance Criteria (WIPP-WAC). A separate report, Volume II, contains data from the gas generation studies

Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers.

Science.gov (United States)

Lidsky, Michael E; Sun, Zhifei; Nussbaum, Daniel P; Adam, Mohamed A; Speicher, Paul J; Blazer, Dan G

2017-08-01

This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoretical advantages for undergoing surgery locally exist. The 1998 to 2012 National Cancer Data Base was queried for T1-3N0-1M0 pancreatic adenocarcinoma patients who underwent PD. Travel distances to treatment centers were calculated. Overlaying the upper and lower quartiles of travel distance with institutional volume established short travel/low-volume (ST/LV) and long travel/high-volume (LT/HV) cohorts. Overall survival was evaluated. Of 7086 patients, 773 ST/LV patients traveled ≤6.3 (median 3.2) miles to centers performing ≤3.3 PDs yearly, and 758 LT/HV patients traveled ≥45 (median 97.3) miles to centers performing ≥16 PDs yearly. LT/HV patients had higher stage disease (P travel to a high-volume center remained associated with reduced long-term mortality (hazard ratio 0.75, P travel burden, patients treated at high-volume centers had improved perioperative outcomes, short-term mortality, and overall survival. These data support ongoing efforts to centralize care for patients undergoing PD.

Magnetite Dissolution Performance of HYBRID-II Decontamination Process

International Nuclear Information System (INIS)

Kim, Seonbyeong; Lee, Woosung; Won, Huijun; Moon, Jeikwon; Choi, Wangkyu

2014-01-01

In this study, we conducted the magnetite dissolution performance test of HYBRID-II (Hydrazine Based Reductive metal Ion Decontamination with sulfuric acid) as a part of decontamination process development. Decontamination performance of HYBRID process was successfully tested with the results of the acceptable decontamination factor (DF) in the previous study. While following-up studies such as the decomposition of the post-decontamination HYBRID solution and corrosion compatibility on the substrate metals of the target reactor coolant system have been continued, we also seek for an alternate version of HYBRID process suitable especially for decommissioning. Inspired by the relationship between the radius of reacting ion and the reactivity, we replaced the nitrate ion in HYBRID with bigger sulfate ion to accommodate the dissolution reaction and named HYBRID-II process. As a preliminary step for the decontamination performance, we tested the magnetite dissolution performance of developing HYBRID-II process and compared the results with those of HYBRID process. HYBRID process developed previously is known have the acceptable decontamination performance, but the relatively larger volume of secondary waste induced by anion exchange resin to treat nitrate ion is the one of the problems related in the development of HYBRID process to be applicable. Therefore we alternatively devised HYBRID-II process using sulfuric acid and tested its dissolution of magnetite in numerous conditions. From the results shown in this study, we can conclude that HYBRID-II process improves the decontamination performance and potentially reduces the volume of secondary waste. Rigorous tests with metal oxide coupons obtained from reactor coolant system will be followed to prove the robustness of HYBRID-II process in the future

Change in brain and lesion volumes after CEE therapies

Science.gov (United States)

Espeland, Mark A.; Hogan, Patricia E.; Resnick, Susan M.; Bryan, R. Nick; Robinson, Jennifer G.; Goveas, Joseph S.; Davatzikos, Christos; Kuller, Lewis H.; Williamson, Jeff D.; Bushnell, Cheryl D.; Shumaker, Sally A.

2014-01-01

Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen–based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixed-effect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen–based postmenopausal HT, previously assigned at WHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings. PMID:24384646

Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II*

Science.gov (United States)

Thorlacius, L.; Garg, A.; Ingram, J.R.; Villumsen, B.; Riis, P. Theut; Gottlieb, A.B.; Merola, J.F.; Dellavalle, R.; Ardon, C.; Baba, R.; Bechara, F.G.; Cohen, A.D.; Daham, N.; Davis, M.; Emtestam, L.; Fernández-Peñas, P.; Filippelli, M.; Gibbons, A.; Grant, T.; Guilbault, S.; Gulliver, S.; Harris, C; Harvent, C.; Houston, K.; Kirby, J.S.; Matusiak, L.; Mehdizadeh, A.; Mojica, T.; Okun, M.; Orgill, D.; Pallack, L.; Parks-Miller, A.; Prens, E.P.; Randell, S.; Rogers, C.; Rosen, C.F.; Choon, S.E.; van der Zee, H.H.; Christensen, R.; Jemec, G.B.E.

2018-01-01

Summary Background A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items. Objectives To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains. Methods The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey. Results Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments. Conclusions The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings. PMID:29080368

Boiling water reactor turbine trip (TT) benchmark. Volume II: Summary Results of Exercise 1

International Nuclear Information System (INIS)

Akdeniz, Bedirhan; Ivanov, Kostadin N.; Olson, Andy M.

2005-06-01

The OECD Nuclear Energy Agency (NEA) completed under US Nuclear Regulatory Commission (NRC) sponsorship a PWR main steam line break (MSLB) benchmark against coupled system three-dimensional (3-D) neutron kinetics and thermal-hydraulic codes. Another OECD/NRC coupled-code benchmark was recently completed for a BWR turbine trip (TT) transient and is the object of the present report. Turbine trip transients in a BWR are pressurisation events in which the coupling between core space-dependent neutronic phenomena and system dynamics plays an important role. The data made available from actual experiments carried out at the Peach Bottom 2 plant make the present benchmark particularly valuable. While defining and coordinating the BWR TT benchmark, a systematic approach and level methodology not only allowed for a consistent and comprehensive validation process, but also contributed to the study of key parameters of pressurisation transients. The benchmark consists of three separate exercises, two initial states and five transient scenarios. The BWR TT Benchmark will be published in four volumes as NEA reports. CD-ROMs will also be prepared and will include the four reports and the transient boundary conditions, decay heat values as a function of time, cross-section libraries and supplementary tables and graphs not published in the paper version. BWR TT Benchmark - Volume I: Final Specifications was issued in 2001 [NEA/NSC/DOC(2001)]. The benchmark team [Pennsylvania State University (PSU) in co-operation with Exelon Nuclear and the NEA] has been responsible for coordinating benchmark activities, answering participant questions and assisting them in developing their models, as well as analysing submitted solutions and providing reports summarising the results for each phase. The benchmark team has also been involved in the technical aspects of the benchmark, including sensitivity studies for the different exercises. Volume II summarises the results for Exercise 1 of the

Volume 2. Probabilistic analysis of HTGR application studies. Supporting data

International Nuclear Information System (INIS)

1980-09-01

Volume II, Probabilistic Analysis of HTGR Application Studies - Supporting Data, gives the detail data, both deterministic and probabilistic, employed in the calculation presented in Volume I. The HTGR plants and the fossil plants considered in the study are listed. GCRA provided the technical experts from which the data were obtained by MAC personnel. The names of the technical experts (interviewee) and the analysts (interviewer) are given for the probabilistic data

Comparison of the performance of different modified graphene oxide nanosheets for the extraction of Pb(II) and Cd(II) from natural samples

International Nuclear Information System (INIS)

Sayar, Omid; Mehrani, Kheirollah; Mehrani, Azadeh; Hoseinzadeh, Fatemeh; Sadeghi, Omid

2014-01-01

Graphene nanosheets were modified with amino groups and the resulting material was used as a sorbent for the extraction of cadmium and lead ions. The nanosheets were characterized by IR spectroscopy, transmission electron microscopy, thermal gravimetric analysis and elemental analysis. The effects of sample pH, eluent parameters (type, concentration and volume of eluent), flow rates (of both sample and eluent), and of a variety of other ions on the efficiency of the extraction of Cd(II) and Pb(II) were optimized. Following solid phase extraction, the elements were determined by FAAS. The limits of detection are <0.9 μg L −1 for Pb(II) and <5 ng L −1 for Cd(II). The relative standard deviations are <2.2 %. The method was validated by analyzing several certified reference materials and was then used for Pb(II) and Cd(II) determination in natural waters and vegetables. (author)

The efficacy and safety of lixivaptan in outpatients with heart failure and volume overload: results of a multicentre, randomized, double-blind, placebo-controlled, parallel-group study.

Science.gov (United States)

Ghali, Jalal K; Orlandi, Cesare; Abraham, William T

2012-06-01

Volume overload is the dominant feature of decompensated heart failure (HF) and it often results in adverse clinical outcomes. Vasopressin receptor antagonists such as lixivaptan may provide effective volume unloading. This study assessed weight loss after 1 day and 8 weeks of treatment with lixivaptan in outpatients with HF and volume overload. This phase II, 8-week, multicentre, double-blind, parallel-group study randomized participants (2:1) to receive lixivaptan 100 mg or placebo once daily (in addition to standard HF therapy). Body weight and cardiovascular assessments were made at baseline, Day 1 (not cardiovascular), Weeks 1, 2, 4, and 8, and 7 days post-treatment. The Trail-making Test, part B (TMT-B) and the Medical Outcomes Survey 6-item cognitive function scale (MOS-6) were assessed at baseline and Week 4. The study randomized 170 participants (lixivaptan, n = 111; placebo, n = 59). Most (97.1%) were receiving pharmacological therapy for HF at baseline. Demographic characteristics were generally similar between the two groups. Body weight decreased significantly from baseline to Day 1 with lixivaptan vs. placebo (least-square mean change ± standard error: - 0.38 ± 0.08 kg vs. +0.13 ± 0.11 kg; P overload, lixivaptan 100 mg once daily, when added to standard therapy, reduced body weight, improved dyspnoea and orthopnoea, and was well tolerated. NCT01055912.

Atrial function, atrial volume and cardiovascular clinical outcomes in patients with end-stage renal disease - A study of cardiac computed tomography

DEFF Research Database (Denmark)

Rasmussen, Laust Dupont; Winther, Simon; Jørgensen, Hanne Skou

2017-01-01

and mortality data were extracted from the Western Denmark Heart Registry, a review of patient records and patient interviews. RESULTS: Baseline patient characteristics did not differ between LAEDV tertiles. LAEDV was positively associated with measures of LV function - both LVEDV (β = 0.36, p ... mass (β = 0.30, p positively and LAEF negatively associated with NT-PRO-BNP (LAEDV: β = 10.28, p patients died and 19 (16.2%) patients suffered......BACKGROUND: Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular events. Previous studies using 2-dimensional echocardiography show that left atrial end-diastolic volume (LAEDV) predicts cardiovascular outcomes and mortality in patients with CKD. However, contrast...

Graphics gems II

CERN Document Server

Arvo, James

1991-01-01

Graphics Gems II is a collection of articles shared by a diverse group of people that reflect ideas and approaches in graphics programming which can benefit other computer graphics programmers.This volume presents techniques for doing well-known graphics operations faster or easier. The book contains chapters devoted to topics on two-dimensional and three-dimensional geometry and algorithms, image processing, frame buffer techniques, and ray tracing techniques. The radiosity approach, matrix techniques, and numerical and programming techniques are likewise discussed.Graphics artists and comput

Technology transfer package on seismic base isolation - Volume III

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-02-14

This Technology Transfer Package provides some detailed information for the U.S. Department of Energy (DOE) and its contractors about seismic base isolation. Intended users of this three-volume package are DOE Design and Safety Engineers as well as DOE Facility Managers who are responsible for reducing the effects of natural phenomena hazards (NPH), specifically earthquakes, on their facilities. The package was developed as part of DOE's efforts to study and implement techniques for protecting lives and property from the effects of natural phenomena and to support the International Decade for Natural Disaster Reduction. Volume III contains supporting materials not included in Volumes I and II.