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Sample records for outcomes volume ii

  1. 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

  2. DART II documentation. Volume III. Appendices

    Energy Technology Data Exchange (ETDEWEB)

    1979-10-01

    The DART II is a remote, interactive, microprocessor-based data acquistion system suitable for use with air monitors. This volume of DART II documentation contains the following appendixes: adjustment and calibration procedures; mother board signature list; schematic diagrams; device specification sheets; ROM program listing; 6800 microprocessor instruction list, octal listing; and cable lists. (RWR)

  3. Site Environmental Report for 1998 Volume II

    International Nuclear Information System (INIS)

    Ruggieri, Michael

    1999-01-01

    Volume II of the Site Environment Report for 1998 is provided by Ernest Orlando Lawrence Berkeley National Laboratory as a supplemental appendix to the report printed in volume I. Volume II contains the environmental monitoring and sampling data used to generate summary results in the main report for routine and non routine activities at the Laboratory (except for groundwater sampling data, which may be found in the reports referred to in chapter 6). Data presented in the tables are given in International System of Units (SI) units of measure

  4. Rectal cancer surgery: volume-outcome analysis.

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2010-12-01

    There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to rectal cancer surgery.

  5. Volume and outcome of organ transplantation

    NARCIS (Netherlands)

    Banta, H.D.; Engel, G.L.; Schersten, T.

    1992-01-01

    In general, technically demanding medical procedures are associated with better outcomes when they are carried out in institutions and by physicians with higher volumes of practice. This paper examines the evidence for a volume-outcome relationship in the case of organ transplantation. Although few

  6. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. 2000 Physical Acoustics Summer School (PASS 00). Volume II: Transparencies

    National Research Council Canada - National Science Library

    Bass, Henry

    2001-01-01

    .... Volume II of these proceedings contains copies of the transparencies used by the lecturers and Volume III contains background materials that were sent to student and discussion leader participants...

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. Introduction to "Global Tsunami Science: Past and Future, Volume II"

    Science.gov (United States)

    Rabinovich, Alexander B.; Fritz, Hermann M.; Tanioka, Yuichiro; Geist, Eric L.

    2017-08-01

    Twenty-two papers on the study of tsunamis are included in Volume II of the PAGEOPH topical issue "Global Tsunami Science: Past and Future". Volume I of this topical issue was published as PAGEOPH, vol. 173, No. 12, 2016 (Eds., E. L. Geist, H. M. Fritz, A. B. Rabinovich, and Y. Tanioka). Three papers in Volume II focus on details of the 2011 and 2016 tsunami-generating earthquakes offshore of Tohoku, Japan. The next six papers describe important case studies and observations of recent and historical events. Four papers related to tsunami hazard assessment are followed by three papers on tsunami hydrodynamics and numerical modelling. Three papers discuss problems of tsunami warning and real-time forecasting. The final set of three papers importantly investigates tsunamis generated by non-seismic sources: volcanic explosions, landslides, and meteorological disturbances. Collectively, this volume highlights contemporary trends in global tsunami research, both fundamental and applied toward hazard assessment and mitigation.

  2. Survey of Biomass Gasification, Volume II: Principles of Gasification

    Energy Technology Data Exchange (ETDEWEB)

    Reed, T.B. (comp.)

    1979-07-01

    Biomass can be converted by gasification into a clean-burning gaseous fuel that can be used to retrofit existing gas/oil boilers, to power engines, to generate electricity, and as a base for synthesis of methanol, gasoline, ammonia, or methane. This survey describes biomass gasification, associated technologies, and issues in three volumes. Volume I contains the synopsis and executive summary, giving highlights of the findings of the other volumes. In Volume II the technical background necessary for understanding the science, engineering, and commercialization of biomass is presented. In Volume III the present status of gasification processes is described in detail, followed by chapters on economics, gas conditioning, fuel synthesis, the institutional role to be played by the federal government, and recommendations for future research and development.

  3. 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).

  4. 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

  5. The application of volume-outcome contouring in data warehousing.

    Science.gov (United States)

    Studnicki, James; Berndt, Donald J; Luther, Stephen L; Fisher, John W

    2004-01-01

    Despite a compelling body of published research on the nature of provider volume and clinical outcomes, healthcare executives and policymakers have not managed to develop and implement systems that are useful in directing patients to higher volume providers via selective referral or avoidance. A specialized data warehouse application, utilizing hospital discharge data linked to physician biographical information, allows detailed analysis of physician and hospital volume and the resulting pattern (contour) of related outcomes such as mortality, complications, and medical errors. The approach utilizes a historical repository of hospital discharge data in which the outcomes of interest, important patient characteristics and risk factors used in severity-adjusting of the outcomes are derived from the coding structure of the data.

  6. Activity report 1990-1992 and proceedings. Volume II

    International Nuclear Information System (INIS)

    Mayer-Rosa, D.; Waniek, L.; Suhadolc, P.

    1993-01-01

    A report of the European Seismological Commission (ESC) on 1990-1992 activities and Proceedings of the General Assembly of the ESC are presented in two volumes. Volume II covers the following topics: study of seismic sound, seismotectonic analysis, deep seismic sounding, the three-dimensional structure of the European lithosphere-asthenosphere system, complexity in earthquake occurrence, earthquake hazard, strong and weak earthquake ground motions, macroseismology, microzonation, and applications in earthquake engineering. One paper dealing with the connection between seismicity and the CO 2 - 222 Rn content in spring water has been inputted to INIS. (Z.S.)

  7. 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)

  8. 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...

  9. 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.

  10. When high-volume PCI operators in high-volume hospitals move to lower volume hospitals-Do they still maintain high volume and quality of outcomes?

    Science.gov (United States)

    Lu, Tsung-Hsueh; Li, Sheng-Tun; Liang, Fu-Wen; Lee, Jo-Chi; Yin, Wei-Hsian

    2017-10-31

    The aim of this quasi-experimental study was to examine whether high-volume percutaneous coronary intervention (PCI) operators still maintain high volume and quality of outcomes when they moved to lower volume hospitals. Systematic reviews have indicated that high-volume PCI operators and hospitals have higher quality outcomes. However, little is known on whether high PCI volume and high quality outcomes are mainly due to operator characteristics (i.e., skill and experience) and is portable across organizations or whether it is due to hospital characteristics (i.e., equipment, team, and management system) and is less portable. We used Taiwan National Health Insurance claims data 2000-2012 to identify 98 high-volume PCI operators, 10 of whom moved from one hospital to another during the study period. We compared the PCI volume, risk-adjusted mortality ratio, and major adverse cardiovascular event (MACE) ratio before and after moving. Of the 10 high-volume operators who moved, 6 moved from high- to moderate- or low-volume hospitals, with median annual PCI volumes (interquartile range) of 130 (117-165) in prior hospitals and 54 (46-84) in subsequent hospitals (the hospital the operator moved to), and the remaining 4 moved from high to high-volume hospitals, with median annual PCI volumes (interquartile range) of 151 (133-162) in prior hospitals and 193 (178-239) in subsequent hospitals. No significant differences were observed in the risk-adjusted mortality ratios and MACE ratios between high-volume operators and matched controls before and after moving. High-volume operators cannot maintain high volume when they moved from high to moderate or low-volume hospitals; however, the quality of care is maintained. High PCI volume and high-quality outcomes are less portable and more hospital bound. © 2017 Wiley Periodicals, Inc.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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 ...

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Reinforced soil structures. Volume II, Summary of research and systems information

    Science.gov (United States)

    1989-11-01

    Volume II was essentially prepared as an Appendix of supporting information for Volume I. This volume contains much of the supporting theory and a summary of the research used to verify the design approach contained in Volume I, as well as general in...

  1. Technical summary of Groundwater Quality Protection Program at Savannah River Plant. Volume II. Radioactive waste

    International Nuclear Information System (INIS)

    Stone, J.A.; Christensen, E.J.

    1983-12-01

    This report (Volume II) presents representative monitoring data for radioactivity in groundwater at SRP. Four major groups of radioactive waste disposal sites and three minor sites are described. Much of the geohydrological and and other background information given in Volume I is applicable to these sites and is incorporated by reference. Several of the sites that contain mixed chemical and radioactive wastes are discussed in both Volumes I and II. Bulk unirradiated uranium is considered primarily a chemical waste which is addressed in Volume I, but generally not in Volume II

  2. 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.

  3. 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.

  4. Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair

    Energy Technology Data Exchange (ETDEWEB)

    Rai, Divyajeet; Velu, Ramesh; Tosenovsky, Patrik; Quigley, Francis [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); The Townsville Hospital, Department of Vascular and Endovascular Surgery, Douglas (Australia); Wisniowski, Brendan; Walker, Philip J. [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); University of Queensland, School of Medicine and Centre for Clinical Research, Department of Vascular Surgery, Royal Brisbane and Women' s Hospital, Herston, QLD (Australia); Bradshaw, Barbara [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); Golledge, Jonathan [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); The Townsville Hospital, Department of Vascular and Endovascular Surgery, Douglas (Australia); University of Queensland, School of Medicine and Centre for Clinical Research, Department of Vascular Surgery, Royal Brisbane and Women' s Hospital, Herston, QLD (Australia)

    2014-08-15

    Aortic calcification and thrombus have been postulated to worsen outcome following endovascular abdominal aortic aneurysm repair (EVAR). The purpose of this study was to assess the association of abdominal aortic aneurysm (AAA) calcification and thrombus volume with outcome following EVAR using a reproducible, quantifiable computed tomography (CT) assessment protocol. Patients with elective EVAR performed between January 2002 and 2012 at the Townsville Hospital, Mater Private Hospital (Townsville) and Royal Brisbane and Women's Hospital (RBWH) were included if preoperative CTAs were available for analysis. AAA calcification and thrombus volume were measured using a semiautomated workstation protocol. Outcomes were assessed in terms of clinical failure, endoleak (type I, type II) and reintervention. Univariate and multivariate analyses were performed. Median follow-up was 1.7 years and the interquartile range 1.0-3.8 years. One hundred thirty-four patients undergoing elective EVAR were included in the study. Rates of primary clinical success and freedom from reintervention were 82.8 % and 88.9 % at the 24-month follow-up. AAA calcification and thrombus volume were not associated with clinical failure, type I endoleak, type II endoleak or reintervention. AAA calcification and thrombus volume were not associated with poorer outcome after EVAR in this study. (orig.)

  5. Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair

    International Nuclear Information System (INIS)

    Rai, Divyajeet; Velu, Ramesh; Tosenovsky, Patrik; Quigley, Francis; Wisniowski, Brendan; Walker, Philip J.; Bradshaw, Barbara; Golledge, Jonathan

    2014-01-01

    Aortic calcification and thrombus have been postulated to worsen outcome following endovascular abdominal aortic aneurysm repair (EVAR). The purpose of this study was to assess the association of abdominal aortic aneurysm (AAA) calcification and thrombus volume with outcome following EVAR using a reproducible, quantifiable computed tomography (CT) assessment protocol. Patients with elective EVAR performed between January 2002 and 2012 at the Townsville Hospital, Mater Private Hospital (Townsville) and Royal Brisbane and Women's Hospital (RBWH) were included if preoperative CTAs were available for analysis. AAA calcification and thrombus volume were measured using a semiautomated workstation protocol. Outcomes were assessed in terms of clinical failure, endoleak (type I, type II) and reintervention. Univariate and multivariate analyses were performed. Median follow-up was 1.7 years and the interquartile range 1.0-3.8 years. One hundred thirty-four patients undergoing elective EVAR were included in the study. Rates of primary clinical success and freedom from reintervention were 82.8 % and 88.9 % at the 24-month follow-up. AAA calcification and thrombus volume were not associated with clinical failure, type I endoleak, type II endoleak or reintervention. AAA calcification and thrombus volume were not associated with poorer outcome after EVAR in this study. (orig.)

  6. 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

  7. 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.

  8. 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

  9. 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…

  10. An Independent Scientific Assessment of Well Stimulation in California Volume II

    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); Bachmann, Corinne E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Birkholzer, Jens T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Camarillo, Mary Kay [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Domen, Jeremy K. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Foxall, William [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Houseworth, James [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Jin, Ling [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Jordan, Preston D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Maddalena, Randy L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McKone, Thomas E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Reagan, Matthew T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sandelin, Whitney L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Stringfellow, William T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Varadharajan, Charuleka [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cooley, Heather [Pacific Inst., Oakland, CA (United States); Donnelly, Kristina [Pacific Inst., Oakland, CA (United States); Heberger, Matthew G. [Pacific Inst., Oakland, CA (United States); Hays, Jake [PSE Healthy Energy, Berkeley, CA (United States); Shonkoff, Seth B.C. [PSE Healthy Energy, Berkeley, CA (United States); Brandt, Adam [Stanford Univ., CA (United States); Englander, Jacob G. [Stanford Univ., CA (United States); Hamdoun, Amro [Univ. of California of San Diego, La Jolla, CA (United States); Nicklisch, Sascha C.T. [Univ. of California of San Diego, La Jolla, CA (United States); Harrison, Robert J. [Univ. of California, San Francisco, CA (United States); Wettstein, Zachary S. [Univ. of California, San Francisco, CA (United States); Banbury, Jenner [California State Univ. Stanislaus, Turlock, CA (United States); Cypher, Brian L. [California State Univ. Stanislaus, Turlock, CA (United States); Phillips, Scott E. [California State Univ. Stanislaus, Turlock, 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, the present volume, 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, also issued in July 2015, presents case studies that assess environmental issues and qualitative risks for specific geographic regions. A final Summary Report summarizes key findings, conclusions and recommendations of all three volumes.

  11. Impact of Case Volume on Outcomes of Ureteroscopy for Ureteral Stones

    DEFF Research Database (Denmark)

    Kandasami, Sangam V; Mamoulakis, Charalampos; El-Nahas, Ahmed R

    2014-01-01

    of case volume on the outcomes of URS for ureteral stones. DESIGN, SETTING, AND PARTICIPANTS: The URS Global Study collected prospective data on consecutive patients with urinary stones treated with URS at 114 centres worldwide for 1 yr. Centres were identified as low or high volume based on the median...... overall annual case volume. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Pre- and intraoperative characteristics, and postoperative outcomes in patients at low- and high-volume centres were compared. The relationships between case volume and stone-free rate (SFR), stone burden, complications...... SFR was 91.9% and 86.3% at high- and low-volume centres, respectively (pstone-free outcome increased with increasing case volume (p

  12. 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)

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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…

  19. 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

  20. 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

  1. 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

  2. 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,

  3. 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

  4. Analysis of some nuclear waste management options. Volume II. Appendices

    International Nuclear Information System (INIS)

    Berman, L.E.; Ensminger, D.A.; Giuffre, M.S.; Koplik, C.M.; Oston, S.G.; Pollak, G.D.; Ross, B.I.

    1978-01-01

    This report describes risk analyses performed on that portion of a nuclear fuel cycle which begins following solidification of high-level waste. Risks associated with handling, interim storage and transportation of the waste are assessed, as well as the long term implications of disposal in deep mined cavities. The risk is expressed in terms of expected dose to the general population and peak dose to individuals in the population. This volume consists of appendices which provide technical details of the work performed

  5. Analysis of some nuclear waste management options. Volume II. Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Berman, L.E.; Ensminger, D.A.; Giuffre, M.S.; Koplik, C.M.; Oston, S.G.; Pollak, G.D.; Ross, B.I.

    1978-10-10

    This report describes risk analyses performed on that portion of a nuclear fuel cycle which begins following solidification of high-level waste. Risks associated with handling, interim storage and transportation of the waste are assessed, as well as the long term implications of disposal in deep mined cavities. The risk is expressed in terms of expected dose to the general population and peak dose to individuals in the population. This volume consists of appendices which provide technical details of the work performed.

  6. 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

  7. 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…

  8. 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

  9. USAF Summer Faculty Research Program. 1981 Research Reports. Volume II.

    Science.gov (United States)

    1981-10-01

    Spec ialty : IIS F ,re ign Policy ; American Indiana State University Nat ioinal Security Policy Dept. of Political Science A. si ,niled: A! Terre Haute...0 C-4 44 C E) I IC C z)~ w z . 0 cnCd d CCC C’) 0-4-9- ..- E-4 (-4 7-A.A).)).) (QUADI) was constructed in the same manner as for the plate bending...IV modifications in accordance with current policy . They are to expedite safety modifications that could ground airborne systems or inactivate ground

  10. 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

  11. 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.

  12. 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 ...

  13. 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

  14. 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.

  15. An excursion through elementary mathematics, volume ii euclidean geometry

    CERN Document Server

    Caminha Muniz Neto, Antonio

    2018-01-01

    This book provides a comprehensive, in-depth overview of elementary mathematics as explored in Mathematical Olympiads around the world. It expands on topics usually encountered in high school and could even be used as preparation for a first-semester undergraduate course. This second volume covers Plane Geometry, Trigonometry, Space Geometry, Vectors in the Plane, Solids and much more. As part of a collection, the book differs from other publications in this field by not being a mere selection of questions or a set of tips and tricks that applies to specific problems. It starts from the most basic theoretical principles, without being either too general or too axiomatic. Examples and problems are discussed only if they are helpful as applications of the theory. Propositions are proved in detail and subsequently applied to Olympic problems or to other problems at the Olympic level. The book also explores some of the hardest problems presented at National and International Mathematics Olympiads, as well as many...

  16. Characterization of large volume HPGe detectors. Part II: Experimental results

    International Nuclear Information System (INIS)

    Bruyneel, Bart; Reiter, Peter; Pascovici, Gheorghe

    2006-01-01

    Measurements on a 12-fold segmented, n-type, large volume, irregular shaped HPGe detector were performed in order to determine the parameters of anisotropic mobility for electrons and holes as charge carriers created by γ-ray interactions. To characterize the electron mobility the complete outer detector surface was scanned in small steps employing photopeak interactions at 60keV. A precise measurement of the hole drift anisotropy was performed with 356keV γ-rays. The drift velocity anisotropy and crystal geometry cause considerable rise time differences in pulse shapes depending on the position of the spatial charge carrier creation. Pulse shapes of direct and transient signals are reproduced by weighting potential calculations with high precision. The measured angular dependence of rise times is caused by the anisotropic mobility, crystal geometry, changing field strength and space charge effects. Preamplified signals were processed employing digital spectroscopy electronics. Response functions, crosstalk contributions and averaging procedures were taken into account implying novel methods due to the segmentation of the Ge-crystal and digital signal processing electronics

  17. Soil microbiology in land reclamation volume II - mycorrhizae

    Energy Technology Data Exchange (ETDEWEB)

    Graves, D.H. (ed.)

    1984-01-01

    This volume contains three separate reports: RRTAC 84-4 (Greenhouse pot studies dealing with amendment of oil sand tailings: effects of peat, sewage sludge and fertilizer on plant growth, mycorrhizae and microbial activity); RRTAC 84-8 (Vesicular-arbuscular mycorrhizal (VAM) development of slender wheatgrass on amended oil sand tailings and subalpine coal mines spoil); RRTAC 84-7 (Ectomycorrhizae in amended oil sand tailings and subalpine coal mine spoil and in undisturbed Jack pine and spruce stands). In the first report mixtures of two peats were used to amend oil sand tailings and either mineral fertilizers or sewage sludge were added at different rates. The growth of slender wheat grass and jack pine grown in the greenhouse in these media were monitored. In the second report the VAM development of slender wheatgrass was monitored over a 4 year period; in the third the mycorrhizal status of jack pine and bear berry grown in oil sand tailings treated with various amendments and of white spruce and willow grown in subalpine coal mine spoil were monitored over the same period.

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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…

  9. 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…

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Positive and negative volume-outcome relationships in the geriatric trauma population.

    Science.gov (United States)

    Matsushima, Kazuhide; Schaefer, Eric W; Won, Eugene J; Armen, Scott B; Indeck, Matthew C; Soybel, David I

    2014-04-01

    In trauma populations, improvements in outcome are documented in institutions with higher case volumes. However, it is not known whether improved outcomes are attributable to the case volume within specific higher-risk groups, such as the elderly, or to the case volume among all trauma patients treated by an institution. To test the hypothesis that outcomes of trauma care for geriatric patients are affected differently by the volume of geriatric cases and nongeriatric cases of an institution. This retrospective cohort study using a statewide trauma registry was set in state-designated levels 1 and 2 trauma centers in Pennsylvania. It included 39 431 eligible geriatric trauma patients (aged >65 years) in the Pennsylvania Trauma Outcomes Study. In-hospital mortality, major complications, and mortality after major complications (failure to rescue). Between 2001 and 2010, 39 431 geriatric trauma patients and 105 046 nongeriatric patients were captured in a review of outcomes in 20 state-designated levels 1 and 2 trauma centers. Larger volumes of geriatric trauma patients were significantly associated with lower odds of in-hospital mortality, major complications, and failure to rescue. In contrast, larger nongeriatric trauma volumes were significantly associated with higher odds of major complications in geriatric patients. Higher rates of in-hospital mortality, major complications, and failure to rescue were associated with lower volumes of geriatric trauma care and paradoxically with higher volumes of trauma care for younger patients. These findings offer the possibility that outcomes might be improved with differentiated pathways of care for geriatric trauma patients.

  16. Assessing the quality of the volume-outcome relationship in uro-oncology.

    Science.gov (United States)

    Mayer, Erik K; Purkayastha, Sanjay; Athanasiou, Thanos; Darzi, Ara; Vale, Justin A

    2009-02-01

    To assess systematically the quality of evidence for the volume-outcome relationship in uro-oncology, and thus facilitate the formulating of health policy within this speciality, as 'Implementation of Improving Outcome Guidance' has led to centralization of uro-oncology based on published studies that have supported a 'higher volume-better outcome' relationship, but improved awareness of methodological drawbacks in health service research has questioned the strength of this proposed volume-outcome relationship. We systematically searched previous relevant reports and extracted all articles from 1980 onwards assessing the volume-outcome relationship for cystectomy, prostatectomy and nephrectomy at the institution and/or surgeon level. Studies were assessed for their methodological quality using a previously validated rating system. Where possible, meta-analytical methods were used to calculate overall differences in outcome measures between low and high volume healthcare providers. In all, 22 studies were included in the final analysis; 19 of these were published in the last 5 years. Only four studies appropriately explored the effect of both the institution and surgeon volume on outcome measures. Mortality and length of stay were the most frequently measured outcomes. The median total quality scores within each of the operation types were 8.5, 9 and 8 for cystectomy, prostatectomy and nephrectomy, respectively (possible maximum score 18). Random-effects modelling showed a higher risk of mortality in low-volume institutions than in higher-volume institutions for both cystectomy and nephrectomy (odds ratio 1.88, 95% confidence interval 1.54-2.29, and 1.28, 1.10-1.49, respectively). The methodological quality of volume-outcome research as applied to cystectomy, prostatectomy and nephrectomy is only modest at best. Accepting several limitations, pooled analysis confirms a higher-volume, lower-mortality relationship for cystectomy and nephrectomy. Future research should

  17. HYDRA-II: A hydrothermal analysis computer code: Volume 1, Equations and numerics

    International Nuclear Information System (INIS)

    McCann, R.A.

    1987-04-01

    HYDRA-II is a hydrothermal computer code capable of three-dimensional analysis of coupled conduction, convection, and thermal radiation problems. This code is especially appropriate for simulating the steady-state performance of spent fuel storage systems. The code has been evaluated for this application for the US Department of Energy's Commercial Spent Fuel Management Program. HYDRA-II provides a finite difference solution in Cartesian coordinates to the equations governing the conservation of mass, momentum, and energy. A cylindrical coordinate system may also be used to enclose the Cartesian coordinate system. This exterior coordinate system is useful for modeling cylindrical cask bodies. The difference equations for conservation of momentum are enhanced by the incorporation of directional porosities and permeabilities that aid in modeling solid structures whose dimensions may be smaller than the computational mesh. The equation for conservation of energy permits of modeling of orthotropic physical properties and film resistances. Several automated procedures are available to model radiation transfer within enclosures and from fuel rod to fuel rod. The documentation of HYDRA-II is presented in three separate volumes. This volume, Volume I - Equations and Numerics, describes the basic differential equations, illustrates how the difference equations are formulated, and gives the solution procedures employed. Volume II - User's Manual contains code flow charts, discusses the code structure, provides detailed instructions for preparing an input file, and illustrates the operation of the code by means of a model problem. The final volume, Volume III - Verification/Validation Assessments, presents results of numerical simulations of single- and multiassembly storage systems and comparisons with experimental data. 4 refs

  18. Latin American Centre for Outcome Mapping - Phase II | IDRC ...

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

    Final technical report / Latin American Centre for Outcome Mapping (CLAMA) ... Organization for Women in Science for the Developing World (OWSD), IDRC is pleased to ... Sharing opportunities for innovation in climate change adaptation.

  19. 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,.

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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....

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. Radiofrequency ablation of liver tumors (II): clinical application and outcomes.

    Science.gov (United States)

    Vanagas, Tomas; Gulbinas, Antanas; Pundzius, Juozas; Barauskas, Giedrius

    2010-01-01

    Radiofrequency ablation is one of the alternatives in the management of liver tumors, especially in patients who are not candidates for surgery. The aim of this article is to review applicability of radiofrequency ablation achieving complete tumor destruction, utility of imaging techniques for patients' follow-up, indications for local ablative procedures, procedure-associated morbidity and mortality, and long-term results in patients with different tumors. The success of local thermal ablation consists in creating adequate volumes of tissue destruction with adequate "clear margin," depending on improved delivery of radiofrequency energy and modulated tissue biophysiology. Different volumes of coagulation necrosis are achieved applying different types of electrodes, pulsing energy sources, utilizing sophisticated ablation schemes. Some additional methods are used to increase the overall deposition of energy through alterations in tissue electrical conductivity, to improve heat retention within the tissue, and to modulate tolerance of tumor tissue to hyperthermia. Contrast-enhanced computed tomography, magnetic resonance imaging, ultrasound or positron emission tomography are applied to control the effectiveness of radiofrequency ablation. The long-term results of radiofrequency ablation are controversial.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. Experience with developmental facial paralysis: part II. Outcomes of reconstruction.

    Science.gov (United States)

    Terzis, Julia K; Anesti, Katerina

    2012-01-01

    The purpose of this study was to document the 30-year experience of the authors' center in the management of developmental facial paralysis and to analyze the outcomes of microsurgical reconstruction. Forty-two cases of developmental facial paralysis were identified in a retrospective clinical review (1980 to 2010); 34 (80.95 percent) were children (age, 8 ± 6 years) and eight (19.05 percent) were adults (age, 27 ± 12 years). Comparisons between preoperative and postoperative results were performed with electrophysiologic studies and video evaluations by three independent observers. Mean follow-up was 8 ± 6.3 years (range, 1 to 23 years). Overall, outcome scores improved in all of the patients, as was evident from the observers' mean scores (preoperatively, 2.44; 2 years postoperatively, 3.66; final, 4.11; p children as compared with adults (p children with developmental facial paralysis and reduces the prevalence of aesthetic and functional sequelae of the condition, thus facilitating reintegration among their peers. The experience of this center should serve as a framework for the establishment of accurate and reliable guidelines that will facilitate early diagnosis and management of developmental facial paralysis and provide support and counseling to the family.

  16. 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

  17. 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.

  18. 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.

  19. Single-case synthesis tools II: Comparing quantitative outcome measures.

    Science.gov (United States)

    Zimmerman, Kathleen N; Pustejovsky, James E; Ledford, Jennifer R; Barton, Erin E; Severini, Katherine E; Lloyd, Blair P

    2018-03-07

    Varying methods for evaluating the outcomes of single case research designs (SCD) are currently used in reviews and meta-analyses of interventions. Quantitative effect size measures are often presented alongside visual analysis conclusions. Six measures across two classes-overlap measures (percentage non-overlapping data, improvement rate difference, and Tau) and parametric within-case effect sizes (standardized mean difference and log response ratio [increasing and decreasing])-were compared to determine if choice of synthesis method within and across classes impacts conclusions regarding effectiveness. The effectiveness of sensory-based interventions (SBI), a commonly used class of treatments for young children, was evaluated. Separately from evaluations of rigor and quality, authors evaluated behavior change between baseline and SBI conditions. SBI were unlikely to result in positive behavior change across all measures except IRD. However, subgroup analyses resulted in variable conclusions, indicating that the choice of measures for SCD meta-analyses can impact conclusions. Suggestions for using the log response ratio in SCD meta-analyses and considerations for understanding variability in SCD meta-analysis conclusions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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...

  13. 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…

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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...

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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…

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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).

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. Review of Department of Defense Education Activity (DODEA) Schools. Volume II: Quantitative Analysis of Educational Quality

    National Research Council Canada - National Science Library

    Anderson, Lowell

    2000-01-01

    This volume compiles, and presents in integrated form, IDA's quantitative analysis of educational quality provided by DoD's dependent schools, It covers the quantitative aspects of volume I in greater...

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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.)

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. Impact of initial tumor volume on radiotherapy outcome in patients with T2 glottic cancer

    International Nuclear Information System (INIS)

    Rutkowski, T.

    2014-01-01

    The aim of this study was to quantify the impact of initial tumor volume (TV) on radiotherapy (RT) outcome in patients with T2 glottic cancer. Initial TV was calculated for 115 consecutive patients with T2 glottic cancer who had been treated with definitive RT alone at a single institution. The results showed strong correlations of TV with 3-year local tumor control (LTC) and disease-free survival (DFS). For TV ≤ 0.7 cm 3 , 3-year LTC was 83 %; for TV 0.7-3.6 cm 3 this was 70 % and for TV 3.6-17 cm 3 44 %. Analysis of total dose vs. initial TV showed that larger T2 glottic tumors with a TV of around 5 cm 3 (2-2.5 cm in diameter with 10 10 cancer cells) need an extra 6.5 Gy to achieve similar 3-year LTC rates as for small tumors with a TV of 0.5 cm 3 (∝1 cm in diameter with 10 9 cancer cells). Although classification of tumors according to TV cannot replace TNM staging in daily practice, it could represent a valuable numerical supplement for planning the optimal dose fractionation scheme for individual patients. (orig.)

  4. Reduced Albumin Dosing During Large-Volume Paracentesis Is Not Associated with Adverse Clinical Outcomes.

    Science.gov (United States)

    Johnson, Kara B; Mueller, Jessica L; Simon, Tracey G; Zheng, Hui; King, Lindsay Y; Makar, Robert S; Gervais, Debra A; Chung, Raymond T

    2015-07-01

    LVP is used to manage diuretic-resistant ascites in cirrhotic patients. Albumin administration prevents complications including acute kidney injury and paracentesis-induced circulatory dysfunction, but the optimal dose is unclear. We sought to assess adherence to guidelines enacted in July 2011 at our center for reducing the albumin dose administered at large-volume paracentesis (LVP) and evaluate the cost and rate of complications of LVPs before and after guideline enactment. All LVPs performed on cirrhotic patients in our center's Department of Radiology between July 2009 and January 2014 were studied. Outcomes included adherence to guidelines, LVP complications, and administered albumin cost. Groups were compared using Student's t tests for continuous data and Chi-square or Fisher's exact tests for categorical data. A repeated measurements model accounted for patients with multiple LVPs. Of the 935 LVPs, 288 occurred before guideline implementation (group 1) and 647 occurred after (group 2). The mean dose of albumin administered was 13.7 g/L of ascites removed in group 1 versus 10.3 g/L in group 2 (p albumin administration and associated cost savings was still observed. There was no increase in LVP-related complications after guideline implementation or in the adherent group, suggesting that albumin dose can be safely reduced. Future efforts should be directed at enhancing guideline adherence and potentially further reducing albumin dosing.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Feedback to Managers, Volume II: A Review and Comparison of Sixteen Multi-Rater Feedback Instruments.

    Science.gov (United States)

    Van Velsor, Ellen; Leslie, Jean Brittain

    "Feedback to Managers" is a two-volume report. Volume 2 compares 16 of the better feedback instruments available. The following are the instruments: (1) ACUMEN Group Feedback; (2) BENCHMARKS; (3) the Campbell Leadership Index; (4) COMPASS: the Managerial Practices Survey; (5) the Executive Success Profile; (6) Leader Behavior Analysis…

  7. 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

  8. 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.

  9. 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.

  10. Outcomes After Orbital Atherectomy of Severely Calcified Left Main Lesions: Analysis of the ORBIT II Study.

    Science.gov (United States)

    Lee, Michael S; Shlofmitz, Evan; Shlofmitz, Richard; Sahni, Sheila; Martinsen, Brad; Chambers, Jeffrey

    2016-09-01

    The ORBIT II trial reported excellent outcomes in patients with severely calcified coronary lesions treated with orbital atherectomy. Severe calcification of the left main (LM) artery represents a complex coronary lesion subset. This study evaluated the safety and efficacy of coronary orbital atherectomy to prepare severely calcified protected LM artery lesions for stent placement. The ORBIT II trial was a prospective, multicenter clinical trial that enrolled 443 patients with severely calcified coronary lesions in the United States. The major adverse cardiac event (MACE) rate through 2 years post procedure, defined by cardiac death, myocardial infarction (CK-MB >3x upper limit of normal with or without a new pathologic Q-wave) and target-vessel revascularization, was compared in the LM and non-left main (NLM) groups. Among the 443 patients, a total of 10 underwent orbital atherectomy of protected LM artery lesions. At 2 years, there was no significant difference in the 2-year MACE rate in the LM and NLM groups (30.0% vs 19.1%, respectively; P=.36). Cardiac death was low in both groups (0% vs 4.4%, respectively; P=.99). Myocardial infarction occurred within 30 days in both groups (10.0% vs 9.7%, respectively; P=.99). Severe dissection, perforation, persistent slow flow, and persistent no reflow did not occur in the LM group. Abrupt closure occurred in 1 patient in the LM group. Orbital atherectomy for patients with heavily calcified LM coronary artery lesions is safe and feasible. Further studies are needed to assess the safety and efficacy of orbital atherectomy in patients with severely calcified LM artery lesions.

  11. 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.

  12. High Power Compact Single-Frequency Volume Bragg Er-Doped Fiber Laser, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — This proposal is based on successful results of Phase I project where it was shown that the use of volume Bragg gratings in PTR glass as selectors of transverse and...

  13. Proceedings of the 1984 workshop on high-energy excitations in condensed matter. Volume II

    International Nuclear Information System (INIS)

    Silver, R.N.

    1984-12-01

    This volume covers electronic excitations, momentum distributions, high energy photons, and a wrap-up session. Abstracts of individual items from the conference were prepared separately for the data base

  14. Elmo Bumpy Torus proof of principle, Phase II: Title 1 report. Volume VII. Cryogenic system

    International Nuclear Information System (INIS)

    Poteat, T.J.

    1982-01-01

    This document, Volume VII EBT-P Cryogenic System Title I Design Report, describes the system that resulted from the Title I Preliminary Design effort. It is a self-contained document that can be read apart from the other Volumes comprising the EBT-P Title I Report. This document is a contract deliverable item and provides the detail necessary to support the Cryogenic System design contained in the EBT-P Baseline Design Data Book

  15. 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 .

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. Outcomes of different Class II treatments : Comparisons using the American Board of Orthodontics Model Grading System.

    Science.gov (United States)

    Akinci Cansunar, Hatice; Uysal, Tancan

    2016-07-01

    The aim of this study was to evaluate the clinical outcomes of three different Class II treatment modalities followed by fixed orthodontic therapy, using the American Board of Orthodontics Model Grading System (ABO-MGS). As a retrospective study, files of patients treated at postgraduate orthodontic  clinics in different cities in Turkey was randomly selected. From 1684 posttreatment records, 669 patients were divided into three groups: 269 patients treated with extraction of two upper premolars, 198 patients treated with cervical headgear, and 202 patients treated with functional appliances. All the cases were evaluated by one researcher using ABO-MGS. The χ (2), Z test, and multivariate analysis of variance were used for statistical evaluation (p < 0.05). No significant differences were found among the groups in buccolingual inclination, overjet, occlusal relationship, and root angulation. However, there were significant differences in alignment, marginal ridge height, occlusal contact, interproximal contact measurements, and overall MGS average scores. The mean treatment time between the extraction and functional appliance groups was significantly different (p = 0.017). According to total ABO-MGS scores, headgear treatment had better results than functional appliances. The headgear group had better tooth alignment than the extraction group. Headgear treatment resulted in better occlusal contacts than the functional appliances and had lower average scores for interproximal contact measurements. Functional appliances had the worst average scores for marginal ridge height. Finally, the functional appliance group had the longest treatment times.

  1. 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.

  2. 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

  3. 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

  4. Survey of fish impingement at power plants in the United States. Volume II. Inland waters

    International Nuclear Information System (INIS)

    Freeman, R.F. III; Sharma, R.K.

    1977-03-01

    Impingement of fish at cooling-water intakes of 33 power plants located on inland waters other than the Great Lakes has been surveyed and data are presented. Descriptions of site, plant, and intake design and operation are provided. Reports in this volume summarize impingement data for individual plants in tabular and histogram formats. Information was available from differing sources such as the utilities themselves, public documents, regulatory agencies, and others. Thus, the extent of detail in the reports varies greatly from plant to plant. Histogram preparation involved an extrapolation procedure that has inadequacies. The reader is cautioned in the use of information presented in this volume to determine intake-design acceptability or intensity of impacts on ecosystems. No conclusions are presented herein; data comparisons are made in Volume IV

  5. 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

  6. Handbook of Game Theory and Industrial Organization, Volume II: Applications. An Introduction

    OpenAIRE

    Corchon, Luis; Marini, Marco A.

    2017-01-01

    We introduce here the second volume of the Handbook of Game Theory and Industrial Organization, by L. C. Corchón and M. A. Marini (ed.), Edward Elgar, Cheltenam, UK and Northampton, MA, describing its main aim and its basic structure.

  7. Developing maintainability for tokamak fusion power systems. Phase I report. Volume II. Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Zahn, H.S.

    1977-10-01

    This volume contains the following appendices: (1) baseline large module time estimates, (2) baseline intermediate module time estimates, (3) baseline small module time estimates, (4) alternate concept estimates, (5) maintenance equipment concepts, (6) additional reactor design definition, and (7) TOCOMO supplements. (MOW)

  8. Influence of pressure on the properties of chromatographic columns. II. The column hold-up volume.

    Science.gov (United States)

    Gritti, Fabrice; Martin, Michel; Guiochon, Georges

    2005-04-08

    The effect of the local pressure and of the average column pressure on the hold-up column volume was investigated between 1 and 400 bar, from a theoretical and an experimental point of view. Calculations based upon the elasticity of the solids involved (column wall and packing material) and the compressibility of the liquid phase show that the increase of the column hold-up volume with increasing pressure that is observed is correlated with (in order of decreasing importance): (1) the compressibility of the mobile phase (+1 to 5%); (2) in RPLC, the compressibility of the C18-bonded layer on the surface of the silica (+0.5 to 1%); and (3) the expansion of the column tube (columns packed with the pure Resolve silica (0% carbon), the derivatized Resolve-C18 (10% carbon) and the Symmetry-C18 (20% carbon) adsorbents, using water, methanol, or n-pentane as the mobile phase. These solvents have different compressibilities. However, 1% of the relative increase of the column hold-up volume that was observed when the pressure was raised is not accounted for by the compressibilities of either the solvent or the C18-bonded phase. It is due to the influence of the pressure on the retention behavior of thiourea, the compound used as tracer to measure the hold-up volume.

  9. Ocean Thermal Energy Conversion (OTEC) platform configuration and integration. Volume II. Conceptual design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-06-01

    The purpose of this project is to evaluate six candidate hullforms as candidates for the OTEC commercial plant. This volume is a summary of the conceptual design including facility requirements, cost, schedule, and site sensitivity. Two OTEC commercial plant configurations are considered in this study: the ship and the semi-submersible. Engineering drawings are presented. (WHR)

  10. Technical Assistance in Evaluating Career Education Projects. Final Report. Volume II: Final Career Education Evaluation Report.

    Science.gov (United States)

    Stenner, A. Jackson; And Others

    This document contains the second of five volumes reporting the activities and results of a career education evaluation project conducted to accomplish the following two objectives: (1) to improve the quality of evaluations by career education projects funded by the United States Office of Career Education (OCE) through the provision of technical…

  11. Catalog of physical protection equipment. Book 1: Volume II. Intrusion detection components

    International Nuclear Information System (INIS)

    Haberman, W.

    1977-06-01

    This volume covers acoustic components, microwave/radar components, electro-optic barriers, electric field components, orientation components, ferrous metal detection components, proximity detection components, vibration detection components, seismic components, pressure-sensitive components, pressure mats, continuity components, electrical/magnetic switches, fire detection components, and mechanical contact switches

  12. Savannah River Plant - Project 8980 engineering and design history. Volume II

    Energy Technology Data Exchange (ETDEWEB)

    1957-01-01

    This volume provides an engineering and design history of the 100 area of the Savannah River Plant. This site consisted of five separate production reactor sites, 100-R, P, L, K, and C. The document summarizes work on design of the reactors, support facilities, buildings, siting, etc. for these areas.

  13. Developing maintainability for tokamak fusion power systems. Phase II report. Volume III: appendices

    International Nuclear Information System (INIS)

    Fuller, G.M.; Zahn, H.S.; Mantz, H.C.; Kaletta, G.R.; Waganer, L.M.; Carosella, L.A.; Conlee, J.L.

    1978-11-01

    This volume contains time estimate summaries to the second level of detail for scheduled or unscheduled maintenance of the first wall/blanket, some selected subsystem components and maintenance equipment. Elaboration of selected maintenance equipment functions and performance as well as conceptual designs is also included

  14. Book Review: Sustainable Luxury and Social Entrepreneurship. Volume II: More Stories from the Pioneers

    DEFF Research Database (Denmark)

    Skjold, Else

    2017-01-01

    volume Sustainable Luxury and Social Entrepreneurship: Stories of the Pioneers, published in 2014. The book series, as well as the awards, seeks to investigate and promote the motives, context, and practical endeavours of sustainable entrepreneurs within the premium and luxury sector....

  15. Higher Education and Development in South-East Asia. Volume II, Country Profiles.

    Science.gov (United States)

    Hayden, Howard; And Others

    This document, the second of three volumes concerned with the role of institutions of higher education in the development of countries in South-East Asia, presents country profiles for Burma, Thailand, Laos, Cambodia, Viet-Nam, Malaysia, Singapore, Indonesia, and the Philippines. The profile emphasizes background, higher education, educational…

  16. Dancetime! 500 Years of Social Dance. Volume II: 20th Century. [Videotape].

    Science.gov (United States)

    Teten, Carol

    This 50-minute VHS videotape is the second in a 2-volume series that presents 500 years of social dance, music, and fashion. It features dance and music of the 20th century, including; 1910s: animal dances, castle walk, apache, and tango; 1920s: black bottom and charleston; 1930s: marathon, movie musicals, big apple, and jitterbug; 1940s: rumba;…

  17. Publications of Los Alamos Research, 1977-1981: formerly Publications of LASL Research. Volume II

    International Nuclear Information System (INIS)

    Sheridan, C.J.; Garcia, C.A.

    1983-03-01

    This volume is a bibliography of Los Alamos publications during the specified period in the following areas: general physics; nuclear physics; particles and fields; radioisotope and radiation applications; nuclear materials security safeguards; solar energy; theoretical plasma physics; and transportation of property and nuclear materials

  18. SEL/Project Language. Level II, Kindergarten, Volume I (Lessons 1-16).

    Science.gov (United States)

    Valladares, Ann E.; And Others

    The document is an intervention curriculum guide designed to facilitate the initial adjustment of disadvantaged Southeastern children to kindergarten or first grade. The major emphasis is on the teaching of language skills in combination with subject matter learning using a language-experience approach. This volume contains Lessons 1-16 of a…

  19. 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

  20. 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

  1. SOLVENT-BASED TO WATERBASED ADHESIVE-COATED SUBSTRATE RETROFIT - VOLUME II: PROCESS OVERVIEW

    Science.gov (United States)

    This volume presents initial results of a study to identify the issues and barriers associated with retrofitting existing solvent-based equipment to accept waterbased adhesives as part of an EPA effort to improve equipment cleaning in the coated and laminated substrate manufactur...

  2. Developing maintainability for tokamak fusion power systems. Phase I report. Volume II. Appendices

    International Nuclear Information System (INIS)

    Zahn, H.S.

    1977-10-01

    This volume contains the following appendices: (1) baseline large module time estimates, (2) baseline intermediate module time estimates, (3) baseline small module time estimates, (4) alternate concept estimates, (5) maintenance equipment concepts, (6) additional reactor design definition, and (7) TOCOMO supplements

  3. A DDC Bibliography on Computers in Information Sciences. Volume II. Information Sciences Series.

    Science.gov (United States)

    Defense Documentation Center, Alexandria, VA.

    The unclassified and unlimited bibliography compiles references dealing specifically with the role of computers in information sciences. The volume contains 239 annotated references grouped under three major headings: Artificial and Programming Languages, Computer Processing of Analog Data, and Computer Processing of Digital Data. The references…

  4. Engineering Drawing Practices - Volume I of II: Aerospace and Ground Support Equipment

    Science.gov (United States)

    Schwindt, Paul A.

    2015-01-01

    This manual establishes the essential requirements and reference documents for the preparation and revision of digital product definition data sets prepared for or by NASA at KSC. This volume is only applicable to KSC in-house programs/projects. These requirements do not apply to the preparation of illustrations, artwork, or figures in technical publications.

  5. Communications Strategies on Alcohol and Highway Safety. Volume II. High School Youth. Final Report.

    Science.gov (United States)

    Grey Advertising, Inc., New York, NY.

    The second part of a two-part, two volume study deals with high school youth and identifies target populations and communications strategies for encouraging personal action steps to prevent drunk driving. Data, collected from interviews and questionnaires, are summarized and presented in tabular form. One fourth of high schoolers in a…

  6. Technical Reports (Part II). End of Project Report, 1968-1971, Volume IV.

    Science.gov (United States)

    Western Nevada Regional Education Center, Lovelock.

    The pamphlets included in this volume are technical reports prepared as outgrowths of the Student Information System of the Western Nevada Regional Education Center funded by a Title III grant under the Elementary and Secondary Education Act of 1965. These reports demonstrate the use of the stored data; methods of interpreting the printouts from…

  7. Systems Book for a Student Information System. End of Project Report, 1968-1971, Volume II.

    Science.gov (United States)

    Western Nevada Regional Education Center, Lovelock.

    The necessary handbooks for use of the Student Information System (SIS), developed and tested by the Western Nevada Regional Education Center under a 1968-71 Title III (Elementary and Secondary Education Act) grant, are presented in this volume. As noted, the purpose of the SIS is to supply data and information to persons or organizations who make…

  8. Industrial Special Wastes Generated in Iowa and Manpower Characteristics of Employee Handlers, Volume II.

    Science.gov (United States)

    Pierce, David R.

    This document, Vol. II in a set, presents the results of the development and instruction of two pilot modules. The first module deals with pesticide container recycling. The second module deals with hazardous substances, especially paints and solvents. Each module contains background information, instructor narrative, student activities, and…

  9. Missouri Journal of Research in Music Education, Volume II, Number 5.

    Science.gov (United States)

    Hilton, Lewis B., Ed.

    1971-01-01

    The six articles presented in this journal are: I. Research in Action: The Transfer of Research in Music and Music Education into the Classroom by Jack R. Stephenson; II. Programmed Instruction and Music Education by Douglas L. Turpin; III. Music Education and the Blind by Joan Thief Gagnepain; IV. Improved Teaching Through the Use of the…

  10. TIBER II/ETR final design report: Volume 1, 1. 0 Introduction; 2. 0 plasma engineering

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J.D. (ed.)

    1987-09-01

    This paper discusses the design of the TIBER II tokamak test reactor. Specific topics discussed are the physics objectives for Tiber, magnetics, baseline operating point, pulsed inductive operation, edge physics and impurity control, fueling, disruption control, vertical stability and impurity flow reversal. (LSP)

  11. The Experience of Soviet Medicine in World War II 1941-1945. Volume I.

    Science.gov (United States)

    1982-02-25

    countries. The low percentage of neuropsychological patients in the Soviet Army is evidence of the achievements of pre- war years of the Soviet people...unsplinted 269 I I II I fracture did not bother them. To the question of the physician about =npn.aints, they most often pointed out hunger . As early

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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)

  17. COOMET.RI(II)-S1.Rn-222 (169/UA/98): Rn-222 volume activity comparison

    International Nuclear Information System (INIS)

    Skliarov, V.; Rottger, A.; Honig, A.; Korostin, S.; Kuznetsov, S.; Lapenas, A.; Milevsky, V.; Ivaniukovich, A.; Kharitonov, I.; Sepman, S.

    2009-01-01

    According to a first program, a supplementary comparison of Rn-222 volume activity was drawn up as a bilateral supplementary comparison between NSC 'Institute of Metrology', Ukraine, and VNIIFTRI, Russia. It took place in March 2005. In April 2005, at the 5. meeting of COOMET held in Braunschweig (Germany), representatives of these institutes exchanged data which showed the comparability of the national standards of Ukraine and Russia for the check points. During the discussion of the procedure some other institutes decided to join the comparison program, which was extended to BelGIM (Belarus), PTB (Germany), VNIIM (Russia) and RMTC (Latvia). The national standards of volume activity of radon-222 were thus calibrated using one standard radon radiometer as the transfer standard. Results are shown in the Final Report of the comparison. (authors)

  18. COOMET.RI(II)-S1.Rn-222 (169/UA/98): Rn-222 volume activity comparison

    Energy Technology Data Exchange (ETDEWEB)

    Skliarov, V. [National Scientific Centre, Institute of Metrology (NSC IM), Kharkiv (Ukraine); Rottger, A.; Honig, A. [Physikalisch-Technische Bundesanstalt (PTB), Braunschweig (Germany); Korostin, S.; Kuznetsov, S. [All-Russian Scientific Research Institute of Physical, Technical and Radio Measurements (VNIIFTRI), Moscow Region, Mendeleyevo (Russian Federation); Lapenas, A. [Latvian National Metrology Centre Ltd, Radiation Metrology and Testing Centre (RMTC), Salaspils (Latvia); Milevsky, V.; Ivaniukovich, A. [Belarussian State Institute of Metrology (BelGIM), Minsk (Belarus); Kharitonov, I.; Sepman, S. [D I Mendeleyev Institute of metrology (VNIIM), Saint Petersburg (Russian Federation)

    2009-06-15

    According to a first program, a supplementary comparison of Rn-222 volume activity was drawn up as a bilateral supplementary comparison between NSC 'Institute of Metrology', Ukraine, and VNIIFTRI, Russia. It took place in March 2005. In April 2005, at the 5. meeting of COOMET held in Braunschweig (Germany), representatives of these institutes exchanged data which showed the comparability of the national standards of Ukraine and Russia for the check points. During the discussion of the procedure some other institutes decided to join the comparison program, which was extended to BelGIM (Belarus), PTB (Germany), VNIIM (Russia) and RMTC (Latvia). The national standards of volume activity of radon-222 were thus calibrated using one standard radon radiometer as the transfer standard. Results are shown in the Final Report of the comparison. (authors)

  19. Preliminary design of the Carrisa Plains solar central receiver power plant. Volume II. Plant specifications

    Energy Technology Data Exchange (ETDEWEB)

    Price, R. E.

    1983-12-31

    The specifications and design criteria for all plant systems and subsystems used in developing the preliminary design of Carrisa Plains 30-MWe Solar Plant are contained in this volume. The specifications have been organized according to plant systems and levels. The levels are arranged in tiers. Starting at the top tier and proceeding down, the specification levels are the plant, system, subsystem, components, and fabrication. A tab number, listed in the index, has been assigned each document to facilitate document location.

  20. Cultural Resources Investigations at Redstone Arsenal, Madison County, Alabama. Volume II.

    Science.gov (United States)

    1980-01-01

    was an infant or child . Parts of broken pottery vessels were found with two of the burials. I As mentioned above, ceramics were relatively infrequent...ai-j- IL is also due to a certain amiount of I tI ’rt ie 1(a ao -- tilit- iV! t-ri i process does not porn i t an extant I ii tfel to !, -,I) Ip it

  1. Preventive Medicine in World War II. Volume 7. Communicable Diseases. Arthropodborne other than Malaria

    Science.gov (United States)

    1964-01-01

    in Peru or in other countries. In Ecuador , bartonellosis has l»een report«! from the Provinces of Loja and Oro. This author " cultivated...fatal, caused by BartoneUa baciUiformis and transmitted by the bite of Phlebotomies. The dis- ease is limited to certain parts of Peru, Ecuador , and...Colombia. The disease was not a military problem in World War II. American troops stationed in Peru (Talara) and Ecuador (Salinas) were outside the

  2. Tank Waste Remediation System, Hanford Site, Richland, Washington. Final Environmental Impact Statement. Volume II

    International Nuclear Information System (INIS)

    1996-08-01

    This document, Volume 2, provides the inventory of waste addressed in this Final Environmental Impact Statement (EIS) for the Tank Waste Remediation System, Hanford Site, Richland, Washington. The inventories consist of waste from the following four groups: (1) Tank waste; (2) Cesium (Cs) and Strontium (Sr) capsules; (3) Inactive miscellaneous underground storage tanks (MUSTs); and (4) Anticipated future tank waste additions. The major component by volume of the overall waste is the tank waste inventory (including future tank waste additions). This component accounts for more than 99 percent of the total waste volume and approximately 70 percent of the radiological activity of the four waste groups identified previously. Tank waste data are available on a tank-by-tank basis, but the accuracy of these data is suspect because they primarily are based on historical records of transfers between tanks rather than statistically based sampling and analyses programs. However, while the inventory of any specific tank may be suspect, the overall inventory for all of the tanks combined is considered more accurate. The tank waste inventory data are provided as the estimated overall chemical masses and radioactivity levels for the single-shell tanks (SSTs) and double-shell tanks (DSTs). The tank waste inventory data are broken down into tank groupings or source areas that were developed for analyzing groundwater impacts

  3. Acuity and case management: a healthy dose of outcomes, part II.

    Science.gov (United States)

    Craig, Kathy; Huber, Diane L

    2007-01-01

    This is the second of a 3-part series presenting 2 effective applications-acuity and dosage-that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Part I also featured a specific exemplar, the CM Acuity Tool, and described how to use acuity to identify and score the complexity of a CM case. Appropriate dosage prescription of CM activity was discussed. Part II further explains dosage and presents two acuity instruments, the Acuity Tool and AccuDiff. Details are provided that show how these applications produce opportunities for better communication about CM cases and for more accurate measurement of the right content that genuinely reflects the essentials of CM practice. The information contained in the 3-part series applies to all CM practice settings and contains ideas and recommendations useful to CM generalists, specialists, and supervisors, plus business and outcomes managers. The Acuity Tools Project was developed from frontline CM practice in one large, national telephonic CM company. Dosage: A literature search failed to find research into dosage of a behavioral intervention. The Huber-Hall model was developed and tested in a longitudinal study of CM models in substance abuse treatment and reported in the literature. Acuity: A structured literature search and needs assessment launched the development of the suite of acuity tools. A gap analysis identified that an instrument to assign and measure case acuity specific to CM activities was needed. Clinical experts, quality specialists, and business analysts (n = 7) monitored the development and testing of the tools, acuity concepts, scores, differentials, and their operating principles and evaluated the validity of the Acuity Tools' content related to CM activities. During the pilot phase of

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. Subseabed Disposal Program Plan. Volume II. FY80 budget and subtask work plans

    International Nuclear Information System (INIS)

    1980-01-01

    This volume of the Subseabed Disposal Program Plan presents a breakdown of the master program structure by major activity. Each activity is described and accompanied by a specific cost plan schedule and a milestone plan. The costs have been compiled in the Cost Plan Schedules attached to each Subtask Work Plan. The FY 1980 budget for the Subseabed Disposal Program is summarized at the second level of the Work Breakdown Structure. The milestone plans for FY 80 are presented. The milestones can be changed only with the concurrence of the Sandia Subseabed Program Manager

  10. Monterey Peninsula Water Supply Project. Supplemental Draft Environmental Impact Report/Statement II. Volume 2.

    Science.gov (United States)

    1993-02-01

    Fueled 7,634,0(X) 51 Geothermal 1,302,M(K) 9 Nuclear 2,160,(MX) 14 Total Thermal 11,096,(kM) 74 Hydroelectric 3,877,M(X) 26 Solar 0 0t Total Company...Nuclear 16,273,963 17 "Total Thermal 48,094,316 50 Hydroelectric 8,007,631 8 Solar 35 0 Total Company Generation 56,101,982 58 Helms Pumpback Energy...returnable beverage containers, prohibition of disposable diapers , and other measures to reduce the volume of the urban solid waste streams. Appeaidix 19-B

  11. Environmental contaminants in food. Volume II-Part B: Working papers

    International Nuclear Information System (INIS)

    1980-01-01

    This volume contains working papers written for Office of Technology Assessment (OTA) to assist in preparation of the report Environmental Contaminants in Food. The contents include: (1) Toxic substances in food information systems: design and management; (2) Assessment of carcinogenic risks from PCBs in food; (3) Economic analysis of alternative action levels in the regulation of environmental contaminants in food; (4) Analysis of foods for radioactivity; (5) Approaches to monitoring environmental contaminants in food; (6) Analytical systems for the determination of metals in food and water supplies; (7) Assessment of methods for regulating 'unavoidable' contaminants in the food supply; and (8) Consumer risk from environmental contaminants in food

  12. Kilowatt isotope power system. Phase II plan. Volume V. Safety, quality assurance and reliability

    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. Included in this volume are: launch and flight safety considerations; quality assurance techniques and procedures to be followed through system fabrication, assembly and inspection; and the reliability program made up of reliability prediction analysis, failure mode analysis and criticality analysis

  13. Structuring polymer blends with bicontinuous phase morphology. Part II. Tailoring blends with ultralow critical volume fraction

    DEFF Research Database (Denmark)

    Lyngaae-Jørgensen, Jørgen; Utracki, Leszek

    2003-01-01

    A hypothesis providing a guideline for the development of immiscible polymer blends with co-continuous phase structure at very low critical volume fraction of one component is. postulated and experimentally verified. Based on a number of simplifying assumptions the following relation was derived......: phi(cr) = k(lambdagamma)(1-z)/(theta(b)(*))(z) where lambdagamma is a Deborah number and theta(b)(*) is a dimensionless break-up time. The equation parameters, k and z are constant that depend on the flow field hence on the blending equipment. For the studies an internal mixer with Walzenkneter...

  14. Heterogeneous Concurrent Modeling and Design in Java (Volume 2: Ptolemy II Software Architecture)

    Science.gov (United States)

    2008-04-01

    file (EPS) suitable for inclusion in word processors. The image in figure 7.3 is such an EPS file imported into FrameMaker . At this time, the EPS...can be imported into word processors. This figure was imported into FrameMaker . 152 Ptolemy II Plot Package 7.2.4 Modifying the format You can control...FixToken class 57 FrameMaker 149 full name 4 function closures 59 function dependency 48 FunctionDependency class 48 FunctionToken 122 FunctionToken

  15. Field Surveys, IOC Valleys. Biological Resources Survey, Dry Lake Valley, Nevada. Volume II, Part I.

    Science.gov (United States)

    1981-08-01

    years ago; the transplant was considered unsuccessful. Sagebrush is the principal item in the diet of adult sage grouse (Centrocercus urophasianus), and...canyon areas in the normal chukar partridge range but can also extend its range to areas too dry for the chukar. The transplant was not con- sidered...determined. - Ertee E-TR-48-II-I SSL1’N SL xx- C - - _ 0S91’ - - I. 009t N - - 0’J o,, s). N, - . ,o 09 -SW,- - - ,o T z X -4 oseo 0L91 - N - = - ozot ma

  16. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-01-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  17. Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  18. Physics of laser fusion. Volume II. Diagnostics of experiments on laser fusion targets at LLNL

    Energy Technology Data Exchange (ETDEWEB)

    Ahlstrom, H.G.

    1982-01-01

    These notes present the experimental basis and status for laser fusion as developed at LLNL. There are two other volumes in this series: Vol. I, by C.E. Max, presents the theoretical laser-plasma interaction physics; Vol. III, by J.F. Holzrichter et al., presents the theory and design of high-power pulsed lasers. A fourth volume will present the theoretical implosion physics. The notes consist of six sections. The first, an introductory section, provides some of the history of inertial fusion and a simple explanation of the concepts involved. The second section presents an extensive discussion of diagnostic instrumentation used in the LLNL Laser Fusion Program. The third section is a presentation of laser facilities and capabilities at LLNL. The purpose here is to define capability, not to derive how it was obtained. The fourth and fifth sections present the experimental data on laser-plasma interaction and implosion physics. The last chapter is a short projection of the future.

  19. Physics of laser fusion. Volume II. Diagnostics of experiments on laser fusion targets at LLNL

    International Nuclear Information System (INIS)

    Ahlstrom, H.G.

    1982-01-01

    These notes present the experimental basis and status for laser fusion as developed at LLNL. There are two other volumes in this series: Vol. I, by C.E. Max, presents the theoretical laser-plasma interaction physics; Vol. III, by J.F. Holzrichter et al., presents the theory and design of high-power pulsed lasers. A fourth volume will present the theoretical implosion physics. The notes consist of six sections. The first, an introductory section, provides some of the history of inertial fusion and a simple explanation of the concepts involved. The second section presents an extensive discussion of diagnostic instrumentation used in the LLNL Laser Fusion Program. The third section is a presentation of laser facilities and capabilities at LLNL. The purpose here is to define capability, not to derive how it was obtained. The fourth and fifth sections present the experimental data on laser-plasma interaction and implosion physics. The last chapter is a short projection of the future

  20. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

  1. Final waste management programmatic environmental impact statement for managing treatment, storage, and disposl of radioactive and hazardous waste. Volume II

    International Nuclear Information System (INIS)

    1997-01-01

    The Final Waste Management Programmatic Environmental Impact Statement (WM PEIS) examines the potential environmental and cost impacts of strategic management alternatives for managing five types of radioactive and hazardous wastes that have resulted and will continue to result from nuclear defense and research activities at a variety of sites around the United States. The five waste types are low-level mixed waste, low-level waste, transuranic waste, high-level waste, and hazardous waste. The WM PEIS provides information on the impacts of various siting alternatives which the Department of Energy (DOE) will use to decide at which sites to locate additional treatment, storage, and disposal capacity for each waste type.Volume II is an integral part of the Office of Environmental Management''s (EM''s) Waste Management Programmatic Environmental Impact Statement (WM PEIS), which portrays the impacts of EM''s waste management activities at each of the 17 major DOE sites evaluated in the WM PEIS

  2. Relationship of collegiate football experience and concussion with hippocampal volume and cognitive outcomes.

    Science.gov (United States)

    Singh, Rashmi; Meier, Timothy B; Kuplicki, Rayus; Savitz, Jonathan; Mukai, Ikuko; Cavanagh, LaMont; Allen, Thomas; Teague, T Kent; Nerio, Christopher; Polanski, David; Bellgowan, Patrick S F

    2014-05-14

    Concussion and subconcussive impacts have been associated with short-term disrupted cognitive performance in collegiate athletes, but there are limited data on their long-term neuroanatomic and cognitive consequences. To assess the relationships of concussion history and years of football experience with hippocampal volume and cognitive performance in collegiate football athletes. Cross-sectional study conducted between June 2011 and August 2013 at a US psychiatric research institute specializing in neuroimaging among collegiate football players with a history of clinician-diagnosed concussion (n = 25), collegiate football players without a history of concussion (n = 25), and non-football-playing, age-, sex-, and education-matched healthy controls (n = 25). History of clinician-diagnosed concussion and years of football experience. High-resolution anatomical magnetic resonance imaging was used to quantify brain volumes. Baseline scores on a computerized concussion-related cognitive battery were used for cognitive assessment in athletes. Players with and without a history of concussion had smaller hippocampal volumes relative to healthy control participants (with concussion: t48 = 7.58; P history of concussion had smaller hippocampal volumes than players without concussion (t48 = 3.15; P football played (t46 = -3.62; P history on 5 cognitive measures but did show an inverse correlation between years of playing football and reaction time (ρ42 = -0.43; 95% CI, -0.46 to -0.40; P = .005). Among a group of collegiate football athletes, there was a significant inverse relationship of concussion and years of football played with hippocampal volume. Years of football experience also correlated with slower reaction time. Further research is needed to determine the temporal relationships of these findings.

  3. PDC 2016. Proceedings of the 14th Participatory Design Conference - Volume II

    DEFF Research Database (Denmark)

    Participatory Design in an Era of Participation : Introduction to volume 2 Participatory Design is a diverse collection of principles and practices aimed at making technologies, tools, environments, businesses and social institutions more responsive to human needs. A central tenet of Participatory...... is ‘Participatory Design in an Era of Participation’. Over 25 years after the first PDC in 1990, participation and co-creation have become essential features of design and research into technology. Living in an era of participation prompts critical questions around the goals and practices of involving people....... • In “Expanding the ‘How’ of Participatory Design”, five papers provide insights into techniques and methods that support novel perspectives on how participatory design activities might be practiced or reflected upon. This includes examples that should benefit practitioners and researchers who wish to think...

  4. Developing maintainability for tokamak fusion power systems. Phase II report. Volume I: executive summary

    International Nuclear Information System (INIS)

    Fuller, G.M.; Zahn, H.S.; Mantz, H.C.; Kaletta, G.R.; Waganer, L.M.; Carosella, L.A.; Conlee, J.L.

    1978-11-01

    The purpose of this report is to identify design features of fusion power reactors which contribute to the achievement of high levels of maintainability. Volume 1, the Executive Summary, presents the progress achieved toward this objective in this phase and includes a comparison with the results of the first phase study efforts. A series of maintainability design guidelines and an improved maintenance system are defined as initial steps in developing the requirements for a maintainable tokamak fusion power system. The principle comparative studies that are summarized include the determination of the benefits of various vacuum wall arrangements, the effect of unscheduled and scheduled maintenance of the first wall/blanket, some initial investigation of maintenance required for subsystems other than the first wall/blanket, and the impact of maintenance equipment failures

  5. The acid digestion process for radioactive waste: The radioactive waste management series. Volume II

    International Nuclear Information System (INIS)

    Cecille, L.; Simon, R.

    1983-01-01

    This volume focuses on the acid digestion process for the treatment of alpha combustible solid waste by presenting detailed performance figures for the principal sub-assemblies of the Alona pilot plant, Belgium. Experience gained from the operation of the US RADTU plant, the only other acid digestion pilot plant, is also summarized, and the performances of these two plants compared. In addition, the research and development programmes carried out or supported by the Commission of the European Communities are reviewed, and details of an alternative to acid digestion for waste contamination described. Topics considered include review of the treatment of actinides-bearing radioactive wastes; alpha waste arisings in fuel fabrication; Alona Demonstration Facility for the acid digestion process at Eurochemic Mol (Belgium); the treatment of alpha waste at Eurochemic by acid digestion-feed pretreatment and plutonium recovery; US experience with acid digestion of combustible transuranic waste; and The European Communities R and D actions on alpha waste

  6. Proceedings of the sixth international conference on fluidized bed combustion. Volume II. Technical sessions

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-08-01

    The Sixth International Conference on Fluidized Bed Combustion was held April 9-11, 1980, at the Atlanta Hilton, Atlanta, Georgia. It was sponsored by the US Department of Energy, the Electric Power Research Institute, the US Environmental Protection Agency, and the Tennessee Valley Authority. The papers covered recent developments in atmospheric and pressurized fluidized-bed combustion, especially the design, operation and control of pilot and demonstration plants. The cleanup of combustion products and the erosion, corrosion and fouling of gas turbines was emphasized also. Fifty-five papers from Volume 2 of the proceedings have been entered individually into EDB and ERA; five papers had been entered previously from other sources. (LTN)

  7. In situ leaching of a nuclear rubblized copper ore body. Volume II

    International Nuclear Information System (INIS)

    1975-06-01

    This volume contains detailed descriptions of technical and economical evaluations undertaken for the feasibility study. A summary of these results can be found in Vol. 1 along with the conclusions derived from the feasibility study and the recommendations tendered for future work. The sections of this study are presented in process order, and each section is complete in itself. The form of the presentation, hopefully, is logical and in a manner suitable for design purposes. As a further aid, each section has its own table of contents. The sections presented include method of attack, reference case, description of concept, nuclear rubblization, blasting plan, underground plumbing, fluid circulation, leaching technology, wellhead plant and pipeline, process plant, material and heat balance, hydrology, radioactivity, seismic, economics, sensitivity analysis, guide for environmental studies, exploration, and recommended experimental program. (U.S.)

  8. Automating the Exchange of Military Personnel Data Among Selected Army Organizations. Volume II. Appendices,

    Science.gov (United States)

    1981-06-30

    w OO Id Sa f3 c c c o AJ -0h C CU 0 L -A- V)’ 0~ uiZ~u ’ w ii C 1a. b. % US %0 0 U4 4 ~ c 0C - = 0 IC a.4 0 0. 0~ 0 >00 ~C U a -60 A f 0 C3T...O 0 o’’ " - _0 3.. T5 4c( #j r. 0 < E C, -. .0 cc1 ,-, ;, 0. .- 0 ". a - c- r-. w 0 . .4 -4 f .%d 00 U a W W)w 44 0 ,U " 0 0 C) Z C4 W oa OC > acCA . 0

  9. Sandia National Laboratories/New Mexico Facilities and Safety Information Document [NOTE: Volume II, Chapter 12

    International Nuclear Information System (INIS)

    March, F.; Guerrero, J.V.; Johns, W.H.; Schetnan, R.; Bayliss, L.S.; Kuzio, K.A.

    1999-01-01

    Operations in Tech Area IV commenced in 1980 with the construction of Buildings 980 and 981 and the Electron Beam Fusion Accelerator, which at the time was a major facility in SNL's Inertial Confinement Fusion Program. The Electron Beam Fusion Accelerator was a third-generation fusion accelerator that followed Proto I and Proto II, which were operated in Tech Area V. Another accelerator, the Particle Beam Fusion Accelerator I, was constructed in Tech Area IV because there was not enough room in Tech Area V, a highly restricted area that contains SNL's reactor facilities. In the early 1980s, more fusion-related facilities were constructed in Tech Area IV. Building 983 was built to house a fourth-generation fusion accelerator, the Particle Beam Fusion Accelerator II, now called Z Machine, and Buildings 960 and 961 were built to house office space, electrical and mechanical laboratories, and highbay space for pulsed power research and development. In the mid 1980s, Building 970 was constructed to house the Simulation Technology Laboratory. The main facility in the Simulation Technology Laboratory is the High-Energy Radiation Megavolt Electron Source (HERMES) III, a third-generation gamma ray accelerator that is used primarily for the simulation of gamma rays produced by nuclear weapons. The previous generations, HERMES I and HERMES II, had been located in Tech Area V. In the late 1980s, Proto II was moved from Tech Area V to the Simulation Technology Laboratory and modified to function as an x-ray simulation accelerator, and construction of Buildings 962 and 963 began. These buildings comprised the Strategic Defense Facility, which was initially intended to support the nation's Strategic Defense Initiative or ''Star Wars'' program. It was to house a variety of pulsed power-related facilities to conduct research in such areas as directed-energy weapons (electron beams, lasers, and microwaves) and an earth-to-orbit launcher. With the reduction of the Strategic Defense

  10. Solvent-refined-coal (SRC) process. Volume II. Sections V-XIV. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-01

    This report documents the completion of development work on the Solvent Refined Coal Process by The Pittsburgh and Midway Coal Mining Co. The work was initiated in 1966 under Office of Coal Research, US Department of Interior, Contract No. 14-01-0001-496 and completed under US Department of Energy Contract No. DE-AC05-79ET10104. This report discusses work leading to the development of the SRC-I and SRC-II processes, construction of the Fort Lewis Pilot Plant for the successful development of these processes, and results from the operation of this pilot plant. Process design data generated on a 1 ton-per-day Process Development Unit, bench-scale units and through numerous research projects in support of the design of major demonstration plants are also discussed in summary form and fully referenced in this report.

  11. New York City Police Department Automated Fuel Monitoring System. Volume II. Documentation Report.

    Science.gov (United States)

    1981-11-16

    toward solving troublesome problems. In addition, the private sector market has been stimulated to respond to system needs identified during the course of...8 -3Q .ifL I.N’ p uii3NLIE- __-U3 7/11 Ud-.i T01 LNI TERM ON-LN 151 071 328- ______ 33N.________ -~R~ NLINE 2141 53 07/11 16-ttl 145 INS TERM ON-LINE...4Z-46 131 LN4 TERM NLINE --3o56a 55 O7ALL-ZU _1 L. N ~Ii8ILON-~ik 1559 53 01/17 eZ-4.8 137 INN TERM4 ON-LINE " . " - 7 - M -1 ------------- - . 7 .Dm

  12. Production Systems as a Programming Language for Artificial Intelligence Applications. Volume II.

    Science.gov (United States)

    1976-12-01

    CUETR1PLE(’ PiM -1,CI,’XX,’XX); This means: "if letter-I is R, then emit cue P and image DUNNO." Note that the LHS test is in two parts, testing the...Il) (IZ 110(31116 (rpEto PI-il (IMM POP$ (CIETPIRLE Mi-i NX XX XXI rvzt ! ni. ti-s ’SriII Otte ISs. ri-S ’S11f FIPE’ USING1 (SlIMEtl LI-I Li-I LI-I...MAi0OfWSENOAVl. *0 l’G(PM) I TACE IN=u P20 06 Otte ’ aMATOWLSVXMOOIOPP) Grp IATONSIM~vgvINV lm.IWMWO) InSAWEQWOI10l a MNT( fI )1s(D7yVSVI) MAIO41S1Ittly 113.111~f

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. Site Outcomes Baseline Multi Year Work Plan Volume 1, River Corridor Restoration Baseline

    International Nuclear Information System (INIS)

    Wintczak, T.M.

    2001-01-01

    The River Corridor Restoration volume is a compilation of Hanford Site scope, which excludes the approximately 194 km 2 Central Plateau. The River Corridor scope is currently contractually assigned to Fluor Hanford, Bechtel Hanford, inc., DynCorp, and Pacific Northwest National Laboratory, and others. The purpose of this project specification is to provide an overall scoping document for the River Corridor Restoration volume, and to provide a link with the overall Hanford Site River Corridor scope. Additionally, this specification provides an integrated and consolidated source of information for the various scopes, by current contract, for the River Corridor Restoration Baseline. It identifies the vision, mission, and goals, as well as the operational history of the Hanford Site, along with environmental setting and hazards

  18. Study of advanced fission power reactor development for the United States. Volume II

    International Nuclear Information System (INIS)

    1976-01-01

    This report presents the results of a multi-phase research study which had as its objective the comparative study of various advanced fission reactors and evaluation of alternate strategies for their development in the USA through the year 2020. By direction from NSF, ''advanced'' reactors were defined as those which met the dual requirements of (1) offering a significant improvement in fissile fuel utilization as compared to light-water reactors and (2) currently receiving U.S. Government funding. (A detailed study of the LMFBR was specifically excluded, but cursory baseline data were obtained from ERDA sources.) Included initially were the High-Temperature Gas-Cooled Reactor (HTGR), Gas-Cooled Fast Reactor (GCFR), Molten Salt Reactor (MSR), and Light-Water Breeder Reactor (LWBR). Subsequently, the CANDU Heavy Water Reactor (HWR) was included for comparison due to increased interest in its potential. This volume presents the reasoning process and analytical methods utilized to arrive at the conclusions for the overall study

  19. Site characterization report for the basalt waste isolation project. Volume II

    International Nuclear Information System (INIS)

    1982-11-01

    The reference location for a repository in basalt for the terminal storage of nuclear wastes on the Hanford Site and the candidate horizons within this reference repository location have been identified and the preliminary characterization work in support of the site screening process has been completed. Fifteen technical questions regarding the qualification of the site were identified to be addressed during the detailed site characterization phase of the US Department of Energy-National Waste Terminal Storage Program site selection process. Resolution of these questions will be provided in the final site characterization progress report, currently planned to be issued in 1987, and in the safety analysis report to be submitted with the License Application. The additional information needed to resolve these questions and the plans for obtaining the information have been identified. This Site Characterization Report documents the results of the site screening process, the preliminary site characterization data, the technical issues that need to be addressed, and the plans for resolving these issues. Volume 2 contains chapters 6 through 12: geochemistry; surface hydrology; climatology, meteorology, and air quality; environmental, land-use, and socioeconomic characteristics; repository design; waste package; and performance assessment

  20. Experimental fusion power reactor conceptual design study. Final report. Volume II

    International Nuclear Information System (INIS)

    Baker, C.C.

    1976-12-01

    This document is the final report which describes the work carried out by General Atomic Company for the Electric Power Research Institute on a conceptual design study of a fusion experimental power reactor (EPR) and an overall EPR facility. The primary objective of the two-year program was to develop a conceptual design of an EPR that operates at ignition and produces continuous net power. A conceptual design was developed for a Doublet configuration based on indications that a noncircular tokamak offers the best potential of achieving a sufficiently high effective fuel containment to provide a viable reactor concept at reasonable cost. Other objectives included the development of a planning cost estimate and schedule for the plant and the identification of critical R and D programs required to support the physics development and engineering and construction of the EPR. This volume contains the following sections: (1) reactor components, (2) auxiliary systems, (3) operations, (4) facility design, (5) program considerations, and (6) conclusions and recommendations

  1. Site characterization report for the basalt waste isolation project. Volume II

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-11-01

    The reference location for a repository in basalt for the terminal storage of nuclear wastes on the Hanford Site and the candidate horizons within this reference repository location have been identified and the preliminary characterization work in support of the site screening process has been completed. Fifteen technical questions regarding the qualification of the site were identified to be addressed during the detailed site characterization phase of the US Department of Energy-National Waste Terminal Storage Program site selection process. Resolution of these questions will be provided in the final site characterization progress report, currently planned to be issued in 1987, and in the safety analysis report to be submitted with the License Application. The additional information needed to resolve these questions and the plans for obtaining the information have been identified. This Site Characterization Report documents the results of the site screening process, the preliminary site characterization data, the technical issues that need to be addressed, and the plans for resolving these issues. Volume 2 contains chapters 6 through 12: geochemistry; surface hydrology; climatology, meteorology, and air quality; environmental, land-use, and socioeconomic characteristics; repository design; waste package; and performance assessment.

  2. LIFAC sorbent injection desulfurization demonstration project. Final report, volume II: Project performance and economics

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    This publication discusses the demonstration of the LIFAC sorbent injection technology at Richmond Power and Light`s Whitewater Valley Unit No. 2, performed under the auspices of the U.S. Department of Energy`s (DOE) Clean Coal Technology Program. LIFAC is a sorbent injection technology capable of removing 75 to 85 percent of a power plant`s SO{sub 2} emissions using limestone at calcium to sulfur molar ratios of between 2 and 2.5 to 1. The site of the demonstration is a coal-fired electric utility power plant located in Richmond, Indiana. The project is being conducted by LIFAC North America (LIFAC NA), a joint venture partnership of Tampella Power Corporation and ICF Kaiser Engineers, in cooperation with DOE, RP&L, and Research Institute (EPRI), the State of Indiana, and Black Beauty Coal Company. The purpose of Public Design Report Volume 2: Project Performance and Economics is to consolidate, for public use, the technical efficiency and economy of the LIFAC Process. The report has been prepared pursuant to the Cooperative Agreement No. DE-FC22-90PC90548 between LIFAC NA and the U.S. Department of Energy.

  3. The International Linear Collider Technical Design Report - Volume 3.II: Accelerator Baseline Design

    Energy Technology Data Exchange (ETDEWEB)

    Adolphsen, Chris [SLAC National Accelerator Lab., Menlo Park, CA (United States); et al.

    2013-06-26

    The International Linear Collider Technical Design Report (TDR) describes in four volumes the physics case and the design of a 500 GeV centre-of-mass energy linear electron-positron collider based on superconducting radio-frequency technology using Niobium cavities as the accelerating structures. The accelerator can be extended to 1 TeV and also run as a Higgs factory at around 250 GeV and on the Z0 pole. A comprehensive value estimate of the accelerator is give, together with associated uncertainties. It is shown that no significant technical issues remain to be solved. Once a site is selected and the necessary site-dependent engineering is carried out, construction can begin immediately. The TDR also gives baseline documentation for two high-performance detectors that can share the ILC luminosity by being moved into and out of the beam line in a "push-pull" configuration. These detectors, ILD and SiD, are described in detail. They form the basis for a world-class experimental programme that promises to increase significantly our understanding of the fundamental processes that govern the evolution of the Universe.

  4. The International Linear Collider Technical Design Report - Volume 3.II: Accelerator Baseline Design

    CERN Document Server

    Adolphsen, Chris; Barish, Barry; Buesser, Karsten; Burrows, Philip; Carwardine, John; Clark, Jeffrey; Durand, Helene Mainaud; Dugan, Gerry; Elsen, Eckhard; Enomoto, Atsushi; Foster, Brian; Fukuda, Shigeki; Gai, Wei; Gastal, Martin; Geng, Rongli; Ginsburg, Camille; Guiducci, Susanna; Harrison, Mike; Hayano, Hitoshi; Kershaw, Keith; Kubo, Kiyoshi; Kuchler, Victor; List, Benno; Liu, Wanming; Michizono, Shinichiro; Nantista, Christopher; Osborne, John; Palmer, Mark; Paterson, James McEwan; Peterson, Thomas; Phinney, Nan; Pierini, Paolo; Ross, Marc; Rubin, David; Seryi, Andrei; Sheppard, John; Solyak, Nikolay; Stapnes, Steinar; Tauchi, Toshiaki; Toge, Nobu; Walker, Nicholas; Yamamoto, Akira; Yokoya, Kaoru

    2013-01-01

    The International Linear Collider Technical Design Report (TDR) describes in four volumes the physics case and the design of a 500 GeV centre-of-mass energy linear electron-positron collider based on superconducting radio-frequency technology using Niobium cavities as the accelerating structures. The accelerator can be extended to 1 TeV and also run as a Higgs factory at around 250 GeV and on the Z0 pole. A comprehensive value estimate of the accelerator is give, together with associated uncertainties. It is shown that no significant technical issues remain to be solved. Once a site is selected and the necessary site-dependent engineering is carried out, construction can begin immediately. The TDR also gives baseline documentation for two high-performance detectors that can share the ILC luminosity by being moved into and out of the beam line in a "push-pull" configuration. These detectors, ILD and SiD, are described in detail. They form the basis for a world-class experimental programme that promises to incr...

  5. Soil Properties Database of Spanish Soils Volume II.- Asturias, Cantabria and Pais Vasco

    International Nuclear Information System (INIS)

    Trueba, C; Millan, R.; Schmid, T.; Roquero, C.; Magister, M.

    1998-01-01

    The soil vulnerability determines the sensitivity of the soil after an accidental radioactive contamination due to Cs-137 and Sr-90. The Departamento de Impacto Ambiental de la Energia of CIEMAT is carrying out an assessment of the radiological vulnerability of the different Spanish soils found on the Iberian Peninsula. This requires the knowledge of the soil properties for the various types of existing soils. In order to achieve this aim, a bibliographical compilation of soil profiles has been made to characterize the different soil types and create a database of their properties. Depending on the year of publication and the type of documentary source, the information compiled from the available bibliography is very heterogeneous. Therefore. an important effort has been made to normalize and process the information prior to its incorporation to the database. This volume presents the criteria applied to normalize and process the data as well as the soil properties of the various soil types belonging to the Comunidades Autonomas de Asturias, Cantabria and Pais Vasco. (Author) 34 refs

  6. A Report to Congress on Long-Term Stewardship. Volume II, Site Summaries

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2001-01-01

    During World War II and the Cold War, the Federal government developed and operated a vast network of industrial facilities for the research, production, and testing of nuclear weapons, as well as for other scientific and engineering research. These processes left a legacy of radioactive and chemical waste, environmental contamination, and hazardous facilities and materials at well over a 100 sites in 30 States and one U.S. Territory. Hundreds of thousand of acres of residually contaminated soils, contaminated groundwater, surface water and sediment contamination, and contaminated buildings are present at many sites across the country. These sites range in size from less than one acre, containing only a single facility, to large sites spanning over 100,000 acres with huge uranium enrichment plants and plutonium processing canyons. Since 1989, the U.S. Department of Energy’s (DOE) Environmental Management (EM) program has made significant progress in addressing this environmental legacy. Millions of cubic meters of waste have been removed, stabilized, or disposed of, resulting in significant risk and cost reduction. In addition, DOE began disposing of transuranic (i.e., plutonium-contaminated) waste in the nation’s first deep geologic repository – the Waste Isolation Pilot Plant in New Mexico. DOE is now carrying out its long-term stewardship obligations at dozens of sites, including smaller sites where DOE has completed cleanup work for the entire site and many larger sites where DOE has remediated portions of the site.

  7. Lake Erie Water Level Study. Appendix A. Regulation. Volume II. Coordinated Basic Data and Computer Programs.

    Science.gov (United States)

    1981-07-01

    F- fta fm~p- ri- a V.- On ;a~V~ I’ .C1A 1" ~ P 0%AJfVtN Q I1’t I O a0 4 . 0 * a C C COO a * a ma. 93 *a Ob fu -E tvvP- fl NurvI M I-Al N Ir-N fuII...NU N4 -4ftfNA fmd .-. - -9 0 0 0r IL 0 w wow 00~ 0Nm(U a 0P.-CM@W aO 0 1.4- 41- &0 M Im -4 & - 40 0 P-0 om fc I- 20o w wwef -4 . aaW4 MMM a-MI- n0 4...O zq~ f-’ W 9 A o a i. po j -4 N NfUfJ .-. AD uw s )LA~L; 4DW L NANI f & ftA DNN W LL) mij 3 z I- -9 9 a -j -z~u nV1 0 ~ OPP~~.N fj- , MD0* n’DCL t cc

  8. Safety analysis report for the TRUPACT-II shipping package (condensed version). Volume 2, Rev. 14

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-10-01

    This appendix determines the effective G values for payload shipping categories of contact handled transuranic (CH-TRU) waste materials, based on the radiolytic G values for waste materials that are discussed in detail in Appendix 3.6.8 of the Safety Analysis Report for the TRUPACT-II Shipping Package. The effective G values take into account self-absorption of alpha decay energy inside particulate contamination and the fraction of energy absorbed by nongas-generating materials. As described in Appendix 3.6.8, an effective G value, G{sub eff}, is defined by: G{sub eff} - {Sigma}{sub M} (F{sub M} x G{sub M}) F{sub M}-fraction of energy absorbed by material maximum G value for a material where the sum is over all materials present inside a waste container. The G value itself is determined primarily by the chemical properties of the material and its temperature. The value of F is determined primarily by the size of the particles containing the radionuclides, the distribution of radioactivity on the various materials present inside the waste container, and the stopping distance of alpha particles in air, in the waste materials, or in the waste packaging materials.

  9. Safety analysis report for the TRUPACT-II shipping package (condensed version). Volume 2, Rev. 14

    International Nuclear Information System (INIS)

    1994-10-01

    This appendix determines the effective G values for payload shipping categories of contact handled transuranic (CH-TRU) waste materials, based on the radiolytic G values for waste materials that are discussed in detail in Appendix 3.6.8 of the Safety Analysis Report for the TRUPACT-II Shipping Package. The effective G values take into account self-absorption of alpha decay energy inside particulate contamination and the fraction of energy absorbed by nongas-generating materials. As described in Appendix 3.6.8, an effective G value, G eff , is defined by: G eff - Σ M (F M x G M ) F M -fraction of energy absorbed by material maximum G value for a material where the sum is over all materials present inside a waste container. The G value itself is determined primarily by the chemical properties of the material and its temperature. The value of F is determined primarily by the size of the particles containing the radionuclides, the distribution of radioactivity on the various materials present inside the waste container, and the stopping distance of alpha particles in air, in the waste materials, or in the waste packaging materials

  10. Anaerobic fermentation of agricultural residue: potential for improvement and implementation. Final report, Volume II

    Energy Technology Data Exchange (ETDEWEB)

    Jewell, W. J.; Dell' orto, S.; Fanfoni, K. J.; Hayes, T. D.; Leuschner, A. P.; Sherman, D. F.

    1980-04-01

    Earlier studies have shown that although large quantities of agricultural residues are generated on small farms, it was difficult to economically justify use of conventional anaerobic digestion technology, such as used for sewage sludge digestion. A simple, unmixed, earthen-supported structure appeared to be capable of producing significant quantities of biogas at a cost that would make it competitive with many existing fuels. The goal of this study was to define and demonstrate a methane fermentation technology that could be practical and economically feasible on small farms. This study provides the first long term, large scale (reactor volumes of 34 m/sup 3/) parallel testing of the major theory, design, construction, and operation of a low cost approach to animal manure fermentation as compared to the more costly and complex designs. The main objectives were to define the lower limits for successful fermentor operation in terms of mixing, insulation, temperature, feed rate, and management requirements in a cold climate with both pilot scale and full scale fermentors. Over a period of four years, innovative fermentation processes for animal manures were developed from theoretical concept to successful full scale demonstration. Reactors were sized for 50 to 65 dairy animals, or for the one-family dairy size. The results show that a small farm biogas generation system that should be widely applicable and economically feasible was operated successfully for nearly two years. Although this low cost system out-performed the completely mixed unit throughout the study, perhaps the greatest advantage of this approach is its ease of modification, operation, and maintenance.

  11. Microcomputer based program for predicting heat transfer under reactor accident conditions. Volume II

    International Nuclear Information System (INIS)

    Cheng, S.C.; Groeneveld, D.C.; Leung, L.K.H.; Wong, Y.L.; Nguyen, C.

    1987-07-01

    A microcomputer based program called Heat Transfer Prediction Software (HTPS) has been developed. It calculates the heat transfer for tube and bundle geometries for steady state and transient conditions. This program is capable of providing the best estimated of the hot pin temperatures during slow transients for 37- and 28-element CANDU type fuel bundles. The program is designed for an IBM-PC AT/XT (or IBM-PC compatible computer) equipped with a Math Co-processor. The following input parameters are required: pressure, mass flux, hydraulic diameter, and quality. For the steady state case, the critical heat flux (CHF), the critical heat flux temperature, the minimum film boiling temperature, and the minimum film boiling heat flux are the primary outputs. With either the surface heat flux or wall temperature specified, the program determines the heat transfer regime and calculates the surface heat flux, wall temperature and heat transfer coefficient. For the slow transient case, the pressure, mass flux, quality, and volumetric heat generation rate are the time dependent input parameters are required to calculate the hot pin sheath temperatures and surface heat fluxes. A simple routine for generating properties has been developed for light water to support the above program. It contains correlations that have been verified for pressures ranging from 0.6kPa to 30 MPa, and temperatures up to 1100 degrees Celcius. The thermodynamic and transport properties that can be generated from this routine are: density, specific volume, enthalpy, specific heat capacity, conductivity, viscosity, surface tension and Prandtle number for saturated liquid, saturated vapour, subcooled liquid of superheated vapour. A software for predicting flow regime has also been developed. It determines the flow pattern at specific flow conditions, and provides a correction factor for calculating the CHF during partially stratified horizontal flow. The technical bases for the program and its structure

  12. Status of volcanic hazard studies for the Nevada Nuclear Waste Storage Investigations. Volume II

    International Nuclear Information System (INIS)

    Crowe, B.M.; Wohletz, K.H.; Vaniman, D.T.; Gladney, E.; Bower, N.

    1986-01-01

    Volcanic hazard investigations during FY 1984 focused on five topics: the emplacement mechanism of shallow basalt intrusions, geochemical trends through time for volcanic fields of the Death Valley-Pancake Range volcanic zone, the possibility of bimodal basalt-rhyolite volcanism, the age and process of enrichment for incompatible elements in young basalts of the Nevada Test Site (NTS) region, and the possibility of hydrovolcanic activity. The stress regime of Yucca Mountain may favor formation of shallow basalt intrusions. However, combined field and drill-hole studies suggest shallow basalt intrusions are rare in the geologic record of the southern Great Basin. The geochemical patterns of basaltic volcanism through time in the NTS region provide no evidence for evolution toward a large-volume volcanic field or increases in future rates of volcanism. Existing data are consistent with a declining volcanic system comparable to the late stages of the southern Death Valley volcanic field. The hazards of bimodal volcanism in this area are judged to be low. The source of a 6-Myr pumice discovered in alluvial deposits of Crater Flat has not been found. Geochemical studies show that the enrichment of trace elements in the younger rift basalts must be related to an enrichment of their mantle source rocks. This geochemical enrichment event, which may have been metasomatic alteration, predates the basalts of the silicic episode and is, therefore, not a young event. Studies of crater dimensions of hydrovolcanic landforms indicate that the worst case scenario (exhumation of a repository at Yucca Mountain by hydrovolcanic explosions) is unlikely. Theoretical models of melt-water vapor explosions, particularly the thermal detonation model, suggest hydrovolcanic explosion are possible at Yucca Mountain. 80 refs., 21 figs., 5 tabs

  13. Fuel Quality/Processing Study. Volume II. Appendix, Task I, literature survey

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J B; Bela, A; Jentz, N E; Klumpe, H W; Kessler, R E; Kotzot, H T; Loran, B I

    1981-04-01

    This activity was begun with the assembly of information from Parsons' files and from contacts in the development and commercial fields. A further more extensive literature search was carried out using the Energy Data Base and the American Petroleum Institute Data Base. These are part of the DOE/RECON system. Approximately 6000 references and abstracts were obtained from the EDB search. These were reviewed and the especially pertinent documents, approximately 300, were acquired in the form of paper copy or microfiche. A Fuel Properties form was developed for listing information pertinent to gas turbine liquid fuel properties specifications. Fuel properties data for liquid fuels from selected synfuel processes, deemed to be successful candidates for near future commercial plants were tabulated on the forms. The processes selected consisted of H-Coal, SRC-II and Exxon Donor Solvent (EDS) coal liquefaction processes plus Paraho and Tosco shale oil processes. Fuel properties analyses for crude and distillate syncrude process products are contained in Section 2. Analyses representing synthetic fuels given refinery treatments, mostly bench scale hydrotreating, are contained in Section 3. Section 4 discusses gas turbine fuel specifications based on petroleum source fuels as developed by the major gas turbine manufacturers. Section 5 presents the on-site gas turbine fuel treatments applicable to petroleum base fuels impurities content in order to prevent adverse contaminant effects. Section 7 relates the environmental aspects of gas turbine fuel usage and combustion performance. It appears that the near future stationary industrial gas turbine fuel market will require that some of the synthetic fuels be refined to the point that they resemble petroleum based fuels.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Market Competition and Density in Liver Transplantation: Relationship to Volume and Outcomes.

    Science.gov (United States)

    Adler, Joel T; Yeh, Heidi; Markmann, James F; Nguyen, Louis L

    2015-08-01

    Liver transplantation centers are unevenly distributed within the Donor Service Areas (DSAs) of the United States. This study assessed how market competition and liver transplantation center density are associated with liver transplantation volume within individual DSAs. We conducted a retrospective cohort study of 53,156 adult liver transplants in 45 DSAs with 110 transplantation centers identified from the Scientific Registry of Transplant Recipients between 2003 and 2012. The following measures were derived annually for each DSA: market competition using the Herfindahl Hirschman Index, transplantation center density by the Average Nearest Neighbor method, liver quality by the Liver Donor Risk Index, and patient risk by the Model for End-Stage Liver Disease. A hierarchical mixed effects negative binomial regression model of the relationship between liver transplants and market factors was created annually. Patient and graft survival were investigated with a Cox proportional hazards model. Transplantation center density was associated with market competition (p market competition (IRR = 1.36; p = 0.02), increased listings (IRR = 1.14; p market variables were associated with increased mortality after transplantation. After controlling for demographic and market factors, a greater concentration of centers was associated with more liver transplants without impacting overall survival. These results warrant additional investigation into the relationship between geospatial factors and liver transplantation volume with consideration for the optimization of scarce resources. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Neurologic Outcomes After Low-Volume, Ultrasound-Guided Interscalene Block and Ambulatory Shoulder Surgery.

    Science.gov (United States)

    Rajpal, Gaurav; Winger, Daniel G; Cortazzo, Megan; Kentor, Michael L; Orebaugh, Steven L

    2016-01-01

    Postoperative neurologic symptoms after interscalene block and shoulder surgery have been reported to be relatively frequent. Reports of such symptoms after ultrasound-guided block have been variable. We evaluated 300 patients for neurologic symptoms after low-volume, ultrasound-guided interscalene block and arthroscopic shoulder surgery. Patients underwent ultrasound-guided interscalene block with 16 to 20 mL of 0.5% bupivacaine or a mix of 0.2% bupivacaine/1.2% mepivacaine solution, followed by propofol/ketamine sedation for ambulatory arthroscopic shoulder surgery. Patients were called at 10 days for evaluation of neurologic symptoms, and those with persistent symptoms were called again at 30 days, at which point neurologic evaluation was initiated. Details of patient demographics and block characteristics were collected to assess any association with persistent neurologic symptoms. Six of 300 patients reported symptoms at 10 days (2%), with one of these patients having persistent symptoms at 30 days (0.3%). This was significantly lower than rates of neurologic symptoms reported in preultrasound investigations with focused neurologic follow-up and similar to other studies performed in the ultrasound era. There was a modest correlation between the number of needle redirections during the block procedure and the presence of postoperative neurologic symptoms. Ultrasound guidance of interscalene block with 16- to 20-mL volumes of local anesthetic solution results in a lower frequency of postoperative neurologic symptoms at 10 and 30 days as compared with investigations in the preultrasound period.

  17. 1999 Annual Mixed Waste Management Facility Groundwater Correction - Action Report (Volumes I, II, and III)

    International Nuclear Information System (INIS)

    Chase, J.

    2000-01-01

    This Corrective Action Report (CAR) for the Mixed Waste Management Facility (MWMF) is being prepared to comply with the Resource Conservation and Recovery Act (RCRA) Permit Number SC1 890 008 989, dated October 31, 1999. This CAR compiles and presents all groundwater sampling and monitoring activities that are conducted at the MWMF. As set forth in previous agreements with South Carolina Department of Health and Environmental Control (SCDHEC), all groundwater associated with the Burial Ground Complex (BGC) (comprised of the MWMF, Low-Level Radioactive Waste Disposal Facility, and Old Radioactive Waste Burial Ground) will be addressed under this RCRA Permit. This CAR is the first to be written for the MWMF and presents monitoring activities and results as an outcome of Interim Status and limited Permitted Status activities. All 1999 groundwater monitoring activities were conducted while the MWMF was operated during Interim Status. Changes to the groundwater monitoring program were made upon receipt of the RCRA Permit, where feasible. During 1999, 152 single-screened and six multi-screened groundwater monitoring wells at the BGC monitored groundwater quality in the uppermost aquifer as required by the South Carolina Hazardous Waste Management Regulations (SCHWMR), settlement agreements 87-52-SW and 91-51-SW, and RCRA Permit SC1 890 008 989. However, overall compliance with the recently issued RCRA Permit could not be implemented until the year 2000 due to the effective date of the RCRA Permit and scheduling of groundwater monitoring activities. Changes have been made to the groundwater monitoring network to meet Permit requirements for all 2000 sampling events

  18. 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

  19. 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...

  20. 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

  1. 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…

  2. Antimicrobial Exposure Assessment Task Force II (AEATF II) Volume 5: Governing Document for a Multi-Year Antimicrobial Chemical Exposure Monitoring Program (interim draft document with changes)

    Science.gov (United States)

    This document describes the overall scope of the AEATF II program, demonstrates the need for additional human exposure monitoring data and explains the proposed methodology for the exposure monitoring studies proposed for conduct by the AEATF II.

  3. Antimicrobial Exposure Assessment Task Force II (AEATF II) Volume 5: Governing Document for a Multi-Year Antimicrobial Chemical Exposure Monitoring Program (interim draft document)

    Science.gov (United States)

    Describes the overall scope of the AEATF II program, demonstrates the need for additional human exposure monitoring data and explains the proposed methodology for the exposure monitoring studies proposed for conduct by the AEATF II.

  4. Good Policy, Good Practice II. Improving Outcomes and Productivity in Higher Education: A Guide for Policymakers

    Science.gov (United States)

    Brenneman, Meghan Wilson; Callan, Patrick M.; Ewell, Peter T.; Finney, Joni E.; Jones, Dennis P.; Zis, Stacey

    2010-01-01

    This new edition of "Good Policy, Good Practice II" revises and updates the authors' 2007 publication. Like the earlier edition, it responds to one of the questions that is raised most frequently in the authors' work with public policy and education leaders as they begin to address the national and state imperatives to increase the proportion of…

  5. 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.

  6. [Outcomes, controversies and gastric volume after laparoscopic sleeve gastrectomy in the treatment of obesity].

    Science.gov (United States)

    García-Díaz, Juan José; Ferrer-Márquez, Manuel; Moreno-Serrano, Almudena; Barreto-Rios, Rogelio; Alarcón-Rodríguez, Raquel; Ferrer-Ayza, Manuel

    2016-01-01

    Laparoscopic sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity. However, there are still controversies regarding its efficiency in terms of weight reduction and incidence of complications. In this prospective study, the experience is presented of a referral centre for the treatment of morbid obesity with laparoscopic sleeve gastrectomy. A prospective study on 73 patients subjected to laparoscopic sleeve gastrectomy from February 2009 to September 2013. Patients were followed-up for a period of 12 months, evaluating the development of complications, reduction of gastric volume, and the weight loss associated with the surgery, as well as their impact on the improvement of comorbidities present at beginning of the study. There was a statistically a significantly reduction between the preoperative body mass index (BMI) and the BMI at 12 months after laparoscopic sleeve gastrectomy (p < 0.001), despite there being an increase in the gastric volume during follow-up, measured at one month and 12 months after surgery (p < 0.001). Five patients (6.85%) had complications, with none of them serious and with no deaths in the whole series. Laparoscopic sleeve gastrectomy is a safe and effective technique for the treatment of morbid obesity. Its use is associated with a significant reduction in the presence of comorbidities associated with obesity. Multicentre studies with a longer period of monitoring are required to confirm the efficacy and safety of this surgical technique. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  7. 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)

  8. 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.

  9. Proton therapy of iris melanoma with 50 CGE. Influence of target volume on clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Riechardt, Aline I.; Joussen, Antonia M. [Charite University of Medicine, Department of Ophthalmology, Berlin (Germany); Karle, Bettina [Helios Klinikum Emil-von-Behring, Department of Radiation Oncology, Berlin (Germany); Cordini, Dino; Heufelder, Jens [Charite University of Medicine, Department of Ophthalmology, Berlin (Germany); Helmholtz-Zentrum Berlin, Lise-Meitner-Campus, Berlin-Protonen, Berlin (Germany); Budach, Volker [Charite University of Medicine, Department of Radiation Oncology, Berlin (Germany); Gollrad, Johannes [Helmholtz-Zentrum Berlin, Lise-Meitner-Campus, Berlin-Protonen, Berlin (Germany); Charite University of Medicine, Department of Radiation Oncology, Berlin (Germany)

    2017-11-15

    The aim of this study was to evaluate local tumour control, incidence of radiation-induced glaucoma and associated interventions of sector-based and whole anterior segment proton beam therapy (PBT) for the treatment of iris melanoma. We retrospectively analysed the data of 77 patients with iris melanoma who underwent PBT applied as 50 CGE in four daily fractions. Of the patients, 47 received PBT with a circular-shaped collimator and 30 with a conformal sector-shaped target volume. Local control, eye preservation and secondary glaucoma were evaluated. Median follow-up time was 54.9 months. Local tumour control was 100% in patients receiving whole anterior segment irradiation. Two patients developed pigment dispersion in the non-irradiated area after sector-based PBT and received whole anterior segment salvage PBT. The mean volume of ciliary body irradiated was 89.0% and 34.9% for whole anterior segment and lesion-based irradiation, respectively. At the end of follow-up, secondary glaucoma was found in 74.3% of the patients with whole anterior segment irradiation and in 19.2% with sector-based irradiation. Patients with sector-based PBT had a stable visual acuity of logMAR 0.1, while it declined from logMAR 0.1 to 0.4 after whole anterior segment irradiation. We found a significant reduction in radiation-induced secondary glaucoma and glaucoma-associated surgical interventions and stable visual acuity after sector-based irradiation compared with whole anterior segment irradiation. Sector-based irradiation revealed a higher risk for local recurrence, but selected patients with well-circumscribed iris melanoma benefit from applying a lesion-based target volume when treated with sector-based PBT. (orig.) [German] Ziel der Arbeit war es, nach Irismelanomtherapie durch sektorielle oder Ganzfeldbestrahlung mittels Protonentherapie mit 50 CGE (Cobalt-Gray-Aequivalent) Tumorkontrolle, Inzidenz des strahleninduzierten Glaukoms und damit assoziierte Interventionen auszuwerten

  10. 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.

  11. 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

  12. Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation

    Directory of Open Access Journals (Sweden)

    Deborah Bambini

    2016-10-01

    Full Text Available There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.

  13. Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation.

    Science.gov (United States)

    Bambini, Deborah; Emery, Matthew; de Voest, Margaret; Meny, Lisa; Shoemaker, Michael J

    2016-10-25

    There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students' perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.

  14. Outcome of strategy training in stroke patients with apraxia: a phase II study.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Dijk, A.J. van; Stehmann-Saris, J.C.; Kinebanian, A.

    1998-01-01

    Objective: Evaluation of a therapy programme for srorke patients with apraxia. The programme is based on teaching patients strategies to compensate for the presence of apraxia. This programme was designed for assessment and treatment by occupational therapists. Design: The outcome was studied in de

  15. 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.

  16. 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.)

  17. 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.

  18. 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.

  19. 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.

  20. Outcomes and hospital admissions during long-term support with a HeartMate II

    DEFF Research Database (Denmark)

    Rossing, Kasper; Jung, Mette Holme; Sander, Kaare

    2015-01-01

    OBJECTIVES: Continuous-flow left ventricular assist devices like the HeartMate II (HMII) improves survival in severe heart failure but little is known about the incidence and causes of hospitalizations during long-term support which was evaluated in this study. DESIGN: Observational follow-up study...... comprising all patients who received a HMII at our institution either as bridge-to-transplantation (BTT) or destination therapy (DT). All patients were followed from HMII implantation to transplantation, device explantation, death, or May 2015. RESULTS: The HMII was implanted in 66(44 BTT, 22 DT) patients...

  1. Influence of Residual Tumor Volume and Radiation Dose Coverage in Outcomes for Clival Chordoma

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Mark W., E-mail: markmcdonaldmd@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Linton, Okechukwu R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Moore, Michael G.; Ting, Jonathan Y. [Department of Otolaryngology, Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana (United States); Cohen-Gadol, Aaron A.; Shah, Mitesh V. [Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana (United States); Goodman Campbell Brain and Spine, Indianapolis, Indiana (United States)

    2016-05-01

    Purpose: The purpose of this study was to evaluate factors associated with tumor control in clival chordomas. Methods and Materials: A retrospective review of 39 patients treated with surgery and proton therapy for clival chordomas between 2004 and 2014 was performed. The median prescribed dose was 77.4 Gy (relative biological effectiveness [RBE]); range was 70.2-79.2 Gy (RBE). Minimum and median doses to gross tumor volume (GTV), radiation dose received by 1 cm{sup 3} of GTV (D1cm{sup 3}), and the equivalent uniform dose were calculated. Receiver operating characteristics curves evaluated the predictive sensitivity and specificity for local failure of potential cutpoint values for GTV and D1cm{sup 3}. Results: After a median follow-up of 51 months, the 5-year estimate of local control (LC) was 69.6% (95% confidence interval [CI] 50.0%-89.2%), and overall survival (OS) was 81.4% (95% CI: 65.3%-97.5%). Tumor histology, GTV at the time of radiation, and prescribed radiation dose were significantly associated with local control on multivariate analysis, whereas D1cm{sup 3} was associated with overall survival. Compared to those patients whose conditions remained controlled, patients experiencing tumor failure had statistically significant larger GTVs and lower D1cm{sup 3}, and prescribed and median doses to GTV. A subset of 21 patients with GTV of ≤20 cm{sup 3} and D1cm{sup 3} of >67 Gy (RBE) had a median follow-up of 47 months. The 5-year estimate of local control in this subset was 81.1% (95% CI: 61.7%-100%; P=.004, overall comparison by GTV ≤20 cm{sup 3} stratified by D1cm{sup 3}). A D1cm{sup 3} of 74.5 Gy (RBE) had 80% sensitivity for local control and 60% specificity, whereas a GTV of 9.3 cm{sup 3} had 80% sensitivity for local control and 66.7% specificity. Conclusions: Local control of clival chordomas was associated with both smaller size of residual tumor and more complete high-dose coverage of residual tumor. Multidisciplinary care should seek

  2. 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.

  3. Outcome of strategy training in stroke patients with apraxia: a phase II study.

    OpenAIRE

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Dijk, A.J. van; Stehmann-Saris, J.C.; Kinebanian, A.

    1998-01-01

    Objective: Evaluation of a therapy programme for srorke patients with apraxia. The programme is based on teaching patients strategies to compensate for the presence of apraxia. This programme was designed for assessment and treatment by occupational therapists. Design: The outcome was studied in de pre-post design. Measurements were conducted at baseline and 12 weeks later. Subjects: Thirty-three stroke patients with apraxia were treated at occupational therapy departments in general hospital...

  4. Impact of Hearing Aid Technology on Outcomes in Daily Life II: Speech Understanding and Listening Effort.

    Science.gov (United States)

    Johnson, Jani A; Xu, Jingjing; Cox, Robyn M

    2016-01-01

    Modern hearing aid (HA) devices include a collection of acoustic signal-processing features designed to improve listening outcomes in a variety of daily auditory environments. Manufacturers market these features at successive levels of technological sophistication. The features included in costlier premium hearing devices are designed to result in further improvements to daily listening outcomes compared with the features included in basic hearing devices. However, independent research has not substantiated such improvements. This research was designed to explore differences in speech-understanding and listening-effort outcomes for older adults using premium-feature and basic-feature HAs in their daily lives. For this participant-blinded, repeated, crossover trial 45 older adults (mean age 70.3 years) with mild-to-moderate sensorineural hearing loss wore each of four pairs of bilaterally fitted HAs for 1 month. HAs were premium- and basic-feature devices from two major brands. After each 1-month trial, participants' speech-understanding and listening-effort outcomes were evaluated in the laboratory and in daily life. Three types of speech-understanding and listening-effort data were collected: measures of laboratory performance, responses to standardized self-report questionnaires, and participant diary entries about daily communication. The only statistically significant superiority for the premium-feature HAs occurred for listening effort in the loud laboratory condition and was demonstrated for only one of the tested brands. The predominant complaint of older adults with mild-to-moderate hearing impairment is difficulty understanding speech in various settings. The combined results of all the outcome measures used in this research suggest that, when fitted using scientifically based practices, both premium- and basic-feature HAs are capable of providing considerable, but essentially equivalent, improvements to speech understanding and listening effort in daily

  5. Volume II: Compendium Abstracts

    Science.gov (United States)

    2008-08-01

    breaking down of fuel into finer droplets, this design aims to increase the efficiency for liquid hydrocarbons and enable the use of JP-8 diesel in...varying the equivalent weight of the oligomeric diamine component, obeys universal response as the test temperature (T) is held constant in relation to...methyl methacrylate) (PMMA) and poly(styrene) (PS), and poly(ethylene glycol) methyl ether methacrylate (POEM) and PS. These copolymers may support ionic

  6. 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

  7. 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....

  8. Standardized assessment to enhance the diagnostic value of prostate volume; Part II: Correlation with prostate-specific antigen levels

    NARCIS (Netherlands)

    Aarnink, R. G.; de la Rosette, J. J.; Huynen, A. L.; Giesen, R. J.; Debruyne, F. M.; Wijkstra, H.

    1996-01-01

    Standardized estimations of prostate volumes are used for interpretation of prostate specific antigen (PSA) levels. In 243 patients with clinically benign diagnosis, automated and reference prostate volumes and transition zone volumes are correlated to PSA levels. Besides, growth curves of PSA level

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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

  1. Outcome of Angiotensin II Inhibition in Pregnant Irradiated Rats and their Embryos

    International Nuclear Information System (INIS)

    Ramadan, F. L.; Ashry, Kh. M.

    2010-01-01

    The study aims to evaluate the synergism of losartan and or irradiation stress on the female rat mothers and their developing embryos as judged by the maternal biochemical pathways during gestation and teratogenic effects on the embryos. Losartan is an angiotensin II AT1-receptor antagonist used to regulate blood pressure. Losartan (5 mg/kg b.wt day) was daily orally administrated to pregnant rats from the 6 th to 18 th gestational days during which they were subjected to intermittent radiation dose levels of 0.5 Gy/4 times at the 9 th, 10 th, 11 th and 12 th days of gestation whereas investigation has been carried out one day prior to parturition. Dual treatment of losartan and radiation resulted in increased maternal serum levels of creatinine and bilirubin.The developing embryos in the uteri due to their high sensitivity showed various teratological, skeletal and histological impairment. Losartan and/or radiation induced effects were detected as growth retardation, malformations expressed as anopthalmia, kypophysis, subcutaneous haemorrhage and microtia as well as elevated intrauterium death and embryonic resorption. Moreover, the examination of endo skeletal system of fetuses showed retardation in the ossification of the skull bones and lack of ossification at the vertebrae and edges. Also, maternal and embryonic histological examination revealed that losartan and gamma radiation induced injury to kidney tissue manifested in rupture and shrinkage of renal corpuscle, infiltration, disappearance of glomularies, while the kidney of fetuses showed loss of renal pattern. Results point out that losartan should be used with caution in women at the reproductive age and those occupationally exposed to irradiation

  2. 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.

  3. 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.

  4. Multiple cluster axis II comorbidity and functional outcome in severe patients with borderline personality disorder.

    Science.gov (United States)

    Palomares, Nerea; McMaster, Antonia; Díaz-Marsá, Marina; de la Vega, Irene; Montes, Ana; Carrasco, José Luis

    2016-11-01

    Current literature suggests that personality disorder comorbidity negatively contributes to both the severity and prognosis of other disorders; however, little literature has been devoted to its influence on borderline personality disorder (BPD). The objective of the present work is to study comorbidity with other personality disorders in a severe clinical sample of patients with BPD, and its relationship with global functionality. A sample of 65 patients with severe borderline personality disorder was included in the study. Clinical and functionality measures were applied in order to study comorbidity of BPD with other disorders and its relationship with functionality. Associations with other comorbid PDs were analyzed with t-tests and linear correlations. Most patients (87%) presented comorbidity with other PDs. Almost half of the sample (42%) presented more than two PDs, and cluster A (paranoid) and C (obsessive and avoidant) PD were more frequent than cluster B (histrionic and antisocial). Only the presence of avoidant PD predicted a worse functional outcome in the long term (U Mann Withney ppersonality disorder might negatively predict for prognosis.

  5. Outcome of strategy training in stroke patients with apraxia: a phase II study.

    Science.gov (United States)

    van Heugten, C M; Dekker, J; Deelman, B G; van Dijk, A J; Stehmann-Saris, J C; Kinebanian, A

    1998-08-01

    Evaluation of a therapy programme for stroke patients with apraxia. The programme is based on teaching patients strategies to compensate for the presence of apraxia. This programme was designed for assessment and treatment by occupational therapists. The outcome was studied in a pre-post test design. Measurements were conducted at baseline and 12 weeks later. Thirty-three stroke patients with apraxia were treated at occupational therapy departments n general hospitals, rehabilitation centres and nursing homes. The following measurements were conducted: an apraxia test, a motor functioning test, observation of activities of daily living (ADL), Barthel Index, and an ADL questionnaire for the therapist and the patient. The patients showed large improvements in ADL functioning on all measures and small improvements on the apraxia test and the motor functioning test. The effect sizes for the disabilities, ranging from 0.92 to 1.06, were large compared to the effect sizes for apraxia (0.34) and motor functioning (0.19). The significant effect of treatment is also seen when individual improvement and subjective improvement are considered. Measured with the Barthel Index for instance, 71% of the patients improved. These results suggest that the programme seems to be successful in teaching patients compensatory strategies that enable them to function more independently, despite the lasting presence of apraxia.

  6. Standards for Clinical Trials in Male and Female Sexual Dysfunction: II. Patient-Reported Outcome Measures.

    Science.gov (United States)

    Fisher, William A; Gruenwald, Ilan; Jannini, Emmanuele A; Lev-Sagie, Ahinoam; Lowenstein, Lior; Pyke, Robert E; Reisman, Yakov; Revicki, Dennis A; Rubio-Aurioles, Eusebio

    2016-12-01

    The second article in this series, Standards for Clinical Trials in Male and Female Sexual Dysfunction, focuses on measurement of patient-reported outcomes (PROs). Together with the design of appropriate phase I to phase IV clinical trials, the development, validation, choice, and implementation of valid PRO measurements-the focus of the present article-form the foundation of research on treatments for male and female sexual dysfunctions. PRO measurements are assessments of any aspect of a patient's health status that come directly from the patient (ie, without the interpretation of the patient's responses by a physician or anyone else). PROs are essential for assessing male and female sexual dysfunction and treatment response, including symptom frequency and severity, personal distress, satisfaction, and other measurements of sexual and general health-related quality of life. Although there are some relatively objective measurements of sexual dysfunction (ie, intravaginal ejaculatory latency time, frequency of sexual activity, etc), these measurements do not comprehensively assess the occurrence and extent of sexual dysfunction or treatment on the patient's symptoms, functioning, and well-being. Data generated by a PRO instrument can provide evidence of a treatment benefit from the patient's perspective. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  7. Different concentrations and volumes of p-phenylenediamine in pet. (equivalent doses) are associated with similar patch test outcomes

    DEFF Research Database (Denmark)

    Andersen, Flemming; Hamann, Carsten R; Andersen, Klaus E

    2018-01-01

    BACKGROUND: Concern about causing active sensitization when patch testing is performed with p-phenylenediamine (PPD) 1% pet. has led to a recommendation to use PPD 0.3% pet. as a potentially safer preparation. However, the dose per area of allergen delivered, and hence the risk of active...... sensitization, depend on the amount dispensed into the patch test chamber, which can vary widely. OBJECTIVE: To evaluate whether patch testing with equivalent doses of different concentrations of PPD in pet. is associated with similar outcomes. METHODS: Seventeen known PPD-sensitive subjects were patch tested...... with different volumes and concentrations of PPD in pet. that deliver the same allergen dose per unit area (6 mg of PPD 1% pet. and 20 mg of PPD 0.3% pet. in Finn Chambers®, both equivalent to ∼ 0.09 mg/cm2 ). RESULTS: Eleven patients (65%) had positive reactions to both doses; 4 patients (24%) had negative...

  8. 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.

  9. Measuring treatment response to systemic therapy and predicting outcome in biliary tract cancer: comparing tumor size, volume, density, and metabolism.

    Science.gov (United States)

    Sahani, Dushyant V; Hayano, Koichi; Galluzzo, Anna; Zhu, Andrew X

    2015-04-01

    The purpose of this study was to evaluate the response of biliary tract cancer treated with multidrug chemotherapy using FDG PET in comparison with morphologic and density changes. In this phase II clinical trial, 28 patients with unresectable or metastatic biliary tract cancers treated with gemcitabine and oxaliplatin combined with bevacizumab (GEMOX-B) underwent FDG PET and contrast-enhanced CT at baseline and after the second cycle of the therapy (8 weeks). A single reviewer recorded tumor maximum standardized uptake value (SUVmax) along with size, volume (3D-sphere), and density. The percentage changes of the parameters were compared with progression-free survival at 7 months. Overall survival was compared with the percentage change of SUVmax. After 8 weeks, measurable reductions (±SD) in size (7.05±4.19 to 5.52±3.28 cm, -21.70%), volume (411.38±540.08 to 212.41±293.45 cm3, -48.36%), and density (60.76±20.65 to 50.68±16.89 HU, -15.59%) were noted along with a substantial drop in SUVmax (5.95±1.95 to 3.36±1.28, -43.52%). The SUVmax change showed positive correlations with tumor size change (R2=0.39, p=0.0004) and volumetric change (R2=0.34, p=0.001). Patients who showed a larger drop in SUVmax at 8 weeks correlated with favorable progression-free survival (p=0.02). ROC analysis showed that a 45% reduction in SUVmax was the best cutoff value to detect favorable progression-free survival patients. When we used this cutoff value, Kaplan-Meier analysis showed that patients with tumors showing greater reduction in SUVmax had favorable progression-free survival and overall survival (p=0.0009, p=0.03). In biliary tract cancers treated with GEMOX-B, the reduction of SUVmax after therapy is a better predictor for survival than morphologic and density changes.

  10. FIASCO II failure to achieve a satisfactory cardiac outcome study: the elimination of system errors.

    Science.gov (United States)

    Farid, Shakil; Page, Aravinda; Jenkins, David; Jones, Mark T; Freed, Darren; Nashef, Samer A M

    2013-07-01

    Death in low-risk cardiac surgical patients provides a simple and accessible method by which modifiable causes of death can be identified. In the first FIASCO study published in 2009, local potentially modifiable causes of preventable death in low-risk patients with a logistic EuroSCORE of 0-2 undergoing cardiac surgery were inadequate myocardial protection and lack of clarity in the chain of responsibility. As a result, myocardial protection was improved, and a formalized system introduced to ensure clarity of the chain of responsibility in the care of all cardiac surgical patients. The purpose of the current study was to re-audit outcomes in low-risk patients to see if improvements have been achieved. Patients with a logistic EuroSCORE of 0-2 who had cardiac surgery from January 2006 to August 2012 were included. Data were prospectively collected and retrospectively analysed. The case notes of patients who died in hospital were subject to internal and external review and classified according to preventability. Two thousand five hundred and forty-nine patients with a logistic EuroSCORE of 0-2 underwent cardiac surgery during the study period. Seven deaths occurred in truly low-risk patients, giving a mortality of 0.27%. Of the seven, three were considered preventable and four non-preventable. Mortality was marginally lower than in our previous study (0.37%), and no death occurred as a result of inadequate myocardial protection or communication failures. We postulate that the regular study of such events in all institutions may unmask systemic errors that can be remedied to prevent or reduce future occurrences. We encourage all units to use this methodology to detect any similarly modifiable factors in their practice.

  11. 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.

  12. Inventory of Federal energy-related environment and safety research for FY 1977. Volume II. Project listings

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-01

    This volume contains Biomedical and Environmental Research, Environmental Control Technology Research, and Operational and Environmental Safety Research project listings. The projects are ordered numerically by log number.

  13. Teaching Standard English as a Second Dialect to Primary School Children in Hilo, Hawaii. Volume I of II Volumes. Final Report.

    Science.gov (United States)

    Peterson, Robert O. H.

    This document describes a four-year program designed to develop and test a method for teaching standard English to nonstandard dialect speakers in the first four grades of elementary school in Hilo, Hawaii. Chapters in this first volume are (1) Introduction, (2) Project Site and Evaluation Strategy, (3) Instrumentation, (4) Development of Lesson…

  14. Association Between Provider Volume and Comorbidity on Hospital Utilization and Outcomes of Total Hip Arthroplasty Among National Health Insurance Enrollees

    Directory of Open Access Journals (Sweden)

    Chung-Shih Huang

    2011-06-01

    Conclusions: This study revealed that the volume of THAs performed by individual surgeons was a more important determinant of hospital utilization than hospital volume. Perioperative adverse events were associated with patients' age and comorbidity.

  15. Introduction to Psychology and Leadership. Part Nine; Morale and Esprit De Corps. Segments I & II, Volume IX-B.

    Science.gov (United States)

    Westinghouse Learning Corp., Annapolis, MD.

    The ninth volume of the introduction to psychology and leadership course (see the final reports which summarize the development project, EM 010 418, EM 010 419, and EM 010 484) concentrates on morale and esprit de corps and is presented in two documents. Like Volume One (EM 010 420), this document is a self-instructional syndactic text with…

  16. 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

  17. Late outcomes of subcostal exchange of the HeartMate II left ventricular assist device: a word of caution.

    Science.gov (United States)

    Yu, Sarah N; Takayama, Hiroo; Han, Jiho; Garan, Arthur R; Kurlansky, Paul; Yuzefpolskaya, Melana; Colombo, Paolo C; Naka, Yoshifumi; Takeda, Koji

    2018-04-10

    Previous studies have shown the usefulness of the subcostal exchange of the HeartMate II left ventricular assist device for device malfunction. However, long-term data are still limited. Between March 2004 and July 2017, 41 of 568 (7.2%) patients who had received a HeartMate II implant at our institution had a device exchange via a subcostal incision. We summarized early and late outcomes. Forty-one patients had a total of 48 subcostal pump exchanges. Indications for device exchange included device thrombosis (n = 31, 76%), driveline infection (n = 2, 5%) and driveline injury (n = 8, 19%). All of the procedures were successful, and there were no in-hospital deaths. A Kaplan-Meier survival curve showed 30-day and 1-year survival rates after subcostal exchange of 100% and 94.6%, respectively. However, 10 (25%) patients had left ventricular assist device-related infections following subcostal exchange that included 7 pump pocket infections and 3 driveline infections. Freedom from left ventricular assist device-related infection at 1 year after subcostal exchange was 79.3%. Thirteen (32%) patients had device malfunction due to pump thrombosis that required a 2nd device exchange. Seven patients had recurrent thrombosis. Three (7%) patients had a stroke. Freedom from device thrombosis and from a stroke event at 1 year was 74.4%. Subcostal pump exchange can be safely performed. However, there is a substantial risk of infection and recurrent thrombosis. Careful follow-up for late complications is mandatory.

  18. Surgical resection of locally advanced primary transverse colon cancer--not a worse outcome in stage II tumor.

    Science.gov (United States)

    Hung, Hsin-Yuan; Yeh, Chien-Yuh; Changchien, Chung-Rong; Chen, Jinn-Shiun; Fan, Chung-Wei; Tang, Reiping; Hsieh, Pao-Shiu; Tasi, Wen-Sy; You, Yau-Tong; You, Jeng-Fu; Wang, Jeng-Yi; Chiang, Jy-Ming

    2011-07-01

    In locally advanced primary transverse colon cancer, a tumor may cause perforation or invade adjacent organs. Extensive resection is the best choice of treatment, but such procedures must be weighed against the potential survival benefits. This study was performed to identify the clinicopathological features and treatment outcomes of such tumors. We retrospectively reviewed the database of the Colorectal Cancer Registry of Chang Gung Memorial Hospital between February 1995 and December 2005. Patients with colon cancer sited between the hepatic and splenic flexure that involved an adjacent organ without distant metastasis were defined as having locally advanced transverse colon cancer. A total of 827 patients who underwent surgery for transverse primary colon cancer were enrolled in the study. Stage II and stage III colon cancer were diagnosed in 548 patients. Thirty-two (5.8%) patients were diagnosed with locally advanced tumors. Multivariate analysis revealed that stage III, preoperative carcinoembryonic antigen ≥5 ng/mL, a tumor with perforation or obstruction, and the presence of a locally advanced tumor were significant prognostic factors for both overall and cancer-specific survival. Postoperative morbidity rates differed significantly between the locally advanced and non-locally advanced tumor groups (22.7% vs. 12.3%, P transverse colon tumors (P = 0.21). Surgical resection of locally advanced transverse colon tumors resulted in a higher morbidity and mortality than that of non-locally advanced tumors, but the benefit of extensive surgery in the case of locally advanced tumors cannot be underestimated. Furthermore, this benefit is more pronounced in the case of stage II tumors.

  19. 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

  20. 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.)

  1. 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.)

  2. Thermodynamic study of (heptane + amine) mixtures. II. Excess and partial molar volumes at 298.15 K

    International Nuclear Information System (INIS)

    Lepori, Luciano; Gianni, Paolo; Spanedda, Andrea; Matteoli, Enrico

    2011-01-01

    Research highlights: → Excess and partial molar volumes of primary (amines + heptane) mixtures. → Excess volumes are positive for small size amines and decrease as the size increases. → Group contributions to predict the partial molar volumes of amines in heptane. → The void volume is larger for branched than for linear amines in heptane. - Abstract: Excess molar volumes V E at 298.15 K were determined by means of a vibrating tube densimeter for binary mixtures of heptane + primary n-alkyl (C 3 to C 10 ) and branched amines (iso-propyl-, iso-, sec-, and tert-butyl-, iso-, tert-pentyl-, and pentan-3-amine) in the whole composition range. The apparent molar volumes of solid dodecyl- and tetradecylamine in heptane dilute solution were also determined. The V E values were found positive for mixtures involving C 3 to C 8 linear amines, with V E decreasing with chain lengthening. Heptane + nonyl and decylamine showed s-shaped, markedly asymmetric, curves. Mixtures with branched C 3 to C 5 amines displayed positive V E 's larger than those observed in the mixtures of the corresponding linear isomers. Partial molar volumes V o at infinite dilution in heptane were evaluated for the examined amines and compared with those of alkanes and alkanols taken from the literature. An additivity scheme, based on the intrinsic volume approach, was applied to estimate group (CH 3 , CH 2 , CH, C, NH 2 , and OH) contributions to V o . The effect of branching on V o and the limiting slope of the apparent excess molar volumes were evaluated and discussed in terms of solute-solvent and solute-solute interactions.

  3. 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

  4. Preliminary thermal and thermomechanical modeling for the near surface test facility heater experiments at Hanford. Volume II: Appendix D

    International Nuclear Information System (INIS)

    Chan, T.; Remer, J.S.

    1978-12-01

    Appendix D is a complete set of figures illustrating the detailed calculations necessary for designing the heater experiments at the Near Surface Test Facility (NSTF) at Hanford, Washington. The discussion of the thermal and thermomechanical modeling that yielded these calculations is presented in Volume 1. A summary of the figures and the models they illustrate is given in table D1. The most important figures have also been included in the discussion in Volume 1, and Table D2 lists the figure numbers in this volume that correspond to figure numbers used there

  5. Development of a wireless MEMS multifunction sensor system and field demonstration of embedded sensors for monitoring concrete pavements, volume II

    Science.gov (United States)

    2016-08-01

    This two-pronged study evaluated the performance of commercial off-the-shelf (COTS) micro-electromechanical sensors and systems (MEMS) embedded in concrete pavement (Final Report Volume I) and developed a wireless MEMS multifunctional sensor system f...

  6. Immobilization of defense high-level waste: an assessment of technological strategies and potential regulatory goals. Volume II

    International Nuclear Information System (INIS)

    1979-06-01

    This volume contains the following appendices: selected immobilization processes, directory of selected European organizations involved in HLW management, U.S. high-level waste inventories, and selected European HLW program

  7. Outcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis.

    Directory of Open Access Journals (Sweden)

    Francine Matthys

    Full Text Available Standard short course chemotherapy is recommended by the World Health Organization to control tuberculosis worldwide. However, in settings with high drug resistance, first line standard regimens are linked with high treatment failure. We evaluated treatment outcomes after standardized chemotherapy with the WHO recommended category II retreatment regimen in a prison with a high prevalence of drug resistant tuberculosis (TB. A cohort of 233 culture positive TB patients was followed through smear microscopy, culture, drug susceptibility testing and DNA fingerprinting at baseline, after 3 months and at the end of treatment. Overall 172 patients (74% became culture negative, while 43 (18% remained positive at the end of treatment. Among those 43 cases, 58% of failures were determined to be due to treatment with an inadequate drug regimen and 42% to either an initial mixed infection or re-infection while under treatment. Overall, drug resistance amplification during treatment occurred in 3.4% of the patient cohort. This study demonstrates that treatment failure is linked to initial drug resistance, that amplification of drug resistance occurs, and that mixed infection and re-infection during standard treatment contribute to treatment failure in confined settings with high prevalence of drug resistance.

  8. 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.

  9. 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

  10. 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 ...

  11. Nuclear proliferation and civilian nuclear power. Report of the Nonproliferation Alternative Systems Assessment Program. Volume II. Proliferation resistance

    International Nuclear Information System (INIS)

    1980-06-01

    The purpose of this volume is limited to an assessment of the relative effects that particular choices of nuclear-power systems, for whatever reasons, may have on the possible spread of nuclear-weapons capabilities. This volume addresses the concern that non-nuclear-weapons states may be able to initiate efforts to acquire or to improve nuclear-weapons capabilities through civilian nuclear-power programs; it also addresses the concern that subnational groups may obtain and abuse the nuclear materials or facilities of such programs, whether in nuclear-weapons states (NWS's) or nonnuclear-weapons states (NNW's). Accordingly, this volume emphasizes one important factor in such decisions, the resistance of nuclear-power systems to the proliferation of nuclear-weapons capabilities

  12. 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.

  13. Solar Pilot Plant, Phase I. Preliminary design report. Volume II. System description and system analysis. CDRL item 2

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-05-01

    Honeywell conducted a parametric analysis of the 10-MW(e) solar pilot plant requirements and expected performance and established an optimum system design. The main analytical simulation tools were the optical (ray trace) and the dynamic simulation models. These are described in detail in Books 2 and 3 of this volume under separate cover. In making design decisions, available performance and cost data were used to provide a design reflecting the overall requirements and economics of a commercial-scale plant. This volume contains a description of this analysis/design process and resultant system/subsystem design and performance.

  14. SMACS - a system of computer programs for probabilistic seismic analysis of structures and subsystems. Volume II. Example problem

    International Nuclear Information System (INIS)

    Maslenikov, O.R.; Johnson, J.J.; Tiong, L.W.; Mraz, M.J.; Bumpus, S.; Gerhard, M.A.

    1985-03-01

    In this volume of the SMACS User's Manual an example problem is presented to demonstrate the type of problem that SMACS is capable of solving and to familiarize the user with format of the various data files involved. This volume is organized into thirteen appendices which follow a short description of the problem. Each appendix contains listings of the input and output files associated with each computer run that was necessary to solve the problem. In cases where one SMACS program uses data generated by another SMACS program, the data file is shown in the appendix for the programs which generated it

  15. 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.

  16. 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

  17. 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.

  18. Entrepreneurship Education for Agriculture. Phase "O" Planning Project Report. Performance Report. Volume II: Bibliography and Storyboard Scripts.

    Science.gov (United States)

    Lee and Associates, Starkville, MS.

    Volume 2 of this report is supplementary and contains three bibliographies: (1) Annotated Bibliography on Minority Entrepreneurship in Agriculture; (2) Annotated Bibliography on Entrepreneurship Education in Agriculture; (3) Bibliography on Entrepreneurship. The next section presents three storyboard scripts for instructional videotapes on…

  19. Introduction to Psychology and Leadership. Part Nine; Morale and Esprit De Corps. Segments I & II, Volume IX-A.

    Science.gov (United States)

    Westinghouse Learning Corp., Annapolis, MD.

    The ninth volume of the introduction to psychology and leadership course (see the final reports which summarize the development project, EM 010 418, EM 010 419, and EM 010 484) concentrates on morale and esprit de corps and is presented in two documents. This document uses an audiotape and panelbook format. EM 010 440 is the second document of the…

  20. Airborne gamma-ray spectrometer and magnetometer survey, Durango D, Colorado. Final report Volume II A. Detail area

    International Nuclear Information System (INIS)

    1983-01-01

    This volume contains geology of the Durango D detail area, radioactive mineral occurrences in Colorado, and geophysical data interpretation. Eight appendices provide: stacked profiles, geologic histograms, geochemical histograms, speed and altitude histograms, geologic statistical tables, geochemical statistical tables, magnetic and ancillary profiles, and test line data

  1. Airborne gamma-ray spectrometer and magnetometer survey, Durango A, Colorado. Final report Volume II A. Detail area

    International Nuclear Information System (INIS)

    1983-01-01

    This volume contains geology of the Durango A detail area, radioactive mineral occurences in Colorado, and geophysical data interpretation. Eight appendices provide the following: stacked profiles, geologic histograms, geochemical histograms, speed and altitude histograms, geologic statistical tables, geochemical statistical tables, magnetic and ancillary profiles, and test line data

  2. Pacific Telecommunications Council Annual Conference Proceedings (15th, Honolulu, Hawaii, January 17-20, 1993). Volumes I and II.

    Science.gov (United States)

    Savage, James G., Ed.; Wedemeyer, Dan J., Ed.

    This two-volume set contains 165 papers presented at a conference that brought together over 1,100 telecommunications leaders and leading commentators from over 40 countries across the Pacific region. The papers indicate that the optimism of the telecommunications industry is possibly greater than during the 1980s, although tempered by a more…

  3. Advanced training course on state systems of accounting for and control of nuclear materials. Volume II. Visual aids

    International Nuclear Information System (INIS)

    Sorenson, R.J.; Schneider, R.A.

    1979-01-01

    Purpose of the course was to train in the accounting and control of nuclear materials in a bulk processing facility, for international safeguards. The Exxon low enriched uranium fabrication plant is used as an example. This volume contains visual aids used for the presentation

  4. Airborne gamma-ray spectrometer and magnetometer survey, Durango D, Colorado. Final report Volume II B. Detail area

    International Nuclear Information System (INIS)

    1983-01-01

    This volume comprises eight appendices containing the following information for the Durango D detail area: 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

  5. TIBER II/ETR final design report: Volume 1, 1.0 Introduction; 2.0 plasma engineering

    International Nuclear Information System (INIS)

    Lee, J.D.

    1987-09-01

    This paper discusses the design of the TIBER II tokamak test reactor. Specific topics discussed are the physics objectives for Tiber, magnetics, baseline operating point, pulsed inductive operation, edge physics and impurity control, fueling, disruption control, vertical stability and impurity flow reversal

  6. Tic-related obsessive-compulsive disorder (OCD): phenomenology and treatment outcome in the Pediatric OCD Treatment Study II.

    Science.gov (United States)

    Conelea, Christine A; Walther, Michael R; Freeman, Jennifer B; Garcia, Abbe M; Sapyta, Jeffrey; Khanna, Muniya; Franklin, Martin

    2014-12-01

    Prior research has shown that youth with co-occurring tic disorders and obsessive-compulsive disorder (OCD) may differ from those with non-tic-related OCD in terms of clinical characteristics and treatment responsiveness. A broad definition of "tic-related" was used to examine whether children with tics in the Pediatric OCD Treatment Study II differed from those without tics in terms of demographic and phenomenological characteristics and acute treatment outcomes. Participants were 124 youth aged 7 to 17 years, inclusive, with a primary diagnosis of OCD who were partial responders to an adequate serotonin reuptake inhibitor (SRI) trial. Participants were randomized to medication management, medication management plus instructions in cognitive-behavioral therapy (CBT), or medication management plus full CBT. Tic status was based on the presence of motor and/or vocal tics on the Yale Global Tic Severity Scale. Tics were identified in 53% of the sample. Those with tic-related OCD did not differ from those with non-tic-related OCD in terms of age, family history of tics, OCD severity, OCD-related impairment, or comorbidity. Those with tics responded equally in all treatment conditions. Tic-related OCD was very prevalent using a broad definition of tic status. Results suggest that youth with this broad definition of tic-related OCD do not have increased OCD severity or inference, higher comorbidity rates or severity, or worsened functioning, and support the use of CBT in this population. This highlights the importance of not making broad assumptions about OCD symptoms most likely to occur in an individual with comorbid tics. Clinical trial registration information-Treatment of Pediatric OCD for SRI Partial Responders; http://clinicaltrials.gov; NCT00074815. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. Summary Report on Phase I and Phase II Results From the 3D Printing in Zero-G Technology Demonstration Mission. Volume II

    Science.gov (United States)

    Prater, T. J.; Werkheiser, N. J.; Ledbetter, F. E., III

    2018-01-01

    In-space manufacturing seeks to develop the processes, skill sets, and certification architecture needed to provide a rapid response manufacturing capability on long-duration exploration missions. The first 3D printer on the Space Station was developed by Made in Space, Inc. and completed two rounds of operation on orbit as part of the 3D Printing in Zero-G Technology Demonstration Mission. This Technical Publication provides a comprehensive overview of the technical objections of the mission, the two phases of hardware operation conducted on orbit, and the subsequent detailed analysis of specimens produced. No engineering significant evidence of microgravity effects on material outcomes was noted. This technology demonstration mission represents the first step in developing a suite of manufacturing capabilities to meet future mission needs.

  13. 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.

  14. 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.

  15. Smolt Monitoring Program, Volume II, Migrational Characteristics of Columbia Basin Salmon and Steelhead Trout, 1986 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Fish Passage Center

    1987-02-01

    Smolt Monitoring Program Annual Report, 1986, Volume I, describes the results of travel time monitoring and other migrational characteristics of yearling and sub-yearling chinook salmon (Oncorhynchus tshawytscha), sockeye salmon (Oncorhynchus nerka), and steelhead trout (Salmo gairdneri). This volume presents the data from Fish Passage Center freeze brands used in the analysis of travel time for Lewiston, Lower Granite, Lower Monumental, Rock Island, McNary, and John Day dams. Summary of data collection procedures and explanation of data listings are presented in conjunction with the mark recapture data. Data for marked fish not presented in this report will be provided upon request. Daily catch statistics (by species), flow, and sample parameters for the smolt monitoring sites, Clearwater, Lewiston, Lower Granite, Lower Monumental, Rock Island, McNary, John Day, and Bonneville also will be provided upon request.

  16. Inventory of Federal energy-related environment and safety research for FY 1978. Volume II. Project listings and indexes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-12-01

    This volume contains summaries of FY-1978 government-sponsored environment and safety research related to energy. Project summaries were collected by Aerospace Corporation under contract with the Department of Energy, Office of Program Coordination, under the Assistant Secretary for Environment. Summaries are arranged by log number, which groups the projects by reporting agency. The log number is a unique number assigned to each project from a block of numbers set aside for each agency. Information about the projects is included in the summary listings. This includes the project title, principal investigators, research organization, project number, contract number, supporting organization, funding level if known, related energy sources with numbers indicating percentages of effort devoted to each, and R and D categories. A brief description of each project is given, and this is followed by subject index terms that were assigned for computer searching and for generating the printed subject index in Volume IV.

  17. Inventory of Federal energy-related environment and safety research for FY 1979. Volume II. Project listings and indexes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-01

    This volume contains summaries of FY 1979 government-sponsored environment and safety research related to energy arranged by log number, which groups the projects by reporting agency. The log number is a unique number assigned to each project from a block of numbers set aside for each contributing agency. Information elements included in the summary listings are project title, principal investigators, research organization, project number, contract number, supporting organization, funding level, related energy sources with numbers indicating percentages of effort devoted to each, and R and D categories. A brief description of each project is given, and this is followed by subject index terms that were assigned for computer searching and for generating the printed subject index in the back of this volume.

  18. Inventory of Federal energy-related environment and safety research for FY 1978. Volume II. Project listings and indexes

    International Nuclear Information System (INIS)

    1979-12-01

    This volume contains summaries of FY-1978 government-sponsored environment and safety research related to energy. Project summaries were collected by Aerospace Corporation under contract with the Department of Energy, Office of Program Coordination, under the Assistant Secretary for Environment. Summaries are arranged by log number, which groups the projects by reporting agency. The log number is a unique number assigned to each project from a block of numbers set aside for each agency. Information about the projects is included in the summary listings. This includes the project title, principal investigators, research organization, project number, contract number, supporting organization, funding level if known, related energy sources with numbers indicating percentages of effort devoted to each, and R and D categories. A brief description of each project is given, and this is followed by subject index terms that were assigned for computer searching and for generating the printed subject index in Volume IV

  19. Inventory of Federal energy-related environment and safety research for FY 1979. Volume II. Project listings and indexes

    International Nuclear Information System (INIS)

    1980-12-01

    This volume contains summaries of FY 1979 government-sponsored environment and safety research related to energy arranged by log number, which groups the projects by reporting agency. The log number is a unique number assigned to each project from a block of numbers set aside for each contributing agency. Information elements included in the summary listings are project title, principal investigators, research organization, project number, contract number, supporting organization, funding level, related energy sources with numbers indicating percentages of effort devoted to each, and R and D categories. A brief description of each project is given, and this is followed by subject index terms that were assigned for computer searching and for generating the printed subject index in the back of this volume

  20. Effects of Simulated Surface Effect Ship Motions on Crew Habitability. Phase II. Volume 2. Facility, Test conditions, and Schedules

    Science.gov (United States)

    1977-05-01

    CLASSIFICATION OF THIS PAGE 18. SUPPLEMENTARY NOTES (continued) motion on crew health and performance. Other organizacions preparing the companion...VOLUME B Blood Pressure Sphygmomanometer measurement of I, III HFR Measurement systolic pressure, sitting Cryptographic Manual decoding and encoding of I...Annual NASA-Univ. Conf. on Manual Control, NASA SP-215, 1970, pp. 391-428. 11. Buckner, Donald N., and C. H. Baker, A Description of the Office of Naval

  1. Light-Weight Radioisotope Heater Unit Safety Analysis Report (LWRHU-SAR). Volume II. Accident model document

    International Nuclear Information System (INIS)

    Johnson, E.W.

    1985-10-01

    Purposes of this volume (AMD), are to: Identify all malfunctions, both singular and multiple, which can occur during the complete mission profile that could lead to release outside the clad of the radioisotopic material contained therein; provide estimates of occurrence probabilities associated with these various accidents; evaluate the response of the LWRHU (or its components) to the resultant accident environments; and associate the potential event history with test data or analysis to determine the potential interaction of the released radionuclides with the biosphere

  2. Potential use of geothermal resources in the Snake River Basin: an environmental overview. Volume II. Annotated bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, S.G.; Russell, B.F.; Sullivan, J.F. (eds.)

    1979-09-01

    This volume is a partially annotated bibliography of reference materials pertaining to the seven KGRA's. The bibliography is divided into sections by program element as follows: terrestrial ecology, aquatic ecology, heritage resources, socioeconomics and demography, geology, geothermal, soils, hydrology and water quality, seismicity, and subsidence. Cross-referencing is available for those references which are applicable to specific KGRA's. (MHR)

  3. Predicting High School Outcomes in the Baltimore City Public Schools. The Senior Urban Education Research Fellowship Series. Volume VII

    Science.gov (United States)

    Mac Iver, Martha Abele; Messel, Matthew

    2012-01-01

    This study of high school outcomes in the Baltimore City Public Schools builds on substantial prior research on the early warning indicators of dropping out. It sought to investigate whether the same variables that predicted a non-graduation outcome in other urban districts--attendance, behavior problems, and course failure--were also significant…

  4. Field Surveys, IOC Valleys. Volume III, Part II. Cultural Resources Survey, Pine and Wah Wah Valleys, Utah.

    Science.gov (United States)

    1981-08-01

    including horse, camel, mammoth, Ertm E-TR-48-III-II 20 musk ox, and certain species of bison, goat, and bear, which had previously inhabited the marsh and...34 - - -9,$.. 𔄃 Im I I I Si to * Location lype/Contents Affiliation 42B@644 rid e over cr ek - P/J depression, cleared areas, Fr elon (f4-5-18-92) ground

  5. [Glomerular filtration and renal volume in type II diabetes (non-insulin-dependent): study in normal and microalbuminuria patients].

    Science.gov (United States)

    Signorini, A M; Tanganelli, I; Fondelli, C; Vattimo, A; Ferrari, F; Borgogni, P; Borgogni, L; Gragnoli, G

    1991-08-01

    In type 2 diabetes elevated glomerular filtration rate (GFR) and increased renal volume (RV), often accompanied to normo or microalbuminuria, were demonstrated. This condition is considered a pathogenetic factor for clinical nephropathy. As this topic is little studied in type 2 diabetes, we have investigated 73 type 2 diabetic patients (34 normo and 39 microalbuminuric), looking for a correlation between GFR, RV, hypertension, duration of diabetes and indexes of metabolic control. GFR was measured by a scintigraphy, after infusion of 99Tc-DTPA. Renal volume was determined by ultrasound scanning. Between the groups GFR and RV weren't different; elevated GFR was demonstrated in 3 patients; increased RV in 1 patient. In the hypertensive group GFR was lower than in normotensive group and in controls. Multivariate analysis in stepwise demonstrated that GFR presents a negative correlation to systolic blood pressure as in normo as in microalbuminuric patients. In the normotensive group GFR didn't correlate to the other variables. The present data suggest that in type 2 diabetes there is a little prevalence of glomerular hyperfiltration and increased renal volume and that hypertension plays a role on GFR of hypertensive diabetic patients.

  6. 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

  7. 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

  8. 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

  9. 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.)

  10. 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.)

  11. OUTCOMES REVIEW OF TOTAL KNEE REPLACEMENT WITH GENESIS II TOTAL KNEE SYSTEM: AUSTRALIAN ORTHOPAEDIC ASSOCIATION NATIONAL JOINT REPLACEMENT REGISTRY DATA

    Directory of Open Access Journals (Sweden)

    N. L. Logvinov

    2014-01-01

    Full Text Available ABSTRACT. The goal of the article was to review Genesis II Total Knee System use according to AoA NJRR report. Genesis II has been widely used in Russian Federation since 1996. The AoA NJRR report was studied in order to learn connection between number of revision procedures and surgeon’s skills or type of the System, adequate choice among cemented, cementless and hybrid fixation, number of surgeries using Genesis II Total Knee System annually, average revision rate for Genesis II and early cumulative revision rate.CONCLUSION. The systematic study of AoA NJRR allows us to make a conclusion that cemented fixation of Genesis II Total Knee System is mostly effective, and this fact is confirmed by domestic experience. 

  12. Evaluation and Ranking of Geothermal Resources for Electrical Generation or Electrical Offset in Idaho, Montana, Oregon and Washington. Volume II.

    Energy Technology Data Exchange (ETDEWEB)

    Bloomquist, R. Gordon

    1985-06-01

    This volume contains appendices on: (1) resource assessment - electrical generation computer results; (2) resource assessment summary - direct use computer results; (3) electrical generation (high temperature) resource assessment computer program listing; (4) direct utilization (low temperature) resource assessment computer program listing; (5) electrical generation computer program CENTPLANT and related documentation; (6) electrical generation computer program WELLHEAD and related documentation; (7) direct utilization computer program HEATPLAN and related documentation; (8) electrical generation ranking computer program GEORANK and related documentation; (9) direct utilization ranking computer program GEORANK and related documentation; and (10) life cycle cost analysis computer program and related documentation. (ACR)

  13. 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.

  14. 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

  15. Does Left Atrial Volume and Pulmonary Venous Anatomy Predict the Outcome of Catheter Ablation of Atrial Fibrillation ?

    NARCIS (Netherlands)

    Hof, Irene; Chilukuri, Karuna; Arbab-Zadeh, Armin; Scherr, Daniel; Dalal, Darshan; Nazarian, Saman; Henrikson, Charles; Spragg, David; Berger, Ronald; Marine, Joseph; Calkins, Hugh

    Introduction: Preprocedural factors may be helpful in selecting patients with atrial fibrillation (AF) for treatment with catheter ablation and in making an assumption regarding their prognosis. The aims of this study were to investigate whether left atrial (LA) volume and pulmonary venous (PV)

  16. Exposure to Severe Urban Air Pollution Influences Cognitive Outcomes, Brain Volume and Systemic Inflammation in Clinically Healthy Children

    Science.gov (United States)

    Calderon-Garciduenas, Lilian; Engle, Randall; Mora-Tiscareno, Antonieta; Styner, Martin; Gomez-Garza, Gilberto; Zhu, Hongtu; Jewells, Valerie; Torres-Jardon, Ricardo; Romero, Lina; Monroy-Acosta, Maria E.; Bryant, Christopher; Gonzalez-Gonzalez, Luis Oscar; Medina-Cortina, Humberto; D'Angiulli, Amedeo

    2011-01-01

    Exposure to severe air pollution produces neuroinflammation and structural brain alterations in children. We tested whether patterns of brain growth, cognitive deficits and white matter hyperintensities (WMH) are associated with exposures to severe air pollution. Baseline and 1 year follow-up measurements of global and regional brain MRI volumes,…

  17. SUPPLEMENTARY COMPARISON: COOMET.RI(II)-S1.Rn-222 (169/UA/98): Rn-222 volume activity comparison

    Science.gov (United States)

    Skliarov, V.; Röttger, A.; Honig, A.; Korostin, S.; Kuznetsov, S.; Lapenas, A.; Milevsky, V.; Ivaniukovich, A.; Kharitonov, I.; Sepman, S.

    2009-01-01

    According to a first program, a supplementary comparison of Rn-222 volume activity was drawn up as a bilateral supplementary comparison between NSC 'Institute of Metrology', Ukraine, and VNIIFTRI, Russia. It took place in March 2005. In April 2005, at the 5th meeting of COOMET held in Braunschweig (Germany), representatives of these institutes exchanged data which showed the comparability of the national standards of Ukraine and Russia for the check points. During the discussion of the procedure some other institutes decided to join the comparison program, which was extended to BelGIM (Belarus), PTB (Germany), VNIIM (Russia) and RMTC (Latvia). The national standards of volume activity of radon-222 were thus calibrated using one standard radon radiometer as the transfer standard. Results are shown in the Final Report of the comparison. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by COOMET, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

  18. Installation Restoration Program. Phase II. Confirmation/Quantification. Stage 1. Volume 2. Appendices A-M. Cannon AFB, New Mexico.

    Science.gov (United States)

    1986-09-01

    44 00 -4 rr - P.- <C Ix do 4a 0 - 4-P .0 0 di E .4 MIb-4 L. ., 0 z i -4 LLii4wI- cnJ LUJLLS C. W~EC... E- XI- <rLLJ < 0C... C:C~n z w cc w w c- td Ii...UL C 4. 04 N apwj ap qD tD G - c- GD 0C GD# GDQD ’Zn iffg.. o -0 L 0 a &0 03 03 4. a a --4l C~ >C C- a 0 =N r- (D 0 a 0 0 M:. -A 0Dd 0 .4- 0 0 0 0 I4...c𔃻 -l I0 4 - z.. z I 4c u Z (--c ~LL 1 LAJ CLl)L .’-. L& ii <C -4. ..= LO LW 21 ci cl L53 E:; L3 C.:11 Zi 4- z z Z Zz zz i-z C ~ jrnw C c r_ w. F- c

  19. 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

  20. West Hackberry Strategic Petroleum Reserve site brine-disposal monitoring, Year I report. Volume II. Physical and chemical oceanography. Final report

    Energy Technology Data Exchange (ETDEWEB)

    DeRouen, L.R.; Hann, R.W.; Casserly, D.M.; Giammona, C.; Lascara, V.J. (eds.)

    1983-02-01

    This project centers around the Strategic Petroleum Site (SPR) known as the West Hackberry salt dome which is located in southwestern Louisiana, and which is designed to store 241 million barrels of crude oil. Oil storage caverns are formed by injecting water into salt deposits, and pumping out the resulting brine. Studies described in this report were designed as follow-on studies to three months of pre-discharge characterization work, and include data collected during the first year of brine leaching operations. The objectives were to: (1) characterize the environment in terms of physical, chemical and biological attributes; (2) determine if significant adverse changes in ecosystem productivity and stability of the biological community are occurring as a result of brine discharge; and (3) determine the magnitude of any change observed. Contents of Volume II include: introduction; physical oceanography; estuarine hydrology and hydrography; analysis of discharge plume; and water and sediment quality.

  1. Alkaline Waterflooding Demonstration Project, Ranger Zone, Long Beach Unit, Wilmington Field, California. Fourth annual report, June 1979-May 1980. Volume 3. Appendices II-XVII

    Energy Technology Data Exchange (ETDEWEB)

    Carmichael, J.D.

    1981-03-01

    Volume 3 contains Appendices II through XVII: mixing instructions for sodium orthosilicate; oil displacement studies using THUMS C-331 crude oil and extracted reservoir core material from well B-110; clay mineral analysis of B-827-A cores; sieve analysis of 4 Fo sand samples from B-110-IA and 4 Fo sand samples from B-827-A; core record; delayed secondary caustic consumption tests; long-term alkaline consumption in reservoir sands; demulsification study for THUMS Long Beach Company, Island White; operating plans and instructions for DOE injection demonstration project, alkaline injection; caustic pilot-produced water test graphs; well test irregularities (6/1/79-5/31/80); alkaline flood pump changes (6/1/79-5/31/80); monthly DOE pilot chemical waterflood injection reports (preflush injection, alkaline-salt injection, and alkaline injection without salt); and caustic safety procedures-alkaline chemicals.

  2. 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 ...

  3. Sources and effects of ionizing radiation. UNSCEAR 2000 report to the General Assembly, with scientific annexes. Volume II: Effects

    International Nuclear Information System (INIS)

    2000-01-01

    Over the past few years the United Nations Scientific Committee on the effects of Atomic Radiation has undertaken a broad review of the sources and effects of ionizing radiation. In the present report, the Committee, drawing on the main conclusions of its scientific assessment summarizes the developments in radiation science in the years leading up to the next millennium. It covers the following: the effects of radiation exposure; levels of radiation exposure; radiological consequences of the Chernobyl accident; sources of radiation exposure including natural exposures, man-made environmental exposures, medical and occupational exposures; radiation associated cancer. This volume includes five Annexes covering: DNA repair and mutagenesis; biological effects at low radiation doses; combined effects of radiation and other agents; epidemiological evaluation of radiation-induced cancer and exposure effects of the Chernobyl accident

  4. Artificial heart development program. Volume II. System support. Phase III summary report, July 1, 1973--September 30, 1977

    International Nuclear Information System (INIS)

    1977-01-01

    Volume 2 covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detailed procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested

  5. Artificial heart development program. Volume II. System support. Phase III summary report, July 1, 1973--September 30, 1977

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    Volume 2 covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detailed procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested.

  6. Compliance problems of small utility systems with the Powerplant and Industrial Fuel Use Act of 1978: volume II - appendices

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-01-01

    A study of the problems of compliance with the Powerplant and Industrial Fuel Use Act of 1978 experienced by electric utility systems which have a total generating capacity of less than 2000 MW is presented. This volume presents the following appendices: (A) case studies (Farmington, New Mexico; Lamar, Colorado; Dover, Delaware; Wolverine Electric Cooperative, Michigan; Central Telephone and Utilities, Kansas; Sierra Pacific Power Company, Nevada; Vero Beach, Florida; Lubbock, Texas; Western Farmers Cooperative, Oklahoma; and West Texas Utilities Company, Texas); (B) contacts and responses to study; (C) joint action legislation chart; (D) Texas Municipal Power Agency case study; (E) existing generating units jointly owned with small utilities; (F) future generating units jointly owned with small utilities; (G) Federal Register Notice of April 17, 1980, and letter of inquiry to utilities; (H) small utility responses; and (I) Section 744, PIFUA. (WHK)

  7. 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

  8. 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.

  9. Early Adolescent Outcomes of Institutionally-Deprived and Non-Deprived Adoptees. II: Language as a Protective Factor and a Vulnerable Outcome

    Science.gov (United States)

    Croft, Carla; Beckett, Celia; Rutter, Michael; Castle, Jenny; Colvert, Emma; Groothues, Christine; Hawkins, Amanda; Kreppner, Jana; Stevens, Suzanne E.; Sonuga-Barke, Edmund J. S.

    2007-01-01

    Background: There is uncertainty about the extent to which language skills are part of general intelligence and even more uncertainty on whether deprivation has differential effects on language and non-language skills. Methods: Language and cognitive outcomes at 6 and 11 years of age were compared between a sample of 132 institution-reared…

  10. Outcomes of visual acuity in carbon ion radiotherapy: Analysis of dose-volume histograms and prognostic factors

    International Nuclear Information System (INIS)

    Hasegawa, Azusa; Mizoe, Jun-etsu; Mizota, Atsushi; Tsujii, Hirohiko

    2006-01-01

    Purpose: To analyze the tolerance dose for retention of visual acuity in patients with head-and-neck tumors treated with carbon ion radiotherapy. Methods and Materials: From June 1994 to March 2000, 163 patients with tumors in the head and neck or skull base region were treated with carbon ion radiotherapy. Analysis was performed on 54 optic nerves (ONs) corresponding to 30 patients whose ONs had been included in the irradiated volume. These patients showed no evidence of visual impairment due to other factors and had a follow-up period of >4 years. All patients had been informed of the possibility of visual impairment before treatment. We evaluated the dose-complication probability and the prognostic factors for the retention of visual acuity in carbon ion radiotherapy, using dose-volume histograms and multivariate analysis. Results: The median age of 30 patients (14 men, 16 women) was 57.2 years. Median prescribed total dose was 56.0 gray equivalents (GyE) at 3.0-4.0 GyE per fraction per day (range, 48-64 GyE; 16-18 fractions; 4-6 weeks). Of 54 ONs that were analyzed, 35 had been irradiated with max ]) resulting in no visual loss. Conversely, 11 of the 19 ONs (58%) irradiated with >57 GyE (D max ) suffered a decrease of visual acuity. In all of these cases, the ONs had been involved in the tumor before carbon ion radiotherapy. In the multivariate analysis, a dose of 20% of the volume of the ON (D 2 ) was significantly associated with visual loss. Conclusions: The occurrence of visual loss seems to be correlated with a delivery of >60 GyE to 20% of the volume of the ON

  11. Validation of Functional Reaching Volume as an Outcome Measure across the Spectrum of Abilities in Muscular Dystrophy

    Science.gov (United States)

    2017-09-01

    refinement of the Soliton software is underway to reassess the utility of Solitons in conjunction with ACTIVE. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION...Solitons in conjunction with ACTIVE. i. Gain local IRB approval for soliton use with ACTIVE The IRB at Nationwide Children’s Hospital granted...approval to allow the use of Solitons in conjunction with the ACTIVE system on 25 February 2016. ii. Gain local IRB approval for verbal consent after

  12. 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

  13. A prospective study of corpus callosum regional volumes and neurocognitive outcomes following cranial radiation for pediatric brain tumors.

    Science.gov (United States)

    Rashid, Arif; Ram, Ashwin N; Kates, Wendy R; Redmond, Kristin J; Wharam, Moody; Mark Mahone, E; Horska, Alena; Terezakis, Stephanie

    2017-06-01

    Cranial radiation therapy (CRT) may disrupt the corpus callosum (CC), which plays an important role in basic motor and cognitive functions. The aim of this prospective longitudinal study was to assess changes in CC mid-sagittal areas, CC volumes, and performance on neuropsychological (NP) tests related to the CC in children following CRT. Twelve pediatric patients were treated with CRT for primary brain malignancies. Thirteen age-matched healthy volunteers served as controls. Brain MRIs and NP assessment emphasizing motor dexterity, processing speed, visuomotor integration, and working memory (visual and verbal) were performed at baseline and at 6, 15, and 27 months following completion of CRT. Linear mixed effects (LME) analyses were used to evaluate patient NP performance and changes in regional CC volumes (genu, anterior body, mid-body, posterior body, and splenium) and mid-sagittal areas over time and with radiation doses, correcting for age at CRT start. The mean age at CRT was 9.41 (range 1.2-15.7) years. The median prescription dose was 54 (range 18-59.4) Gy. LME analysis revealed a significant decrease in overall CC volumes over time (p memory (both p memory. Further prospective study of larger cohorts of patients is needed to establish the relationship between CRT dose, neuroanatomical, and functional changes in the CC.

  14. Fort Hood Solar Total Energy Project. Volume II. Preliminary design. Part 1. System criteria and design description. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None,

    1979-01-01

    This volume documents the preliminary design developed for the Solar Total Energy System to be installed at Fort Hood, Texas. Current system, subsystem, and component designs are described and additional studies which support selection among significant design alternatives are presented. Overall system requirements which form the system design basis are presented. These include program objectives; performance and output load requirements; industrial, statutory, and regulatory standards; and site interface requirements. Material in this section will continue to be issued separately in the Systems Requirements Document and maintained current through revision throughout future phases of the project. Overall system design and detailed subsystem design descriptions are provided. Consideration of operation and maintenance is reflected in discussion of each subsystem design as well as in an integrated overall discussion. Included are the solar collector subsystem; the thermal storage subsystem, the power conversion sybsystem (including electrical generation and distribution); the heating/cooling and domestic hot water subsystems; overall instrumentation and control; and the STES building and physical plant. The design of several subsystems has progressed beyond the preliminary stage; descriptions for such subsystems are therefore provided in more detail than others to provide complete documentation of the work performed. In some cases, preliminary design parameters require specific verificaton in the definitive design phase and are identified in the text. Subsystem descriptions will continue to be issued and revised separately to maintain accuracy during future phases of the project. (WHK)

  15. Solid Waste Operations Complex W-113, Detail Design Report (Title II). Volume 5: Design validation assessments and lists

    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. The following Code Evaluation analyzes the applicable sections of the National Fire Protection Association (NFPA) 101, Life Safety Code, 1994 Edition and the 1994 Edition of the Uniform Building Code (UBC) to the W113 Trench Enclosure. A Building Code Analysis generally establishes four primary design criteria: occupancy classification; separation requirements; egress requirements; and construction type. The UBC establishes requirements for all criteria. This analysis is limited to the Trench Enclosure Building. The General Office Building and the Retrieval Staff Change Building is not within the scope of this analysis

  16. 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.

  17. 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...

  18. Hospital volumes and later year of operation correlates with better outcomes in acute Type A aortic dissection

    DEFF Research Database (Denmark)

    Geirsson, Arnar; Ahlsson, Anders; Franco-Cereceda, Anders

    2018-01-01

    and C and cardiopulmonary bypass time, whereas later calendar year and higher hospital operative volumes predicted improved survival. CONCLUSIONS: Surgical mortality for acute Type A aortic dissection remains high but has decreased significantly over the last decade. This correlated with later year...... A Aortic Dissection is a retrospective database comprising 1159 patients (mean age 61.6 ± 12.2 years, 68% male) treated for acute Type A aortic dissection at 8 centres in Denmark, Finland, Iceland and Sweden from 2005 to 2014. Data gathered included demographics, symptoms, type of procedure, complications...

  19. 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

  20. Proposed Tenaska Washington II Generation Project : Final Environmental Impact Statement. Volume 1: Environmental Analysis and Technical Appendices.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1994-01-01

    BPA is considering whether to purchase electrical power from a proposed privately-owned combustion-turbine electrical generation plant in Washington. The plant would be fired by natural gas and would use combined-cycle technology to generate 240 average megawatts (aMW) of energy. The plant would be developed, owned, and operated by Tenaska Washington Partners II, L.P. The project would be located about 19 kilometers (12 miles) southeast of downtown Tacoma in the Frederickson Industrial Area, Pierce County. The proposed plant would occupy about half of a 6.4-hectare (16-acre) parcel and would be consistent with the industrial character of its surroundings. The proposed site is currently undeveloped and zoned for industrial use by the county. Main environmental concerns identified in the scoping process and in comments on the Draft Environmental Impact Statement (EIS) include: (1) potential air quality impacts, such as emissions and their contribution to the {open_quotes}greenhouse{close_quotes} effect; (2) potential health and safety impacts, such as nuisance odors, plant safety, visibility and heat-emission systems which may affect low-flying planes and potential health effects of electric and magnetic fields; and (3) potential water quality and quantity impacts, such as the amount of wastewater to be discharged, the source and amount of water required for plant operation. These and other issues are discussed in detail in the EIS. The proposed project already includes many features designed to reduce environmental impacts. Based on investigations performed for the EIS, no significant unavoidable adverse environmental impacts associated with the proposed project were identified, and no evidence emerged to suggest that the proposed action is controversial. The EIS is being mailed to numerous agencies, groups, and individuals (see Section 8.0). There will be a 30-day no-action period before any decisions are made and the Record of Decision is signed.

  1. Long-Term Follow-Up of Class II Adults Treated with Orthodontic Camouflage: A Comparison with Orthognathic Surgery Outcomes

    National Research Council Canada - National Science Library

    Mihalik, Colin

    2002-01-01

    .... These were compared to similar data for long-term outcomes in patients who had surgical correction. Small mean changes in skeletal landmark positions did occur long-term, but were in general much smaller than in the surgery patients...

  2. 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.

  3. Exposure to severe urban air pollution influences cognitive outcomes, brain volume and systemic inflammation in clinically healthy children.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Engle, Randall; Mora-Tiscareño, Antonieta; Styner, Martin; Gómez-Garza, Gilberto; Zhu, Hongtu; Jewells, Valerie; Torres-Jardón, Ricardo; Romero, Lina; Monroy-Acosta, Maria E; Bryant, Christopher; González-González, Luis Oscar; Medina-Cortina, Humberto; D'Angiulli, Amedeo

    2011-12-01

    Exposure to severe air pollution produces neuroinflammation and structural brain alterations in children. We tested whether patterns of brain growth, cognitive deficits and white matter hyperintensities (WMH) are associated with exposures to severe air pollution. Baseline and 1 year follow-up measurements of global and regional brain MRI volumes, cognitive abilities (Wechsler Intelligence Scale for Children-Revised, WISC-R), and serum inflammatory mediators were collected in 20 Mexico City (MC) children (10 with white matter hyperintensities, WMH(+), and 10 without, WMH(-)) and 10 matched controls (CTL) from a low polluted city. There were significant differences in white matter volumes between CTL and MC children - both WMH(+) and WMH(-) - in right parietal and bilateral temporal areas. Both WMH(-) and WMH(+) MC children showed progressive deficits, compared to CTL children, on the WISC-R Vocabulary and Digit Span subtests. The cognitive deficits in highly exposed children match the localization of the volumetric differences detected over the 1 year follow-up, since the deficits observed are consistent with impairment of parietal and temporal lobe functions. Regardless of the presence of prefrontal WMH, Mexico City children performed more poorly across a variety of cognitive tests, compared to CTL children, thus WMH(+) is likely only partially identifying underlying white matter pathology. Together these findings reveal that exposure to air pollution may perturb the trajectory of cerebral development and result in cognitive deficits during childhood. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. 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.

  5. Programmatic implications of implementing the relational algebraic capacitated location (RACL algorithm outcomes on the allocation of laboratory sites, test volumes, platform distribution and space requirements

    Directory of Open Access Journals (Sweden)

    Naseem Cassim

    2017-02-01

    Full Text Available Introduction: CD4 testing in South Africa is based on an integrated tiered service delivery model that matches testing demand with capacity. The National Health Laboratory Service has predominantly implemented laboratory-based CD4 testing. Coverage gaps, over-/under-capacitation and optimal placement of point-of-care (POC testing sites need investigation. Objectives: We assessed the impact of relational algebraic capacitated location (RACL algorithm outcomes on the allocation of laboratory and POC testing sites. Methods: The RACL algorithm was developed to allocate laboratories and POC sites to ensure coverage using a set coverage approach for a defined travel time (T. The algorithm was repeated for three scenarios (A: T = 4; B: T = 3; C: T = 2 hours. Drive times for a representative sample of health facility clusters were used to approximate T. Outcomes included allocation of testing sites, Euclidian distances and test volumes. Additional analysis included platform distribution and space requirement assessment. Scenarios were reported as fusion table maps. Results: Scenario A would offer a fully-centralised approach with 15 CD4 laboratories without any POC testing. A significant increase in volumes would result in a four-fold increase at busier laboratories. CD4 laboratories would increase to 41 in scenario B and 61 in scenario C. POC testing would be offered at two sites in scenario B and 20 sites in scenario C. Conclusion: The RACL algorithm provides an objective methodology to address coverage gaps through the allocation of CD4 laboratories and POC sites for a given T. The algorithm outcomes need to be assessed in the context of local conditions.

  6. Validation of the LOD score compared with APACHE II score in prediction of the hospital outcome in critically ill patients.

    Science.gov (United States)

    Khwannimit, Bodin

    2008-01-01

    The Logistic Organ Dysfunction score (LOD) is an organ dysfunction score that can predict hospital mortality. The aim of this study was to validate the performance of the LOD score compared with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in a mixed intensive care unit (ICU) at a tertiary referral university hospital in Thailand. The data were collected prospectively on consecutive ICU admissions over a 24 month period from July1, 2004 until June 30, 2006. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUROC). The calibration was assessed by the Hosmer-Lemeshow goodness-of-fit H statistic. The overall fit of the model was evaluated by the Brier's score. Overall, 1,429 patients were enrolled during the study period. The mortality in the ICU was 20.9% and in the hospital was 27.9%. The median ICU and hospital lengths of stay were 3 and 18 days, respectively, for all patients. Both models showed excellent discrimination. The AUROC for the LOD and APACHE II were 0.860 [95% confidence interval (CI) = 0.838-0.882] and 0.898 (95% Cl = 0.879-0.917), respectively. The LOD score had perfect calibration with the Hosmer-Lemeshow goodness-of-fit H chi-2 = 10 (p = 0.44). However, the APACHE II had poor calibration with the Hosmer-Lemeshow goodness-of-fit H chi-2 = 75.69 (p < 0.001). Brier's score showed the overall fit for both models were 0.123 (95%Cl = 0.107-0.141) and 0.114 (0.098-0.132) for the LOD and APACHE II, respectively. Thus, the LOD score was found to be accurate for predicting hospital mortality for general critically ill patients in Thailand.

  7. Toxoplasma Chinese 1 Strain of WH3Δrop16I/III/gra15II Genetic Background Contributes to Abnormal Pregnant Outcomes in Murine Model

    Directory of Open Access Journals (Sweden)

    Cong Wang

    2018-06-01

    Full Text Available Toxoplasma gondii infection evokes a strong Th1-type response with interleukin (IL-12 and interferon (IFN-γ secretion. Recent studies suggest that the infection of pregnant mice with T. gondii may lead to adverse pregnancy results caused by subversion of physiological immune tolerance at maternofetal interface rather than direct invasion of the parasite. Genotype-associated dense granule protein GRA15II tends to induce classically activated macrophage (M1 differentiation and subsequently activating NK, Th1, and Th17 cells whereas rhoptry protein ROP16I/III drives macrophages to alternatively activated macrophage (M2 polarization and elicits Th2 immune response. Unlike the archetypal strains of types I, II, and III, type Chinese 1 strains possess both GRA15II and ROP16I/III, suggesting a distinct pathogenesis of Toxoplasma-involved adverse pregnancies. We constructed T. gondii type Chinese 1 strain of WH3Δrop16 based on CRISPR/Cas9 technology to explore the ROP16I/III-deficient/GRA15II-dominant parasites in induction of trophoblast apoptosis in vitro and abnormal pregnant outcomes of mice in vivo. Our study showed that Toxoplasma WH3Δrop16 remarkably induced apoptosis of trophoblasts. C57BL/6 pregnant mice injected with the tachyzoites of WH3Δrop16 presented increased absorptivity of fetuses in comparison with the mice infected with WH3 wild type (WH3 WT parasites although no remarkable difference of virulence to mice was seen between the two strains. Additionally, the mice inoculated with WH3Δrop16 tachyzoites exhibited a notable expression of both IL-17A and IFN-γ, while the percentage of CD4+CD25+FoxP3 [T regulatory cells (Tregs] were diminished in splenocytes and placenta tissues compared to those infected with WH3 WT parasites. Accordingly, expressions of IL-4, IL-10, and transforming growth factor beta 1, the pivotal cytokines of Th2 and Tregs response, were significantly dampened whereas IFN-γ and IL-12 expressions were

  8. Effect of Risk Acceptance for Bundled Care Payments on Clinical Outcomes in a High-Volume Total Joint Arthroplasty Practice After Implementation of a Standardized Clinical Pathway.

    Science.gov (United States)

    Kee, James R; Edwards, Paul K; Barnes, Charles L

    2017-08-01

    The Bundled Payments for Care Improvement (BPCI) initiative and the Arkansas Payment Improvement (API) initiative seek to incentivize reduced costs and improved outcomes compared with the previous fee-for-service model. Before participation, our practice initiated a standardized clinical pathway (CP) to reduce length of stay (LOS), readmissions, and discharge to postacute care facilities. This practice implemented a standardized CP focused on patient education, managing patient expectations, and maximizing cost outcomes. We retrospectively reviewed all primary total joint arthroplasty patients during the initial 2-year "at risk" period for both BPCI and API and determined discharge disposition, LOS, and readmission rate. During the "at risk" period, the average LOS decreased in our total joint arthroplasty patients and our patients discharged home >94%. Patients within the BPCI group had a decreased discharge to home and decreased readmission rates after total hip arthroplasty, but also tended to be older than both API and nonbundled payment patients. While participating in the BPCI and API, continued use of a standardized CP in a high-performing, high-volume total joint practice resulted in maintenance of a low-average LOS. In addition, BPCI patients had similar outcomes after total knee arthroplasty, but had decreased rates of discharge to home and readmission after total hip arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. 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

  10. SU-E-J-88: Margin Reduction of Level II/III Planning Target Volume for Image-Guided Simultaneous Integrated Boost Head-And-Neck Treatment

    International Nuclear Information System (INIS)

    Can, S; Neylon, J; Qi, S; Santhanam, A; Low, D

    2014-01-01

    Purpose: To investigate the feasibility of improved normal tissue sparing for head-and-neck (H'N) image-guided radiotherapy (IGRT) by employing tighter CTV-to-PTV margins for target level II/III though a GPU-based deformable image registration and dose accumulation framework. Methods: Ten H'N simultaneous integrated boost cases treated on TomoTherapy were retrospectively analyzed. Weekly kVCT scans in addition to daily MVCT scans were acquired for each patient. Reduced margin plans were generated with 0- mm margin for level II and III PTV (while 3-5 mm margin for PTV1) and compared with the standard margin plan using 3-5mm margin to all CTV1-3 (reference plan). An in-house developed GPU-based 3D image deformation tool was used to register and deform the weekly KVCTs with the planning CT and determine the delivered mean/minimum/maximum dose, dose volume histograms (DVHs), etc. Results: Compared with the reference plans, the averaged cord maximum, the right and left parotid doses reduced by 22.7 %, 16.5 %, and 9 % respectively in the reduced margin plans. The V95 for PTV2 and PTV3 were found within 2 and 5% between the reference and tighter margin plans. For the reduced margin plans, the averaged cumulative mean doses were consistent with the planned dose for PTV1, PTV2 and PTV3 within 1.5%, 1.7% and 1.4%. Similar dose variations of the delivered dose were seen for the reference and tighter margin plans. The delivered maximum and mean doses for the cord were 3.55 % and 2.37% higher than the planned doses; a 5 % higher cumulative mean dose for the parotids was also observed for the delivered dose than the planned doses in both plans. Conclusion: By imposing tighter CTV-to-PTV margins for level II and III targets for H'N irradiation, acceptable cumulative doses were achievable when coupled with weekly kVCT guidance while improving normal structure sparing

  11. 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...

  12. Comparison of esthetic outcome after extraction or non-extraction orthodontic treatment in class II division 1 malocclusion patients

    Directory of Open Access Journals (Sweden)

    Sneh Lata Verma

    2013-01-01

    Full Text Available Introduction: The extraction of premolars as a practical form of orthodontic therapy has been accepted for many years, but there remains a controversy regarding the effect of premolar extraction to improve esthetics as well as dentoskeletal relationship. The esthetic impact of the soft-tissue profile might play a major role in deciding on premolar extraction or non-extraction treatment, particularly in borderline patients. This cephalometric study was undertaken to compare the post-treatment soft-tissue profiles of successfully managed Class II, Division 1 malocclusions treated with either all first premolar extractions or treatment with a non-extraction therapy. Materials and Methods: The sample consisted of 100 post-pubertal female patients of Class II Division I malocclusion. Group 1, treated with four first premolar extractions, consisted of 50 female patients with a mean age of 14 years 1 month. Group 2, treated without extractions, consisted of 50 patients with a mean age of 13 years 5 months. Pre-treatment and post-treatment lateral cephalometric radiographs were evaluated. The pre-treatment to post-treatment stage comparison and the intergroup comparison of the treatment changes were conducted between extraction and non-extraction groups of Class II malocclusion samples with t-tests. Results: The soft-tissue facial profiles of the extraction and non-extraction samples were the same following active treatment except for a more retruded lower lip and a more pronounced lower labial sulcus in those patients subjected to extraction. Conclusions: The extraction or non-extraction decision, if based on sound diagnostic criteria, seems to have no systematic detrimental effects on the facial profile.

  13. Sex differences in cell genesis, hippocampal volume and behavioral outcomes in a rat model of neonatal HI.

    Science.gov (United States)

    Waddell, Jaylyn; Hanscom, Marie; Shalon Edwards, N; McKenna, Mary C; McCarthy, Margaret M

    2016-01-01

    Hypoxia-ischemia (HI) of the brain in near-term and term infants is a leading cause of infant mortality and lifelong disability but current therapeutic approaches remain limited. Males consistently display greater vulnerability to the deleterious consequences of HI in both humans and animal models. Neurogenesis increases after neonatal HI and offers a potential therapeutic target for recovery. The steroid hormone estradiol has been extensively explored as a neuroprotectant in adult models of stroke but with mixed results. Less consideration has been afforded to this naturally occurring agent in the developing brain, which has unique challenges from the adult. Using a model of term HI in the rat we have explored the impact of this insult on cell genesis in the hippocampus of males and females and the ability of estradiol treatment immediately after insult to restore function. Both short-term (3 days) and long-term (7 days) post-injury were assessed and revealed that only females had markedly increased cell genesis on the short-term but both sexes were increased long-term. A battery of behavioral tests revealed motor impairment in males and compromised episodic memory while both sexes were modestly impaired in spatial memory. Juvenile social play was also depressed in both sexes after HI. Estradiol therapy improved behavioral performance in both sexes but did not reverse a deficit in hippocampal volume ipsilateral to the insult. Thus the effects of estradiol do not appear to be via cell death or proliferation but rather involve other components of neural functioning. Published by Elsevier Inc.

  14. Sex differences in cell genesis, hippocampal volume and behavioral outcomes in a rat model of neonatal HI

    Science.gov (United States)

    Waddell, Jaylyn; Hanscom, Marie; Edwards, N. Shalon; McKenna, Mary C.; McCarthy, Margaret M.

    2015-01-01

    Hypoxia ischemia (HI) of the brain in near-term and term infants is a leading cause of infant mortality and lifelong disability but current therapeutic approaches remain limited. Males consistently display greater vulnerability to the deleterious consequences of HI in both humans and animal models. Neurogenesis increases after neonatal HI and offers a potential therapeutic target for recovery. The steroid hormone estradiol has been extensively explored as a neuroprotectant in adult models of stroke but with mixed results. Less consideration has been afforded to this naturally occurring agent in the developing brain, which has unique challenges from the adult. Using a model of term HI in the rat we have explored the impact of this insult on cell genesis in the hippocampus of males and females and the ability of estradiol treatment immediately after insult to restore function. Both short-term (3 days) and long-term (7 days) post-injury were assessed and revealed that only females had markedly increased cell genesis on the short-term but both sexes were increased long-term. A battery of behavioral tests revealed motor impairment in males and compromised episodic memory while both sexes were modestly impaired in spatial memory. Juvenile social play was also depressed in both sexes after HI. Estradiol therapy improved behavioral performance in both sexes but did not reverse a deficit in hippocampal volume ipsilateral to the insult. Thus the effects of estradiol do not appear to be via cell death or proliferation but rather involve other components of neural functioning. PMID:26376217

  15. Comparison of surgical and non-surgical orthodontic treatment approaches on occlusal and cephalometric outcomes in patients with Class II Division I malocclusions

    Directory of Open Access Journals (Sweden)

    Sheila Daniels

    2017-07-01

    Full Text Available Abstract Background This study aimed to examine end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical or non-surgical approaches. This study tests the hypotheses that occlusal outcomes (ABO-OGS and cephalometric outcomes differ between these groups. Methods A total of 60 patients were included: 20 of which underwent surgical correction and 40 of which did not. Cast grading of initial and final study models was performed and information was gathered from pre- to post-treatment cephalometric radiographs. The end-of-treatment ABO-OGS and cephalometric outcomes were compared to Mann-Whitney U tests and multivariable linear regression models. Results Following adjustment for multiple confounders (age, gender, complexity of case, and skeletal patterns, the final deband score (ABO-OGS was similar for both groups (23.8 for surgical group versus 22.5 for non-surgical group. Those treated surgically had a significantly larger reduction in ANB angle, 3.4° reduction versus 1.5° reduction in the non-surgical group (p = 0.002. The surgical group also showed increased maxillary incisor proclination (p = 0.001 compared to the non-surgical group. This might be attributed to retroclination of maxillary incisors during treatment selection in the non-surgical group—namely, extraction of premolars to mask the discrepancy. Conclusions Those treated surgically had a significantly larger reduction in ANB angle and increased maxillary incisor proclination compared to those treated non-surgically with no significant changes in occlusal outcomes.

  16. The Anglo-Scandinavian Cardiac Outcomes Trial: blood pressure-lowering limb: effects in patients with type II diabetes

    DEFF Research Database (Denmark)

    Ostergren, Jan; Poulter, Neil R; Sever, Peter S

    2008-01-01

    OBJECTIVE: To compare the effects of two antihypertensive treatment strategies for the prevention of coronary heart disease and other cardiovascular events in the large subpopulation (n=5137) with diabetes mellitus in the blood pressure-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial...... nonsignificantly by 8% (hazard ratio 0.92, confidence interval 0.74-1.15). CONCLUSION: In the large diabetic subgroup in the blood pressure-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial, the benefits of amlodipine-based treatment, compared with atenolol-based treatment, on the incidence of total...... with addition of thiazide as required (atenolol-based). Therapy was titrated to achieve a target blood pressure of less than 130/80 mmHg. RESULTS: The trial was terminated early due to significant benefits on mortality and stroke associated with the amlodipine-based regimen. In patients with diabetes mellitus...

  17. A prospective study of musculoskeletal outcomes among manufacturing workers: II. Effects of psychosocial stress and work organization factors.

    Science.gov (United States)

    Gerr, Fredric; Fethke, Nathan B; Anton, Dan; Merlino, Linda; Rosecrance, John; Marcus, Michele; Jones, Michael P

    2014-02-01

    The aim of this study was to characterize associations between psychosocial and work organizational risk factors and upper-extremity musculoskeletal symptoms and disorders. Methodological limitations of previous studies of psychosocial and work organizational risk factors and musculoskeletal outcomes have produced inconsistent associations. In this prospective epidemiologic study of 386 workers, questionnaires to assess decision latitude ("control") and psychological job demands ("demand") were administered to study participants and were used to classify them into job strain "quadrants". Measures of job stress and job change were collected during each week of follow-up. Incident hand/arm and neck/shoulder symptoms and disorders were ascertained weekly. Associations between exposure measures and musculoskeletal outcomes were estimated with proportional hazard methods. When compared to the low-demand/high-control job strain referent category, large increases in risk of hand/arm disorders were observed for both high-demand/high-control (hazard ratio [HR] = 4.49, 95% confidence interval [CI] = [1.23, 16.4]) and high-demand/low-control job strain categories (HR = 5.18,95% CI = [1.39, 19.4]). Similar associations were observed for hand/arm symptoms. A strong association was also observed between the low-demand/low-control job strain category and neck/shoulder disorders (HR = 6.46, 95% CI = [1.46, 28.6]). Statistically significant associations were also observed between weekly stress level and weekly job change and several musculoskeletal outcomes. Associations between psychosocial risk factors and work organizational factors and musculoskeletal outcomes were large and in the hypothesized direction. Prevention of occupational musculoskeletal disorders may require attention to psychosocial and work organizational factors in addition to physical factors. Methods to control adverse effects of psychosocial and work organizational risk factors should be explored.

  18. Pro-ACT II: integrating utilization management, discharge planning, and nursing case management into the outcomes manager role.

    Science.gov (United States)

    Brett, J L; Bueno, M; Royal, N; Kendall-Sengin, K

    1997-02-01

    Building on redesign efforts that created case management, clinical care technicians, support service hosts, and pharmacy technician roles, this redesign focused on integrating case management, utilization management, and discharge planning functions into a new outcomes manager role. The authors describe the process of developing and implementing the new role and outline specific actions that eliminated redundancy and inefficiency. Results of the evaluation of the project are reviewed, including full-time equivalent and salary savings and employee and physician satisfaction improvements.

  19. COLLISIONS BETWEEN GRAVITY-DOMINATED BODIES. II. THE DIVERSITY OF IMPACT OUTCOMES DURING THE END STAGE OF PLANET FORMATION

    International Nuclear Information System (INIS)

    Stewart, Sarah T.; Leinhardt, Zoë M.

    2012-01-01

    Numerical simulations of the stochastic end stage of planet formation typically begin with a population of embryos and planetesimals that grow into planets by merging. We analyzed the impact parameters of collisions leading to the growth of terrestrial planets from recent N-body simulations that assumed perfect merging and calculated more realistic outcomes using a new analytic collision physics model. We find that collision outcomes are diverse and span all possible regimes: hit-and-run, merging, partial accretion, partial erosion, and catastrophic disruption. The primary outcomes of giant impacts between planetary embryos are approximately evenly split between partial accretion, graze-and-merge, and hit-and-run events. To explore the cumulative effects of more realistic collision outcomes, we modeled the growth of individual planets with a Monte Carlo technique using the distribution of impact parameters from N-body simulations. We find that fewer planets reached masses >0.7 M Earth using the collision physics model compared to simulations that assumed every collision results in perfect merging. For final planets with masses >0.7 M Earth , 60% are enriched in their core-to-mantle mass fraction by >10% compared to the initial embryo composition. Fragmentation during planet formation produces significant debris (∼15% of the final mass) and occurs primarily by erosion of the smaller body in partial accretion and hit-and-run events. In partial accretion events, the target body grows by preferentially accreting the iron core of the projectile and the escaping fragments are derived primarily from the silicate mantles of both bodies. Thus, the bulk composition of a planet can evolve via stochastic giant impacts.

  20. In-hospital outcome in patients with ST elevation myocardial infarction and right bundle branch block. A sub-study from RENASICA II, a national multicenter registry.

    Science.gov (United States)

    Juárez-Herrera, Ursulo; Jerjes Sánchez, Carlos; González-Pacheco, Héctor; Martínez-Sánchez, Carlos

    2010-01-01

    Compare in-hospital outcome in patients with ST-elevation myocardial infarction with right versus left bundle branch block. RENASICA II, a national Mexican registry enrolled 8098 patients with final diagnosis of acute coronary syndrome secondary to ischemic heart disease. In 4555 STEMI patients, 545 had bundle branch block, 318 (58.3%) with right and 225 patients with left (41.6%). Both groups were compared in terms of in-hospital outcome through major cardiovascular adverse events; (cardiovascular death, recurrent ischemia and reinfarction). Multivariable analysis was performed to identify in-hospital mortality risk among right and left bundle branch block patients. There were not statistical differences in both groups regarding baseline characteristics, time of ischemia, myocardial infarction location, ventricular dysfunction and reperfusion strategies. In-hospital outcome in bundle branch block group was characterized by a high incidence of major cardiovascular adverse events with a trend to higher mortality in patients with right bundle branch block (OR 1.70, CI 1.19 - 2.42, p right bundle branch block accompanying ST-elevation myocardial infarction of any location at emergency room presentation was an independent predictor of high in-hospital mortality.

  1. The influence of 2 weeks of low-volume high-intensity interval training on health outcomes in adolescent boys.

    Science.gov (United States)

    Barker, Alan R; Day, Josephine; Smith, Aaron; Bond, Bert; Williams, Craig A

    2014-01-01

    The present study aimed to establish whether 2 weeks of high-intensity interval training would have a beneficial effect on aerobic fitness, fat oxidation, blood pressure and body mass index (BMI) in healthy adolescent boys. Ten adolescent boys (15.1 ± 0.3 years, 1.3 ± 0.2 years post-estimated peak height velocity) completed six sessions of Wingate-style high-intensity interval training over a 2-week period. The first session consisted of four sprints with training progressed to seven sprints in the final session. High-intensity interval training had a beneficial effect on maximal O2 uptake (mean change, ±90% confidence intervals: 0.19 L · min(-1), ±0.19, respectively), on the O2 uptake at the gas exchange threshold (0.09 L · min(-1), ±0.13) and on the O2 cost of sub-maximal exercise (-0.04 L · min(-1), ±0.04). A beneficial effect on the contribution of lipid (0.06 g · min(-1), ±0.06) and carbohydrate (-0.23 g · min(-1), ±0.14) oxidation was observed during sub-maximal exercise, but not for the maximal rate of fat oxidation (0.04 g · min(-1), ±0.08). Systolic blood pressure (1 mmHg, ±4) and BMI (0.1 kg · m2, ±0.1) were not altered following training. These data demonstrate that meaningful changes in health outcomes are possible in healthy adolescent boys after just six sessions of high-intensity interval training over a 2-week period.

  2. Outcome quality and long-term (≥15 years) stability after Class II:2 Herbst-multibracket appliance treatment in comparison to untreated Class I controls.

    Science.gov (United States)

    Bock, Niko C; Saffar, Mitra; Hudel, Helge; Evälahti, Marjut; Heikinheimo, Kaisa; Rice, David P; Ruf, Sabine

    2017-12-09

    To investigate the outcome quality and the long-term (≥15 years) post-treatment (Tx) changes after Class II:2 Herbst-multibracket appliance (MBA) Tx. In this longitudinal observational study, a recall of Class II:2 patients who had been treated by a Herbst-MBA during adolescence was conducted. Study models from before and after active Tx, after retention and after recall were assessed using standard occlusal variables and the peer assessment rating index (PAR). These data were compared to historical untreated Class I controls. Twenty out of 33 patients (61%) could be located and participated at age 33.9 ± 2.7 years. When comparing their data to the 13 patients who did not participate, the pre- and post-Tx occlusal findings did not differ systematically; however, the PAR scores of the non-participants were by 3.3-8.2 points higher at all times and the non-participants were 2.1-2.5 years older. Pre-Tx at age 14.4 ± 2.7 years, the participants showed the following mean values: PAR = 15.0 ± 7.0, Class II molar relationship (MR) = 0.8 ± 0.3 cusp widths (cw), overbite = 5.3 ± 1.3 mm. After Tx, a PAR score of 2.9 ± 1.3 and a super Class I MR (-0.1 ± 0.1 cw) with normal overbite (1.2 ± 0.8 mm) existed. At recall, a PAR score increase to 5.9 ± 3.6 points had occurred, mainly caused by an increase of overbite to 2.5 ± 1.5 mm. The average MR remained Class I (0.0 ± 0.2 cw). For all variables, the untreated controls exhibited similar findings. The occlusal outcome of Class II:2 Herbst-MBA Tx exhibited very good long-term stability. While mild post-Tx changes occurred, the long-term findings are similar to untreated Class I controls. © The Author(s) 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  3. Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

    International Nuclear Information System (INIS)

    Kaltenborn, Alexander; Carl, Ulrich Martin; Hinsche, Tanja; Nitsche, Mirko; Hermann, Robert Michael

    2017-01-01

    Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [de

  4. Military Message Experiment. Volume II.

    Science.gov (United States)

    1982-04-01

    elements of the Department of Defense. This resulted in a memorandum from the Director, Telecomunications and Comand and Control, OSD, in June 1975...1978 to April 1979 and provides a discussion of the telecomunications inter- face aspects of the experiment. This Final Report covers the period of...arise in the telecomunication system which require A retransmission of an outgoing message. A "service" message may be created within the

  5. 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.

  6. Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kaltenborn, Alexander [Federal Armed Forces Hospital Westerstede, Department of Orthopedic and Trauma Surgery, Westerstede (Germany); Hannover Medical School, Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover (Germany); Carl, Ulrich Martin; Hinsche, Tanja [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Nitsche, Mirko [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); University of Schleswig Holstein, Campus Kiel, Department of Radiotherapy, Karl-Lennert Cancer Center, Kiel (Germany); Hermann, Robert Michael [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Hannover Medical School, Department of Radiotherapy and Special Oncology, Hannover (Germany)

    2017-04-15

    Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [German] In der Behandlung des

  7. A Phase II Trial of Brachytherapy Alone After Lumpectomy for Select Breast Cancer: Tumor Control and Survival Outcomes of RTOG 95-17

    International Nuclear Information System (INIS)

    Arthur, Douglas W.; Winter, Kathryn; Kuske, Robert R.; Bolton, John; Rabinovitch, Rachel; White, Julia; Hanson, William F.; Wilenzick, Raymond M.; McCormick, Beryl

    2008-01-01

    Purpose: Radiation Therapy Oncology Group 95-17 is a prospective Phase II cooperative group trial of accelerated partial breast irradiation (APBI) alone using multicatheter brachytherapy after lumpectomy in select early-stage breast cancers. Tumor control and survival outcomes are reported. Methods and Materials: Eligibility criteria included Stage I/II breast carcinoma confirmed to be <3 cm, unifocal, invasive nonlobular histology with zero to three positive axillary nodes without extracapsular extension. APBI treatment was delivered with either low-dose-rate (LDR) (45 Gy in 3.5-5 days) or high-dose-rate (HDR) brachytherapy (34 Gy in 10 twice-daily fractions over 5 days). End points evaluated included in-breast control, regional control, mastectomy-free rate, mastectomy-free survival, disease-free survival, and overall survival. The study was designed to analyze the HDR and LDR groups separately and without comparison. Results: Between 1997 and 2000, 100 patients were accrued and 99 were eligible; 66 treated with HDR brachytherapy and 33 treated with LDR brachytherapy. Eighty-seven patients had T1 lesions and 12 had T2 lesions. Seventy-nine were pathologically N0 and 20 were N1. Median follow-up in the HDR group is 6.14 years with the 5-year estimates of in-breast, regional, and contralateral failure rates of 3%, 5%, and 2%, respectively. The LDR group experienced similar results with a median follow-up of 6.22 years. The 5-year estimates of in-breast, regional, and contralateral failure rates of 6%, 0%, and 6%, respectively. Conclusion: Patients treated with multicatheter partial breast brachytherapy in this trial experienced excellent in-breast control rates and overall outcome that compare with reports from APBI studies with similar extended follow-up

  8. California drug courts: outcomes, costs and promising practices: an overview of Phase II in a statewide study.

    Science.gov (United States)

    Carey, Shannon M; Finigan, Michael; Crumpton, Dave; Waller, Mark

    2006-11-01

    The rapid expansion of drug courts in California and the state's uncertain fiscal climate highlighted the need for definitive cost information on drug court programs. This study focused on creating a research design that can be utilized for statewide and national cost-assessment of drug courts by conducting in-depth case studies of the costs and benefits in nine adult drug courts in California. A Transactional Institutional Costs Analysis (TICA) approach was used, allowing researchers to calculate costs based on every individual's transactions within the drug court or the traditional criminal justice system. This methodology also allows the calculation of costs and benefits by agency (e.g., Public Defender's office, court, District Attorney). Results in the nine sites showed that the majority of agencies save money in processing an offender though drug court. Overall, for these nine study sites, participation in drug court saved the state over 9 million dollars in criminal justice and treatment costs due to lower recidivism in drug court participants. Based on the lessons learned in Phases I and II, Phase III of this study focuses on the creation of a web-based drug court cost self-evaluation tool (DC-CSET) that drug courts can use to determine their own costs and benefits.

  9. Demographics and Outcomes of Stage I-II Merkel Cell Carcinoma Treated with Mohs Micrographic Surgery Compared with Wide Local Excision in the National Cancer Data Base.

    Science.gov (United States)

    Singh, Babu; Qureshi, Muhammad M; Truong, Minh Tam; Sahni, Debjani

    2018-02-03

    The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined. To compare survival outcomes in patients with early stage MCC treated with MOHS versus WLE. A retrospective review of all cases in the National Cancer Data Base (NCDB) of MCC of clinical Stage I-II MCC treated with WLE or MOHS was performed. 1,795 cases of Stage I-II MCC were identified who underwent WLE (N=1,685) or MOHS (N=110). There was no difference in residual tumor on surgical margins between the two treatment groups (p=0.588). On multivariate analysis, there was no difference in overall survival between the treatment modalities (adjusted HR 1.02; 95% CI 0.72-1.45, p=0.897). There was no difference in overall survival between the two groups on propensity score matched analysis. Disease specific survival was not reported as this data in not available in the NCDB. MOHS appears to be as effective as WLE in treating early stage MCC. Copyright © 2018. Published by Elsevier Inc.

  10. NUPEC BWR Full-size Fine-mesh Bundle Test (BFBT) Benchmark. Volume II: uncertainty and sensitivity analyses of void distribution and critical power - Specification

    International Nuclear Information System (INIS)

    Aydogan, F.; Hochreiter, L.; Ivanov, K.; Martin, M.; Utsuno, H.; Sartori, E.

    2010-01-01

    experimental cases from the BFBT database for both steady-state void distribution and steady-state critical power uncertainty analyses. In order to study the basic thermal-hydraulics in a single channel, where the concern regarding the cross-flow effect modelling could be removed, an elemental task is proposed, consisting of two sub-tasks that are placed in each phase of the benchmark scope as follows: - Sub-task 1: Void fraction in elemental channel benchmark; - Sub-task 2: Critical power in elemental channel benchmark. The first task can also be utilised as an uncertainty analysis exercise for fine computational fluid dynamics (CFD) models for which the full bundle sensitivity or uncertainty analysis is more difficult. The task is added to the second volume of the specification as an optional exercise. Chapter 2 of this document provides the definition of UA/SA terms. Chapter 3 provides the selection and characterisation of the input uncertain parameters for the BFBT benchmark and the description of the elemental task. Chapter 4 describes the suggested approach for UA/SA of the BFBT benchmark. Chapter 5 provides the selection of data sets for the uncertainty analysis and the elemental task from the BFBT database. Chapter 6 specifies the requested output for void distribution and critical power uncertainty analyses (Exercises I-4 and II-3) as well as for the elemental task. Chapter 7 provides conclusions. Appendix 1 discusses the UA/SA methods. Appendix 2 presents the Phenomena Identification Ranking Tables (PIRT) developed at PSU for void distribution and critical power predictions in order to assist participants in selecting the most sensitive/uncertain code model parameters

  11. Effect of patient Age on surgical outcomes for Graves’ disease: a case–control study of 100 consecutive patients at a high volume thyroid surgical center

    Directory of Open Access Journals (Sweden)

    Breuer Christopher K

    2013-01-01

    Full Text Available Abstract Objective To compare outcomes between children ( Summary of background data Reported complication rates for children undergoing surgery for Graves’ disease are worse than for adults. Methods 100 consecutive patients (32 children; 68 adults who underwent total thyroidectomy for Graves’ disease (GD by a high-volume endocrine surgery team from were compared. Results The mean patient age was 9.7 yrs (range 3.4-17.9 yrs in children versus 44.9 yrs (range 18.4-84.2 yrs in adults. Operative times were longer in children (2.18 ± 0.08 hrs than in adults (1.66 ± 0.03 hrs (p = 0.003. Pediatric thyroid specimens averaged 38.6.0 ± 8.9 gm (range: 9–293 gm and adult thyroid specimens averaged 48.0 ± 6.4 gm (range: 6.6-203 gm (p = 0.34. Thyroid to body weight ratios were greater in children (0.94 ± 0.11 gm/kg than adults (0.67 ± 0.8 gm/kg (p = 0.05. In all patients, the hyperthyroid state resolved after surgery. There was no operative mortality, recurrence, or permanent hypoparathyroidism. Transient post-operative hypocalcemia requiring calcium infusion was greater in children than adults (6/32 vs. 1/68; p = 0.004. Transient recurrent laryngeal nerve dysfunction occurred in two children and in no adults (p = 0.32. Postoperative hematoma occurred in two adults and in no children (p = 0.46. The length of stay was longer for children (1.41 ± 0.12 days than for adults (1.03 ±0.03 days (p = 0.004. Conclusion Surgical management of GD is technically more challenging in children as evidenced by longer operative times. Whereas temporary hypocalcemia occurs more commonly in children than adults, the risks of major complications including disease recurrence, permanent hypoparathyroidism, recurrent laryngeal nerve injury, or neck hematoma were indistinguishable. These data suggest that excellent and equivalent outcomes can be achieved for GD surgery in children and adults when care is rendered

  12. Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Arens, Anne I.J.; Grootjans, Willem; Oyen, Wim J.G.; Visser, Eric P. [Radboud University Medical Center, Department of Nuclear Medicine, P.O. Box 9101, Nijmegen (Netherlands); Troost, Esther G.C. [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Maastricht University Medical Centre, MAASTRO clinic, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Hoeben, Bianca A.W.; Bussink, Johan; Kaanders, Johannes H.A.M. [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Lee, John A.; Gregoire, Vincent [St-Luc University Hospital, Department of Radiation Oncology, Universite Catholique de Louvain, Brussels (Belgium); Hatt, Mathieu; Visvikis, Dimitris [Laboratoire de Traitement de l' Information Medicale (LaTIM), INSERM UMR1101, Brest (France)

    2014-05-15

    Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer {sup 18}F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome. The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV{sub CT}). PVs were visually determined on all PET scans (PV{sub VIS}). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV{sub RTL}), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV{sub W} and {sub C}), and a fuzzy locally adaptive Bayesian algorithm (PV{sub FLAB}). Pretreatment PV{sub VIS} correlated best with PV{sub FLAB} and GTV{sub CT}. Correlations with PV{sub RTL} and PV{sub W} and {sub C} were weaker although statistically significant. During treatment, the PV{sub VIS}, PV{sub W} and {sub C} and PV{sub FLAB} significant decreased over time with the steepest decline over time for PV{sub FLAB}. Among these advanced segmentation methods, PV{sub FLAB} was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV{sub W} and {sub C} and 27 % for PV{sub RTL}). A decrease in PV{sub FLAB} above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %). In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. This may

  13. Childhood outcomes after prescription of antibiotics to pregnant women with spontaneous preterm labour: 7-year follow-up of the ORACLE II trial.

    Science.gov (United States)

    Kenyon, S; Pike, K; Jones, D R; Brocklehurst, P; Marlow, N; Salt, A; Taylor, D J

    2008-10-11

    The ORACLE II trial compared the use of erythromycin and/or amoxicillin-clavulanate (co-amoxiclav) with that of placebo for women in spontaneous preterm labour and intact membranes, without overt signs of clinical infection, by use of a factorial randomised design. The aim of the present study--the ORACLE Children Study II--was to determine the long-term effects on children after exposure to antibiotics in this clinical situation. We assessed children at age 7 years born to the 4221 women who had completed the ORACLE II study and who were eligible for follow-up with a structured parental questionnaire to assess the child's health status. Functional impairment was defined as the presence of any level of functional impairment (severe, moderate, or mild) derived from the mark III Multi-Attribute Health Status classification system. Educational outcomes were assessed with national curriculum test results for children resident in England. Outcome was determined for 3196 (71%) eligible children. Overall, a greater proportion of children whose mothers had been prescribed erythromycin, with or without co-amoxiclav, had any functional impairment than did those whose mothers had received no erythromycin (658 [42.3%] of 1554 children vs 574 [38.3%] of 1498; odds ratio 1.18, 95% CI 1.02-1.37). Co-amoxiclav (with or without erythromycin) had no effect on the proportion of children with any functional impairment, compared with receipt of no co-amoxiclav (624 [40.7%] of 1523 vs 608 [40.0%] of 1520; 1.03, 0.89-1.19). No effects were seen with either antibiotic on the number of deaths, other medical conditions, behavioural patterns, or educational attainment. However, more children whose mothers had received erythromycin or co-amoxiclav developed cerebral palsy than did those born to mothers who received no erythromycin or no co-amoxiclav, respectively (erythromycin: 53 [3.3%] of 1611 vs 27 [1.7%] of 1562, 1.93, 1.21-3.09; co-amoxiclav: 50 [3.2%] of 1587 vs 30 [1.9%] of 1586, 1

  14. Management Trends and Outcomes for Stage I to II Mantle Cell Lymphoma Using the National Cancer Data Base: Ascertaining the Ideal Treatment Paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Beant S.; Vargo, John A. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Pai, Sarah S. [Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Balasubramani, Goundappa K. [Department of Epidemiology, Epidemiology Data Center, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States)

    2015-11-01

    Purpose: Mantle cell lymphoma (MCL) is a rare, albeit aggressive subset of non-Hodgkin lymphoma, resulting in varied treatment approaches. Given the paucity of data defining the optimal management for early-stage MCL, we conducted an analysis using the National Cancer Data Base (NCDB) to identify practice patterns and outcomes. Methods and Materials: The NCDB was queried for patients with stage I to II MCL diagnosed from 1998 to 2012 receiving chemotherapy (CT) or radiation therapy (RT), or both (CT+RT). Univariate and multivariable analyses for factors associated with treatment selection were completed using logistic regression. Propensity scores with inverse probability treatment weighting (IPTW) were calculated based on the conditional probability of receiving CT+RT. The log-rank test and Cox proportional hazards modeling with IPTW adjustment were conducted for the survival analyses. Results: In total, 2539 patients were identified. The key characteristics were as follows: 69% were male, 71% were aged ≥60 years, 28% had extranodal involvement, and 51% had stage I disease. Of the 2539 patients, 70% underwent CT, 11% underwent RT, and 19% underwent CT+RT. The use of CT+RT decreased from 23.1% to 14.1% in 1998 to 2002 and 2010 to 2012 (P<.001). CT+RT usage was lower for patients with the following characteristics: age ≥60 years, female sex, stage II disease, and the presence of B symptoms. With a median follow-up period of 42.8 months, the unadjusted 3-year overall survival estimates for patients receiving CT, RT, or CT+RT were 67.8%, 72.4%, and 79.8%, respectively (P<.001). After correcting for indication bias through IPTW-adjusted modeling, CT+RT reduced the risk of overall mortality compared with monotherapy (hazard ratio 0.65, P=.029). Conclusions: Although uncommon, patients with stage I-II MCL can have favorable outcomes. Despite a continued decline in the usage of consolidative RT, combined modality therapy improves survival in this cohort compared

  15. Management Trends and Outcomes for Stage I to II Mantle Cell Lymphoma Using the National Cancer Data Base: Ascertaining the Ideal Treatment Paradigm

    International Nuclear Information System (INIS)

    Gill, Beant S.; Vargo, John A.; Pai, Sarah S.; Balasubramani, Goundappa K.; Beriwal, Sushil

    2015-01-01

    Purpose: Mantle cell lymphoma (MCL) is a rare, albeit aggressive subset of non-Hodgkin lymphoma, resulting in varied treatment approaches. Given the paucity of data defining the optimal management for early-stage MCL, we conducted an analysis using the National Cancer Data Base (NCDB) to identify practice patterns and outcomes. Methods and Materials: The NCDB was queried for patients with stage I to II MCL diagnosed from 1998 to 2012 receiving chemotherapy (CT) or radiation therapy (RT), or both (CT+RT). Univariate and multivariable analyses for factors associated with treatment selection were completed using logistic regression. Propensity scores with inverse probability treatment weighting (IPTW) were calculated based on the conditional probability of receiving CT+RT. The log-rank test and Cox proportional hazards modeling with IPTW adjustment were conducted for the survival analyses. Results: In total, 2539 patients were identified. The key characteristics were as follows: 69% were male, 71% were aged ≥60 years, 28% had extranodal involvement, and 51% had stage I disease. Of the 2539 patients, 70% underwent CT, 11% underwent RT, and 19% underwent CT+RT. The use of CT+RT decreased from 23.1% to 14.1% in 1998 to 2002 and 2010 to 2012 (P<.001). CT+RT usage was lower for patients with the following characteristics: age ≥60 years, female sex, stage II disease, and the presence of B symptoms. With a median follow-up period of 42.8 months, the unadjusted 3-year overall survival estimates for patients receiving CT, RT, or CT+RT were 67.8%, 72.4%, and 79.8%, respectively (P<.001). After correcting for indication bias through IPTW-adjusted modeling, CT+RT reduced the risk of overall mortality compared with monotherapy (hazard ratio 0.65, P=.029). Conclusions: Although uncommon, patients with stage I-II MCL can have favorable outcomes. Despite a continued decline in the usage of consolidative RT, combined modality therapy improves survival in this cohort compared

  16. Outcome assessment of lingual and labial appliances compared with cephalometric analysis, peer assessment rating, and objective grading system in Angle Class II extraction cases.

    Science.gov (United States)

    Deguchi, Toru; Terao, Fumie; Aonuma, Tomo; Kataoka, Tomoki; Sugawara, Yasuyo; Yamashiro, Takashi; Takano-Yamamoto, Teruko

    2015-05-01

    To validate our hypothesis that there would be significant differences in treatment outcomes, including cephalometric values, degree of root resorption, occlusal indices, and functional aspect, between cases treated with labial and lingual appliances. Twenty-four consecutively treated Class II cases with extractions and lingual appliance were compared with 25 matched cases treated with extraction and labial appliance. Orthodontic treatment outcomes were evaluated by cephalometric analysis, peer assessment rating, and an objective grading system (OGS). Additionally, functional analysis was also performed in both groups after orthodontic treatment. Statistical comparison was performed using the Wilcoxon signed rank test within the groups, and the Mann-Whitney U-test was used to compare between the labial and lingual groups. The only significant difference between the groups was that the interincisal angle was larger in the lingual group than in the labial group. OGS evaluation showed that control over root angulation was significantly worse in the lingual group than in the labial group. There was no significant difference between groups in the amount of root resorption or in functional evaluation. Generally, lingual appliances offer comparable treatment results to those obtained with labial appliances. However, care should be taken with lingual appliances because they are more prone to produce uprighted incisors and root angulation.

  17. Neoadjuvant Down-Sizing of Hilar Cholangiocarcinoma with Photodynamic Therapy—Long-Term Outcome of a Phase II Pilot Study

    Directory of Open Access Journals (Sweden)

    Andrej Wagner

    2015-11-01

    Full Text Available Hilar cholangiocarcinoma (CC is non-resectable in the majority of patients often due to intrahepatic extension along bile duct branches/segments, and even after complete resection (R0 recurrence can be as high as 70%. Photodynamic therapy (PDT is an established palliative local tumor ablative treatment for non-resectable hilar CC. We report the long-term outcome of curative resection (R0 performed after neoadjuvant PDT for downsizing of tumor margins in seven patients (median age 59 years with initially non-resectable hilar CC. Photofrin® was injected intravenously 24–48 h before laser light irradiation of the tumor stenoses and the adjacent bile duct segments. Major resective surgery was done with curative intention six weeks after PDT. All seven patients had been curatively (R0 resected and there were no undue early or late complications for the neoadjuvant PDT and surgery. Six of seven patients died from tumor recurrence at a median of 3.2 years after resection, the five-year survival rate was 43%. These results are comparable with published data for patients resected R0 without pre-treatment, indicating that neoadjuvant PDT is feasible and could improve overall survival of patients considered non-curatively resectable because of initial tumor extension in bile duct branches/segments—however, this concept needs to be validated in a larger trial.

  18. Administration of angiotensin II and a bradykinin B2 receptor blocker in midpregnancy impairs gestational outcome in guinea pigs.

    Science.gov (United States)

    Valdés, Gloria; Schneider, Daniela; Corthorn, Jenny; Ortíz, Rita; Acuña, Stephanie; Padilla, Oslando

    2014-06-04

    The opposing renin-angiotensin system (RAS) and kallikrein-kinin system (KKS) are upregulated in pregnancy and localize in the utero-placental unit. To test their participation as counter-regulators, circulating angiotensin II (AII) was exogenously elevated and the bradykinin B2 receptor (B2R) was antagonized in pregnant guinea-pigs. We hypothesized that disrupting the RAS/KKS balance during the period of maximal trophoblast invasion and placental development would provoke increased blood pressure, defective trophoblast invasion and a preeclampsia-like syndrome. Pregnant guinea-pigs received subcutaneous infusions of AII (200 μg/kg/day), the B2R antagonist Bradyzide (BDZ; 62.5 microg/kg/day), or both (AII + BDZ) from gestational day 20 to 34. Non-pregnant cycling animals were included in a control group (C NP) or received AII + BDZ (AII + BDZ NP) during 14 days. Systolic blood pressure was determined during cycle in C NP, and on the last day of infusion, and 6 and 26 days thereafter in the remaining groups. Twenty six days after the infusions blood and urine were extracted, fetuses, placentas and kidneys were weighed, and trophoblast invasion of spiral arteries was defined in the utero-placental units by immunocytochemistry. Systolic blood pressure transiently rose in a subgroup of the pregnant females while receiving AII + BDZ infusion, but not in AII + BDZ NP. Plasma creatinine was higher in AII- and BDZ-treated dams, but no proteinuria or hyperuricemia were observed. Kidney weight increased in AII + BDZ-treated pregnant and non-pregnant females. Aborted and dead fetuses were increased in dams that received AII and AII + BDZ. The fetal/placental weight ratio was reduced in litters of AII + BDZ-treated mothers. All groups that received interventions during pregnancy showed reduced replacement of endothelial cells by extravillous trophoblasts in lateral and myometrial spiral arteries. The acute effects on fetal viability, and the persistently impaired renal

  19. Arginase II expressed in cancer-associated fibroblasts indicates tissue hypoxia and predicts poor outcome in patients with pancreatic cancer.

    Directory of Open Access Journals (Sweden)

    Yoshinori Ino

    Full Text Available An adequate level of arginine in the tissue microenvironment is essential for T cell activity and survival. Arginine levels are regulated by the arginine-catabolizing enzyme, arginase (ARG. It has been reported that arginase II (ARG2, one of two ARGs, is aberrantly expressed in prostate cancer cells, which convert arginine into ornithine, resulting in a lack of arginine that weakens tumor-infiltrating lymphocytes and renders them dysfunctional. However, immune suppression mediated by ARG2-expressing cancer cells in lung cancer has not been observed. Here we studied the expression of ARG2 in pancreatic ductal carcinoma (PDC tissue clinicopathologically by examining over 200 cases of PDC. In contrast to prostate cancer, ARG2 expression was rarely demonstrated in PDC cells by immunohistochemistry, and instead ARG2 was characteristically expressed in α-smooth muscle actin-positive cancer-associated fibroblasts (CAFs, especially those located within and around necrotic areas in PDC. The presence of ARG2-expressing CAFs was closely correlated with shorter overall survival (OS; P  = 0.003 and disease-free survival (DFS; P  = 0.0006. Multivariate Cox regression analysis showed that the presence of ARG2-expressing CAFs in PDC tissue was an independent predictor of poorer OS (hazard ratio [HR]  = 1.582, P  = 0.007 and DFS (HR  = 1.715, P  = 0.001 in PDC patients. In addition to the characteristic distribution of ARG2-expressing CAFs, such CAFs co-expressed carbonic anhydrase IX, SLC2A1, or HIF-1α, markers of hypoxia, in PDC tissue. Furthermore, in vitro experiments revealed that cultured fibroblasts extracted from PDC tissue expressed the ARG2 transcript after exposure to hypoxia, which had arginase activity. These results indicate that cancer cell-mediated immune suppression through ARG2 expression is not a general event and that the presence of ARG2-expressing CAFs is an indicator of poor prognosis, as well as hypoxia, in PDC

  20. Contrast-enhanced T1 mapping-based extracellular volume fraction independently predicts clinical outcome in patients with non-ischemic dilated cardiomyopathy: a prospective cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Youn, Jong-Chan [Hallym University College of Medicine, Division of Cardiology, Dongtan Sacred Heart Hospital, Hwaseong (Korea, Republic of); Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of); Hong, Yoo Jin; Lee, Hye-Jeong; Han, Kyunghwa; Suh, Young Joo; Hur, Jin; Kim, Young Jin; Choi, Byoung Wook [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Shim, Chi Young; Hong, Geu-Ru; Kang, Seok-Min [Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of)

    2017-09-15

    We aimed to evaluate the prognostic role of cardiac magnetic resonance imaging (CMR)-based extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) and compare it with late gadolinium enhancement (LGE) parameters. This was a single-center, prospective, cohort study of 117 NIDCM patients (71 men, 51.9 ± 16.7 years) who underwent clinical 3.0-T CMR. Myocardial ECV and LGE were quantified on the left ventricular myocardium. The presence of midwall LGE was also detected. Nineteen healthy subjects served as controls. The primary end points were cardiovascular (CV) events defined by CV death, rehospitalization due to heart failure, and heart transplantation. During the follow-up period (median duration, 11.2 months; 25{sup th}-75{sup th} percentile, 7.8-21.9 months), the primary end points occurred in 19 patients (16.2%). The ECV (per 3% and 1% increase) was associated with a hazard ratio of 1.80 and 1.22 (95% confidence interval [CI], 1.48-2.20 and 1.14-1.30, respectively; p < 0.001) for the CV events. Multivariable analysis also indicated that ECV was an independent prognostic factor and had a higher prognostic value (Harrell's c statistic, 0.88) than LGE quantification values (0.77) or midwall LGE (0.80). CMR-based ECV independently predicts the clinical outcome in NIDCM patients. (orig.)