Comparison of circuit patency and exchange rates between 2 different continuous renal replacement therapy machines.

Science.gov (United States)

Razavi, Seyed Amirhossein; Still, Mary D; White, Sharon J; Buchman, Timothy G; Connor, Michael J

2014-04-01

Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit (ICU) bedside nurse delivery model for CRRT while comparing circuit patency and circuit exchange rates in 2 Food and Drug Administration-approved CRRT devices. This article presents the data comparing circuit exchange rates for 2 different CRRT machines. A group of ICU nurses were selected to undergo expanded training in CRRT operation and empowered to deliver all aspects of CRRT. The ICU nurses then provided all aspects of CRRT on 2 Food and Drug Administration-approved CRRT devices for 6 months. Each device was used exclusively in the designated ICU for a 2-week run-in period followed by 3-month data collection period. The primary end point for the study was the differences in average number of filter exchanges per day during each CRRT event. A total of 45 unique patients who underwent 64 separate CRRT treatment periods were included. Four CRRT events were excluded (see text for details). Twenty-eight CRRT events occurred in the NxStage System One arm (NxStage Medical, Lawrence, Mass) and 32 events in the Gambro Prismaflex arm (Gambro Renal Products, Boulder, Colo). Average (SD) filter exchanges per day was 0.443 (0.60) for the NxStage System One machine and 0.553 (0.65) for Gambro Prismaflex machine (P = .09). There was no demonstrable difference in circuit patency as defined by the rate of filter exchanges per day of CRRT therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

Maintenance of vascular access patency in pediatrics

International Nuclear Information System (INIS)

Hoffer, F.A.; Wyly, J.B.; Fellows, K.E.; Harmon, W.; Levey, R.H.

1986-01-01

The patency of vascular access shunts and fistulae has been prolonged by a combined surgical and radiological approach that includes percutaneous transluminal angioplasty (PTA), surgical revision, thrombectomy, and thrombolysis. Over the last 3 years, 35 vascular accesses in 27 patients were found to have angiographic abnormality. PTA was performed 32 times of 19 accesses and 7 PTAs resulted in patent accesses by the end of the study. Surgical revision was performed 9 times on 8 accesses and 2 of the surgical revisions resulted in a patent access by the end of the study. Concerning Thomas femoral shunts, PTA prolonged the patency by 2.2 months and surgical revision by 3.8 months per procedure. Concerning arteriovenous (AV) fistulae, PTA prolonged the patency by 4.3 months and surgical revision by 3.5 months per procedure. A combination of procedures effectively doubles the duration of patency of Thomas femoral shunts and almost triples the duration of patency of AV fistulae in children. Forty-one percent of these accesses remain open 1 year following the initiation of these procedures. (orig.)

Eustachian tube patency

Science.gov (United States)

Eustachian tube patency refers to how much the eustachian tube is open. The eustachian tube runs between the middle ear and the throat. It controls the pressure behind the eardrum and middle ear space. This helps keep ...

Myocardial perfusion as an indicator of graft patency after coronary artery bypass surgery

International Nuclear Information System (INIS)

Kolibash, A.J.; Call, T.D.; Bush, C.A.; Tetalman, M.R.; Lewis, R.P.

1980-01-01

Stress and resting myocardial perfusion were assessed in 38 patients who received 96 grafts. Stress perfusion was evaluated with thallium-201 and resting myocardial blood flow distribution with radiolabeled particles. When both stress and rest perfusion were normal, graft patency was 82% (51 of 62 grafts). Graft patency was also high (81%, 13 of 16) in areas where stress perfusion abnormalities resolved or become less apparent at rest. However, when stress perfusion defects remained unchanged at rest, the graf was likely to be occuluded (73%, 11 of 15). Maintenance of normal rest perfusion or improvement of rest perfusion postoperatively was also associated with a high graft patency rate (80%, 35 of 44), whereas the development of new rest perfusion defects postoperatively implied graft occlusion

Predictors of the patency of self-expandable metallic stents in malignant gastroduodenal obstruction.

Science.gov (United States)

Kim, Seung Han; Chun, Hoon Jai; Yoo, In Kyung; Lee, Jae Min; Nam, Seung Joo; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck

2015-08-14

To investigate the predictive factors of self-expandable metallic stent patency after stent placement in patients with inoperable malignant gastroduodenal obstruction. A total of 116 patients underwent stent placements for inoperable malignant gastroduodenal obstruction at a tertiary academic center. Clinical success was defined as acceptable decompression of the obstructive lesion within the malignant gastroduodenal neoplasm. We evaluated patient comorbidities and clinical statuses using the World Health Organization's scoring system and categorized patient responses to chemotherapy using the Response Evaluation Criteria in Solid Tumors criteria. We analyzed the relationships between possible predictive factors and stent patency. Self-expandable metallic stent placement was technically successful in all patients (100%), and the clinical success rate was 84.2%. In a multivariate Cox proportional hazards model, carcinoembryonic antigen (CEA) levels were correlated with a reduction in stent patency [P = 0.006; adjusted hazard ratio (aHR) = 2.92, 95%CI: 1.36-6.25]. Palliative chemotherapy was statistically associated with an increase in stent patency (P = 0.009; aHR = 0.27, 95%CI: 0.10-0.72). CEA levels can easily be measured at the time of stent placement and may help clinicians to predict stent patency and determine the appropriate stent procedure.

Assessment of the form and patency of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP)

International Nuclear Information System (INIS)

Kitamura, Masaya; Takahashi, Tuyoshi; Yoshida, Muneki; Shimada, Ken; Kakita, Akira; Isobe, Yoshinori

1999-01-01

There have been no reliable methods for the assessment of the patency of an end-to-side style pancreaticojejunal anastomosis in Whipple procedure. We evaluated the ability of MR-Cholangiopancreatography (MRCP) to assess the form and patency of the pancreatic duct in 181 patients. The pancreatic duct was displayed on MRCP in 70.9% of the patients. The domostrative rate of the pancreatic duct on MRCP and the PFD test were well correlated (p=0.031). Further, we assessed the patency of pancreaticojejunal anastomosis in Whipple procedure by MRCP following a secretin load. It was considered that the pancreatic duct to be patent when pancreatic excretion into the jejunum had increased and/or the ability to display the pancreatic duct had improved on MRCP following an i.v. load of secretin. A secretin-loading MRCP was suggested to be of much help in the assessment of the patency of pancreaticojejunostomy in patients undergoing Whipple procedure for a long-term follow up. (author)

Assessment of the form and patency of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP)

Energy Technology Data Exchange (ETDEWEB)

Kitamura, Masaya; Takahashi, Tuyoshi; Yoshida, Muneki; Shimada, Ken; Kakita, Akira; Isobe, Yoshinori [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine

1999-02-01

There have been no reliable methods for the assessment of the patency of an end-to-side style pancreaticojejunal anastomosis in Whipple procedure. We evaluated the ability of MR-Cholangiopancreatography (MRCP) to assess the form and patency of the pancreatic duct in 181 patients. The pancreatic duct was displayed on MRCP in 70.9% of the patients. The domostrative rate of the pancreatic duct on MRCP and the PFD test were well correlated (p=0.031). Further, we assessed the patency of pancreaticojejunal anastomosis in Whipple procedure by MRCP following a secretin load. It was considered that the pancreatic duct to be patent when pancreatic excretion into the jejunum had increased and/or the ability to display the pancreatic duct had improved on MRCP following an i.v. load of secretin. A secretin-loading MRCP was suggested to be of much help in the assessment of the patency of pancreaticojejunostomy in patients undergoing Whipple procedure for a long-term follow up. (author)

Cost-effectiveness of tubal patency tests.

Science.gov (United States)

Verhoeve, H R; Moolenaar, L M; Hompes, P; van der Veen, F; Mol, B W J

2013-04-01

Guidelines are not in agreement on the most effective diagnostic scenario for tubal patency testing; therefore, we evaluated the cost-effectiveness of invasive tubal testing in subfertile couples compared with no testing and treatment. Cost-effectiveness analysis. Decision analytic framework. Computer-simulated cohort of subfertile women. We evaluated six scenarios: (1) no tests and no treatment; (2) immediate treatment without tubal testing; (3) delayed treatment without tubal testing; (4) hysterosalpingogram (HSG), followed by immediate or delayed treatment, according to diagnosis (tailored treatment); (5) HSG and a diagnostic laparoscopy (DL) in case HSG does not prove tubal patency, followed by tailored treatment; and (6) DL followed by tailored treatment. Expected cumulative live births after 3 years. Secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. For a 30-year-old woman with otherwise unexplained subfertility for 12 months, 3-year cumulative live birth rates were 51.8, 78.1, 78.4, 78.4, 78.6 and 78.4%, and costs per couple were €0, €6968, €5063, €5410, €5405 and €6163 for scenarios 1, 2, 3, 4, 5 and 6, respectively. The incremental cost-effectiveness ratios compared with scenario 1 (reference strategy), were €26,541, €19,046, €20,372, €20,150 and €23,184 for scenarios 2, 3, 4, 5 and 6, respectively. Sensitivity analysis showed the model to be robust over a wide range of values for the variables. The most cost-effective scenario is to perform no diagnostic tubal tests and to delay in vitro fertilisation (IVF) treatment for at least 12 months for women younger than 38 years old, and to perform no tubal tests and start immediate IVF treatment from the age of 39 years. If an invasive diagnostic test is planned, HSG followed by tailored treatment, or a DL if HSG shows no tubal patency, is more cost-effective than DL. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013

Influence of Diabetes on Long-Term Coronary Artery Bypass Graft Patency.

Science.gov (United States)

Raza, Sajjad; Blackstone, Eugene H; Houghtaling, Penny L; Rajeswaran, Jeevanantham; Riaz, Haris; Bakaeen, Faisal G; Lincoff, A Michael; Sabik, Joseph F

2017-08-01

Nearly 50% of patients undergoing coronary artery bypass grafting have diabetes. However, little is known about the influence of diabetes on long-term patency of bypass grafts. Because patients with diabetes have more severe coronary artery stenosis, we hypothesized that graft patency is worse in patients with than without diabetes. This study sought to examine the influence of diabetes on long-term patency of bypass grafts. From 1972 to 2011, 57,961 patients underwent primary isolated coronary artery bypass grafting. Of these, 1,372 pharmacologically treated patients with diabetes and 10,147 patients without diabetes had 15,887 postoperative angiograms; stenosis was quantified for 7,903 internal thoracic artery (ITA) grafts and 20,066 saphenous vein grafts. Status of graft patency across time was analyzed by longitudinal nonlinear mixed-effects modeling. ITA graft patency was stable over time and similar in patients with and without diabetes: at 1, 5, 10, and 20 years, 97%, 97%, 96%, and 96% in patients with diabetes, and 96%, 96%, 95%, and 93% in patients without diabetes, respectively (early p = 0.20; late p = 0.30). In contrast, saphenous vein graft patency declined over time and similarly in patients with and without diabetes: at 1, 5, 10, and 20 years, 78%, 70%, 57%, and 42% in patients with diabetes, and 82%, 72%, 58%, and 41% in patients without diabetes, respectively (early p < 0.002; late p = 0.60). After adjusting for patient characteristics, diabetes was associated with higher early patency of ITA grafts (odds ratio: 0.63; 95% confidence limits: 0.43 to 0.91; p = 0.013), but late patency of ITA grafts was similar in patients with and without diabetes (p = 0.80). Early and late patency of saphenous vein grafts were similar in patients with and without diabetes (early p = 0.90; late p = 0.80). Contrary to our hypothesis, diabetes did not influence long-term patency of bypass grafts. Use of ITA grafts should be maximized in patients

Intraarterial 9-beta-methyl carbacyclin improves canine polytetrafluoroethylene graft patency

International Nuclear Information System (INIS)

Dacey, L.J.; Hees, P.S.; Cronenwett, J.L.

1988-01-01

This study examined the effect of 9-beta-methyl carbacyclin, a synthetic, stable prostacyclin analog, on canine polytetrafluoroethylene (PTFE) graft patency. Twenty-five dogs had 4 mm x 7 cm PTFE grafts implanted bilaterally into the femoral arteries. A subcutaneous infusion pump was used to deliver either saline solution (control) or 9-beta-methyl carbacyclin (Ciprostine) at 100 (CARB-100) or 200 ng/kg/min (CARB-200) through a femoral artery branch just proximal to one of the femoral grafts, with the contralateral graft serving as a noninfused control. Graft-platelet deposition (with 111 In-labeled platelets) was measured between the fifth and seventh days, with patency determined on the seventh day. Dogs were classified as aggregators (AGG [+]) if the preoperative epinephrine-enhanced sodium arachidonate platelet aggregation was greater than 20%. CARB-200 infusion significantly improved ipsilateral graft patency (80%) compared with noninfused grafts (50%, p less than 0.05), or grafts in control and CARB-100 dogs (43%, p less than 0.05). Anastomotic platelet deposition was decreased bilaterally in CARB-200 dogs by 45% to 59% compared with CARB-100 and control dogs (p less than 0.05). With the exception of grafts infused with CARB-200, AGG (+) dogs had significantly lower graft patency (26%) than nonaggregator AGG (-) dogs (71%, p less than 0.01). CARB-200 infusion significantly improved graft patency in AGG (+) dogs (71%), compared with control and CARB-100-infused grafts (19%, p less than 0.025). Intra-arterial 9-beta-methyl carbacyclin improved early PTFE graft patency and inhibited platelet deposition in a severe canine model, independent of baseline platelet aggregation status, which also had an important effect on graft patency

Mild anastomotic stenosis in patient-specific CABG model may enhance graft patency: a new hypothesis.

Directory of Open Access Journals (Sweden)

Yunlong Huo

Full Text Available It is well known that flow patterns at the anastomosis of coronary artery bypass graft (CABG are complex and may affect the long-term patency. Various attempts at optimal designs of anastomosis have not improved long-term patency. Here, we hypothesize that mild anastomotic stenosis (area stenosis of about 40-60% may be adaptive to enhance the hemodynamic conditions, which may contribute to slower progression of atherosclerosis. We further hypothesize that proximal/distal sites to the stenosis have converse changes that may be a risk factor for the diffuse expansion of atherosclerosis from the site of stenosis. Twelve (12 patient-specific models with various stenotic degrees were extracted from computed tomography images using a validated segmentation software package. A 3-D finite element model was used to compute flow patterns including wall shear stress (WSS and its spatial and temporal gradients (WSS gradient, WSSG, and oscillatory shear index, OSI. The flow simulations showed that mild anastomotic stenosis significantly increased WSS (>15 dynes · cm(-2 and decreased OSI (<0.02 to result in a more uniform distribution of hemodynamic parameters inside anastomosis albeit proximal/distal sites to the stenosis have a decrease of WSS (<4 dynes · cm(-2. These findings have significant implications for graft adaptation and long-term patency.

Mild anastomotic stenosis in patient-specific CABG model may enhance graft patency: a new hypothesis.

Science.gov (United States)

Huo, Yunlong; Luo, Tong; Guccione, Julius M; Teague, Shawn D; Tan, Wenchang; Navia, José A; Kassab, Ghassan S

2013-01-01

It is well known that flow patterns at the anastomosis of coronary artery bypass graft (CABG) are complex and may affect the long-term patency. Various attempts at optimal designs of anastomosis have not improved long-term patency. Here, we hypothesize that mild anastomotic stenosis (area stenosis of about 40-60%) may be adaptive to enhance the hemodynamic conditions, which may contribute to slower progression of atherosclerosis. We further hypothesize that proximal/distal sites to the stenosis have converse changes that may be a risk factor for the diffuse expansion of atherosclerosis from the site of stenosis. Twelve (12) patient-specific models with various stenotic degrees were extracted from computed tomography images using a validated segmentation software package. A 3-D finite element model was used to compute flow patterns including wall shear stress (WSS) and its spatial and temporal gradients (WSS gradient, WSSG, and oscillatory shear index, OSI). The flow simulations showed that mild anastomotic stenosis significantly increased WSS (>15 dynes · cm(-2)) and decreased OSI (<0.02) to result in a more uniform distribution of hemodynamic parameters inside anastomosis albeit proximal/distal sites to the stenosis have a decrease of WSS (<4 dynes · cm(-2)). These findings have significant implications for graft adaptation and long-term patency.

High dose urokinase for restoration of patency of occluded permanent central venous catheters in hemodialysis patients.

Science.gov (United States)

Shavit, L; Lifschitz, M; Plaksin, J; Grenader, T; Slotki, I

2010-10-01

Catheter thrombosis is common and results in inadequate dialysis treatment and, frequently, in catheter loss. Since dialysis treatment runs on a strict schedule, occluded catheters need to be restored in a timely and cost effective manner. We present a new shortened protocol of urokinase infusion that allows hemodialysis to be performed within 90 minutes. To chronic hemodialysis patients, who developed complete catheter occlusion, urokinase was infused simultaneously through both lumens of the catheter (125,000 units to each lumen) over 90 minutes. Technical success was defined as restoring blood pump speed to at least 250 ml/min. We determined the average time from catheter placement to first clot event (primary patency PP), recurrent clot event after urokinase treatment (secondary patency SP), catheter salvage rate and cause for removal. 37 catheters developed total thrombosis and urokinase was used to restore patency one or more times (total 47 treatments). Catheter salvage rate was 97 %. The average time of PP was 152 ± 56 days (7 - 784 days). Nine patients (30%) developed recurrent occlusion and the average time of SP was 64 ± 34 days (2 - 364 days). One catheter was removed because of dysfunction due to thrombosis. Other catheters were removed due to infection, fistula maturation or fell out spontaneously. Hemodialysis was performed immediately after treatment with blood speed of 250 ml/min in all patients. Our protocol is highly effective, short, and allows to restore patency of totally occluded central venous catheters with minimal disruption of the dialysis session.

Graft Patency in Long-term Survivors after Renovisceral Debranching with VORTEC

Energy Technology Data Exchange (ETDEWEB)

Winklehner, Anna, E-mail: anna.winklehner@usz.ch; Nguyen-Kim, Thi Dan Linh, E-mail: thidanlinh.nguyen@usz.ch; Pfammatter, Thomas, E-mail: thomas.pfammatter@usz.ch [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland); Rancic, Zoran, E-mail: zoran.rancic@usz.ch; Mayer, Dieter, E-mail: dieter.mayer@usz.ch; Lachat, Mario, E-mail: mario.lachat@usz.ch [University Hospital Zurich, Clinic for Cardiovascular Surgery (Switzerland); Frauenfelder, Thomas, E-mail: Thomas.Frauenfelder@usz.ch [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland)

2015-06-15

PurposeThis study was designed to evaluate retrospectively the long-term stent-graft patency after renovisceral revascularization with Viabahn Open Revascularization Technique (VORTEC) using computed tomography angiography (CTA) and magnetic resonance angiography (MRA).MethodsIn 34 patients (seven women; mean age 72 ± 8 years) with aortic aneurysm, 63 renovisceral vessels (i.e., 54 renal, nine visceral arteries) were revascularized with VORTEC between 2004 and 2009. All patients obtained a pre- and postinterventional CTA and at least one follow-up CTA or MRA after 6 or more months following intervention (median follow up: 43 months). Detection of bypass occlusion, bypass stenosis, infolding, stent-graft fractures and dislocations, and kidney shrinkage were noted by two readers in consensus. Furthermore, mortality during follow-up was assessed using the medical report.ResultsDuring follow-up, 12.6 % of stent-grafts occluded. Cumulative patency rate was 95.2 ± 2.7 % at 12 months, 87.7 ± 4.4 % at 24 and 36 months, and 84.7 ± 5.2 % at 48, 60, 72, 84, and 89 months, respectively. Overall, 19 % of stent-grafts (12/63) developed bypass stenosis (<50 %, 10 stent-grafts; > 50 %, 2 stent-grafts), in one case stenosis (>70 %) was suspected to be hemodynamically significant. No secondary dislocation, no infolding of renovisceral stent-grafts, and no stent-graft fracture occurred. Kidney shrinkage occurred in nine patients, primarily in patients with an occluded Viabahn (n = 7). Eleven patients (32.3 %) died within the follow-up time period.ConclusionsIn long-term survivors after VORTEC cumulative patency rate remained high, and no stent-graft fractures or secondary dislocations occurred.

Role Of Hysteroscopy In The Evaluation Of Tubal Patency In Infertile Women

International Nuclear Information System (INIS)

Rashed, A.M.; Sweedan, Kh.H.; ElBishry, G.A.; Serag, I.F.; Ahmed, W.E.

2012-01-01

Purpose: To evaluate the effectiveness of hysteroscopy as a method for the diagnosis of tubal patency using saline distention media. Methods: In this prospective study, 64 infertile women underwent hysteroscopy (HSC) and hysterosalpingography (HSG) on two consecutive days. Transvaginal ultrasonography (TVS) carried out before and after hysteroscopy in order to measure the fluid in the cul-de-sac.The difference between the two methods in diagnosis of tubal patency was compared using laparoscopy/chromotubationas a gold standard. Fluid volume measurements were used to determine a cut off value for tubal patency. Pain was recorded at the end of the processes. Results: According to the laparoscopy, the sensitivity and specificity of HSC and HSG in detecting tubal patency were (94.6% and 100% vs 92.8% and 50%, respectively). The best cut off point of the fluid volume in the cul-de-sac at which both tubes are patent is 6 ml. All of the patients reported significantly less pain during hysteroscopy in response to HSG. Conclusions: office HSC combined with TVS may be used as an alternative to HSG in the diagnosis of tubal patency in an easy, rapid, safe way with minimal pain.

Evaluation of early coronary graft patency after coronary artery bypass graft surgery using multislice computed tomography angiography

Directory of Open Access Journals (Sweden)

Raissi Kamal

2009-12-01

Full Text Available Abstract Background Coronary artery bypass graft (CABG surgery is the standard of care in the treatment of advanced coronary artery disease, and its long-term results are affected by the failure of bypass grafts. The aim of the present study was to evaluate the early patency rate in coronary bypass grafts. Methods A total of 107 consecutive patients who underwent CABG were included in this study. Early graft patency was evaluated via computed tomography (CT angiography in the first week after surgery. Results There were a total of 366 grafts, comprised of 250 venous grafts and 116 arterial grafts. Multi-slice CT detected acute graft occlusions in 32 (8.7% of all the grafts, including 26 (10% of the 250 venous grafts and 6 (5% of the 116 arterial grafts. The patency rates obtained were 97.3% for the left internal mammary (IMA grafts, 50% for the radial artery grafts, and 50% for the right IMA grafts. Additionally, 107 (96.4% grafts to the left anterior descending artery (LAD were classified as patent, whereas 1 (30% of the 3 grafts in the left circumflex (LCX region and 1 (50% of the 2 grafts in the right coronary artery (RCA territory were found to be occluded. In the venous category, 8 (13.7% of the 58 grafts to LAD were found to be occluded. In the LCX region, 9 (8.5% of the 106 grafts were classified as occluded, while the remaining 97 (91.5% grafts were patent. The venous grafts to RCA were occluded in 9 (10.4% of the 86 grafts. Amongst the multiple preoperative, intraoperative, and postoperative factors, pump time was significantly longer in the patients with occluded grafts than in those with patent grafts (P = 0.04. Conclusion The IMA grafts had the highest early patency rate amongst the coronary bypass grafts. However, the other arterial grafts were associated with a high rate of acute occlusions.

Ventriculo-pleural shunt patency study

International Nuclear Information System (INIS)

Yeates, K.

2000-01-01

Full text: A twenty-four year old male was admitted to hospital complaining of headaches, drowsiness and blurred vision. He suffered from congenital hydrocephalus and had had a ventriculo-peritoneal shunt inserted in infancy. This had undergone many revisions due to persistent peritoneal infections and had recently been replaced with a ventriculo-pleural shunt. The symptoms described suggested shunt blockage and he was referred for a Shunt Patency Study. The current shunt is a HAKIM Programmable Valve Shunt System and the opening pressure was 12cm of CSF (within the normal range). Forty megabecquerels of filtered 99 Tc m O 4 was injected into the pre-chamber of the shunt. Serial images and counts were obtained for twenty-five minutes after the injection. The images showed the tracer flowing from the shunt within the first ten minutes. At twenty minutes almost all of the tracer had drained from the shunt and was present in the right pleural cavity, indicating shunt patency. This study is presented to demonstrate the appearances of a normally functioning, but rarely seen Ventriculo-Pleural CSF Shunt. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

PEACE I all-comers registry: patency evaluation after implantation of the 4-French Pulsar-18 self-expanding nitinol stent in femoropopliteal lesions.

Science.gov (United States)

Lichtenberg, Michael; Kolks, Oliver; Hailer, Birgit; Stahlhoff, Wilhelm-Friedrich; Tiefenbacher, Christiane; Nolte-Ernsting, Claus; Arjumand, Jawed; Wittenberg, Guenther

2014-06-01

To evaluate the 1-year patency of the 4-F Pulsar-18 self-expanding nitinol stent for treatment of femoropopliteal occlusive disease in a national, prospective, multicenter, all-comers registry. Between January and June 2012, the German PEACE I all-comers prospective registry enrolled 148 patients with symptomatic femoropopliteal lesions (Rutherford category 2-5) undergoing recanalization and implantation of the Pulsar-18 SE nitinol stent at 6 clinical centers. Thirty patients did not have the 12-month follow-up visit (18 declined reevaluation, 5 withdrew consent, and 7 died), leaving 118 patients (64 men; mean 71.9±9.6 age years) for the 1-year evaluation. The average lesion length was 111.5±71.4 mm, and 38 of the 118 lesions were classified as TASC II D. More than half the lesions (67, 56.7%) were chronic total occlusions (CTO). The popliteal segment was involved in 22 (18.7%) lesions. The mean stented length was 122.7±64.5 mm. Routine follow-up included duplex ultrasound at 6 and 12 months. Outcome measures were primary patency and no clinically driven target lesion revascularization (TLR) within 12 months. The overall primary patency rates after 6 and 12 months were 87.4% and 79.5%, respectively; in the popliteal segments, the rate was 71.4% after 12 months. The overall freedom from TLR was 93.2% after 6 months and 81% after 12 months. Ankle-brachial index, pain-free walking distance, and Rutherford category all improved significantly (pPulsar-18 self-expanding nitinol stent in femoropopliteal lesions averaging 111.5 mm long showed promising primary patency and freedom from TLR after 6 and 12 months. Diabetes had no negative impact on patency. Primary patency in the popliteal segments was acceptable at 12 months.

Parylene MEMS patency sensor for assessment of hydrocephalus shunt obstruction.

Science.gov (United States)

Kim, Brian J; Jin, Willa; Baldwin, Alexander; Yu, Lawrence; Christian, Eisha; Krieger, Mark D; McComb, J Gordon; Meng, Ellis

2016-10-01

Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment. The sensor was fabricated on a flexible polymer substrate to eventually allow integration into a shunt. In this study, the sensor was packaged for use with external ventricular drainage systems for clinical validation. Insights into the transduction mechanism of the sensor were obtained. The impact of electrode size, clinically relevant temperatures and flows, and hydrogen peroxide (H2O2) plasma sterilization on sensor function were evaluated. Sensor performance in the presence of static and dynamic obstruction was demonstrated using 3 different models of obstruction. Electrode size was found to have a minimal effect on sensor performance and increased temperature and flow resulted in a slight decrease in the baseline impedance due to an increase in ionic mobility. However, sensor response did not vary within clinically relevant temperature and flow ranges. H2O2 plasma sterilization also had no effect on sensor performance. This low power and simple format sensor was developed with the intention of future integration into shunts for wireless monitoring of shunt state and more importantly, a more accurate and timely diagnosis of shunt failure.

The Relationship Between Neutrophil–Lymphocyte Ratio and Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Arteriovenous Fistula Stenosis When Using Conventional and Drug-Eluting Balloons

Energy Technology Data Exchange (ETDEWEB)

Çildağ, Mehmet Burak, E-mail: mbcildag@yahoo.com [Adnan Menderes University, Department of Diagnostic and Interventional Radiology (Turkey); Çildağ, Songül, E-mail: songulcildag@yahoo.com [Adnan Menderes University, Department of Immunology and Allergy (Turkey); Köseoğlu, Ömer Faruk Kutsi, E-mail: kutsikoseoglu@yahoo.com [Adnan Menderes University, Department of Diagnostic and Interventional Radiology (Turkey)

2016-12-15

ObjectiveThe aim of this study is to investigate the potential association of neutrophil–lymphocyte ratio (NLR) between primary patency of percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistula stenosis and type (Conventional and Drug-Eluting) of balloons used in PTA.Material-MethodThis retrospective study consists of 78 patients with significant arteriovenous fistulas stenosis who were treated with PTA by using Drug-Eluting Balloon (DEB) (n = 29) or Conventional Balloon (CB) (n = 49). NLR was calculated from preinterventional blood samples. All patients were classified into two groups. Group A; primary patency <12 months (43/78), Group B; primary patency ≥12 months (35/78). Cox regression analysis and Kaplan–Meier method were used to determine respectively independent factors affecting the primary patency and to compare the primary patency for the two balloon types.ResultsNLR ratio and balloon type of the two groups were significantly different (p = 0.002, p = 0.010). The cut-off value of NLR was 3.18 for determination of primary patency, with sensitivity of 81.4 % and specificity of 51.4 %. Primary patency rates between PTA with DEB and CB displayed statistically significant differences (p < 0.05). The cut-off value was 3.28 for determination of 12-month primary patency with the conventional balloon group; sensitivity was 81.8 % and specificity was 81.3 %. There was no statistical relation between NLR levels and the drug-eluting balloon group in 12-month primary patency (p = 0.927).ConclusionIncreased level of NLR may be a risk factor in the development of early AVF restenosis after successful PTA. Preferring Drug-Eluting Balloon at an increased level of NLR can be beneficial to prolong patency.

Primary Patency of Wallstents in Malignant Bile Duct Obstruction: Single vs. Two or More Noncoaxial Stents

International Nuclear Information System (INIS)

Maybody, Majid; Brown, Karen T.; Brody, Lynn A.; Covey, Anne M.; Sofocleous, Constantinos T.; Thornton, Raymond H.; Getrajdman, George I.

2009-01-01

The purpose of this study was to determine the primary patency of two or more noncoaxial self-expanding metallic Wallstents (Boston Scientific, Natick, MA) and to compare this with the primary patency of a single stent in malignant bile duct obstruction. From August 2002 to August 2004, 127 patients had stents placed for malignant bile duct obstruction. Forty-five patients were treated with more than one noncoaxial self-expanding metallic stents and 82 patients had a single stent placed. Two patients in the multiple-stent group were lost to follow-up. The primary patency period was calculated from the date of stenting until the first poststenting intervention for stent occlusion, death, or the time of last documented follow-up. The patency of a single stent was significantly different from that of multiple stents (P = 0.0004). In the subset of patients with high bile duct obstruction, the patency of a single stent remained significantly different from that of multiple stents (P = 0.02). In the single-stent group, there was no difference in patency between patients with high vs. those with low bile duct obstruction (P = 0.43). The overall median patency for the multistent group and the single-stent group was 201 and 261 days, respectively. In conclusion, the patency of a single stent placed for malignant low or high bile duct obstruction is similar, and significantly longer than, that of multiple stents placed for malignant high bile duct obstruction. Given the median patency of 201 days, when indicated, percutaneous stenting of multiple bile ducts is an effective palliative measure for patients with malignant high bile duct obstruction.

Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment

Directory of Open Access Journals (Sweden)

Ashwini Thimmarayappa

2015-01-01

Full Text Available Aims: The aim of the study was to measure airway patency objectively during dexmedetomidine sedation under radiographic guidance in spontaneously breathing pediatric patients scheduled for cardiac catheterization procedures. Subjects and Methods: Thirty-five patients in the age group 5-10 years scheduled for cardiac catheterization procedures were enrolled. All study patients were given loading dose of dexmedetomidine at 1 mg/kg/min for 10 min and then maintenance dose of 1.5 mg/kg/h. Radiographic airway patency was assessed at the start of infusion (0 min and after 30 min. Antero-posterior (AP diameters were measured manually at the nasopharyngeal and retroglossal levels. Dynamic change in airway between inspiration and expiration was considered a measure of airway collapsibility. Patients were monitored for hemodynamics, recovery time and complications. Statistical Analysis: Student paired t-test was used for data analysis. P < 0.05 was considered significant. Results: Minimum and maximum AP diameters were compared at 0 and 30 min. Nasopharyngeal level showed significant reduction in the minimum (6.27 ± 1.09 vs. 4.26 ± 1.03, P < 0.0001 and maximum (6.51 ± 1.14 vs. 5.99 ± 1.03, P < 0.0001 diameters. Similarly retroglossal level showed significant reduction in the minimum (6.98 ± 1.09 vs. 5.27 ± 1.15, P < 0.0001 and maximum (7.49 ± 1.22 vs. 6.92 ± 1.12, P < 0.0003 diameters. The degree of collapsibility was greater at 30 min than baseline ( P < 0.0001. There was a significant decrease in heart rate ( P < 0.0001, and the average recovery time was 39.86 ± 12.22 min. Conclusion: Even though airway patency was maintained in all children sedated with dexmedetomidine, there were significant reductions in the upper airway dimensions measured, so all precautions to manage the airway failure should be taken.

Evaluation of aqueductal patency in patients with hydrocephalus: Three-dimensional high-sampling efficiency technique(SPACE) versus two-dimensional turbo spin echo at 3 Tesla

International Nuclear Information System (INIS)

Ucar, Murat; Guryildirim, Melike; Tokgoz, Nil; Kilic, Koray; Borcek, Alp; Oner, Yusuf; Akkan, Koray; Tali, Turgut

2014-01-01

To compare the accuracy of diagnosing aqueductal patency and image quality between high spatial resolution three-dimensional (3D) high-sampling-efficiency technique (sampling perfection with application optimized contrast using different flip angle evolutions [SPACE]) and T2-weighted (T2W) two-dimensional (2D) turbo spin echo (TSE) at 3-T in patients with hydrocephalus. This retrospective study included 99 patients diagnosed with hydrocephalus. T2W 3D-SPACE was added to the routine sequences which consisted of T2W 2D-TSE, 3D-constructive interference steady state (CISS), and cine phase-contrast MRI (PC-MRI). Two radiologists evaluated independently the patency of cerebral aqueduct and image quality on the T2W 2D-TSE and T2W 3D-SPACE. PC-MRI and 3D-CISS were used as the reference for aqueductal patency and image quality, respectively. Inter-observer agreement was calculated using kappa statistics. The evaluation of the aqueductal patency by T2W 3D-SPACE and T2W 2D-TSE were in agreement with PC-MRI in 100% (99/99; sensitivity, 100% [83/83]; specificity, 100% [16/16]) and 83.8% (83/99; sensitivity, 100% [67/83]; specificity, 100% [16/16]), respectively (p < 0.001). No significant difference in image quality between T2W 2D-TSE and T2W 3D-SPACE (p = 0.056) occurred. The kappa values for inter-observer agreement were 0.714 for T2W 2D-TSE and 0.899 for T2W 3D-SPACE. Three-dimensional-SPACE is superior to 2D-TSE for the evaluation of aqueductal patency in hydrocephalus. T2W 3D-SPACE may hold promise as a highly accurate alternative treatment to PC-MRI for the physiological and morphological evaluation of aqueductal patency.

Evaluation of aqueductal patency in patients with hydrocephalus: Three-dimensional high-sampling efficiency technique(SPACE) versus two-dimensional turbo spin echo at 3 Tesla

Energy Technology Data Exchange (ETDEWEB)

Ucar, Murat; Guryildirim, Melike; Tokgoz, Nil; Kilic, Koray; Borcek, Alp; Oner, Yusuf; Akkan, Koray; Tali, Turgut [School of Medicine, Gazi University, Ankara (Turkey)

2014-12-15

To compare the accuracy of diagnosing aqueductal patency and image quality between high spatial resolution three-dimensional (3D) high-sampling-efficiency technique (sampling perfection with application optimized contrast using different flip angle evolutions [SPACE]) and T2-weighted (T2W) two-dimensional (2D) turbo spin echo (TSE) at 3-T in patients with hydrocephalus. This retrospective study included 99 patients diagnosed with hydrocephalus. T2W 3D-SPACE was added to the routine sequences which consisted of T2W 2D-TSE, 3D-constructive interference steady state (CISS), and cine phase-contrast MRI (PC-MRI). Two radiologists evaluated independently the patency of cerebral aqueduct and image quality on the T2W 2D-TSE and T2W 3D-SPACE. PC-MRI and 3D-CISS were used as the reference for aqueductal patency and image quality, respectively. Inter-observer agreement was calculated using kappa statistics. The evaluation of the aqueductal patency by T2W 3D-SPACE and T2W 2D-TSE were in agreement with PC-MRI in 100% (99/99; sensitivity, 100% [83/83]; specificity, 100% [16/16]) and 83.8% (83/99; sensitivity, 100% [67/83]; specificity, 100% [16/16]), respectively (p < 0.001). No significant difference in image quality between T2W 2D-TSE and T2W 3D-SPACE (p = 0.056) occurred. The kappa values for inter-observer agreement were 0.714 for T2W 2D-TSE and 0.899 for T2W 3D-SPACE. Three-dimensional-SPACE is superior to 2D-TSE for the evaluation of aqueductal patency in hydrocephalus. T2W 3D-SPACE may hold promise as a highly accurate alternative treatment to PC-MRI for the physiological and morphological evaluation of aqueductal patency.

Improving arteriovenous fistula patency: Transdermal delivery of diclofenac reduces cannulation-dependent neointimal hyperplasia via AMPK activation

Science.gov (United States)

MacAskill, Mark G.; Watson, David G.; Ewart, Marie-Ann; Wadsworth, Roger; Jackson, Andrew; Aitken, Emma; MacKenzie, Graeme; Kingsmore, David; Currie, Susan; Coats, Paul

2015-01-01

Creation of an autologous arteriovenous fistula (AVF) for vascular access in haemodialysis is the modality of choice. However neointimal hyperplasia and loss of the luminal compartment result in AVF patency rates of ~ 60% at 12 months. The exact cause of neointimal hyperplasia in the AVF is poorly understood. Vascular trauma has long been associated with hyperplasia. With this in mind in our rabbit model of AVF we simulated cannulation autologous to that undertaken in vascular access procedures and observed significant neointimal hyperplasia as a direct consequence of cannulation. The neointimal hyperplasia was completely inhibited by topical transdermal delivery of the non-steroidal anti-inflammatory (NSAID) diclofenac. In addition to the well documented anti-inflammatory properties we have identified novel anti-proliferative mechanisms demonstrating diclofenac increases AMPK-dependent signalling and reduced expression of the cell cycle protein cyclin D1. In summary prophylactic transdermal delivery of diclofenac to the sight of AVF cannulation prevents adverse neointimal hyperplasic remodelling and potentially offers a novel treatment option that may help prolong AVF patency and flow rates. PMID:25866325

Inflation-deflation test as a predictor of aditus patency in patients with chronic suppurative otitis media.

Science.gov (United States)

Kurien, Regi; Chrisolyte, Shipra; Rupa, V

2009-09-01

To assess eustachian tubal function (ETF) preoperatively in patients with chronic suppurative otitis media (CSOM) with central perforation by performing the inflation-deflation test. To correlate the results of the inflation-deflation test with the finding of aditus patency or block in patients with CSOM STUDY DESIGN: Prospective, cohort Tertiary care hospital Eighty adult patients with chronic suppurative otitis media and central perforation were recruited into the study. There were 45 males and 35 females. All patients underwent preoperative inflation-deflation test followed by cortical mastoidectomy and tympanoplasty. The patency of the aditus was assessed intraoperatively. Equalization of pressure on inflation-deflation test and intraoperative assessment of aditus patency Of a total of 80 patients, 49 patients were found to have discharging ears and 31 had dry ears at the time of surgery. In dry ears the inflation-deflation test had a sensitivity of 93% in predicting aditus patency although the specificity was lower at 67%. In discharging ears the sensitivity in predicting aditus patency was 72% and the specificity was 67%. The eustachian tube inflation-deflation test is a sensitive test for predicting aditus patency in patients with dry ears but less so in patients with discharging ears. Hence, it could be used in the former to avoid unnecessary exploration of the mastoid.

Effect of ticlopidine on the long-term patency of saphenous-vein bypass grafts in the legs. Etude de la Ticlopidine après Pontage Fémoro-Poplité and the Association Universitaire de Recherche en Chirurgie.

Science.gov (United States)

Becquemin, J P

1997-12-11

Optimal therapy to prevent late occlusion of arterial bypass grafts in the legs has not been determined. We assessed the effect of ticlopidine, an inhibitor of platelet aggregation, on the long-term patency of saphenous-vein bypass grafts for the treatment of peripheral vascular disease. A total of 243 patients with femoropopliteal or femorotibial saphenous-vein bypass grafts were randomly assigned to receive either ticlopidine (250 mg twice a day) or matching placebo for two years. The primary end point was graft patency at two years, as assessed by physical examination, measurement of the ankle brachial index, and duplex ultrasonography or arteriography. The incidence of death and major ischemic events was also analyzed in the two groups. After two years, 66.4 percent of the patients were alive with a patent graft in the ticlopidine group, as compared with 51.2 percent in the placebo group (95 percent confidence interval for the difference between the two groups, 2.9 to 27.4 percent; P=0.02). The two-year cumulative patency rate was 82 percent in the ticlopidine group and 63 percent in the placebo group (P=0.002). There was no significant difference between groups in overall mortality or major ischemic events. Ticlopidine significantly improved the long-term patency of saphenous-vein bypass grafts in the legs. Since the drug was well tolerated, its use can be recommended after peripheral-vein bypass surgery.

Optimal Discount Rates for Government Projects

OpenAIRE

Park, Sangkyun

2012-01-01

Project selection based on the net present value can be optimal only if the discount rate is optimal. The optimal discount rate for a government project can be a risk-free rate, a comparable market rate (market interest rate corresponding to the risk of cash flows to the government), or an adjusted market rate, depending on circumstances. This paper clarifies the conditions for each case. Provided that the optimal discount rate is the comparable market rate, it varies across intervention meth...

Non-invasive assessment of coronary artery bypass graft patency using 16-slice computed tomography angiography

Directory of Open Access Journals (Sweden)

Uren Neal G

2007-06-01

Full Text Available Abstract Background Invasive coronary angiography is the gold standard means of imaging bypass vessels and carries a small but potentially serious risk of local vascular complications, including myocardial infarction, stroke and death. We evaluated computed tomography as a non-invasive means of assessing graft patency. Methods Fifty patients with previous coronary artery bypass surgery who were listed for diagnostic coronary angiography underwent contrast enhanced computed tomography angiography using a 16-slice computed tomography scanner. Images were retrospectively gated to the electrocardiogram and two dimensional axial, multiplanar and three dimensional reconstructions acquired. Sensitivity, specificity, positive and negative predictive value, accuracy and level of agreement for detection of graft patency by multidetector computed tomography. Results A total of 116 grafts were suitable for analysis. The specificity of CT for the detection of graft patency was 100%, with a sensitivity of 92.8%, positive predictive value 100%, negative predictive value 85.8% and an accuracy of 94.8%. The kappa value of agreement between the two means of measuring graft patency was 0.9. Mean radiation dose was 9.0 ± 7.2 mSv for coronary angiography and 18.5 ± 4 mSv for computed tomography. Pooled analysis of eight studies, incorporating 932 grafts, confirmed a 97% accuracy for the detection of graft patency by multidetector computed tomography. Conclusion Computed tomography is an accurate, rapid and non-invasive method of assessing coronary artery bypass graft patency. However, this was achieved at the expense of an increase in radiation dose.

Budd-Chiari syndrome due to prothrombotic disorder: mid-term patency and efficacy of endovascular stents

Energy Technology Data Exchange (ETDEWEB)

Pelage, Jean-Pierre; Denys, Alban; Sibert, Annie; Menu, Yves [Department of Radiology, Hopital Beaujon, AP-HP, 100 Boulevard du General Leclerc, 92110 Clichy (France); Valla, Dominique [Department of Hepatology, Hopital Beaujon, AP-HP, 100 Boulevard du General Leclerc, 92110 Clichy (France); Sauvanet, Alain; Belghiti, Jacques [Department of Surgery, Hopital Beaujon, AP-HP, 100 Boulevard du General Leclerc, 92110 Clichy (France)

2003-02-01

Our objective was to evaluate efficacy and patency of metallic stent placement for symptomatic Budd-Chiari syndrome (BCS) due to prothrombotic disorders. Eleven patients with proved BCS due to prothrombotic disorders were referred for endovascular treatment because of refractory ascites (n=9), abdominal pain (n=8), jaundice (n=6), and/or gastrointestinal bleeding (n=4). Stents were inserted for stenosed hepatic vein (n=7), inferior vena cava (n=2), or mesenterico-caval shunt (n=2). Clinical efficacy and stent patency was evaluated by clinical and Doppler follow-up. After a mean follow-up of 21 months, 6 patients had fully patent stents without reintervention (primary stent patency: 55%). Two patients with hepatic vein stenosis had stent thrombosis and died 4 months after procedure. Restenosis occurred in 3 cases (2 hepatic vein and 1 mesenterico-caval shunt stenosis) and were successfully treated by balloon angioplasty (n=2) and addition of new stents (n=1) leading to a 82% secondary stent patency. Of 9 patients with patent stent, 7 were asymptomatic (77%) at the end of the study. Stent placement is a safe and effective procedure to control of symptomatic BCS. Prothrombotic disorder does not seem to jeopardize patency in anticoagulated patients. (orig.)

The Primary Patency and Fracture Rates of Self-Expandable Nitinol Stents Placed in the Popliteal Arteries, Especially in the P2 and P3 Segments, in Korean Patients

Energy Technology Data Exchange (ETDEWEB)

Chang, Il Soo; Chee, Hyun Keun; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Kim, Jun Seok; Chang, Seong Hwan; Jung, Hong Geun [Konkuk University Hospital, Seoul (Korea, Republic of)

2011-04-15

We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for steno occlusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2: n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at the 2-year follow-up did not have stent fracture. The primary patency was 94%, 61% and 44% at 1, 3 and 6 months, respectively, and the group with stent implantation up to P3 had a higher fracture rate than that of the group that underwent stenting up to P2 (p < 0.05). We suggest that stent placement up to the popliteal arterial P3 segment and over P2 in an Asian population can worsen the stent patency owing to stent fracture. It may be necessary to develop a stent design and structure for the Asian population that can resist the bending force in the knee joint

Assessment of extracranial-intracranial bypass patency with 64-slice multidetector computerized tomography angiography

Energy Technology Data Exchange (ETDEWEB)

Thines, Laurent [Lille University Hospital, Department of Neurosurgery, Lille (France); Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Agid, Ronit; Da Costa, Leodante; Terbrugge, Karel G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Dehdashti, Amir R.; Wallace, M.C.; Tymianski, Michael [Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada)

2009-08-15

Extracranial-intracranial (EC/IC) bypass is a useful procedure for the treatment of cerebral vascular insufficiency or complex aneurysms. We explored the role of multidetector computed tomography angiography (MDCTA), instead of digital subtraction angiography (DSA), for the postoperative assessment of EC/IC bypass patency. We retrospectively analyzed a consecutive series of 21 MDCTAs from 17 patients that underwent 25 direct or indirect EC/IC bypass procedures between April 2003 and November 2007. Conventional DSA was available for comparison in 13 cases. MDCTA used a 64-slice MDCT scanner (Aquilion 64, Toshiba). The proximal and distal patencies were analyzed independently on MDCTA and DSA by a neuroradiologist and a neurosurgeon. The bypass was considered patent when the entire donor vessel was opacified without discontinuity from proximal to distal ends and was visibly in contact with the recipient vessel. MDCTA depicted the patency status in every patient. Bypasses were patent in 22 cases, stenosed in one, and occluded in two. DSA always confirmed the results of the MDCTA (sensitivity = 100%, 95% CI = 0.655-1.0; specificity 100%, 95% CI = 0.05-1.0). MDCTA is a non-invasive and accurate exam to assess the postoperative EC/IC bypass patency and is a promising technique in routine follow-up. (orig.)

Improving arteriovenous fistula patency: Transdermal delivery of diclofenac reduces cannulation-dependent neointimal hyperplasia via AMPK activation.

Science.gov (United States)

MacAskill, Mark G; Watson, David G; Ewart, Marie-Ann; Wadsworth, Roger; Jackson, Andrew; Aitken, Emma; MacKenzie, Graeme; Kingsmore, David; Currie, Susan; Coats, Paul

2015-08-01

Creation of an autologous arteriovenous fistula (AVF) for vascular access in haemodialysis is the modality of choice. However neointimal hyperplasia and loss of the luminal compartment result in AVF patency rates of ~60% at 12months. The exact cause of neointimal hyperplasia in the AVF is poorly understood. Vascular trauma has long been associated with hyperplasia. With this in mind in our rabbit model of AVF we simulated cannulation autologous to that undertaken in vascular access procedures and observed significant neointimal hyperplasia as a direct consequence of cannulation. The neointimal hyperplasia was completely inhibited by topical transdermal delivery of the non-steroidal anti-inflammatory (NSAID) diclofenac. In addition to the well documented anti-inflammatory properties we have identified novel anti-proliferative mechanisms demonstrating diclofenac increases AMPK-dependent signalling and reduced expression of the cell cycle protein cyclin D1. In summary prophylactic transdermal delivery of diclofenac to the sight of AVF cannulation prevents adverse neointimal hyperplasic remodelling and potentially offers a novel treatment option that may help prolong AVF patency and flow rates. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

MR inflow angiography for the evaluation of dural sinus patency

International Nuclear Information System (INIS)

Poncelet, B.; Baleriaux, D.; Grand, C.; Van Dijk, P.; De Graaf, R.; Segebarth, C.

1990-01-01

This paper assesses dural sinus patency with two-dimensional inflow MR angiography. Twelve patients with potential dural sinus (superior sagittal and transverse sinus) involvement related to tumors of the falx or the convexity (meningiomas, metastasis) were examined with digital subtraction angiography (DSA), Mr imaging (1.5-T Gyroscan system), including T1-weighted (pre- and post-agadolinium) and T2-weighted spin-echo imaging, and MR angiography. For the MR angiographic study, a gradient-echo fast field echo sequence with flow compensation was used. Thin (2-mm), contiguous coronal or transverse sections were acquired sequentially. Three-dimensional reconstruction with MIP processing was then performed. CT, DSA, and MR imaging were performed for presurgical evaluation. Surgical confirmation of sinus patency was obtained for all patients

Patency of the posterior communicating artery following treatment with the Pipeline Embolization Device.

Science.gov (United States)

Daou, Badih; Valle-Giler, Edison P; Chalouhi, Nohra; Starke, Robert M; Tjoumakaris, Stavropoula; Hasan, David; Rosenwasser, Robert H; Hebert, Ryan; Jabbour, Pascal

2017-02-01

OBJECTIVE The Pipeline Embolization Device (PED) has become an effective treatment strategy for some cerebral aneurysms. Concerns regarding the patency of branch arteries have been raised. The objective of this study was to assess the patency of the posterior communicating artery (PCoA) following treatment of PCoA aneurysms using the PED. METHODS All patients with PCoA aneurysms treated with the PED who had angiographic follow-up were retrospectively identified. The patency of the PCoA at follow-up was evaluated by 2 authors who were not involved in the intervention. Univariate and multivariate analyses were performed to identify factors associated with the following: 1) PCoA patency versus no or diminished flow, and 2) PCoA patency and diminished flow versus PCoA occlusion. RESULTS Thirty patients with an angiographic follow-up of 6 months were included. Aneurysm obliteration was achieved in 25 patients (83.3%). The PCoA was patent in 7 patients (23.3%), had diminished flow in 7 patients (23.3%), and was occluded in 16 patients (53.3%). In the univariate analysis of outcome, there was a trend for aneurysms with incomplete occlusion, aneurysms not previously treated, those with presence of a fetal PCoA, and those with an artery coming from the aneurysm to have higher odds of the PCoA remaining patent. In univariate and multivariate analyses of factors associated with outcome, fetal PCoA and presence of an artery coming from the aneurysm were associated with the PCoA remaining open with or without diminished flow. No patients had symptoms related to PCoA occlusion. CONCLUSIONS Occlusion and diminished flow through the PCoA is common following PED treatment of PCoA aneurysms. However, it is clinically insignificant in most cases.

Partially Covered Metal Stents May Not Prolong Stent Patency Compared to Uncovered Stents in Unresectable Malignant Distal Biliary Obstruction

Science.gov (United States)

Kim, Jae Yun; Ko, Gyu Bong; Lee, Tae Hoon; Park, Sang-Heum; Lee, Yun Nah; Cho, Young Sin; Jung, Yunho; Chung, Il-Kwun; Choi, Hyun Jong; Cha, Sang-Woo; Moon, Jong Ho; Cho, Young Deok; Kim, Sun-Joo

2017-01-01

Background/Aims Controversy still exists regarding the benefits of covered self-expandable metal stents (SEMSs) compared to uncovered SEMSs. We aimed to compare the patency and stent-related adverse events of partially covered SEMSs (PC-SEMSs) and uncovered SEMSs in unresectable malignant distal biliary obstruction. Methods A total of 134 patients who received a PC-SEMS or uncovered SEMS for palliation of unresectable malignant distal biliary obstruction were reviewed retrospectively. The main outcome measures were stent patency, stent-related adverse events, and overall survival. Results The median stent patency was 118 days (range, 3 to 802 days) with PC-SEMSs and 105 days (range, 2 to 485 days) with uncovered SEMSs (p=0.718). The overall endoscopic revision rate due to stent dysfunction was 36.6% (26/71) with PC-SEMSs and 36.5% (23/63) with uncovered SEMSs (p=0.589). Tumor ingrowth was more frequent with uncovered SEMSs (4.2% vs 19.1%, p=0.013), but migration was more frequent with PC-SEMSs (11.2% vs 1.5%, p=0.04). The incidence of stent-related adverse events was 2.8% (2/71) with PC-SEMSs and 9.5% (6/63) with uncovered SEMSs (p=0.224). The median overall survival was 166 days with PC-SEMSs and 168 days with uncovered SEMSs (p=0.189). Conclusions Compared to uncovered SEMSs, PC-SEMSs did not prolong stent patency in unresectable malignant distal biliary obstruction. Stent migration was more frequent with PC-SEMSs. However, tumor ingrowth was less frequent with PC-SEMSs compared to uncovered SEMSs. PMID:28208003

Assessment of patency capsule retention using MR diffusion-weighted imaging

Energy Technology Data Exchange (ETDEWEB)

Klang, Eyal; Rozendorn, Noa; Amitai, Michal Marianne [Sheba Medical Center, Department of Diagnostic Imaging, Ramat Gan (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Kopylov, Uri; Ben-Horin, Shomron; Lahat, Adi; Yablecovitch, Doron; Eliakim, Rami [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Sheba Medical Center, Department of Gastroenterology, Ramat Gan (Israel)

2017-12-15

Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD). Clinical and imaging data were prospectively reviewed for 80 CD patients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis. Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm{sup 2}/s showed 90.0% sensitivity and 50.0% specificity for retention. Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy. (orig.)

Assessment of patency capsule retention using MR diffusion-weighted imaging

International Nuclear Information System (INIS)

Klang, Eyal; Rozendorn, Noa; Amitai, Michal Marianne; Kopylov, Uri; Ben-Horin, Shomron; Lahat, Adi; Yablecovitch, Doron; Eliakim, Rami

2017-01-01

Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD). Clinical and imaging data were prospectively reviewed for 80 CD patients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis. Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm 2 /s showed 90.0% sensitivity and 50.0% specificity for retention. Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy. (orig.)

Oral cholecystography compared to cholescintigraphy for evaluation of cystic duct patency prior to ESWL treatment

International Nuclear Information System (INIS)

Monrad, H.; Groenvall, S.; Hoegaard, L.

1994-01-01

In a prospective, blinded study of 109 patients with cholecystolithiasis, oral cholecystography and 99 Tc m -EHIDA cholescintigraphy were compared in terms of reliability for demonstrating cystic duct patency: one of the prerequisites for extracorporal shock wave lithotripsy (ESWL) treatment of cholecystolithiasis. Patients with a positive result on one or both tests were regarded as having cystic duct patency. Patients with negative and uncertain result of both tests or one of each were regarded as having no cystic duct patency. Concordance between the two tests was obtained in 93 of 109 patients. The diagnostic reliability of cholescintigraphy and oral cholecystography were 95 and 86%, respectively (P < 0.05), suggesting a more precise determination of gallbladder filling with scintigraphy. (author)

Double-contrast barium enteroclysis as a patency tool for nonsteroidal anti-inflammatory drug-induced enteropathy.

Science.gov (United States)

Matsumoto, Takayuki; Esaki, Motohiro; Kurahara, Koichi; Hirai, Fumihito; Fuchigami, Tadahiko; Matsui, Toshiyuki; Iida, Mitsuo

2011-11-01

Evaluating small bowel patency is recommended for capsule endoscopy in patients suspected of nonsteroidal anti-inflammatory drug-induced (NSAID) enteropathy. The aim of this investigation was to examine whether radiography is a candidate of patency tool in NSAID enteropathy. We reviewed double-contrast barium enteroclysis in 21 patients with NSAID enteropathy diagnosed either by capsule endoscopy or balloon-assisted endoscopy. The endoscopic findings were classified into circular ulcers, linear ulcers and small mucosal defects. The radiographic signs of the corresponding endoscopic findings were retrieved and the depiction rate was calculated. Of the 21 patients, endoscopy detected circular ulcers, linear ulcers, and small ulcers in 12, 3 and 12 patients, respectively. Small bowel radiography depicted circular narrowing as pseudo-folds in 10 patients (83%) and linear ulcers as eccentric rigidity in 2 patients (67%). However, radiography was able to depict small mucosal defects in only 3 patients (17%). Two of 5 patients with pseudo-folds experienced retention of the capsule. "Pseudo-folds" is a sign corresponding to circular ulcer in NSAID enteropathy, which may be predictive of capsule retention.

Internal jugular vein patency and treatment methods after neck dissection in patients with oral cancer

International Nuclear Information System (INIS)

Makiguchi, Takaya; Yokoo, Satoshi; Miyazaki, Hidetaka; Ogawa, Masaru; Takayama, Yu; Negishi, Akihide

2014-01-01

Stenosis and obstruction of the internal jugular vein (IJV) sometimes occur following modified radical neck dissection or selective neck dissection, in which the IJV is preserved. The objective of this study was to assess risk factors for stenosis or obstruction of the IJV following neck dissection. A total of 58 neck dissections performed in 51 patients by the same surgeon at Gunma University Hospital were retrospectively reviewed. The relationships of the patency of the IJV with gender, side of dissection, number of lymph node metastases, invasion out of the lymph node, radiotherapy, and reconstructive method were examined. The patency of the IJV was evaluated postoperatively using enhanced computed tomography. All cases with obstruction of the IJV received postoperative radiotherapy and neck dissection on the left side. Postoperative radiotherapy was a significant risk factor for obstruction of the IJV. Free flap reconstruction was not a risk factor for stenosis and obstruction. The rate of obstruction of the IJV was significantly decreased in cases with pectoral major musculocutaneous flap reconstruction or extended supraomohyoid neck dissection in which the muscle extensively covered the IJV. (author)

[Damage to cranial and peripheral nerves following patency restoration of the internal carotid artery].

Science.gov (United States)

Myrcha, P; Ciostek, P; Szopiński, P; Noszczyk, W

2001-01-01

The aim of the study was an assessment of the incidence of injury to cranial and peripheral nerves as complication of patency restoration of the internal carotid artery, and analysis of the effect of peripheral nerve injury on the results of carotid patency restoration. From Oct 1987 to Sept 1999 543 procedures were carried out for restoration of patency of the internal carotid artery. After the operation hypoglossus nerve injury was found in 7 cases (1.4%), vagus injury in 9 (1.8%). Signs of exclusively recurrent laryngeal nerve damage were found in 6 cases (1.2%). Glossopharyngeus nerve was damaged in 2 cases (0.4%), transient phrenic nerve palsy as a result of conduction anaesthesia was noted in 2 cases (0.4%). Damage to the transverse cervical nerve was found in 96 cases (60%). In 2 patients (1.2%) lower position of mouth angle was due to section of the mandibular ramus of the facial nerve. In another 2 cases skin sensation disturbances were a consequence of lesion of the auricularis magnus nerve and always they coexisted with signs of transverse cervical nerve damage. damage to the cranial nerves during operation for carotid patency restoration are frequent but mostly they are not connected with any health risks and often they regress spontaneously.

Novel strategies to improve the patency of vascular prostheses

NARCIS (Netherlands)

Heyligers, J.M.M.

2006-01-01

Two novel strategies to improve the patency of vascular prostheses are described in this thesis. To improve the outcome of synthetic vascular bypass surgery, cell seeding is a promising concept that has extensively been investigated and is still evolving. To improve the short term effects due to

Oral cholecystography compared to cholescintigraphy for evaluation of cystic duct patency prior to ESWL treatment

Energy Technology Data Exchange (ETDEWEB)

Monrad, H.; Groenvall, S.; Hoegaard, L. (Copenhagen Univ. (Denmark). Hvidovre Hospital)

1994-01-01

In a prospective, blinded study of 109 patients with cholecystolithiasis, oral cholecystography and [sup 99]Tc[sup m]-EHIDA cholescintigraphy were compared in terms of reliability for demonstrating cystic duct patency: one of the prerequisites for extracorporal shock wave lithotripsy (ESWL) treatment of cholecystolithiasis. Patients with a positive result on one or both tests were regarded as having cystic duct patency. Patients with negative and uncertain result of both tests or one of each were regarded as having no cystic duct patency. Concordance between the two tests was obtained in 93 of 109 patients. The diagnostic reliability of cholescintigraphy and oral cholecystography were 95 and 86%, respectively (P < 0.05), suggesting a more precise determination of gallbladder filling with scintigraphy. (author).

Effect of Patency File on Transportation and Curve Straightening in Canal Preparation with ProTaper System.

Science.gov (United States)

Hasheminia, Seyed Mohsen; Farhadi, Nastaran; Shokraneh, Ali

2013-01-01

The aim of this ex vivo study was to evaluate the effect of using a patency file on apical transportation and curve straightening during canal instrumentation with the ProTaper rotary system. Seventy permanent mandibular first molars with mesiobuccal canals, measuring 18-23 mm in length and with a 25-40° curvature (according to the Schneider method), were selected. The working lengths were determined and the teeth were mounted and divided into two experimental groups: (A) prepared by the ProTaper system without using a patency file (n = 35) and (B) prepared by the ProTaper system using a patency file (n = 35). Radiographs taken before and after the preparation were imported into Photoshop software and the apical transportation, and curve straightening were measured. Data were analyzed using independent t-test. Partial correlation analysis was performed to evaluate the relationship between the initial curvature, transportation, and curve straightening (α = 0.05). Using a patency file during canal preparation significantly decreased both apical transportation and curve straightening (P system.

The effect of lowering LDL cholesterol on vascular access patency

DEFF Research Database (Denmark)

Herrington, William; Emberson, Jonathan; Staplin, Natalie

2014-01-01

BACKGROUND AND OBJECTIVES: Reducing LDL cholesterol (LDL-C) with statin-based therapy reduces the risk of major atherosclerotic events among patients with CKD, including dialysis patients, but the effect of lowering LDL-C on vascular access patency is unclear. DESIGN, SETTING, PARTICIPANTS...

Superior Lower Extremity Vein Graft Bypass Patency among Married Patients with Peripheral Artery Disease.

Science.gov (United States)

Lagergren, Emily; Kempe, Kelly; Craven, Timothy E; Kornegay, Susan T; Hurie, Justin B; Garg, Nitin; Velazquez-Ramirez, Gabriela; Edwards, Matthew S; Corriere, Matthew A

2017-10-01

Outcome disparities associated with lower extremity bypass (LEB) for peripheral artery disease (PAD) have been identified but are poorly understood. Marital status may affect outcomes through factors related to health risk behaviors, adherence, and access to care but has not been characterized as a predictor of surgical outcomes and is often omitted from administrative data sets. We evaluated associations between marital status and vein graft patency following LEB using multivariable models adjusting for established risk factors. Consecutive patients undergoing autogenous LEB for PAD were identified and analyzed. Survival analysis and Cox proportional hazards models were used to evaluate patency stratified by marital status (married versus single, divorced, or widow[er]) adjusting for demographic, comorbidity, and anatomic factors in multivariable models. Seventy-three participants who underwent 79 autogenous vein LEB had complete data and were analyzed. Forty-three patients (58.9%) were married, and 30 (41.1%) were unmarried. Compared with unmarried patients, married patients were older at the time of their bypass procedure (67.3 ± 10.8 years vs. 62.2 ± 10.6 years; P = 0.05). Married patients also had a lower prevalence of female gender (11.6% vs. 33.3%; P = 0.02). Diabetes, hypertension, hyperlipidemia, and smoking were common among both married and unmarried patients. Minimum great saphenous vein conduit diameters were larger in married versus unmarried patients (2.82 ± 0.57 mm vs. 2.52 ± 0.65 mm; P = 0.04). Twenty-four-month primary patency was 66% for married versus 38% for unmarried patients. In a multivariable proportional hazards model adjusting for proximal and distal graft inflow/outflow, medications, gender, age, race, smoking, diabetes, and minimum vein graft diameter, married status was associated with superior primary patency (hazard ratio [HR] = 0.33; 95% confidence limits [0.11, 0.99]; P = 0.05); other predictive covariates

A comparison of patency and interventions in thigh versus Hemodialysis Reliable Outflow grafts for chronic hemodialysis vascular access.

Science.gov (United States)

Brownie, Evan R; Kensinger, Clark D; Feurer, Irene D; Moore, Derek E; Shaffer, David

2016-11-01

With improvements in medical management and survival of patients with end-stage renal disease, maintaining durable vascular access is increasingly challenging. This study compared primary, assisted primary, and secondary patency, and procedure-specific complications, and evaluated whether the number of interventions to maintain or restore patency differed between prosthetic femoral-femoral looped inguinal access (thigh) grafts and Hemodialysis Reliable Outflow (HeRO; Hemosphere Inc, Minneapolis, Minn) grafts. A single-center, retrospective, intention-to-treat analysis was conducted of consecutive thigh and HeRO grafts placed between May 2004 and June 2015. Medical history, interventions to maintain or restore patency, and complications were abstracted from the electronic medical record. Data were analyzed using parametric and nonparametric statistical tests, Kaplan-Meier survival methods, and multivariable proportional hazards regression and logistic regression. Seventy-six (43 thigh, 33 HeRO) grafts were placed in 61 patients (54% male; age 53 [standard deviation, 13] years). Median follow-up time in the intention-to-treat analysis was 21.2 months (min, 0.0; max, 85.3 months) for thigh grafts and 6.7 months (min, 0.0; max, 56.3 months) for HeRO grafts (P = .02). The groups were comparable for sex, age, coronary artery disease, diabetes mellitus, peripheral vascular disease, and smoking history (all P ≥ .12). One thigh graft (2%) and five HeRO (15%) grafts failed primarily. In the intention-to-treat analysis, patency durations were significantly longer in the thigh grafts (all log-rank P ≤ .01). Point estimates of primary patency at 6 months, 1 year, and 3 years were 61%, 46%, and 4% for the thigh grafts and 25%, 15%, and 6% for the HeRO grafts. Point estimates of assisted primary patency at 6 months, 1 year, and 3 years were 75%, 66%, and 54% for the thigh grafts and 41%, 30%, and 10% for the HeRO grafts. Point estimates of secondary patency at 6�

Transcatheter Arterial Chemoembolization of Liver Tumors: Effects of Embolization Protocol on Injectable Volume of Chemotherapy and Subsequent Arterial Patency

International Nuclear Information System (INIS)

Geschwind, Jean-Francois H.; Ramsey, Douglas E.; Wal, B.C.H. van der; Kobeiter, Hicham; Juluru, Krishna; Hartnell, George G.; Choti, Michael A.

2003-01-01

The purpose of this study was to determine whether transcatheter arterial chemoembolization (TACE) protocol affects the total volume of chemotherapy injected into the liver as well as subsequent arterial patency. A total of 160 patients with primary or secondary liver cancer were treated with 3 different chemoembolization protocols at a single institution. Data were analyzed retrospectively.Group 1 (n = 36) consisted of slurry of chemotherapy,oil and polyvinyl alcohol particles (PVA), group 2 (n =91), chemotherapy and oil followed by PVA, and group 3(n = 33), chemotherapy and oil followed by Gelfoampledgets. The total volume of chemotherapy injected into the liver was recorded. Arterial patency was determined during subsequent chemoembolizations. The mean percentage of total intended chemotherapydose administered was 54.6% for group 1, 75.3% for group 2, and 80.6% for group 3. Arterial patency at follow-up angiography was 56% for group 1, 74% for group 2, and 81% for group 3. The slurry protocol (group 1) significantly reduced arterial patency and injectable volume of chemotherapy during TACE

Differential effects of tissue plasminogen activator and streptokinase on infarct size and on rate of enzyme release: influence of early infarct related artery patency : The GUSTO Enzyme Substudy

NARCIS (Netherlands)

T. Baardman (Taco); W.T. Hermens (Wim); G.P. Molhoek; G. Grollier (Gilles); M.E. Pfisterer (Matthias); M.L. Simoons (Maarten); T. Lenderink (Timo)

1996-01-01

textabstractBACKGROUND: The recent international GUSTO trial of 41,021 patients with acute myocardial infarction demonstrated improved 90-min infarct related artery patency as well as reduced mortality in patients treated with an accelerated regimen of tissue plasminogen activator, compared to

The effect on patency of type, shape and volume of a vein collar used at the distal anastomis of PTFE-bypass to arteries below-knee

DEFF Research Database (Denmark)

Lundgren, F; Schroeder, Torben Veith

2012-01-01

The aim of this paper was to study the effect on patency rate of different types of vein collar (Miller's original or St Mary's boot), different length/height shapes of vein collar, and different vein collar volumes at the distal anastomosis of PTFE-bypass grafts to below-knee arteries in patients...

Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings.

Science.gov (United States)

Yuceler, Zeyneb; Kantarci, Mecit; Yuce, Ihsan; Kizrak, Yesim; Bayraktutan, Ummugulsum; Ogul, Hayri; Kiris, Adem; Celik, Omer; Pirimoglu, Berhan; Genc, Berhan; Gundogdu, Fuat

2014-01-01

Our aim was to evaluate the diagnostic accuracy of 256-slice, high-pitch mode multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency. Eighty-eight patients underwent 256-slice MDCT angiography to evaluate their graft patency after CABG surgery using a prospectively synchronized electrocardiogram in the high-pitch spiral acquisition mode. Effective radiation doses were calculated. We investigated the diagnostic accuracy of high-pitch, low-dose, prospective, electrocardiogram-triggering, dual-source MDCT for CABG patency compared with catheter coronary angiography imaging findings. A total of 215 grafts and 645 vessel segments were analyzed. All graft segments had diagnostic image quality. The proximal and middle graft segments had significantly (P < 0.05) better mean image quality scores (1.18 ± 0.4) than the distal segments (1.31 ± 0.5). Using catheter coronary angiography as the reference standard, high-pitch MDCT had the following sensitivity, specificity, positive predictive value, and negative predictive value of per-segment analysis for detecting graft patency: 97.1%, 99.6%, 94.4%, and 99.8%, respectively. In conclusion, MDCT can be used noninvasively with a lower radiation dose for the assessment of restenosis in CABG patients.

Diagnostic value of 64 multislice computed tomography in the assessment of the coronary graft patency

International Nuclear Information System (INIS)

Llerena Rojas, Luis R; Mendoza Rodriguez, Vladimir; Olivares Aquiles, Eddy

2011-01-01

Symptoms recurrence after surgical coronary artery revascularization requires the assessment of graft patency. At the moment, promissory results have been reported using the multislice computed tomography

The optimal rating philosophy for the rating of SMEs

NARCIS (Netherlands)

Rikkers, F.; Thibeault, A.

2007-01-01

The objective of this research is to determine the optimal rating philosophy for the rating of SMEs, and to describe the consequences of the chosen philosophy on several related aspects. As to our knowledge, this is the first paper that studies the considerations of financial institutions on what

Conversion rate optimization in Finnish online businesses

OpenAIRE

Ratia, Miramaria; Ruoho, Vilma

2016-01-01

Conversion rate optimization (CRO) is an unfamiliar term to many online business owners even though it has become almost as important as search engine optimization is in e-commerce today. It is a method that is used to turn passive visitors into active users in order to improve a website’s performance. The main objective of this thesis was to find out what kinds of conversion rate optimization methods do Finnish small and medium-sized online businesses use. The thesis also studies what ar...

Trypan blue to assess Baerveldt tube patency after repair of its obstruction.

Science.gov (United States)

Grigg, John; Jang, John D W; Fung, Adrian T; Hunyor, Alex P; Wilson, Trevor

2011-12-01

Tubal obstruction is a recognized complication of glaucoma drainage implants. In correcting a blocked tube, the surgeon may be uncertain about shunt competence even after removing the suspected cause of obstruction. We report the use of trypan blue dye to show tubal patency directly after the repair of a blocked Baerveldt tube.

Effect of Ticagrelor Plus Aspirin, Ticagrelor Alone, or Aspirin Alone on Saphenous Vein Graft Patency 1 Year After Coronary Artery Bypass Grafting: A Randomized Clinical Trial.

Science.gov (United States)

Zhao, Qiang; Zhu, Yunpeng; Xu, Zhiyun; Cheng, Zhaoyun; Mei, Ju; Chen, Xin; Wang, Xiaowei

2018-04-24

The effect of ticagrelor with or without aspirin on saphenous vein graft patency in patients undergoing coronary artery bypass grafting (CABG) is unknown. To compare the effect of ticagrelor + aspirin or ticagrelor alone vs aspirin alone on saphenous vein graft patency 1 year after CABG. Randomized, multicenter, open-label, clinical trial among 6 tertiary hospitals in China. Eligible patients were aged 18 to 80 years with indications for elective CABG. Patients requiring urgent revascularization, concomitant cardiac surgery, dual antiplatelet or vitamin K antagonist therapy post-CABG, and who were at risk of serious bleeding were excluded. From July 2014 until November 2015, 1256 patients were identified and 500 were enrolled. Follow-up was completed in January 2017. Patients were randomized (1:1:1) to start ticagrelor (90 mg twice daily) + aspirin (100 mg once daily) (n = 168), ticagrelor (90 mg twice daily) (n = 166), or aspirin (100 mg once daily) (n = 166) within 24 hours post-CABG. Neither patients nor treating physicians were blinded to allocation. Primary outcome was saphenous vein graft patency 1 year after CABG (FitzGibbon grade A) adjudicated independently by a committee blinded to allocation. Saphenous vein graft patency was assessed by multislice computed tomographic angiography or coronary angiography. Among 500 randomized patients (mean age, 63.6 years; women, 91 [18.2%]), 461 (92.2%) completed the trial. Saphenous vein graft patency rates 1 year post-CABG were 88.7% (432 of 487 vein grafts) with ticagrelor + aspirin; 82.8% (404 of 488 vein grafts) with ticagrelor alone; and 76.5% (371 of 485 vein grafts) with aspirin alone. The difference between ticagrelor + aspirin vs aspirin alone was statistically significant (12.2% [95% CI, 5.2% to 19.2%]; P aspirin alone was not statistically significant (6.3% [95% CI, -1.1% to 13.7%]; P = .10). Five major bleeding episodes occurred during 1 year of follow-up (3 with

Effect of menstrual cycle phase and hormonal treatments on evaluation of tubal patency in baboons.

Science.gov (United States)

Jensen, Jeffrey T; Hanna, Carol; Mishler, Emily; Lim, Jeong Y; Slayden, Ov D

2018-02-01

We evaluated whether menstrual cycle phase influences the assessment of tubal patency by hysterosalpingography (HSG) in baboons. Retrospective analysis of baseline tubal patency studies and serum estradiol (E 2 ) and progesterone (P4) values obtained from female baboons used as models for development of non-surgical permanent contraception in women. The main outcome measure was bilateral tubal patency (BTP) in relationship with estradiol level. Female baboons (n = 110) underwent a single (n = 81), two (n = 26), or three (n = 3) HSG examinations. In 33/142 (23%) HSG examinations, one or both tubes showed functional occlusion (FO). The median E 2 in studies with BTP (49 pg/mL) was significantly higher than in those studies with FO (32 pg/mL, P = .005). Among 18 animals with repeat examinations where serum E 2 changed from <60 to ≥ 60 pg/mL, 13 results changed from FO to BTP (P = .0001). No sets showed a change from BTP to FO with an increase in estradiol. In baboons, functional occlusion of the fallopian tube is associated with low estradiol levels, supporting a role for estrogen-mediated relaxation of the utero-tubal junction. © 2017 The Authors. Journal of Medical Primatology Published by John Wiley & Sons Ltd.

Noninvasive detection of coronary artery bypass graft patency by intravenous electron beam computed tomographic angiography.

Science.gov (United States)

Yamakami, Shoji; Toyama, Junji; Okamoto, Mitsuhiro; Matsushita, Toyoaki; Murakami, Yoshimasa; Ogata, Masaki; Ito, Shigenori; Fukutomi, Tatsuya; Okayama, Naotsuka; Itoh, Makoto

2003-11-01

This study evaluates the usefullness of intravenous electron beam computed tomographic angiography (EBA) for the detection of coronary artery bypass graft patency in 43 patients (33 men and 10 women, mean age, 65 years) who had coronary artery bypass graft surgery. EBA was performed a few days before selective bypass graft angiography (SGA). Forty axial cross-sections of angiographic images of the heart were acquired consecutively by an electrocardiographic trigger signal at 40% of the RR interval, which corresponds to the end-systolic phase. EBA data were reconstructed as a three-dimensional shaded surface display of the heart and bypass grafts. Detectability of the patency of bypass gratis was evaluated, taking selective angiographic images of the bypass grafts as a gold standard. One hundred and nine grafts (96%) out of 114 grafts were subjected to evaluation: 37 grafts were left internal mammary artery grafts (LIMA), 7 were right internal mammary artery grafts (RIMA), 6 were gastroepiploic artery grafts (GEA), 7 were free gastroepiploic artery grafts with venous drainage (free-GEA), 7 were radial artery grafts (RAG), and 45 were saphenous vein gratis (SVG). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBA were 98%, 100%, 100%, 91%, and 98%, respectively. EBA sampled at the end-systolic period was determined to be useful for the detection of coronary artery bypass graft patency and occlusion.

Optimization of automation: III. Development of optimization method for determining automation rate in nuclear power plants

International Nuclear Information System (INIS)

Lee, Seung Min; Kim, Jong Hyun; Kim, Man Cheol; Seong, Poong Hyun

2016-01-01

Highlights: • We propose an appropriate automation rate that enables the best human performance. • We analyze the shortest working time considering Situation Awareness Recovery (SAR). • The optimized automation rate is estimated by integrating the automation and ostracism rate estimation methods. • The process to derive the optimized automation rate is demonstrated through case studies. - Abstract: Automation has been introduced in various industries, including the nuclear field, because it is commonly believed that automation promises greater efficiency, lower workloads, and fewer operator errors through reducing operator errors and enhancing operator and system performance. However, the excessive introduction of automation has deteriorated operator performance due to the side effects of automation, which are referred to as Out-of-the-Loop (OOTL), and this is critical issue that must be resolved. Thus, in order to determine the optimal level of automation introduction that assures the best human operator performance, a quantitative method of optimizing the automation is proposed in this paper. In order to propose the optimization method for determining appropriate automation levels that enable the best human performance, the automation rate and ostracism rate, which are estimation methods that quantitatively analyze the positive and negative effects of automation, respectively, are integrated. The integration was conducted in order to derive the shortest working time through considering the concept of situation awareness recovery (SAR), which states that the automation rate with the shortest working time assures the best human performance. The process to derive the optimized automation rate is demonstrated through an emergency operation scenario-based case study. In this case study, four types of procedures are assumed through redesigning the original emergency operating procedure according to the introduced automation and ostracism levels. Using the

CT-control of the H-graft interposition mesocaval shunt patency

Energy Technology Data Exchange (ETDEWEB)

Partanen, P L.K.; Oksala, I

1984-02-01

A method for assessing the patency of the H-graft interposition mesocaval shunts by computerized tomography is described. Five patients with such shunts were examined with a 5.5 second CT scanner. After locating the graft a 50 cc bolus of 76% diatrizoate was injected into a cubital vein and 3-4 scans were executed at a preselected level. A distinct vessel like enhancement appeared if the shunt was open. With dynamic CT-scanning the flow can be demonstrated in graphical form as time-density curves.

Does patency after a vein collar and PTFE-bypass depend on sex and age?

DEFF Research Database (Denmark)

Lundgren, F; Schroeder, Torben Veith

2012-01-01

Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect...

Angiotensin Converting-Enzyme Inhibitors, Angiotensin Receptor Blockers, and Calcium Channel Blockers Are Associated with Prolonged Vascular Access Patency in Uremic Patients Undergoing Hemodialysis.

Directory of Open Access Journals (Sweden)

Fu-An Chen

Full Text Available Vascular access failure is a huge burden for patients undergoing hemodialysis. Many efforts have been made to maintain vascular access patency, including pharmacotherapy. Angiotensin converting enzyme inhibitor (ACE-I, angiotensin receptor blocker (ARB, and calcium channel blocker (CCB are known for their antihypertensive and cardio-protective effects, however, their effects on long-term vascular access patency are still inconclusive.We retrospectively enrolled patients commencing maintenance hemodialysis between January 1, 2000, and December 31, 2006 by using National Health Insurance Research Database in Taiwan. Primary patency was defined as the date of first arteriovenous fistula (AVF or arteriovenous graft (AVG creation to the time of access thrombosis or any intervention aimed to maintain or re-establish vascular access patency. Cox proportional hazards models were used to adjust the influences of patient characteristics, co-morbidities and medications.Total 42244 patients were enrolled in this study, 37771 (89.4% used AVF, 4473 (10.6% used AVG as their first long term dialysis access. ACE-I, ARB, and CCB use were all associated with prolonged primary patency of AVF [hazard ratio (HR 0.586, 95% confidence interval (CI 0.557-0.616 for ACE-I use; HR 0.532, CI 0.508-0.556 for ARB use; HR 0.485, CI 0.470-0.501 for CCB use] and AVG (HR 0.557, CI 0.482-0.643 for ACE-I use, HR 0.536, CI 0.467-0.614 for ARB use, HR 0.482, CI 0.442-0.526 for CCB use.In our analysis, ACE-I, ARB, and CCB were strongly associated with prolonged primary patency of both AVF and AVG. Further prospective randomized studies are still warranted to prove the causality.

Assessment Lumboperitoneal or Ventriculoperitoneal Shunt Patency by Radionuclide Technique: A Review Experience Cases

International Nuclear Information System (INIS)

Chiewvit, Sunanta; Nuntaaree, Sarun; Kanchaanapiboon, Potjanee; Chiewvit, Pipat

2014-01-01

Hydrocephalus-related symptoms that worsen after shunt placement may indicate a malfunctioning or obstructed shunt. The assessment of shunt patency and site of obstruction is important for planning of treatment. The radionuclide cerebrospinal fluid (CSF) shunt study provides a simple, effective, and low-radiation-dose method of assessing CSF shunt patency. The radionuclide CSF shuntography is a useful tool in the management of patients presenting with shunt-related problems not elucidated by conventional radiological examination. This article described the imaging technique of ventriculoperitoneal (VP) shunt and lumbar puncture (LP) shunt. The normal finding, abnormal finding of completed obstruction and partial obstruction is present by our cases experience. The radiopharmaceutical (Tc-99m diethylenetriaminepentaacetic acid) was injected via the reservoir for VP shunt and via lumbar puncture needle in subarachnoid space for LP shunt, then serial image in the head and abdominal area. The normal function of VP and LP shunt usually rapid spillage of the radioactivity in the abdominal cavity diffusely. The patent proximal tube VP shunt demonstrates ventricular reflux. The early image of patent LP shunt reveals no activity in the ventricular system contrast to distal LP shunt reveals early reflux of activity in the ventricular system. The completed distal VP and LP shunt obstruction show absence of tracer in the peritoneal area or markedly delayed appearance of abdominal activity. The partial distal VP and LP shunt obstruction recognized by slow transit or accumulation of tracer at the distal end or focal tracer in the peritoneal cavity near the tip of distal shunt. The images of the normal and abnormal CSF shunt as describe before are present in the full paper. Radionuclide CSF shuntography is a reliable and simple procedure for assessment shunt patency

Oral cholecystography compared to cholescintigraphy for evaluation of cystic duct patency prior to ESWL treatment

DEFF Research Database (Denmark)

Monrad, H; Grønvall, S; Højgaard, L

1994-01-01

In a prospective, blinded study of 109 patients with cholecystolithiasis, oral cholecystography and 99Tcm-EHIDA cholescintigraphy were compared in terms of reliability for demonstrating cystic duct patency: one of the prerequisites for extracorporeal shock wave lithotripsy (ESWL) treatment...

Assessment of coronary artery bypass graft patency by multidetector computed tomography and electron-beam tomography

NARCIS (Netherlands)

Piers, LH; Dorgelo, J; Tio, RA; Jessurun, GAJ; Oudkerk, M; Zijlstra, F

This case report describes the use of retrospectively ECG-gated 16-slice multidetector computed tomography (MDCT) and electron-beam tomography (EBT) for assessing bypass graft patency in two patients with recurrent angina after coronary artery bypass graft surgery. The results of each tomographic

Why 'Optimal' Payment for Healthcare Providers Can Never be Optimal Under Community Rating.

Science.gov (United States)

Zweifel, Peter; Frech, H E

2016-02-01

This article extends the existing literature on optimal provider payment by accounting for consumer heterogeneity in preferences for health insurance and healthcare. This heterogeneity breaks down the separation of the relationship between providers and the health insurer and the relationship between consumers and the insurer. Both experimental and market evidence for a high degree of heterogeneity are presented. Given heterogeneity, a uniform policy fails to effectively control moral hazard, while incentives for risk selection created by community rating cannot be neutralized through risk adjustment. Consumer heterogeneity spills over into relationships with providers, such that a uniform contract with providers also cannot be optimal. The decisive condition for ensuring optimality of provider payment is to replace community rating (which violates the principle of marginal cost pricing) with risk rating of contributions combined with subsidization targeted at high risks with low incomes.

Optimal power allocation of a sensor node under different rate constraints

KAUST Repository

Ayala Solares, Jose Roberto; Rezki, Zouheir; Alouini, Mohamed-Slim

2012-01-01

The optimal transmit power of a sensor node while satisfying different rate constraints is derived. First, an optimization problem with an instantaneous transmission rate constraint is addressed. Next, the optimal power is analyzed, but now

Max-Min Optimality of Service Rate Control in Closed Queueing Networks

KAUST Repository

Xia, Li

2013-04-01

In this technical note, we discuss the optimality properties of service rate control in closed Jackson networks. We prove that when the cost function is linear to a particular service rate, the system performance is monotonic w.r.t. (with respect to) that service rate and the optimal value of that service rate can be either maximum or minimum (we call it Max-Min optimality); When the second-order derivative of the cost function w.r.t. a particular service rate is always positive (negative), which makes the cost function strictly convex (concave), the optimal value of such service rate for the performance maximization (minimization) problem can be either maximum or minimum. To the best of our knowledge, this is the most general result for the optimality of service rates in closed Jackson networks and all the previous works only involve the first conclusion. Moreover, our result is also valid for both the state-dependent and load-dependent service rates, under both the time-average and customer-average performance criteria.

Improved patency and reduced intimal hyperplasia in PTFE grafts with luminal immobilized heparin compared with standard PTFE grafts at six months in a sheep model.

Science.gov (United States)

Pedersen, G; Laxdal, E; Ellensen, V; Jonung, T; Mattsson, E

2010-06-01

The aim of this study was to compare the performance of polytetrafluoroethylene (PTFE) grafts with luminal coating of immobilized heparin to that of standard PTFE grafts at six months. Twenty-eight common carotid arteries in fourteen sheep were bypassed with heparin-coated PTFE grafts (6 mm diameter, 6 cm length) on one side and standard PTFE grafts on the other. The grafts were explanted after six months. The thickness of intimal hyperplasia (IH) in open grafts was measured with histomorphometrical methods. Two of 14 heparinized PTFE grafts and nine of 14 grafts in the control PTFE-group were occluded at explantation (P=0.006). Six-month patency rates for heparinized PTFE grafts and for standard PTFE grafts were 86% and 36%, respectively. Mean graft anastomotic IH thickness in open grafts were 0.074 mm for heparinized PTFE grafts and 0.259 mm for PTFE-grafts (P=0.006). PTFE grafts with luminal coating containing immobilized heparin had significantly better patency and recruited less intimal hyperplasia than standard PTFE grafts at six months.

Cine CT in the evaluation of coronary bypass graft patency

International Nuclear Information System (INIS)

Stanford, W.; Rooholamini, M.; Rumberger, J.; Marcus, M.; Hiratzka, L.

1986-01-01

Cine CT produces axial images over an 8-cm section of the aorta in 50 msec. This characteristic makes the technique useful for evaluating coronary bypass graft (CBG) patency. With the use of 40 ml of 67% iothalamate sodium injected via an antecubital vein, 28 patients with 68 CBGs underwent cine CT. Ten patients with 21 CBGs also underwent cardiac catheterization. In the latter group the overall accuracy of cine CT compared to cardiac catheterization was 95.2% (20/21). The sensitivity was 94.1% (16/17), and the specificity was 100% (4/4). This figure compares favorably with the 92% sensitivity achieved with conventional CT

Optimal regional biases in ECB interest rate setting

NARCIS (Netherlands)

Arnold, I.J.M.

2005-01-01

This paper uses a simple model of optimal monetary policy to consider whether the influence of national output and inflation rates on ECB interest rate setting should equal a country’s weight in the eurozone economy. The findings depend on assumptions regarding interest rate elasticities, exchange

Evaluation of the patency of an extracranial-intracranial bypass using magnetic resonance angiography with selective presaturation of bypass vessels

Energy Technology Data Exchange (ETDEWEB)

Mabuchi, Shoji; Nakayama, Naoki; Isu, Toyohiko; Harata, Tatsuo; Nanbu, Toshikazu [Kushiro Rousai Hospital, Hokkaido (Japan)

1994-06-01

Three-dimensional time-of-flight magnetic resonance (MR) angiography using radiofrequency presaturation pulses was used to evaluate the patency of extracranial-intracranial (EC/IC) bypass in 11 patients. Presaturation causes signal loss in the vascular territory supplied by the presaturated EC/IC bypass graft. In all patients with a patent EC/IC bypass graft confirmed on conventional angiography, disappearance of the signal of the middle cerebral artery receiving blood flow from the bypass graft was clearly observed on MR angiograms with presaturation, indicating patency of the EC/IC bypass graft. MR angiography with presaturation pulses is a noninvasive and repeatable method for evaluation of the function of an EC/IC bypass graft. (author).

Conversion Rate Optimization : Visual Neuro Programming Principles

OpenAIRE

Berezhnaya, Anastasia

2016-01-01

The influence of the world wide web has already spread in every business. Consequently, it has become crucial to develop strong online presence and offer qualified user experience for website visitors. Website optimization undeniably has proved its importance in the recent decade. This research was conducted in order to study the practical application and structure of the stages of the CRO (Conversion Rate Optimization) framework that focuses on the most representative website metric – c...

Validity of administrative database code algorithms to identify vascular access placement, surgical revisions, and secondary patency.

Science.gov (United States)

Al-Jaishi, Ahmed A; Moist, Louise M; Oliver, Matthew J; Nash, Danielle M; Fleet, Jamie L; Garg, Amit X; Lok, Charmaine E

2018-03-01

We assessed the validity of physician billing codes and hospital admission using International Classification of Diseases 10th revision codes to identify vascular access placement, secondary patency, and surgical revisions in administrative data. We included adults (≥18 years) with a vascular access placed between 1 April 2004 and 31 March 2013 at the University Health Network, Toronto. Our reference standard was a prospective vascular access database (VASPRO) that contains information on vascular access type and dates of placement, dates for failure, and any revisions. We used VASPRO to assess the validity of different administrative coding algorithms by calculating the sensitivity, specificity, and positive predictive values of vascular access events. The sensitivity (95% confidence interval) of the best performing algorithm to identify arteriovenous access placement was 86% (83%, 89%) and specificity was 92% (89%, 93%). The corresponding numbers to identify catheter insertion were 84% (82%, 86%) and 84% (80%, 87%), respectively. The sensitivity of the best performing coding algorithm to identify arteriovenous access surgical revisions was 81% (67%, 90%) and specificity was 89% (87%, 90%). The algorithm capturing arteriovenous access placement and catheter insertion had a positive predictive value greater than 90% and arteriovenous access surgical revisions had a positive predictive value of 20%. The duration of arteriovenous access secondary patency was on average 578 (553, 603) days in VASPRO and 555 (530, 580) days in administrative databases. Administrative data algorithms have fair to good operating characteristics to identify vascular access placement and arteriovenous access secondary patency. Low positive predictive values for surgical revisions algorithm suggest that administrative data should only be used to rule out the occurrence of an event.

A Predictive Framework to Elucidate Venous Stenosis: CFD & Shape Optimization.

Science.gov (United States)

Javid Mahmoudzadeh Akherat, S M; Cassel, Kevin; Boghosian, Michael; Hammes, Mary; Coe, Fredric

2017-07-01

The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient's upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to excessive neointimal hyperplasia (NH) and subsequently stenosis. Development of a framework to monitor and predict the evolution of the venous system post access creation can greatly contribute to maintaining access patency. Computational fluid dynamics (CFD) has been exploited to inspect the non-homeostatic wall shear stress (WSS) distribution that is speculated to trigger NH in the patient cohort under investigation. Thereafter, CFD in liaison with a gradient-free shape optimization method has been employed to analyze the deformation modes of the venous system enduring non-physiological hemodynamics. It is observed that the optimally evolved shapes and their corresponding hemodynamics strive to restore the homeostatic state of the venous system to a normal, pre-surgery condition. It is concluded that a CFD-shape optimization coupling that seeks to regulate the WSS back to a well-defined physiological WSS target range can accurately predict the mode of patient-specific access failure.

Optimal power allocation of a sensor node under different rate constraints

KAUST Repository

Ayala Solares, Jose Roberto

2012-06-01

The optimal transmit power of a sensor node while satisfying different rate constraints is derived. First, an optimization problem with an instantaneous transmission rate constraint is addressed. Next, the optimal power is analyzed, but now with an average transmission rate constraint. The optimal solution for a class of fading channels, in terms of system parameters, is presented and a suboptimal solution is also proposed for an easier, yet efficient, implementation. Insightful asymptotical analysis for both schemes, considering a Rayleigh fading channel, are shown. Finally, the optimal power allocation for a sensor node in a cognitive radio environment is analyzed where an optimum solution for a class of fading channels is again derived. In all cases, numerical results are provided for either Rayleigh or Nakagami-m fading channels. © 2012 IEEE.

Optimized Beam Sculpting with Generalized Fringe-rate Filters

Science.gov (United States)

Parsons, Aaron R.; Liu, Adrian; Ali, Zaki S.; Cheng, Carina

2016-03-01

We generalize the technique of fringe-rate filtering, whereby visibilities measured by a radio interferometer are re-weighted according to their temporal variation. As the Earth rotates, radio sources traverse through an interferometer’s fringe pattern at rates that depend on their position on the sky. Capitalizing on this geometric interpretation of fringe rates, we employ time-domain convolution kernels to enact fringe-rate filters that sculpt the effective primary beam of antennas in an interferometer. As we show, beam sculpting through fringe-rate filtering can be used to optimize measurements for a variety of applications, including mapmaking, minimizing polarization leakage, suppressing instrumental systematics, and enhancing the sensitivity of power-spectrum measurements. We show that fringe-rate filtering arises naturally in minimum variance treatments of many of these problems, enabling optimal visibility-based approaches to analyses of interferometric data that avoid systematics potentially introduced by traditional approaches such as imaging. Our techniques have recently been demonstrated in Ali et al., where new upper limits were placed on the 21 {cm} power spectrum from reionization, showcasing the ability of fringe-rate filtering to successfully boost sensitivity and reduce the impact of systematics in deep observations.

Determination of the Optimal Exchange Rate Via Control of the Domestic Interest Rate in Nigeria

Directory of Open Access Journals (Sweden)

Virtue U. Ekhosuehi

2014-01-01

Full Text Available An economic scenario has been considered where the government seeks to achieve a favourable balance-of-payments over a fixed planning horizon through exchange rate policy and control of the domestic interest rate. The dynamics of such an economy was considered in terms of a bounded optimal control problem where the exchange rate is the state variable and the domestic interest rate is the control variable. The idea of balance-of-payments was used as a theoretical underpinning to specify the objective function. By assuming that, changes in exchange rates were induced by two effects: the impact of the domestic interest rate on the exchange rate and the exchange rate system adopted by the government. Instances for both fixed and flexible optimal exchange rate regimes have been determined. The use of the approach has been illustrated employing data obtained from the Central Bank of Nigeria (CBN statistical bulletin. (original abstract

Revascularização endovascular infrainguinal: fatores determinantes para a perviedade Endovascular infrainguinal revascularization: predictive factors for patency

Directory of Open Access Journals (Sweden)

Felipe Nasser

2009-03-01

angioplasty in patients with critical lower limb ischemia. Methods: During the study, 114 patients were submitted to angioplasty or stenting and followed during an average of 12 months. Mean age was 66 years, and 53% were female; 23.7% presented disabling claudication, 8.8% ischemic rest pain and 67.5% tissue loss. Lesions were classified as A (53%, B (34%, C (5% and D (9% according to the TransAtlantic Inter-Society Consensus II. Results: Angiographic run-off analysis showed an average of 1.4±1.0 patent infrapopliteal artery. Initial success rate was 97%. At 1, 6, 12 and 24 months of the follow-up period, primary patencies of 94, 78, 48 and 31%, and assisted primary patencies of 94, 84, 73 and 61% were achieved (p = 0.005. Poor run-off and diabetes mellitus were directly associated with lower primary patency rates (p = 0.01, while angiographic severity of the lesions did not influence results. Limb salvage rates calculated at 6, 12 and 24 months were 95, 90 and 90%, respectively. Conclusions: Lesion length was not a determinant factor of lower success rates for angioplasty or stenting, which may suggest that indications for endovascular treatment can be extended to patients with TransAtlantic Inter-Society Consensus II C/D lesions.

Game-Theoretic Rate-Distortion-Complexity Optimization of High Efficiency Video Coding

DEFF Research Database (Denmark)

Ukhanova, Ann; Milani, Simone; Forchhammer, Søren

2013-01-01

profiles in order to tailor the computational load to the different hardware and power-supply resources of devices. In this work, we focus on optimizing the quantization parameter and partition depth in HEVC via a game-theoretic approach. The proposed rate control strategy alone provides 0.2 dB improvement......This paper presents an algorithm for rate-distortioncomplexity optimization for the emerging High Efficiency Video Coding (HEVC) standard, whose high computational requirements urge the need for low-complexity optimization algorithms. Optimization approaches need to specify different complexity...

Wheeling rates evaluation using optimal power flows

International Nuclear Information System (INIS)

Muchayi, M.; El-Hawary, M. E.

1998-01-01

Wheeling is the transmission of electrical power and reactive power from a seller to a buyer through a transmission network owned by a third party. The wheeling rates are then the prices charged by the third party for the use of its network. This paper proposes and evaluates a strategy for pricing wheeling power using a pricing algorithm that in addition to the fuel cost for generation incorporates the optimal allocation of the transmission system operating cost, based on time-of-use pricing. The algorithm is implemented for the IEEE standard 14 and 30 bus system which involves solving a modified optimal power flow problem iteratively. The base of the proposed algorithm is the hourly spot price. The analysis spans a total time period of 24 hours. Unlike other algorithms that use DC models, the proposed model captures wheeling rates of both real and reactive power. Based on the evaluation, it was concluded that the model has the potential for wide application in calculating wheeling rates in a deregulated competitive power transmission environment. 9 refs., 3 tabs

[Transjugular intrahepatic portosystemic shunting with covered stents in children: a preliminary study of safety and patency].

Science.gov (United States)

Zurera, L J; Espejo, J J; Canis, M; Bueno, A; Vicente, J; Gilbert, J J

2014-01-01

To retrospectively analyze the safety and efficacy of transjugular intrahepatic portosystemic shunting (TIPS) using covered stents in children. We present 6 children (mean age, 10.6 years; mean weight, 33.5kg) who underwent TIPS with 8mm diameter Viatorr(®) covered stents for acute (n=4) or recurrent (n=2) upper digestive bleeding that could not be controlled by endoscopic measures. Five of the children had cirrhosis and the other had portal vein thrombosis with cavernous transformation. We analyzed the relapse of upper digestive bleeding, the complications that appeared, and the patency of the TIPS shunt on sequential Doppler ultrasonography or until transplantation. A single stent was implanted in a single session in each child; none of the children died. The mean transhepatic gradient decreased from 16mmHg (range: 12-21mmHg) before the procedure to 9mmHg (range: 1-15mmHg) after TIPS. One patient developed mild encephalopathy, and the girl who had portal vein thrombosis with cavernous transformation developed an acute occlusion of the TIPS that resolved after the implantation of a coaxial stent. Three children received transplants (7, 9, and 10 months after the procedure, respectively), and the patency of the TIPS was confirmed at transplantation. In the three remaining children, patency was confirmed with Doppler ultrasonography 1, 3, and 5 months after implantation. None of the children had new episodes of upper digestive bleeding during follow-up after implantation (mean: 8.1 months). Our results indicate that TIPS with 8mm diameter Viatorr(®) covered stents can be safe and efficacious for the treatment of upper digestive bleeding due to gastroesophageal varices in cirrhotic children; our findings need to be corroborated in larger series. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Optimization in the nuclear fuel cycle I: Temporal variation of dose rate

International Nuclear Information System (INIS)

Pereira, W.S.; Silva, A.X.; Lopes, J.M.; Carmo, A.S.; Fernandes, T.S.; Mello, C.R.; Kelecom, A.

2017-01-01

Radioprotection aims to protect man and the environment from the harmful effects of radiation. Radioprotection is based on three fundamental principles: justification, dose limitation and optimization. Optimization is a complementary principle to dose limitation and should be applied in all phases of development, and even in unregulated situations. The aim of this work is to use the exposure rate as a tool to optimize radioprotection. The exposure rate at a nuclear facility was monitored at 15 points for one year and statistical tools for data analysis were proposed as auxiliary tools for the process of optimizing the dose rates measured at the facility. A total of 9,125 exposure-rate measures were performed during 2014. The monthly averages were organized by sampling point and by month of the year. No statistical difference was observed in the monthly variation of the dose rate. Therefore, this variable can not be used in the optimization process in this nuclear installation

Maximum production rate optimization for sulphuric acid decomposition process in tubular plug-flow reactor

International Nuclear Information System (INIS)

Wang, Chao; Chen, Lingen; Xia, Shaojun; Sun, Fengrui

2016-01-01

A sulphuric acid decomposition process in a tubular plug-flow reactor with fixed inlet flow rate and completely controllable exterior wall temperature profile and reactants pressure profile is studied in this paper by using finite-time thermodynamics. The maximum production rate of the aimed product SO 2 and the optimal exterior wall temperature profile and reactants pressure profile are obtained by using nonlinear programming method. Then the optimal reactor with the maximum production rate is compared with the reference reactor with linear exterior wall temperature profile and the optimal reactor with minimum entropy generation rate. The result shows that the production rate of SO 2 of optimal reactor with the maximum production rate has an increase of more than 7%. The optimization of temperature profile has little influence on the production rate while the optimization of reactants pressure profile can significantly increase the production rate. The results obtained may provide some guidelines for the design of real tubular reactors. - Highlights: • Sulphuric acid decomposition process in tubular plug-flow reactor is studied. • Fixed inlet flow rate and controllable temperature and pressure profiles are set. • Maximum production rate of aimed product SO 2 is obtained. • Corresponding optimal temperature and pressure profiles are derived. • Production rate of SO 2 of optimal reactor increases by 7%.

Optimal harvesting of fish stocks under a time-varying discount rate.

Science.gov (United States)

Duncan, Stephen; Hepburn, Cameron; Papachristodoulou, Antonis

2011-01-21

Optimal control theory has been extensively used to determine the optimal harvesting policy for renewable resources such as fish stocks. In such optimisations, it is common to maximise the discounted utility of harvesting over time, employing a constant time discount rate. However, evidence from human and animal behaviour suggests that we have evolved to employ discount rates which fall over time, often referred to as "hyperbolic discounting". This increases the weight on benefits in the distant future, which may appear to provide greater protection of resources for future generations, but also creates challenges of time-inconsistent plans. This paper examines harvesting plans when the discount rate declines over time. With a declining discount rate, the planner reduces stock levels in the early stages (when the discount rate is high) and intends to compensate by allowing the stock level to recover later (when the discount rate will be lower). Such a plan may be feasible and optimal, provided that the planner remains committed throughout. However, in practice there is a danger that such plans will be re-optimized and adjusted in the future. It is shown that repeatedly restarting the optimization can drive the stock level down to the point where the optimal policy is to harvest the stock to extinction. In short, a key contribution of this paper is to identify the surprising severity of the consequences flowing from incorporating a rather trivial, and widely prevalent, "non-rational" aspect of human behaviour into renewable resource management models. These ideas are related to the collapse of the Peruvian anchovy fishery in the 1970's. Copyright © 2010 Elsevier Ltd. All rights reserved.

Choice of optimal exchange rate system For the Republic of Croatia

Directory of Open Access Journals (Sweden)

Dražen Koški

2008-12-01

Full Text Available The aim of research whose results are presented in this article was to choose the optimal system of exchange rate for the Republic of Croatia, of course before its accession to EU. The analyzed exchange rate systems here range from free-floating exchange rate to system without domestic currency in circulation. Naturally, the classification of International Monetary Fond is included in it. After that, the comparison of basic economic advantages and disadvantages of the fixed exchange rate in relation to floating exchange rate were carried out. Although the question is about the extreme systems, disregarding the system without domestic currency in circulation, their comparison makes possible completely satisfactory basis for the right conclusions on the choice of optimal exchange rate system for the Republic of Croatia. Considering its economic particularities, the system of managed-floating exchange rate without proclaimed exchange direction in advance is certainly optimal for the Republic of Croatia. Namely, within the framework of this system the limited floating exchange rates decrease the foreign exchange risk allowing to monetary authorities, at least partly, the independent monetary policy

Is the time between onset of pain and restoration of patency of infarct-related artery shortened in patients with myocardial infarction? The effects of the Kielce Region System for Optimal Management of Acute Myocardial Infarction

Directory of Open Access Journals (Sweden)

Marcin Sadowski

2014-09-01

Full Text Available Introduction : The importance of delay in the restoration of infarct-related artery patency in patients with myocardial infarction was discussed, and actions were undertaken in the Kielce Region aimed at shortening this time within the System for Optimal Management of Acute Myocardial Infarction. Aim of the research: To evaluate the effectiveness of shortening time delays during transport of patients and diagnostics of myocardial infarction in the Kielce Region. Material and methods: Time delays were analysed in 5,934 patients with ST-segment elevation myocardial infarction (STEMI, hospitalised in cardiology wards with interventional cardiology on 24-hour duty, during the period 2008–2012. Time delays were analysed between the onset of myocardial infarction pain and undertaking treatment – T1 and T2 time – within which a patient with myocardial infarction, after admission to hospital, has intervention performed on infarct-related coronary artery. Results : During the period 2008–2012, the median T1 time was successfully shortened from 355 to 203 min, and the T2 time from 101 to 48 min. Conclusions: The effectiveness of the system was confirmed, and the necessity for further improvement of the system indicated.

Minimizing transient influence in WHPA delineation: An optimization approach for optimal pumping rate schemes

Science.gov (United States)

Rodriguez-Pretelin, A.; Nowak, W.

2017-12-01

For most groundwater protection management programs, Wellhead Protection Areas (WHPAs) have served as primarily protection measure. In their delineation, the influence of time-varying groundwater flow conditions is often underestimated because steady-state assumptions are commonly made. However, it has been demonstrated that temporary variations lead to significant changes in the required size and shape of WHPAs. Apart from natural transient groundwater drivers (e.g., changes in the regional angle of flow direction and seasonal natural groundwater recharge), anthropogenic causes such as transient pumping rates are of the most influential factors that require larger WHPAs. We hypothesize that WHPA programs that integrate adaptive and optimized pumping-injection management schemes can counter transient effects and thus reduce the additional areal demand in well protection under transient conditions. The main goal of this study is to present a novel management framework that optimizes pumping schemes dynamically, in order to minimize the impact triggered by transient conditions in WHPA delineation. For optimizing pumping schemes, we consider three objectives: 1) to minimize the risk of pumping water from outside a given WHPA, 2) to maximize the groundwater supply and 3) to minimize the involved operating costs. We solve transient groundwater flow through an available transient groundwater and Lagrangian particle tracking model. The optimization problem is formulated as a dynamic programming problem. Two different optimization approaches are explored: I) the first approach aims for single-objective optimization under objective (1) only. The second approach performs multiobjective optimization under all three objectives where compromise pumping rates are selected from the current Pareto front. Finally, we look for WHPA outlines that are as small as possible, yet allow the optimization problem to find the most suitable solutions.

Comparison of heparinized saline and 0.9% sodium chloride for maintaining peripheral intravenous catheter patency in dogs.

Science.gov (United States)

Ueda, Yu; Odunayo, Adesola; Mann, F A

2013-01-01

To determine whether heparinized saline would be more effective in maintaining the patency of peripheral IV catheters in dogs compared to 0.9% sodium chloride. Prospective blinded randomized study. University Veterinary Teaching Hospital. Thirty healthy purpose bred dogs, intended for use in the junior surgery laboratory, were utilized. The dogs were randomized into 1 of 3 groups, 2 treatment groups and a control group. An 18-Ga cephalic catheter was placed in the cephalic vein of each dog. Each dog in the treatment group had their catheter flushed with either 10 IU/mL heparinized saline or 0.9% sodium chloride every 6 hours for 42 hours. The dogs in the control group did not have their catheters flushed until the end of the study period. Immediately prior to flushing catheters, each catheter was evaluated for patency by aspiration of blood and the catheter site was evaluated for phlebitis. All dogs in the heparinized saline and 0.9% sodium chloride group had catheters that flushed easily at each evaluation point. More dogs in the saline group had catheters from which blood could not be aspirated, but there was no significant difference between these groups. All dogs in the control group had catheters that flushed easily at the end of the assigned 6 hour interval except in 1 dog. Phlebitis was not detected in any dog. Flushes of 0.9% sodium chloride were found to be as effective as 10 IU/mL heparinized saline flushes in maintaining patency of 18-Ga peripheral venous catheters in dogs for up to 42 hours. For peripheral catheters placed with the intention of performing serial blood draws, heparinized flushes may be warranted. © Veterinary Emergency and Critical Care Society 2013.

Usefulness of multiplanar reformatted images of multi-detector row helical CT in assessment of biliary stent patency

International Nuclear Information System (INIS)

Kim, Soo Jin; Kim, Suk; Kim, Chang Won; Lee, Jun Woo; Lee, Tae Hong; Choo, Ki Seok; Koo, Young Baek; Moon, Tae Yong; Lee, Suk Hong

2004-01-01

To evaluate the usefulness of multi-detector row helical CT (MDCT), multiplanar reformatted images for the noninvasive assessment of biliary stent patency, and for the planning for management in patients with a sele-expandable metallic stent due to malignant biliary obstruction. Among 90 consecutive patients, from August 1999 to July 2003, 26 cases in 23 patients with malignant biliary obstruction who underwent self-expandable metaIlic stent insertion in the biliary system and percutaneous transhepatic biliary drainage within 7 days after CT were enrolled in this study. On CT images, the complete and functional obstruction of the stent and the precise level of obstruction were evaluated. The presence of an enhancing intraluminal mass or wall thickening around stent was determined, and the causes of obstruction were evaluated. These findings were then compared with percutaneous transhepatic cholangiography. Multi-detector row helical CT correctly demonstrated the patency of a stent in 24 cases (92.3%). It was adequate in helping to depict the precise level of stent occlusion in 23 cases (88.5%). Multi-detector row helical CT also revealed the extent of tumor that represented as an enhancing intraluminal mass or wall thickening around the stent in 23 cases, and this was represented as complete obstruction on percutaneous transhepatic cholangiography. In the case of functional obstruction, MDCT predicted the possible cause of the obstruction. Multiplanar reformatted images of multi-detector row helical CT is a useful imaging modality for the noninvasive assessment of stent patency and the precise level of obstruction when stent obstruction is suspected in the patients with self-expandable metallic stent due to malignant biliary obstruction. It can also predict the possible cause of the obstruction and allows adequate planning for the medical management of such cases

Usefulness of multiplanar reformatted images of multi-detector row helical CT in assessment of biliary stent patency

Energy Technology Data Exchange (ETDEWEB)

Kim, Soo Jin; Kim, Suk; Kim, Chang Won; Lee, Jun Woo; Lee, Tae Hong; Choo, Ki Seok; Koo, Young Baek; Moon, Tae Yong; Lee, Suk Hong [Pusan National Univ. Hospital, Busan (Korea, Republic of)

2004-08-01

To evaluate the usefulness of multi-detector row helical CT (MDCT), multiplanar reformatted images for the noninvasive assessment of biliary stent patency, and for the planning for management in patients with a sele-expandable metallic stent due to malignant biliary obstruction. Among 90 consecutive patients, from August 1999 to July 2003, 26 cases in 23 patients with malignant biliary obstruction who underwent self-expandable metaIlic stent insertion in the biliary system and percutaneous transhepatic biliary drainage within 7 days after CT were enrolled in this study. On CT images, the complete and functional obstruction of the stent and the precise level of obstruction were evaluated. The presence of an enhancing intraluminal mass or wall thickening around stent was determined, and the causes of obstruction were evaluated. These findings were then compared with percutaneous transhepatic cholangiography. Multi-detector row helical CT correctly demonstrated the patency of a stent in 24 cases (92.3%). It was adequate in helping to depict the precise level of stent occlusion in 23 cases (88.5%). Multi-detector row helical CT also revealed the extent of tumor that represented as an enhancing intraluminal mass or wall thickening around the stent in 23 cases, and this was represented as complete obstruction on percutaneous transhepatic cholangiography. In the case of functional obstruction, MDCT predicted the possible cause of the obstruction. Multiplanar reformatted images of multi-detector row helical CT is a useful imaging modality for the noninvasive assessment of stent patency and the precise level of obstruction when stent obstruction is suspected in the patients with self-expandable metallic stent due to malignant biliary obstruction. It can also predict the possible cause of the obstruction and allows adequate planning for the medical management of such cases.

Optimal feeding rate for Nile tilapia (Oreochromis niloticus)

OpenAIRE

Chowdhury, Dilip Kumar

2011-01-01

The aim of this study was to define optimal feeding rates for Nile tilapia (Oreochromis niloticus). Four experiments were carried out to evaluate the effect of feeding rate on growth performance of larger and juvenile tilapia by means of estimating growth rates, apparent nutrient digestibilities, feed utilization, body compositions, and nutrient and energy retentions. One nutritionally balanced diet (crude protein 342, crude fat 67, ash 47, starch 251 (all values in g (kg dry matter)-1)) was ...

Optimized reaction mechanism rate rules for ignition of normal alkanes

KAUST Repository

Cai, Liming

2016-08-11

The increasing demand for cleaner combustion and reduced greenhouse gas emissions motivates research on the combustion of hydrocarbon fuels and their surrogates. Accurate detailed chemical kinetic models are an important prerequisite for high fidelity reacting flow simulations capable of improving combustor design and operation. The development of such models for many new fuel components and/or surrogate molecules is greatly facilitated by the application of reaction classes and rate rules. Accurate and versatile rate rules are desirable to improve the predictive accuracy of kinetic models. A major contribution in the literature is the recent work by Bugler et al. (2015), which has significantly improved rate rules and thermochemical parameters used in kinetic modeling of alkanes. In the present study, it is demonstrated that rate rules can be used and consistently optimized for a set of normal alkanes including n-heptane, n-octane, n-nonane, n-decane, and n-undecane, thereby improving the predictive accuracy for all the considered fuels. A Bayesian framework is applied in the calibration of the rate rules. The optimized rate rules are subsequently applied to generate a mechanism for n-dodecane, which was not part of the training set for the optimized rate rules. The developed mechanism shows accurate predictions compared with published well-validated mechanisms for a wide range of conditions.

Optimal mutation rates for the (1+λ) EA on OneMax

DEFF Research Database (Denmark)

Gießen, Christian; Witt, Carsten

2016-01-01

We study the (1 + λ) EA with mutation probability c/n, where c > 0 is a constant, on the ONEMAX problem. Using an improved variable drift theorem, we show that upper and lower bounds on the expected runtime of the (1+λ) EA obtained from variable drift theorems are at most apart by a small lower...... mutation rates for the (1+λ) EA for various parameter settings of c and λ and also for moderate sizes of n. This makes the need for potentially lengthy and costly experiments in order to optimize the parameters unnecessary. Interestingly, even for moderate n and not too small λ it turns out that mutation...... rates up to 10% larger than the asymptotically optimal rate 1/n minimize the expected runtime. However, in absolute terms the expected runtime does not change by much when replacing 1/n with the optimal mutation rate....

Clinical evaluation of interventional treatment for Budd-Chiari syndrome

International Nuclear Information System (INIS)

Zhong Hongshan; Xu Ke; Xiao Liang

2009-01-01

Objective: To evaluate the interventional treatment of Budd-Chiari syndrome (BCS) with regard to different types of the disease. Methods: One hundred and fifty-nine consecutive cases with BCS underwent interventional treatments with regard to different types of the diseases, including percutaneous angioplasty (PTA), transcatheter thrombolysis, endovascular stent implantation and modified transjugular intrahepatic portosystemic shunt (MTIPS). Among them, 147 cases that underwent complete follow-up were enrolled in this study. Simple obstruction of HV, membranous obstruction of IVC, membranous obstruction of IVC combined with thrombosis in the distal lumen and segmental obstruction of IVC constituted 13.6% (20), 66.0% (97), 6.1% (9)and 14.3% (21/147), respectively. The technical success rate of each type was determined. They were followed up for (67.3±9.0) months (16 h-104 months). Overall primary patency rate was evaluated. The late effect on liver function was analyzed according to the Child-Pugh score. Results: The primary patency rate of PTA was 65.6% (86/131) and the secondary, patency rate was 96.9% (124/128). The primary patency rate of stent implantation was 78.9% (15/19) and the secondary patency rate was 92.3% (24/26). One patient of type IIIa that received recanalization, catheter-directed thrombolysis and PTA in IVC died of hemoptysis 72 h after the procedure. One patients of type I b who received MTIPS died of DIC 16 hrs after the procedure. And one patient of type Ib who received MTIPS died of liver failure 13 months after the procedure. Twelve patients died in 7-79 months after the interventional procedure due to unrelated causes. At the end of follow-up, the liver function of the patients was improved. Conclusions: Optimal application of various vascular interventional techniques has a satisfactory primary and secondary patency rate and improves the long-term liver function. (authors)

Quality assurance for high dose rate brachytherapy treatment planning optimization: using a simple optimization to verify a complex optimization

International Nuclear Information System (INIS)

Deufel, Christopher L; Furutani, Keith M

2014-01-01

As dose optimization for high dose rate brachytherapy becomes more complex, it becomes increasingly important to have a means of verifying that optimization results are reasonable. A method is presented for using a simple optimization as quality assurance for the more complex optimization algorithms typically found in commercial brachytherapy treatment planning systems. Quality assurance tests may be performed during commissioning, at regular intervals, and/or on a patient specific basis. A simple optimization method is provided that optimizes conformal target coverage using an exact, variance-based, algebraic approach. Metrics such as dose volume histogram, conformality index, and total reference air kerma agree closely between simple and complex optimizations for breast, cervix, prostate, and planar applicators. The simple optimization is shown to be a sensitive measure for identifying failures in a commercial treatment planning system that are possibly due to operator error or weaknesses in planning system optimization algorithms. Results from the simple optimization are surprisingly similar to the results from a more complex, commercial optimization for several clinical applications. This suggests that there are only modest gains to be made from making brachytherapy optimization more complex. The improvements expected from sophisticated linear optimizations, such as PARETO methods, will largely be in making systems more user friendly and efficient, rather than in finding dramatically better source strength distributions. (paper)

Dynamic Programming Optimization of Multi-rate Multicast Video-Streaming Services

Directory of Open Access Journals (Sweden)

Nestor Michael Caños Tiglao

2010-06-01

Full Text Available In large scale IP Television (IPTV and Mobile TV distributions, the video signal is typically encoded and transmitted using several quality streams, over IP Multicast channels, to several groups of receivers, which are classified in terms of their reception rate. As the number of video streams is usually constrained by both the number of TV channels and the maximum capacity of the content distribution network, it is necessary to find the selection of video stream transmission rates that maximizes the overall user satisfaction. In order to efficiently solve this problem, this paper proposes the Dynamic Programming Multi-rate Optimization (DPMO algorithm. The latter was comparatively evaluated considering several user distributions, featuring different access rate patterns. The experimental results reveal that DPMO is significantly more efficient than exhaustive search, while presenting slightly higher execution times than the non-optimal Multi-rate Step Search (MSS algorithm.

Cross-Layer Optimal Rate Allocation for Heterogeneous Wireless Multicast

Directory of Open Access Journals (Sweden)

Amr Mohamed

2009-01-01

Full Text Available Heterogeneous multicast is an efficient communication scheme especially for multimedia applications running over multihop networks. The term heterogeneous refers to the phenomenon when multicast receivers in the same session require service at different rates commensurate with their capabilities. In this paper, we address the problem of resource allocation for a set of heterogeneous multicast sessions over multihop wireless networks. We propose an iterative algorithm that achieves the optimal rates for a set of heterogeneous multicast sessions such that the aggregate utility for all sessions is maximized. We present the formulation of the multicast resource allocation problem as a nonlinear optimization model and highlight the cross-layer framework that can solve this problem in a distributed ad hoc network environment with asynchronous computations. Our simulations show that the algorithm achieves optimal resource utilization, guarantees fairness among multicast sessions, provides flexibility in allocating rates over different parts of the multicast sessions, and adapts to changing conditions such as dynamic channel capacity and node mobility. Our results show that the proposed algorithm not only provides flexibility in allocating resources across multicast sessions, but also increases the aggregate system utility and improves the overall system throughput by almost 30% compared to homogeneous multicast.

Optimal Power Allocation of a Wireless Sensor Node under Different Rate Constraints

KAUST Repository

Solares, Jose

2011-07-01

Wireless sensor networks consist of the placement of sensors over a broad area in order to acquire data. Depending on the application, different design criteria should be considered in the construction of the sensors but among all of them, the battery life-cycle is of crucial interest. Power minimization is a problem that has been addressed from different approaches which include an analysis from an architectural perspective and with bit error rate and/or discrete instantaneous transmission rate constraints, among others. In this work, the optimal transmit power of a sensor node while satisfying different rate constraints is derived. First, an optimization problem with an instantaneous transmission rate constraint is addressed. Next, the optimal power is analyzed, but now with an average transmission rate constraint. The optimal solution for a class of fading channels, in terms of system parameters, is presented and a suboptimal solution is also proposed for an easier, yet efficient, implementation. Insightful asymptotical analysis for both schemes, considering a Rayleigh fading channel, are shown. Furthermore, the optimal power allocation for a sensor node in a cognitive radio environment is analyzed where an optimum solution for a class of fading channels is again derived. In all cases, numerical results are provided for either Rayleigh or Nakagami-m fading channels. The results obtained are extended to scenarios where we have either one transmitter-multiple receivers or multiple transmitters-one receiver.

Multidetector CT angiography as a noninvasive tool to assess graft patency of surgically reconstructed diffusely diseased coronary arteries

Directory of Open Access Journals (Sweden)

Ahmed I. Rezk

2014-03-01

Conclusion: Extensive reconstruction of the diffusely diseased LAD using an ITA graft could be performed safely with very encouraging results. MDCT angiography is an excellent non invasive tool not only to evaluate graft patency in the reconstructed LAD but also to detect other findings in asymptomatic patients with diffuse coronary artery disease for better and more close follow up.

Pareto-optimal electricity tariff rates in the Republic of Armenia

International Nuclear Information System (INIS)

Kaiser, M.J.

2000-01-01

The economic impact of electricity tariff rates on the residential sector of Yerevan, Armenia, is examined. The effect of tariff design on revenue generation and equity measures is considered, and the combination of energy pricing and compensatory social policies which provides the best mix of efficiency and protection for poor households is examined. An equity measure is defined in terms of a cumulative distribution function which describes the percent of the population that spends x percent or less of their income on electricity consumption. An optimal (Pareto-efficient) tariff is designed based on the analysis of survey data and an econometric model, and the Armenian tariff rate effective 1 January 1997 to 15 September 1997 is shown to be non-optimal relative to this rate. 22 refs

Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study.

Science.gov (United States)

Zeller, Thomas; Langhoff, Ralf; Rocha-Singh, Krishna J; Jaff, Michael R; Blessing, Erwin; Amann-Vesti, Beatrice; Krzanowski, Marek; Peeters, Patrick; Scheinert, Dierk; Torsello, Giovanni; Sixt, Sebastian; Tepe, Gunnar

2017-09-01

Studies assessing drug-coated balloons (DCB) for the treatment of femoropopliteal artery disease are encouraging. However, challenging lesions, such as severely calcified, remain difficult to treat with DCB alone. Vessel preparation with directional atherectomy (DA) potentially improves outcomes of DCB. DEFINITIVE AR study (Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency-A Pilot Study of Anti-Restenosis Treatment) was a multicenter randomized trial designed to estimate the effect of DA before DCB to facilitate the development of future end point-driven randomized studies. One hundred two patients with claudication or rest pain were randomly assigned 1:1 to DA+DCB (n=48) or DCB alone (n=54), and 19 additional patients with severely calcified lesions were treated with DA+DCB. Mean lesion length was 11.2±4.0 cm for DA+DCB and 9.7±4.1 cm for DCB ( P =0.05). Predilation rate was 16.7% for DA+DCB versus 74.1% for DCB; postdilation rate was 6.3% for DA+DCB versus 33.3% for DCB. Technical success was superior for DA+DCB (89.6% versus 64.2%; P =0.004). Overall bail-out stenting rate was 3.7%, and rate of flow-limiting dissections was 19% for DCB and 2% for DA+DCB ( P =0.01). One-year primary outcome of angiographic percent diameter stenosis was 33.6±17.7% for DA+DCB versus 36.4±17.6% for DCB ( P =0.48), and clinically driven target lesion revascularization was 7.3% for DA+DCB and 8.0% for DCB ( P =0.90). Duplex ultrasound patency was 84.6% for DA+DCB, 81.3% for DCB ( P =0.78), and 68.8% for calcified lesions. Freedom from major adverse events at 1 year was 89.3% for DA+DCB and 90.0% for DCB ( P =0.86). DA+DCB treatment was effective and safe, but the study was not powered to show significant differences between the 2 methods of revascularization in 1-year follow-up. An adequately powered randomized trial is warranted. http://www.clinicaltrials.gov. Unique Identifier: NCT01366482. Copyright © 2017 The

Rate-distortion optimization for compressive video sampling

Science.gov (United States)

Liu, Ying; Vijayanagar, Krishna R.; Kim, Joohee

2014-05-01

The recently introduced compressed sensing (CS) framework enables low complexity video acquisition via sub- Nyquist rate sampling. In practice, the resulting CS samples are quantized and indexed by finitely many bits (bit-depth) for transmission. In applications where the bit-budget for video transmission is constrained, rate- distortion optimization (RDO) is essential for quality video reconstruction. In this work, we develop a double-level RDO scheme for compressive video sampling, where frame-level RDO is performed by adaptively allocating the fixed bit-budget per frame to each video block based on block-sparsity, and block-level RDO is performed by modelling the block reconstruction peak-signal-to-noise ratio (PSNR) as a quadratic function of quantization bit-depth. The optimal bit-depth and the number of CS samples are then obtained by setting the first derivative of the function to zero. In the experimental studies the model parameters are initialized with a small set of training data, which are then updated with local information in the model testing stage. Simulation results presented herein show that the proposed double-level RDO significantly enhances the reconstruction quality for a bit-budget constrained CS video transmission system.

Post-angioplasty far infrared radiation therapy improves 1-year angioplasty-free hemodialysis access patency of recurrent obstructive lesions.

Science.gov (United States)

Lai, C-C; Fang, H-C; Mar, G-Y; Liou, J-C; Tseng, C-J; Liu, C-P

2013-12-01

To explore the role of far infrared (FIR) radiation therapy for hemodialysis (HD) access maintenance after percutaneous transluminal angioplasties (PTA). This was a prospective observational study. Eligible patients were those who received repeated PTA with the last PTA successfully performed within 1 week before the study enrollments. Consecutively enrolled patients undergoing successful HD treatments after PTA were randomly assigned to the FIR-radiated group or control group without radiation. FIR-radiated therapy meaning 40-minute radiation at the major lesion site or anastomosed site three times a week was continued until an end-point defined as dysfunction-driven re-PTA or the study end was reached. Of 216 participants analyzed, including 97 with arteriovenous grafts (AVG) (49 FIR-radiated participants and 48 control participants) and 119 with arteriovenous fistulas (AVF) (69 FIR-radiated participants and 50 control participants), the FIR-radiated therapy compared with free-radiated usual therapy significantly enhanced PTA-unassisted patency at 1 year in the AVG subgroup (16.3% vs. 2.1%; p radiated therapy improves PTA-unassisted patency in patients with AVG who have undergone previous PTA. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Diagnostic efficacy for coronary in-stent patency with parameters defined on Hounsfield CT value-spatial profile curves

International Nuclear Information System (INIS)

Yamazaki, Tadashi; Suzuki, Jun-ichi; Shimamoto, Ryoichi; Tsuji, Taeko; Ohmoto-Sekine, Yuki; Morita, Toshihiro; Yamashita, Hiroshi; Honye, Junko; Nagai, Ryozo; Komatsu, Shuhei; Akahane, Masaaki; Ohtomo, Kuni

2008-01-01

Purpose: Hounsfield CT values across coronary CT angiograms constitute CT value-spatial profile curves. These CT profile curves are independent of window settings, and therefore, parameters derived from the curves can be used for objective anatomic analyses. Applicability of parameters derived from the curves to quantification of coronary in-stent patency has not yet been evaluated. Methods: Twenty-five CT value-spatial profile curves were delineated from 10 consecutive coronary stents to test correlation between the curve derived parameter (i.e., the minimum extreme value normalized by dividing by the maximum value of the curves obtained at neighboring outside of stents) and three intravascular ultrasound (IVUS) parameters. Results: Correlation coefficients between normalized minimum extreme value of CT value-spatial profile curves and three IVUS parameters (such as patent cross-sectional in-stent area, the percentage of patent cross-sectional in-stent area, and coronary artery intra-stent diameter) were 0.65 (p < 0.01), 0.44 (p < 0.05) and 0.51 (p < 0.05), respectively. Conclusions: CT parameters defined on Hounsfield CT value-spatial profile curves correlated significantly with IVUS parameters for quantitative coronary in-stent patency. A new approach with CT coronary angiography is therefore indicated for the noninvasive assessment of in-stent re-stenosis

The Optimal Progressive Income Tax -- The Existence and the Limit Tax Rates

OpenAIRE

Mamoru Kaneko

1981-01-01

The purpose of this paper is to consider the problem of optimal income taxation in the domain of progressive (convex) income tax function. This paper proves the existence of an optimal tax function and that the optimal marginal and average tax rates tend asymptotically to 100 percent as income level becomes arbitrarily high.

Optimal Interest-Rate Setting in a Dynamic IS/AS Model

DEFF Research Database (Denmark)

Jensen, Henrik

2011-01-01

This note deals with interest-rate setting in a simple dynamic macroeconomic setting. The purpose is to present some basic and central properties of an optimal interest-rate rule. The model framework predates the New-Keynesian paradigm of the late 1990s and onwards (it is accordingly dubbed “Old...

Optimal Rate Private Information Retrieval from Homomorphic Encryption

Directory of Open Access Journals (Sweden)

Kiayias Aggelos

2015-06-01

Full Text Available We consider the problem of minimizing the communication in single-database private information retrieval protocols in the case where the length of the data to be transmitted is large. We present first rate-optimal protocols for 1-out-of-n computationallyprivate information retrieval (CPIR, oblivious transfer (OT, and strong conditional oblivious transfer (SCOT. These protocols are based on a new optimalrate leveled homomorphic encryption scheme for large-output polynomial-size branching programs, that might be of independent interest. The analysis of the new scheme is intricate: the optimal rate is achieved if a certain parameter s is set equal to the only positive root of a degree-(m + 1 polynomial, where m is the length of the branching program. We show, by using Galois theory, that even when m = 4, this polynomial cannot be solved in radicals. We employ the Newton-Puiseux algorithm to find a Puiseux series for s, and based on this, propose a Θ (logm-time algorithm to find an integer approximation to s.

Study on Rail Profile Optimization Based on the Nonlinear Relationship between Profile and Wear Rate

Directory of Open Access Journals (Sweden)

Jianxi Wang

2017-01-01

Full Text Available This paper proposes a rail profile optimization method that takes account of wear rate within design cycle so as to minimize rail wear at the curve in heavy haul railway and extend the service life of rail. Taking rail wear rate as the object function, the vertical coordinate of rail profile at range optimization as independent variable, and the geometric characteristics and grinding depth of rail profile as constraint conditions, the support vector machine regression theory was used to fit the nonlinear relationship between rail profile and its wear rate. Then, the profile optimization model was built. Based on the optimization principle of genetic algorithm, the profile optimization model was solved to achieve the optimal rail profile. A multibody dynamics model was used to check the dynamic performance of carriage running on optimal rail profile. The result showed that the average relative error of support vector machine regression model remained less than 10% after a number of training processes. The dynamic performance of carriage running on optimized rail profile met the requirements on safety index and stability. The wear rate of optimized profile was lower than that of standard profile by 5.8%; the allowable carrying gross weight increased by 12.7%.

The Optimal Interest Rates and the Current Interest Rate System

Directory of Open Access Journals (Sweden)

Ioannis N. Kallianiotis

2014-12-01

Full Text Available The paper discusses the current target interest rate, which is closed to zero with the new experiment of quantitative easing since 2009 and has reduced the rate of return and the income and has made the real savings rate negative. This target rate has not reduced unemployment and has not improved growth (it is not optimal, but has increased the debt of individuals and the low taxes on businesses have magnified the budget deficits and the national debt. People were borrowing the present value of their uncertain future wealth and their high debt and low income raise the risk and this high risk premium heighten the interest rate on loans, especially on credit cards. The current monetary system needs to be changed and an interest rate floor on deposits (savings and an interest rate ceiling on individuals‟ loans (borrowings is necessary to improve social welfare, fairness, and justice in our society and not to support only disintermediation (financial markets. The middle class cannot work only to pay taxes and interest on its debt (redistribution of their wealth to government and banks or worse to be in chronic unemployment. Many home owners defaulted on their loans payments and their homes are foreclosed. They will end up without property (real assets. The unconcern towards the middle class will affect negatively the entire socio-economic structure of the nation and after losing its productive power, it will start declining, as history has shown to us with so many empires that do not exist anymore. We hope the leaders (the democratic governments to improve public policies, to regulate the financial market and institutions, and to satisfy their policy ultimate objective, which is citizens‟ perfection and the nation‟s highest point of prosperity.

Innovative model-based flow rate optimization for vanadium redox flow batteries

Science.gov (United States)

König, S.; Suriyah, M. R.; Leibfried, T.

2016-11-01

In this paper, an innovative approach is presented to optimize the flow rate of a 6-kW vanadium redox flow battery with realistic stack dimensions. Efficiency is derived using a multi-physics battery model and a newly proposed instantaneous efficiency determination technique. An optimization algorithm is applied to identify optimal flow rates for operation points defined by state-of-charge (SoC) and current. The proposed method is evaluated against the conventional approach of applying Faraday's first law of electrolysis, scaled to the so-called flow factor. To make a fair comparison, the flow factor is also optimized by simulating cycles with different charging/discharging currents. It is shown through the obtained results that the efficiency is increased by up to 1.2% points; in addition, discharge capacity is also increased by up to 1.0 kWh or 5.4%. Detailed loss analysis is carried out for the cycles with maximum and minimum charging/discharging currents. It is shown that the proposed method minimizes the sum of losses caused by concentration over-potential, pumping and diffusion. Furthermore, for the deployed Nafion 115 membrane, it is observed that diffusion losses increase with stack SoC. Therefore, to decrease stack SoC and lower diffusion losses, a higher flow rate during charging than during discharging is reasonable.

Primary Stenting Is Not Necessary in Benign Central Venous Stenosis.

Science.gov (United States)

Rangel, Lynsey E; Lyden, Sean P; Clair, Daniel G

2018-01-01

The aim of this study is to evaluate central venous stenosis (CVS) etiologies and presentation within a vascular surgery practice. We evaluated endovascular treatment modalities and the patency rates of our interventions. Five-year retrospective review of endovascular intervention for CVS. Patient demographics, medical comorbidities, and variables were collected including etiology, indwelling device, previous upper extremity (UE) deep venous thrombosis, long-term UE indwelling device (defined as >30 days), malignancy status, hypercoagulable disorders, history of radiation or mediastinal fibrosis or masses, and anticoagulation and/or antiplatelet therapy. Follow-up variables included symptoms, imaging, and anticoagulation and/or antiplatelet utilization. Living patients without recent follow-up were contacted with a telephone survey regarding current symptoms. Patency was evaluated by imaging or clinically by recurrence of signs or symptoms through January 2016. A total of 61 patients underwent attempted endovascular CVS interventions from January 2007 to 2013. Forty-seven (83%) patients had successful interventions. There were 22 (36%) end-stage renal disease (ESRD) patients. The primary etiology in 79% of patients was benign CVS secondary to an indwelling device. Eighty-nine percent of the interventions were primary angioplasty (PTA). The overall primary patency rates at 6, 12, and 24 months were 49%, 34%, and 24%, respectively. Secondary patency rates at 6, 12, and 24 months were 97%, 93%, and 88%, respectively. There were no statistical differences in demographics or outcomes in patients treated successfully with PTA or those requiring stenting. There was no statistical difference in the patency rates between ESRD and non-ESRD patients. Previous interventions were not a predictor of loss of patency. Our study supported the rising trend of benign CVS predominantly secondary to indwelling devices. We demonstrated acceptable secondary patency with PTA alone

Worst-Case Portfolio Optimization under Stochastic Interest Rate Risk

Directory of Open Access Journals (Sweden)

Tina Engler

2014-12-01

Full Text Available We investigate a portfolio optimization problem under the threat of a market crash, where the interest rate of the bond is modeled as a Vasicek process, which is correlated with the stock price process. We adopt a non-probabilistic worst-case approach for the height and time of the market crash. On a given time horizon [0; T], we then maximize the investor’s expected utility of terminal wealth in the worst-case crash scenario. Our main result is an explicit characterization of the worst-case optimal portfolio strategy for the class of HARA (hyperbolic absolute risk aversion utility functions.

The mechanical properties of infrainguinal vascular bypass grafts: their role in influencing patency.

Science.gov (United States)

Sarkar, S; Salacinski, H J; Hamilton, G; Seifalian, A M

2006-06-01

When autologous vein is unavailable, prosthetic graft materials, particularly expanded polytetrafluoroethylene are used for peripheral arterial revascularisation. Poor long term patency of prosthetic materials is due to distal anastomotic intimal hyperplasia. Intimal hyperplasia is directly linked to shear stress abnormalities at the vessel wall. Compliance and calibre mismatch between native vessel and graft, as well as anastomotic line stress concentration contribute towards unnatural wall shear stress. High porosity reduces graft compliance by causing fibrovascular infiltration, whereas low porosity discourages the development of an endothelial lining and hence effective antithrombogenicity. Therefore, consideration of mechanical properties is necessary in graft development. Current research into synthetic vascular grafts concentrates on simulating the mechanical properties of native arteries and tissue engineering aims to construct a new biological arterial conduit.

Graft patency after off-pump coronary artery bypass surgery is inferior even with identical heparinization protocols

DEFF Research Database (Denmark)

Houlind, Kim; Fenger-Grøn, Morten; Holme, Susanne J

2014-01-01

OBJECTIVE: To determine whether graft patency after on-pump and off-pump coronary artery bypass surgery is similar when performed using the same heparinization protocol. METHODS: In a randomized, controlled, multicenter trial, 900 patients more than 70 years of age received either on-pump or off......-pump coronary artery bypass surgery. Heparin was given to achieve an activated clotting time of 400 seconds before arteriotomy in both groups. After the procedure, protamine sulfate was given to revert the activated clotting time to less than 120 seconds. Coronary angiography was performed 6 months after...

Biometric Quantization through Detection Rate Optimized Bit Allocation

Directory of Open Access Journals (Sweden)

C. Chen

2009-01-01

Full Text Available Extracting binary strings from real-valued biometric templates is a fundamental step in many biometric template protection systems, such as fuzzy commitment, fuzzy extractor, secure sketch, and helper data systems. Previous work has been focusing on the design of optimal quantization and coding for each single feature component, yet the binary string—concatenation of all coded feature components—is not optimal. In this paper, we present a detection rate optimized bit allocation (DROBA principle, which assigns more bits to discriminative features and fewer bits to nondiscriminative features. We further propose a dynamic programming (DP approach and a greedy search (GS approach to achieve DROBA. Experiments of DROBA on the FVC2000 fingerprint database and the FRGC face database show good performances. As a universal method, DROBA is applicable to arbitrary biometric modalities, such as fingerprint texture, iris, signature, and face. DROBA will bring significant benefits not only to the template protection systems but also to the systems with fast matching requirements or constrained storage capability.

Optimal control of arrival and service rates in tandem queues

International Nuclear Information System (INIS)

Moustafa, M.S.

1995-08-01

We consider n M/M/1 queues in series. At queue one the arrival and service rates are chosen in pair from a finite set whenever there are arrivals or service completions at any queue. Customers arriving to queue L (L=1,2,...,n-1) must go on to queue L+1 after finishing service at server L. Customers arriving to queue n leave the system after finishing service at the last server. At queues 2 to n arrival and service rates are fixed. The objective is to minimize the expected discounted cost of the system over finite and infinite horizons. We show that the optimal policy is of threshold type. In order to establish the result, we formulate the optimal control problem as a Linear Programming. (author). 9 refs

Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

International Nuclear Information System (INIS)

Wu, Tian-tian; Li, Wei-min; Li, Hu-cheng; Ao, Guo-kun; Zheng, Fang; Lin, Hu

2017-01-01

PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

Energy Technology Data Exchange (ETDEWEB)

Wu, Tian-tian, E-mail: matthewwu1979@hotmail.com; Li, Wei-min, E-mail: weimin-li-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Li, Hu-cheng, E-mail: hucheng-li-surgery@126.com [The 307th Hospital of PLA, General Surgery Department (China); Ao, Guo-kun, E-mail: guokun-ao-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China); Zheng, Fang, E-mail: fang-zheng-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Lin, Hu, E-mail: hu-lin-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China)

2017-02-15

PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

An artificial intelligence heat rate/NOx optimization system for Ontario Hydro`s Lambton Generating Station

Energy Technology Data Exchange (ETDEWEB)

Luk, J.; Bachalo, K.; Henrikson, J. [Ontario Hydro, Toronto, ON (Canada); Roland, W.; Booth, R.C.; Parikh, N.; Radl, B. [Pegasus Technologies Ltd., Painesville, OH (United States)

1998-12-01

The utilization of artificial Intelligence (AI)-based software programs to optimize power plant operations by simultaneously improving heat rate performance and reducing NOx emissions was discussed. While many AI programs were initially used for demonstration purposes, they are now available for commercial use due to their promising results. In 1996, the Fossil Business Unit of Ontario Hydro initiated a study to evaluate AI technology as a tool for optimizing heat rate and NOx reduction in coal fired stations. Tests were conducted at Units 3 and 4 of the Lambton Generation Station, located just south of Sarnia, Ontario. The tests were conducted to examine three desirable options: (1) achieve at least 0.5 per cent improvement in heat rate concurrently with a NOx reduction of at least 5 per cent, (2) optimize on `heat rate` only with minimum improvement of 2 per cent, and optimize `minimal NOx` only with reduction target of 20 per cent or more, and (3) reach a collaborative agreement with a supplier to further explore and develop AI optimization applications for other advanced and more complex plant processes. Results indicated that NOx reduction and heat rate improvement are not contradictory goals. 15 refs., 1 fig.

A mathematical framework for yield (vs. rate) optimization in constraint-based modeling and applications in metabolic engineering.

Science.gov (United States)

Klamt, Steffen; Müller, Stefan; Regensburger, Georg; Zanghellini, Jürgen

2018-02-07

The optimization of metabolic rates (as linear objective functions) represents the methodical core of flux-balance analysis techniques which have become a standard tool for the study of genome-scale metabolic models. Besides (growth and synthesis) rates, metabolic yields are key parameters for the characterization of biochemical transformation processes, especially in the context of biotechnological applications. However, yields are ratios of rates, and hence the optimization of yields (as nonlinear objective functions) under arbitrary linear constraints is not possible with current flux-balance analysis techniques. Despite the fundamental importance of yields in constraint-based modeling, a comprehensive mathematical framework for yield optimization is still missing. We present a mathematical theory that allows one to systematically compute and analyze yield-optimal solutions of metabolic models under arbitrary linear constraints. In particular, we formulate yield optimization as a linear-fractional program. For practical computations, we transform the linear-fractional yield optimization problem to a (higher-dimensional) linear problem. Its solutions determine the solutions of the original problem and can be used to predict yield-optimal flux distributions in genome-scale metabolic models. For the theoretical analysis, we consider the linear-fractional problem directly. Most importantly, we show that the yield-optimal solution set (like the rate-optimal solution set) is determined by (yield-optimal) elementary flux vectors of the underlying metabolic model. However, yield- and rate-optimal solutions may differ from each other, and hence optimal (biomass or product) yields are not necessarily obtained at solutions with optimal (growth or synthesis) rates. Moreover, we discuss phase planes/production envelopes and yield spaces, in particular, we prove that yield spaces are convex and provide algorithms for their computation. We illustrate our findings by a small

Long Term Follow-up of a Transjugular Intrahepatic Portosystemic Shunt: A Comparison of Covered and Uncovered Stents

Energy Technology Data Exchange (ETDEWEB)

Joo, Seung Moon; Park, Jae Hyung; Kim, Hyo Cheol; Jae, Hwan Jun; Chung, Jin Wook [Seoul National University Hospital, Seoul (Korea, Republic of)

2009-01-15

To evaluate the long term patency of transjugular intrahepatic portosystemic shunts (TIPS) and to compare the patency rate of covered and uncovered stents in TIPS. The study population included 78 patients with portal hypertension that underwent TIPS between January 1999 and July 2007 at our institution using uncovered stents in 53 patients and covered stents in 25 patients. The primary and secondary patency rates of TIPS were estimated to compare the uncovered and covered stent groups. The primary and secondary patency rates of the TIPS patients were found to be 83.9% and 93.9% at the 6 month follow-up and 73.5% and 88.5% at the12 month follow-up for uncovered and covered stents, respectively. A breakdown patency rates for the 12 month follow-up revealed that the primary patency rates were 76.6% and 66.3% for uncovered and covered stents, respectively; whereas, the secondary patency rates were 94.3% and 73.8% for the uncovered and covered stents, respectively. A comparative analysis did not provide evidence to suggest that a difference exists between the patency rates of the uncovered and covered stent groups (p>0.05). No significant difference was found between the patency rates of the uncovered and covered stent groups. A follow-up to this study would be a more thorough randomized evaluation of the different types of covered stents to compare long-term patency rates.

Therapeutic value of selective salpingography for infertile women with patent fallopian tubes: the impact on pregnancy rate.

Science.gov (United States)

Kamiyama, S; Miyagi, H; Kanazawa, K

2000-01-01

To determine the therapeutic value of selective salpingography (SSG) for infertile women with patent fallopian tubes. Retrospective, case-control analysis. University Hospital, infertility clinic. Infertile cases with patent tubes documented by hysterosalpingography (HSG) or by HSG followed by laparoscopic examination (n = 80). Hysteroscopic SSG. Patency rate of tubes by SSG. Pregnancy rate following SSG. Eighty cases were divided into the study group (SSG performed, 37 cases) and the case-control group (SSG not performed, 43 cases). Successful SSG of at least one tube was obtained in all of 37 cases (100%) in whom SSG was attempted. A patency rate of 95.9% was documented in the 73 cannulated tubes of these cases. The total subsequent pregnancy rate (48.6%) within 12 months of follow-up after SSG was significantly higher than that (11.6%) obtained in the control group (p women, either as a sole therapeutic approach or in association with other methods of assisted reproductive technology, even if their fallopian tubes are shown to be patent by HSG. Copyright 2000 S. Karger AG, Basel

Power Doppler flow mapping and four-dimensional ultrasound for evaluating tubal patency compared with laparoscopy.

Science.gov (United States)

Soliman, Amr A; Shaalan, Waleed; Abdel-Dayem, Tamer; Awad, Elsayed Elbadawy; Elkassar, Yasser; Lüdders, Dörte; Malik, Eduard; Sallam, Hassan N

2015-12-01

To study the accuracy of four-dimensional (4D) ultrasound and power Doppler flow mapping in detecting tubal patency in women with sub-/infertility, and compare it with laparoscopy and chromopertubation. A prospective study. The study was performed in the outpatient clinic and infertility unit of a university hospital. The sonographic team and laparoscopic team were blinded to the results of each other. Women aged younger than 43 years seeking medical advice due to primary or secondary infertility and who planned to have a diagnostic laparoscopy performed, were recruited to the study after signing an informed consent. All of the recruited patients had power Doppler flow mapping and 4D hysterosalpingo-sonography by injecting sterile saline into the fallopian tubes 1 day before surgery. Registering Doppler signals, while using power Doppler, both at the tubal ostia and fimbrial end and the ability to demonstrate the course of the tube especially the isthmus and fimbrial end, while using 4D mode, was considered a patent tube. Out of 50 recruited patients, 33 women had bilateral patent tubes and five had unilateral patent tubes as shown by chromopertubation during diagnostic laparoscopy. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for two-dimensional power Doppler hysterosalpingography were 94.4%, 100%, 100%, 89.2%, and 96.2%, respectively and for 4D ultrasound were 70.4%, 100%, 100%, 70.4%, and 82.6%, respectively. Four-dimensional saline hysterosalpingography has acceptable accuracy in detecting tubal patency, but is surpassed by power Doppler saline hysterosalpingography. Power Doppler saline hysterosalpingography could be incorporated into the routine sub-/infertility workup. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Optimization of mass flow rate in RGTT200K coolant purification for Carbon Monoxide conversion process

International Nuclear Information System (INIS)

Sumijanto; Sriyono

2016-01-01

Carbon monoxide is a species that is difficult to be separated from the reactor coolant helium because it has a relatively small molecular size. So it needs a process of conversion from carbon monoxide to carbondioxide. The rate of conversion of carbon monoxide in the purification system is influenced by several parameters including concentration, temperature and mass flow rate. In this research, optimization of the mass flow rate in coolant purification of RGTT200K for carbon monoxide conversion process was done. Optimization is carried out by using software Super Pro Designer. The rate of reduction of reactant species, the growth rate between the species and the species products in the conversion reactions equilibrium were analyzed to derive the mass flow rate optimization of purification for carbon monoxide conversion process. The purpose of this study is to find the mass flow rate of purification for the preparation of the basic design of the RGTT200K coolant helium purification system. The analysis showed that the helium mass flow rate of 0.6 kg/second resulted in an un optimal conversion process. The optimal conversion process was reached at a mass flow rate of 1.2 kg/second. A flow rate of 3.6 kg/second – 12 kg/second resulted in an ineffective process. For supporting the basic design of the RGTT200K helium purification system, the mass flow rate for carbon monoxide conversion process is suggested to be 1.2 kg/second. (author)

Optimal tax rate and economic growth. Evidence from Nigeria and South Africa

Directory of Open Access Journals (Sweden)

Olufemi Muibi SAIBU

2015-05-01

Full Text Available The recent economic crisis had made developing countries to look inward for financial resources to finance development. The readily alternative is the tax revenues however, the possible adverse direct and indirect effects of tax on productivity and work efforts as well as on aggregate consumption had make some African countries (especially Nigeria and South Africa reluctant in implementing far reaching tax policy reform. This paper examines optimal tax burden and real output growth Nigeria and South Africa, two of the top four economies in Africa. The paper empirically determined what should be the optimal tax rate for Nigeria and South Africa-the two leading economies in Africa. The paper found that nonlinearity hypothesis in the effects of tax in the case of South Africa is rejected while a significant nonlinear relationship is found in the case of Nigeria. The results suggest that the growth-maximizing tax rate is about 15% of per capita GDP for South Africa and 30% for Nigeria. At that tax rate, the economic growth rate would be around 6% and 8% instead of the actual mean growth rate of 2.84% and 4.51% for South Africa and Nigeria respectively. The paper concluded the current tax burden in the two countries may be sub-optimal and may hurt long term sustainable growth process in the two countries

Two-Way Multiple Relays Channel: Achievable Rate Region and Optimal Resources

Directory of Open Access Journals (Sweden)

Zouhair Al-Qudah

2016-01-01

Full Text Available This paper considers a communication model containing two users that exchange their information with the help of multiple parallel relay nodes. To avoid interference at these common nodes, two users are required to transmit over the different frequency bands. Based on this scenario, the achievable rate region is initially derived. Next, an optimization scheme is described to choose the best relays that can be used by each user. Then, two power allocation optimization schemes are investigated to allocate the proper average power value to each node. Finally, comparisons between these two optimization schemes are carried out through some numerical examples.

Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patients

Science.gov (United States)

2012-01-01

Background Endoscopic biliary drainage of hilar cholangiocarcinoma is controversial with respect to the optimal types of stents and the extent of drainage. This study evaluated endoscopic palliation in patients with hilar cholangiocarcinoma using self-expandable metallic stents (SEMS) and plastic stents (PS).We also compared unilateral and bilateral stent placement according to the Bismuth classification. Methods Data on 480 patients receiving endoscopic biliary drainage for hilar cholangiocarcinoma between September 1995 and December 2010 were retrospectively reviewed to evaluate the following outcome parameters: technical success (TS), functional success (FS), early and late complications, stent patency and survival. Patients were followed from stent insertion until death or stent occlusion. Patients were divided into 3 groups according to the Bismuth classification (Group 1, type I; Group 2, type II; Group 3, type > III). Results The initial stent insertion was successful in 450 (93.8%) patients. TS was achieved in 204 (88.3%) patients treated with PS and in 246 (98.8%) patients palliated with SEMS (p stent patency in weeks (w) were as follows: 20 w in patients palliated with PS and 27 w in patients treated with SEMS (p stent patency. Conclusions SEMS insertion for the palliation of hilar cholangiocarcinoma offers higher technical and clinical success rates in the ITT analysis as well as lower complication rates and a superior cumulative stent patency when compared with PS placement in all Bismuth classifications. The cumulative patency of bilateral SEMS or PS stents was significantly higher than that of unilateral SEMS or PS stents, with lower occlusion rates in Bismuth II patients. PMID:22873816

Comparison of traditional low-dose-rate to optimized and nonoptimized high-dose-rate tandem and ovoid dosimetry

International Nuclear Information System (INIS)

Decker, William E.; Erickson, Beth; Albano, Katherine; Gillin, Michael

2001-01-01

Purpose: Few dose specification guidelines exist when attempting to perform high-dose-rate (HDR) dosimetry. The purpose of this study was to model low-dose-rate (LDR) dosimetry, using parameters common in HDR dosimetry, to achieve the 'pear-shape' dose distribution achieved with LDR tandem and ovoid applications. Methods and Materials: Radiographs of Fletcher-Suit LDR applicators and Nucletron 'Fletcher-like' HDR applicators were taken with the applicators in an idealized geometry. Traditional Fletcher loadings of 3M Cs-137 sources and the Theratronics Planning System were used for LDR dosimetry. HDR dosimetry was performed using the Nucletron Microselectron HDR UPS V11.22 with an Ir-192 source. Dose optimization points were initially located along a line 2 cm lateral to the tandem, beginning at the tandem tip at 0.5-cm intervals, ending at the sail, and optimized to 100% of the point A dose. A single dose optimization point was also placed laterally from the center of each ovoid equal to the radius of the ovoid (ovoid surface dose). For purposes of comparison, dose was also calculated for points A and B, and a point located 1 cm superior to the tandem tip in the plane of the tandem, (point F). Four- and 6-cm tandem lengths and 2.0-, 2.5-, and 3.0-cm ovoid diameters were used for this study. Based on initial findings, dose optimization schemes were developed to best approximate LDR dosimetry. Finally, radiographs were obtained of HDR applications in two patients. These radiographs were used to compare the optimization schemes with 'nonoptimized' treatment plans. Results: Calculated doses for points A and B were similar for LDR, optimized HDR, and nonoptimized HDR. The optimization scheme that used tapered dose points at the tandem tip and optimized a single ovoid surface point on each ovoid to 170% of point A resulted in a good approximation of LDR dosimetry. Nonoptimized HDR resulted in higher doses at point F, the bladder, and at points lateral to the tandem tip

Optimization between heating load and entropy-production rate for endoreversible absorption heat-transformers

International Nuclear Information System (INIS)

Sun Fengrui; Qin Xiaoyong; Chen Lingen; Wu Chih

2005-01-01

For an endoreversible four-heat-reservoir absorption heat-transformer cycle, for which a linear (Newtonian) heat-transfer law applies, an ecological optimization criterion is proposed for the best mode of operation of the cycle. This involves maximizing a function representing the compromise between the heating load and the entropy-production rate. The optimal relation between the ecological criterion and the COP (coefficient of performance), the maximum ecological criterion and the corresponding COP, heating load and entropy production rate, as well as the ecological criterion and entropy-production rate at the maximum heating load are derived using finite-time thermodynamics. Moreover, compared with the heating-load criterion, the effects of the cycle parameters on the ecological performance are studied by numerical examples. These show that achieving the maximum ecological criterion makes the entropy-production rate decrease by 77.0% and the COP increase by 55.4% with only 27.3% heating-load losses compared with the maximum heating-load objective. The results reflect that the ecological criterion has long-term significance for optimal design of absorption heat-transformers

Optimized support vector regression for drilling rate of penetration estimation

Science.gov (United States)

Bodaghi, Asadollah; Ansari, Hamid Reza; Gholami, Mahsa

2015-12-01

In the petroleum industry, drilling optimization involves the selection of operating conditions for achieving the desired depth with the minimum expenditure while requirements of personal safety, environment protection, adequate information of penetrated formations and productivity are fulfilled. Since drilling optimization is highly dependent on the rate of penetration (ROP), estimation of this parameter is of great importance during well planning. In this research, a novel approach called `optimized support vector regression' is employed for making a formulation between input variables and ROP. Algorithms used for optimizing the support vector regression are the genetic algorithm (GA) and the cuckoo search algorithm (CS). Optimization implementation improved the support vector regression performance by virtue of selecting proper values for its parameters. In order to evaluate the ability of optimization algorithms in enhancing SVR performance, their results were compared to the hybrid of pattern search and grid search (HPG) which is conventionally employed for optimizing SVR. The results demonstrated that the CS algorithm achieved further improvement on prediction accuracy of SVR compared to the GA and HPG as well. Moreover, the predictive model derived from back propagation neural network (BPNN), which is the traditional approach for estimating ROP, is selected for comparisons with CSSVR. The comparative results revealed the superiority of CSSVR. This study inferred that CSSVR is a viable option for precise estimation of ROP.

4D phase contrast flow imaging for in-stent flow visualization and assessment of stent patency in peripheral vascular stents--a phantom study.

Science.gov (United States)

Bunck, Alexander C; Jüttner, Alena; Kröger, Jan Robert; Burg, Matthias C; Kugel, Harald; Niederstadt, Thomas; Tiemann, Klaus; Schnackenburg, Bernhard; Crelier, Gerard R; Heindel, Walter; Maintz, David

2012-09-01

4D phase contrast flow imaging is increasingly used to study the hemodynamics in various vascular territories and pathologies. The aim of this study was to assess the feasibility and validity of MRI based 4D phase contrast flow imaging for the evaluation of in-stent blood flow in 17 commonly used peripheral stents. 17 different peripheral stents were implanted into a MR compatible flow phantom. In-stent visibility, maximal velocity and flow visualization were assessed and estimates of in-stent patency obtained from 4D phase contrast flow data sets were compared to a conventional 3D contrast-enhanced magnetic resonance angiography (CE-MRA) as well as 2D PC flow measurements. In all but 3 of the tested stents time-resolved 3D particle traces could be visualized inside the stent lumen. Quality of 4D flow visualization and CE-MRA images depended on stent type and stent orientation relative to the magnetic field. Compared to the visible lumen area determined by 3D CE-MRA, estimates of lumen patency derived from 4D flow measurements were significantly higher and less dependent on stent type. A higher number of stents could be assessed for in-stent patency by 4D phase contrast flow imaging (n=14) than by 2D phase contrast flow imaging (n=10). 4D phase contrast flow imaging in peripheral vascular stents is feasible and appears advantageous over conventional 3D contrast-enhanced MR angiography and 2D phase contrast flow imaging. It allows for in-stent flow visualization and flow quantification with varying quality depending on stent type. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Flow Rates in Liquid Chromatography, Gas Chromatography and Supercritical Fluid Chromatography: A Tool for Optimization

Directory of Open Access Journals (Sweden)

Joris Meurs

2016-08-01

Full Text Available This paper aimed to develop a standalone application for optimizing flow rates in liquid chromatography (LC, gas chromatography (GC and supercritical fluid chromatography (SFC. To do so, Van Deemter’s equation, Knox’ equation and Golay’s equation were implemented in a MATLAB script and subsequently a graphical user interface (GUI was created. The application will show the optimal flow rate or linear velocity and the corresponding plate height for the set input parameters. Furthermore, a plot will be shown in which the plate height is plotted against the linear flow velocity. Hence, this application will give optimized flow rates for any set conditions with minimal effort.

Choice of optimal exchange rate system For the Republic of Croatia

OpenAIRE

Dražen Koški

2008-01-01

The aim of research whose results are presented in this article was to choose the optimal system of exchange rate for the Republic of Croatia, of course before its accession to EU. The analyzed exchange rate systems here range from free-floating exchange rate to system without domestic currency in circulation. Naturally, the classification of International Monetary Fond is included in it. After that, the comparison of basic economic advantages and disadvantages of the fixed exchan...

Optimal Mutation Rates for the (1+lambda) EA on OneMax Through Asymptotically Tight Drift Analysis

DEFF Research Database (Denmark)

Gießen, Christian; Witt, Carsten

2018-01-01

We study the (1+) EA, a classical population-based evolutionary algorithm, with mutation probability c / n, where and are constant, on the benchmark function OneMax, which counts the number of 1-bits in a bitstring. We improve a well-established result that allows to determine the first hitting t...... that mutation rates up to 10% larger than the asymptotically optimal rate 1 / n minimize the expected runtime. However, in absolute terms the expected runtime does not change by much when replacing 1 / n with the optimal mutation rate....... drift is known. This reduces the analysis of expected optimization time to finding an exact expression for the drift. We then give an exact closed-form expression for the drift and develop a method to approximate it very efficiently, enabling us to determine approximate optimal mutation rates for the (1......+) EA for various parameter settings of c and and also for moderate sizes of n. This makes the need for potentially lengthy and costly experiments in order to optimize c for fixed n and for the optimization of OneMax unnecessary. Interestingly, even for moderate n and not too small it turns out...

Optimal Dynamic Investment Policy under Different Rates for Tax Depreciation and Economic Depreciation

NARCIS (Netherlands)

Wielhouwer, J.L.; De Waegenaere, A.M.B.; Kort, P.M.

1999-01-01

This paper analyzes the consequences of incorporating a different rate for tax depreciation than for economic depreciation. Firms most often choose their tax depreciation rate in a strategic way. It would therefore be a coincidence if this optimization process leads to a tax depreciation rate that

Criteria for Selecting Optimal Nitrogen Fertilizer Rates for Precision Agriculture

Directory of Open Access Journals (Sweden)

Bruno Basso

Full Text Available Yield rates vary spatially and maps produced by the yield monitor systems are evidence of the degree of withinfield variability. The magnitude of this variability is a good indication of the suitability of implementing a spatially variable management plan. Crop simulation models have the potential to integrate the effects of temporal and multiple stress interaction on crop growth under different environmental and management conditions. The strength of these models is their ability to account for stress by simulating the temporal interaction of stress on plant growth each day during the season. The objective of paper is to present a procedure that allows for the selection of optimal nitrogen fertilizer rates to be applied spatially on previously identified management zones through crop simulation modelling. The integration of yield maps, remote sensing imagery, ground truth measurements, electrical resistivity imaging allowed for the identifications of three distinct management zones based on their ability to produce yield and their stability over time (Basso et al., 2009. After validating the model, we simulated 7 N rates from 0 to 180 kg N/ha with a 30 kg N/ha increment. The model results illustrate the different N responses for each of the zone. The analysis allowed us to identify the optimal N rate for each of the zone based on agronomic, economic and environmental sustainability of N management.

Criteria for Selecting Optimal Nitrogen Fertilizer Rates for Precision Agriculture

Directory of Open Access Journals (Sweden)

Bruno Basso

2009-12-01

Full Text Available Yield rates vary spatially and maps produced by the yield monitor systems are evidence of the degree of withinfield variability. The magnitude of this variability is a good indication of the suitability of implementing a spatially variable management plan. Crop simulation models have the potential to integrate the effects of temporal and multiple stress interaction on crop growth under different environmental and management conditions. The strength of these models is their ability to account for stress by simulating the temporal interaction of stress on plant growth each day during the season. The objective of paper is to present a procedure that allows for the selection of optimal nitrogen fertilizer rates to be applied spatially on previously identified management zones through crop simulation modelling. The integration of yield maps, remote sensing imagery, ground truth measurements, electrical resistivity imaging allowed for the identifications of three distinct management zones based on their ability to produce yield and their stability over time (Basso et al., 2009. After validating the model, we simulated 7 N rates from 0 to 180 kg N/ha with a 30 kg N/ha increment. The model results illustrate the different N responses for each of the zone. The analysis allowed us to identify the optimal N rate for each of the zone based on agronomic, economic and environmental sustainability of N management.

Criteria for Selecting Optimal Nitrogen Fertilizer Rates for Precision Agriculture

Directory of Open Access Journals (Sweden)

Francesco Basso

2011-02-01

Full Text Available Yield rates vary spatially and maps produced by the yield monitor systems are evidence of the degree of withinfield variability. The magnitude of this variability is a good indication of the suitability of implementing a spatially variable management plan. Crop simulation models have the potential to integrate the effects of temporal and multiple stress interaction on crop growth under different environmental and management conditions. The strength of these models is their ability to account for stress by simulating the temporal interaction of stress on plant growth each day during the season. The objective of paper is to present a procedure that allows for the selection of optimal nitrogen fertilizer rates to be applied spatially on previously identified management zones through crop simulation modelling. The integration of yield maps, remote sensing imagery, ground truth measurements, electrical resistivity imaging allowed for the identifications of three distinct management zones based on their ability to produce yield and their stability over time (Basso et al., 2009. After validating the model, we simulated 7 N rates from 0 to 180 kg N/ha with a 30 kg N/ha increment. The model results illustrate the different N responses for each of the zone. The analysis allowed us to identify the optimal N rate for each of the zone based on agronomic, economic and environmental sustainability of N management.

Cross-layer optimized rate adaptation and scheduling for multiple-user wireless video streaming

NARCIS (Netherlands)

Ozcelebi, T.; Sunay, M.O.; Tekalp, A.M.; Civanlar, M.R.

2007-01-01

We present a cross-layer optimized video rate adaptation and user scheduling scheme for multi-user wireless video streaming aiming for maximum quality of service (QoS) for each user,, maximum system video throughput, and QoS fairness among users. These objectives are jointly optimized using a

An optimal policy for deteriorating items with time-proportional deterioration rate and constant and time-dependent linear demand rate

Science.gov (United States)

Singh, Trailokyanath; Mishra, Pandit Jagatananda; Pattanayak, Hadibandhu

2017-12-01

In this paper, an economic order quantity (EOQ) inventory model for a deteriorating item is developed with the following characteristics: (i) The demand rate is deterministic and two-staged, i.e., it is constant in first part of the cycle and linear function of time in the second part. (ii) Deterioration rate is time-proportional. (iii) Shortages are not allowed to occur. The optimal cycle time and the optimal order quantity have been derived by minimizing the total average cost. A simple solution procedure is provided to illustrate the proposed model. The article concludes with a numerical example and sensitivity analysis of various parameters as illustrations of the theoretical results.

Optimal Training for Time-Selective Wireless Fading Channels Using Cutoff Rate

Directory of Open Access Journals (Sweden)

Tong Lang

2006-01-01

Full Text Available We consider the optimal allocation of resources—power and bandwidth—between training and data transmissions for single-user time-selective Rayleigh flat-fading channels under the cutoff rate criterion. The transmitter exploits statistical channel state information (CSI in the form of the channel Doppler spectrum to embed pilot symbols into the transmission stream. At the receiver, instantaneous, though imperfect, CSI is acquired through minimum mean-square estimation of the channel based on some set of pilot observations. We compute the ergodic cutoff rate for this scenario. Assuming estimator-based interleaving and -PSK inputs, we study two special cases in-depth. First, we derive the optimal resource allocation for the Gauss-Markov correlation model. Next, we validate and refine these insights by studying resource allocation for the Jakes model.

Coronary artery bypass grafting hemodynamics and anastomosis design: a biomedical engineering review.

Science.gov (United States)

Ghista, Dhanjoo N; Kabinejadian, Foad

2013-12-13

In this paper, coronary arterial bypass grafting hemodynamics and anastomosis designs are reviewed. The paper specifically addresses the biomechanical factors for enhancement of the patency of coronary artery bypass grafts (CABGs). Stenosis of distal anastomosis, caused by thrombosis and intimal hyperplasia (IH), is the major cause of failure of CABGs. Strong correlations have been established between the hemodynamics and vessel wall biomechanical factors and the initiation and development of IH and thrombus formation. Accordingly, several investigations have been conducted and numerous anastomotic geometries and devices have been designed to better regulate the blood flow fields and distribution of hemodynamic parameters and biomechanical factors at the distal anastomosis, in order to enhance the patency of CABGs. Enhancement of longevity and patency rate of CABGs can eliminate the need for re-operation and can significantly lower morbidity, and thereby reduces medical costs for patients suffering from coronary stenosis. This invited review focuses on various endeavors made thus far to design a patency-enhancing optimized anastomotic configuration for the distal junction of CABGs.

Iteration particle swarm optimization for contract capacities selection of time-of-use rates industrial customers

International Nuclear Information System (INIS)

Lee, Tsung-Ying; Chen, Chun-Lung

2007-01-01

This paper presents a new algorithm for solving the optimal contract capacities of a time-of-use (TOU) rates industrial customer. This algorithm is named iteration particle swarm optimization (IPSO). A new index, called iteration best is incorporated into particle swarm optimization (PSO) to improve solution quality and computation efficiency. Expanding line construction cost and contract recovery cost are considered, as well as demand contract capacity cost and penalty bill, in the selection of the optimal contract capacities. The resulting optimal contract capacity effectively reaches the minimum electricity charge of TOU rates users. A significant reduction in electricity costs is observed. The effects of expanding line construction cost and contract recovery cost on the selection of optimal contract capacities can also be estimated. The feasibility of the new algorithm is demonstrated by a numerical example, and the IPSO solution quality and computation efficiency are compared to those of other algorithms

4D phase contrast flow imaging for in-stent flow visualization and assessment of stent patency in peripheral vascular stents – A phantom study

International Nuclear Information System (INIS)

Bunck, Alexander C.; Jüttner, Alena; Kröger, Jan Robert; Burg, Matthias C.; Kugel, Harald; Niederstadt, Thomas; Tiemann, Klaus; Schnackenburg, Bernhard; Crelier, Gerard R.

2012-01-01

Purpose: 4D phase contrast flow imaging is increasingly used to study the hemodynamics in various vascular territories and pathologies. The aim of this study was to assess the feasibility and validity of MRI based 4D phase contrast flow imaging for the evaluation of in-stent blood flow in 17 commonly used peripheral stents. Materials and methods: 17 different peripheral stents were implanted into a MR compatible flow phantom. In-stent visibility, maximal velocity and flow visualization were assessed and estimates of in-stent patency obtained from 4D phase contrast flow data sets were compared to a conventional 3D contrast-enhanced magnetic resonance angiography (CE-MRA) as well as 2D PC flow measurements. Results: In all but 3 of the tested stents time-resolved 3D particle traces could be visualized inside the stent lumen. Quality of 4D flow visualization and CE-MRA images depended on stent type and stent orientation relative to the magnetic field. Compared to the visible lumen area determined by 3D CE-MRA, estimates of lumen patency derived from 4D flow measurements were significantly higher and less dependent on stent type. A higher number of stents could be assessed for in-stent patency by 4D phase contrast flow imaging (n = 14) than by 2D phase contrast flow imaging (n = 10). Conclusions: 4D phase contrast flow imaging in peripheral vascular stents is feasible and appears advantageous over conventional 3D contrast-enhanced MR angiography and 2D phase contrast flow imaging. It allows for in-stent flow visualization and flow quantification with varying quality depending on stent type

The Optimal Replenishment Policy under Trade Credit Financing with Ramp Type Demand and Demand Dependent Production Rate

Directory of Open Access Journals (Sweden)

Juanjuan Qin

2014-01-01

Full Text Available This paper investigates the optimal replenishment policy for the retailer with the ramp type demand and demand dependent production rate involving the trade credit financing, which is not reported in the literatures. First, the two inventory models are developed under the above situation. Second, the algorithms are given to optimize the replenishment cycle time and the order quantity for the retailer. Finally, the numerical examples are carried out to illustrate the optimal solutions and the sensitivity analysis is performed. The results show that if the value of production rate is small, the retailer will lower the frequency of putting the orders to cut down the order cost; if the production rate is high, the demand dependent production rate has no effect on the optimal decisions. When the trade credit is less than the growth stage time, the retailer will shorten the replenishment cycle; when it is larger than the breakpoint of the demand, within the maturity stage of the products, the trade credit has no effect on the optimal order cycle and the optimal order quantity.

Joint sensor location/power rating optimization for temporally-correlated source estimation

KAUST Repository

Bushnaq, Osama M.; Chaaban, Anas; Al-Naffouri, Tareq Y.

2017-01-01

via wireless AWGN channel. In addition to selecting the optimal sensing location, the sensor type to be placed in these locations is selected from a pool of T sensor types such that different sensor types have different power ratings and costs

An Optimal Commitment Model of Exchange Rate Stabilization

OpenAIRE

Kyung-Soo Kim

2006-01-01

Recently East Asian countries that have amassed large US dollar reserves face a growing threat of big losses from a sudden decline in the dollar. This threat evokes an issue of the optimal commitment of exchange rate stabilization once raised by Isard (1995) who interpreted the cost of breaking the parity as the capital gain awarded to speculators, in the event the domestic currency is devalued. The only difference in this paper is revaluation. This paper models the central bank��s optima...

Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency

Science.gov (United States)

Langhoff, Ralf; Rocha-Singh, Krishna J.; Jaff, Michael R.; Blessing, Erwin; Amann-Vesti, Beatrice; Krzanowski, Marek; Peeters, Patrick; Scheinert, Dierk; Torsello, Giovanni; Sixt, Sebastian; Tepe, Gunnar

2017-01-01

Background— Studies assessing drug-coated balloons (DCB) for the treatment of femoropopliteal artery disease are encouraging. However, challenging lesions, such as severely calcified, remain difficult to treat with DCB alone. Vessel preparation with directional atherectomy (DA) potentially improves outcomes of DCB. Methods and Results— DEFINITIVE AR study (Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency—A Pilot Study of Anti-Restenosis Treatment) was a multicenter randomized trial designed to estimate the effect of DA before DCB to facilitate the development of future end point-driven randomized studies. One hundred two patients with claudication or rest pain were randomly assigned 1:1 to DA+DCB (n=48) or DCB alone (n=54), and 19 additional patients with severely calcified lesions were treated with DA+DCB. Mean lesion length was 11.2±4.0 cm for DA+DCB and 9.7±4.1 cm for DCB (P=0.05). Predilation rate was 16.7% for DA+DCB versus 74.1% for DCB; postdilation rate was 6.3% for DA+DCB versus 33.3% for DCB. Technical success was superior for DA+DCB (89.6% versus 64.2%; P=0.004). Overall bail-out stenting rate was 3.7%, and rate of flow-limiting dissections was 19% for DCB and 2% for DA+DCB (P=0.01). One-year primary outcome of angiographic percent diameter stenosis was 33.6±17.7% for DA+DCB versus 36.4±17.6% for DCB (P=0.48), and clinically driven target lesion revascularization was 7.3% for DA+DCB and 8.0% for DCB (P=0.90). Duplex ultrasound patency was 84.6% for DA+DCB, 81.3% for DCB (P=0.78), and 68.8% for calcified lesions. Freedom from major adverse events at 1 year was 89.3% for DA+DCB and 90.0% for DCB (P=0.86). Conclusions— DA+DCB treatment was effective and safe, but the study was not powered to show significant differences between the 2 methods of revascularization in 1-year follow-up. An adequately powered randomized trial is warranted. Clinical Trial Registration— http

Clinical-pathological-angiographic correlations following transluminal atherectomy

International Nuclear Information System (INIS)

Althaus, S.J.; Maynar, M.; Reyes, R.; Pulido-Duque, J.M.; Casal, G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

1989-01-01

Following percutaneous atherectomy, arterial and catheter diameter relationships were correlated with angiographic and ankle-arm index results. There was a greater amount of tissue removed, improved luminal reconstitution, and ankle-arm index in lesions where the catheter and arterial diameters were equal or within 0.5 mm. Excluding lesions requiring angioplasty, 77% of our lesions had less than 30% residual stenosis; including lesions requiring concomitant angioplasty, the initial overall patency was 93%, with a 1-year patency rate of 92.5%. This study indicates that adequate matching of the atherectomy catheter diameter to the arterial diameter is necessary to optimize tissue removal and clinical results

Modelling on optimal portfolio with exchange rate based on discontinuous stochastic process

Science.gov (United States)

Yan, Wei; Chang, Yuwen

2016-12-01

Considering the stochastic exchange rate, this paper is concerned with the dynamic portfolio selection in financial market. The optimal investment problem is formulated as a continuous-time mathematical model under mean-variance criterion. These processes follow jump-diffusion processes (Weiner process and Poisson process). Then the corresponding Hamilton-Jacobi-Bellman(HJB) equation of the problem is presented and its efferent frontier is obtained. Moreover, the optimal strategy is also derived under safety-first criterion.

Angiographic predictors of 3-year patency of bypass grafts implanted on the right coronary artery system: a prospective randomized comparison of gastroepiploic artery, saphenous vein, and right internal thoracic artery grafts.

Science.gov (United States)

Glineur, David; D'hoore, William; de Kerchove, Laurent; Noirhomme, Philippe; Price, Joel; Hanet, Claude; El Khoury, Gebrine

2011-11-01

Saphenous vein, in situ right gastroepiploic artery, and right internal thoracic artery grafts are routinely used to revascularize the right coronary artery. Little is known about the predictive value of objective preoperative angiographic parameters on midterm graft patency. We prospectively enrolled 210 consecutive patients undergoing coronary revascularization. Revascularization of the right coronary artery was randomly performed with the saphenous vein grafts in 81 patients and the right gastroepiploic artery in 92 patients. During the same study period, 37 patients received right coronary artery revascularization with the right internal thoracic artery used in a Y-composite fashion. All patients underwent a protocol-driven coronary angiogram 3 years after surgery. Preoperative angiographic parameters included minimum lumen diameter percent stenosis measured by quantitative angiography. A graft was considered "not functional" with patency scores of 0 to 2 and "functional" with patency scores of 3 or 4. Angiographic follow-up was 100% complete. A significant difference in the distribution of flow patterns was observed in the 3 groups. In multivariate analysis, the use of a saphenous vein graft was associated with superior graft functionality compared with the other conduits (odds ratio, 6.1; 95% confidence interval, 2.4-15). Graft function was negatively influenced by the minimum lumen diameter (odds ratio, 0.11; confidence interval, 0.05-0.25). In the right gastroepiploic artery and right internal thoracic artery groups, the proportion of functional grafts was higher when the minimum lumen diameter was below a threshold value in the third minimum lumen diameter quartile (0.64-1.30 mm). Preoperative angiography predicts graft patency in the right gastroepiploic artery and right internal thoracic artery, whereas the flow pattern in saphenous vein grafts is significantly less influenced by quantitative angiographic parameters. Copyright © 2011 The American

Dynamic Optimization Design of Cranes Based on Human–Crane–Rail System Dynamics and Annoyance Rate

Directory of Open Access Journals (Sweden)

Yunsheng Xin

2017-01-01

Full Text Available The operators of overhead traveling cranes experience discomfort as a result of the vibrations of crane structures. These vibrations are produced by defects in the rails on which the cranes move. To improve the comfort of operators, a nine-degree-of-freedom (nine-DOF mathematical model of a “human–crane–rail” system was constructed. Based on the theoretical guidance provided in ISO 2631-1, an annoyance rate model was established, and quantization results were determined. A dynamic optimization design method for overhead traveling cranes is proposed. A particle swarm optimization (PSO algorithm was used to optimize the crane structural design, with the structure parameters as the basic variables, the annoyance rate model as the objective function, and the acceleration amplitude and displacement amplitude of the crane as the constraint conditions. The proposed model and method were used to optimize the design of a double-girder 100 t–28.5 m casting crane, and the optimal parameters are obtained. The results show that optimization decreases the human annoyance rate from 28.3% to 9.8% and the root mean square of the weighted acceleration of human vibration from 0.59 m/s2 to 0.38 m/s2. These results demonstrate the effectiveness and practical applicability of the models and method proposed in this paper.

Optimizing the nitrogen application rate for maize and wheat based on yield and environment on the Northern China Plain.

Science.gov (United States)

Zhang, Yitao; Wang, Hongyuan; Lei, Qiuliang; Luo, Jiafa; Lindsey, Stuart; Zhang, Jizong; Zhai, Limei; Wu, Shuxia; Zhang, Jingsuo; Liu, Xiaoxia; Ren, Tianzhi; Liu, Hongbin

2018-03-15

Optimizing the nitrogen (N) application rate can increase crop yield while reducing the environmental risks. However, the optimal N rates vary substantially when different targets such as maximum yield or maximum economic benefit are considered. Taking the wheat-maize rotation cropping system on the North China Plain as a case study, we quantified the variation of N application rates when targeting constraints on yield, economic performance, N uptake and N utilization, by conducting field experiments between 2011 and 2013. Results showed that the optimal N application rate was highest when targeting N uptake (240kgha -1 for maize, and 326kgha -1 for wheat), followed by crop yield (208kgha -1 for maize, and 277kgha -1 for wheat) and economic income (191kgha -1 for maize, and 253kgha -1 for wheat). If environmental costs were considered, the optimal N application rates were further reduced by 20-30% compared to those when targeting maximum economic income. However, the optimal N rate, with environmental cost included, may result in soil nutrient mining under maize, and an extra input of 43kgNha -1 was needed to make the soil N balanced and maintain soil fertility in the long term. To obtain a win-win situation for both yield and environment, the optimal N rate should be controlled at 179kgha -1 for maize, which could achieve above 99.5% of maximum yield and have a favorable N balance, and at 202kgha -1 for wheat to achieve 97.4% of maximum yield, which was about 20kgNha -1 higher than that when N surplus was nil. Although these optimal N rates vary on spatial and temporal scales, they are still effective for the North China Plain where 32% of China's total maize and 45% of China's total wheat are produced. More experiments are still needed to determine the optimal N application rates in other regions. Use of these different optimal N rates would contribute to improving the sustainability of agricultural development in China. Copyright © 2017 Elsevier B.V. All rights

Assessment of portal venous system patency in the liver transplant candidate: A prospective study comparing ultrasound, microbubble-enhanced colour Doppler ultrasound, with arteriography and surgery

International Nuclear Information System (INIS)

Marshall, M.M.; Beese, R.C.; Muiesan, P.; Sarma, D.I.; O'Grady, J.; Sidhu, P.S.

2002-01-01

AIM: To determine the role of microbubble-enhanced colour Doppler ultrasound (CDUS) in assessing portal venous patency prior to liver transplantation. MATERIALS AND METHODS: Over a 2-year period, all patients with chronic liver disease undergoing routine pre-transplant CDUS examination in whom the portal venous system was inadequately demonstrated were recruited to the study. CDUS was performed in 368 patients and 33 patients (9%) were recruited. A repeat CDUS examination following an intravenous bolus injection of the microbubble contrast agent Levovist[reg] (Schering Healthcare AG, Berlin, Germany) was performed. Diagnostic confidence was recorded on a free linear analogue scale for both examinations. Findings were compared with indirect portography and surgery. RESULTS: Of the 33 patients with sub-optimal baseline examinations, improvement in portal vein visualization was achieved in 31 patients (94%). Median diagnostic confidence increased from 50% (interquartile range 30-60) to 90% (interquartile range 75-98) (P < 0.001) following administration of Levovist[reg]. Overall accuracy of portal vein assessment using microbubble-enhanced CDUS in 15 patients in whom a definitive diagnosis was made within 2 months was 87%. CONCLUSION: Microbubble-enhanced CDUS is a simple, inexpensive adjunct to standard pre liver transplant screening of the portal vein. It is particularly helpful in patients with end-stage cirrhosis who are at high risk of portal vein thrombosis and in whom the conventional examination is sub-optimal.Marshall, M.M. et al. (2002)

Long-term patency of experimental magnetic compression gastroenteric anastomoses achieved with covered stents.

Science.gov (United States)

Cope, C; Ginsberg, G G

2001-06-01

Our aim was to evaluate the efficacy of a prototype "YO-YO"-shaped covered stent for keeping experimental magnetic compression gastroenteric fistulas patent for 6 months. Magnets were introduced perorally with endoscopic and fluoroscopic guidance and were mated across the gastric and jejunal walls of 5 dogs. After a mean of 5.5 days a 12-mm diameter YO-YO stent was placed perorally in the resulting fistula. The gastroenteric anastomosis (GEA) with stent was observed endoscopically and gastrographically at 1- to 2-month intervals. There was no morbidity and there were no significant weight changes. The GEA was widely patent at necropsy at 6 months (n = 4); partial membrane separation occurred at 5 months in the fifth dog. There was minor breakage of the stent prongs in 2 animals. Peroral creation of a stented magnetic compression GEA is safe and provides long-term patency. This technique may be potentially useful for managing gastric outlet obstruction caused by malignancy.

Global optimization numerical strategies for rate-independent processes

Czech Academy of Sciences Publication Activity Database

Benešová, Barbora

2011-01-01

Roč. 50, č. 2 (2011), s. 197-220 ISSN 0925-5001 R&D Projects: GA ČR GAP201/10/0357 Grant - others:GA MŠk(CZ) LC06052 Program:LC Institutional research plan: CEZ:AV0Z20760514 Keywords : rate-independent processes * numerical global optimization * energy estimates based algorithm Subject RIV: BA - General Mathematics Impact factor: 1.196, year: 2011 http://math.hnue.edu.vn/portal/rss.viewpage.php?id=0000037780&ap=L3BvcnRhbC9ncmFiYmVyLnBocD9jYXRpZD0xMDEyJnBhZ2U9Mg==

Effect of antithrombotic agents on the patency of PTFE-Covered stents in the inferior vena cava: An experimental study

International Nuclear Information System (INIS)

Makutani, Shiro; Kichikawa, Kimihiko; Uchida, Hideo; Maeda, Munehiro; Konishi, Noboru; Hiasa, Yoshio; Yoshikawa, Tomohiro; Kimura, Yukio

1999-01-01

Purpose: To evaluate the efficacy of antithrombotic agents in the prevention of stenosis of polytetrafluororethylene (PTFE)-covered stents in the venous system.Methods: Spiral Z stents covered with PTFE (PTFE-covered stents) were placed in the inferior vena cava (IVC) of 34 dogs. Nineteen dogs, used as a control group, were sacrificed at 2, 4, and 12 weeks. Fifteen dogs, previously given antithrombotic agents [cilostazol (n=5), warfarin potassium (n=5), cilostazol plus warfarin potassium (n=5)] were sacrificed at 4 weeks, and then examined angiographically and histopathologically. The effect of the antithrombotic agents was compared between groups.Results: The patency rate of the antithrombotic agent group was 93% (14/15), which was higher than the control group rate of 63% (12/19). The mean stenosis rate of the patent stent at both ends and at the midportion was lower at 4 weeks in the antithrombotic agent group than in the control group. In particular, the mean stenosis rate in the cilostazol plus warfarin potassium group was significantly lower than the control group (Tukey's test, p < 0.05). The mean neointimal thickness of the patent stent at both ends and at the midportion was thinner at 4 weeks in the antithrombotic agent group than in the control group. In particular, the thickness of the neointima in the cilostazol plus warfarin potassium group was significantly decreased when compared with the control group (Tukey's test p < 0.05). At 4 weeks, endothelialization in the antithrombotic agent group tended to be almost identical to that in the control group.Conclusion: The present study suggests that administration of an antithrombotic agent is an effective way of preventing the stenosis induced by a neointimal thickening of PTFE-covered stents in the venous system.

Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization

International Nuclear Information System (INIS)

Gay, H A; Allison, R R; Downie, G H; Mota, H C; Austerlitz, C; Jenkins, T; Sibata, C H

2007-01-01

A number of patients with lung cancer receive either palliative or curative high-dose-rate (HDR) endobronchial brachytherapy. Up to a third of patients treated with endobronchial HDR die from hemoptysis. Rather than accept hemoptysis as an expected potential consequence of HDR, we have calculated the radial dose distribution for an Ir-192 HDR source, rigorously examined the dose and prescription points recommended by the American Brachytherapy Society (ABS), and performed a radiobiological-based analysis. The radial dose rate of a commercially available Ir-192 source was calculated with a Monte Carlo simulation. Based on the linear quadratic model, the estimated palliative, curative and blood vessel rupture radii from the center of an Ir-192 source were obtained for the ABS recommendations and a series of customized HDR prescriptions. The estimated radius at risk for blood vessel perforation for the ABS recommendations ranges from 7 to 9 mm. An optimized prescription may in some situations reduce this radius to 4 mm. The estimated blood perforation radius is generally smaller than the palliative radius. Optimized and individualized endobronchial HDR prescriptions are currently feasible based on our current understanding of tumor and normal tissue radiobiology. Individualized prescriptions could minimize complications such as fatal hemoptysis without sacrificing efficacy. Fiducial stents, HDR catheter centering or spacers and the use of CT imaging to better assess the relationship between the catheter and blood vessels promise to be useful strategies for increasing the therapeutic index of this treatment modality. Prospective trials employing treatment optimization algorithms are needed

Effect of percutaneous transluminal angioplasty on the stenosis of autogenous radiocephalic ateriovenous fistula for hemodialysis

Energy Technology Data Exchange (ETDEWEB)

Jeong, Sun Min; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin MMo; Choi, Sang Tae; Kim, Jong Woo; Kim, Hyung Sik; Choi, Hye Young [Gachon University Gil Medical Center, Incheon (Korea, Republic of); Park, Jae Hyung [Dept. of Radiology, Seonam University College of Medicine, Myongji Hospital, Goyang (Korea, Republic of)

2016-02-15

The purpose of this study was to evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) on stenosis of autogenous radiocephalic arteriovenous fistula (RCF) for hemodialysis and to determine the factors influencing patency. This retrospective study included 136 patients referred for PTA of RCF stenosis between March 2005 and July 2014. The technical success rate, complications, and patency rate were evaluated. The following factors were analyzed as they might influence patency: age, gender, site and duration of arteriovenous fistula, underlying disease, body mass index, hypercholesterolemia, smoking, peripheral artery or coronary artery occlusive disease, stenosis length/grade, cutting balloon, and balloon size. The initial technical success rate was 91.9% (125/136). Complications included vessel rupture (n = 2) and vessel dissection (n = 2). The patency rates at 6, 12, 24, and 48 months after PTA were 81.9, 67.1, 52.7, and 42.3%, respectively. The patency rate was higher in cases with longer (> 3 cm) stenosis (p = 0.04). Use of cutting balloon and larger size of balloon catheter made the patency longer, but this difference was not statistically significant (p = 0.637, 0.258). PTA is a safe and effective way to manage stenosis in RCF. The length of stenosis was the only factor which affected the patency rate in this study.

Avaliação da perviedade precoce das fístulas arteriovenosas para hemodiálise Evaluation of early patency of the arteriovenous fistulas for hemodialysis

Directory of Open Access Journals (Sweden)

Milton Alves das Neves Junior

2011-06-01

(AVF are the best option for this purpose. OBJECTIVE: To evaluate the early patency of AVFs and to identify the causes of their failure. METHODS: All patients AVF underwent operations for dialysis from August, 2008 to January, 2009. The AVF patency was evaluated on the 1st, 10th and 30th postoperative days. Thirty-one operations for AVF were performed in our hospital in the period; 18 patients were males and the mean age was 63.03 years. RESULTS: Twenty-six AVF were distal, all radial-cephalic; four were proximal, out of which two were brachiocephalic and two were brachiobasilic; one AVF was a femoral-femoral loop PTFE graft. The patency rate in the first month was of 71%. The use of central venous catheters was a risk factor for AVF occlusion (p=0.01. AVF remains the most accepted and safe vascular access. Early performance of the AVF is very important to avoid the complications resulting from long-term use of central venous catheters. CONCLUSIONS: Data regarding early patency found in this study were similar to those found in literature, and the use of central venous catheters before performing AVF is an important risk factor for occlusion.

Long-Term Results after Placement of Aortic Bifurcation Self-Expanding Stents: 10 Year Mortality, Stent Restenosis, and Distal Disease Progression

International Nuclear Information System (INIS)

Houston, J. Graeme; Bhat, Raj; Ross, Rose; Stonebridge, Peter A.

2007-01-01

Purpose. To retrospectively evaluate the 10 year follow-up results in patients who had 'kissing' self-expanding stent aortic bifurcation reconstruction. Methods. Forty-three patients were treated with 'kissing' self-expanding stents for aortoiliac occlusive disease. Early follow-up with clinical and ankle brachial pressure indices (ABPI) was performed at 3, 6, 12, and 24 months and with intra-arterial digital subtraction angiography at 12-24 months; clinical and angiographic follow-up was performed for symptom recurrence up to 10 years after treatment. Retrospective record review was performed to assess mortality, clinical patency, angiographic patency, and secondary assisted patency of both stents and downstream peripheral vessels at 5 and 10 years follow-up. Results. The 2 year primary angiographic and secondary assisted stent patencies were 89% and 93%, respectively. At 10 years follow-up in 40 patients the mortality was 38% (due to myocardial infarction, stroke, chronic renal failure, malignancy, and liver failure). At 5 and 10 years follow-up the primary clinical stent patency was 82% and 68%, and the secondary assisted stent patency 93% and 86%, respectively. At 5 and 10 years, the distal vessel patency was 86% and 72%, and the secondary assisted distal vessel patency treated by surgical or endovascular techniques was 94% and 88%, respectively. At 10 years there was no limb loss. Conclusion. The long-term (10 year) results of aortic bifurcation arterial self-expanding stent placement in patients with arterial occlusive disease show a 10 year primary stent patency rate of 68% but a secondary assisted patency rate of 86%. In addition there is a high overall mortality due to other cardiovascular causes and the rate of distal disease progression and loss of patency is similar to the loss of stent patency rate

Central venous obstruction in hemodialysis patients: the usefulness of percutaneous treatment

International Nuclear Information System (INIS)

Kim, Cheol Young; Goo, Dong Erk; Kim, Dae Ho; Hong, Hyun Suk; Lee, Hae Kyoung; Choi, Duk Lin; Yang, Sung Boo; Moon, Chul

2002-01-01

To analyse the effectiveness of percutaneous treatment of central venous obstruction in patients undergoing hemodialysis. In 100 patients, 107 central venous strictures (56 subclavian (occlusion:21, stenosis:35) and 51 innominate (occlusion:23,stenosis:28)) were assessed, and 170 percutaneous angioplasty procedures were performed. Balloon dilation of the venous lumen was the preferred mode, but if dilation was incomplete we inserted a stent at the site of the stricture. Technical success, procedural complications and the long-term patency rate were evaluated, and the patency difference according to location and degree of stricture, the existence of DM, and any history of central catheter insertion was also determined. We inserted 52 stents in 170 procedures, in 157 (92.4%) of which initial technical success was achieved. Stent migration occurred in two cases and balloon rupture in three. The 6- and 12-month primary patency rates were 46.2% and 24.1%, respectively, and the mean patency rate was 8.5 months. The 1-, 2-and 3-year accumulative patency rates were 59.8%, 47.5% and 35.7%, respectively, and the mean patency rate was 23.5 months. Other than in the history of central catheter insertion, there were no statistically significant differences in patency rates (p=0.0128). In hemodialysis patients with a central venous stricture, percutaneous angioplasty is a safe and useful procedure, but to maintain long-term central venous patency, repeated interventions are required

Effect of early correction of nasal septal deformity in unilateral cleft lip and palate on inferior turbinate hypertrophy and nasal patency.

Science.gov (United States)

Pinto, Valentina; Piccin, Ottavio; Burgio, Luca; Summo, Valeria; Antoniazzi, Elisa; Morselli, Paolo G

2018-05-01

A relatively neglected aspect of cleft lip nasal deformity is the effect of septal deviation and inferior turbinate hypertrophy (ITH) on the functional airway. In particular, ITH in the noncleft side can be especially problematic, because it reduces the healthy nasal area, creating bilateral nasal obstruction that might affect the growth of the maxillofacial skeleton. Although these anatomic and functional changes are documented, few recommendations have been developed regarding the proper approach to ITH. The aim of the present study was to asses the ITH severity and determine the degree of nasal airway patency in patients who have undergone primary correction of the nasal septum during lip repair compared to patients operated on without primary septal correction. The study population included two groups. One group consisted of twenty unilateral cleft lip palate UCLP patients who have previously undergone primary rhinoseptoplasty as part of their treatment plan. The control group consisted of twenty UCLP patients operated on without rhinoseptal correction. The Nasal Obstructive Symptom Evaluation (NOSE) scale and nasal endoscopy were used to assess nasal obstruction. The overall untreated group reported severe symptoms across all NOSE scale dimensions more frequently than children who have undergone primary rhinoseptoplasty. The difference was statistically significant for each dimensions (p cleft lip repair results in a statistically significant reduction in IT size and improvement of nasal patency. Copyright © 2018 Elsevier B.V. All rights reserved.

Sampling optimization trade-offs for long-term monitoring of gamma dose rates

NARCIS (Netherlands)

Melles, S.J.; Heuvelink, G.B.M.; Twenhöfel, C.J.W.; Stöhlker, U.

2008-01-01

This paper applies a recently developed optimization method to examine the design of networks that monitor radiation under routine conditions. Annual gamma dose rates were modelled by combining regression with interpolation of the regression residuals using spatially exhaustive predictors and an

Trade balance instability and the optimal exchange rate regime: The case of OPEC countries

Energy Technology Data Exchange (ETDEWEB)

Aljerrah, M.A.

1993-01-01

The OPEC members have experienced wide fluctuations in their trade balances. This can be attributed to several factors: (1) heavy dependence of national income and export earnings on a single primary export-oil; (2) instability of price and world demand for oil; and (3) the exchange rate regime practiced in recent years. An exchange rate policy can be used to minimize the fluctuations in trade balance, given the changes in exchange rates of major international currencies. The purpose of this study is two fold; first, examine the effects of fluctuations in trade balance on the OPEC economies, and second, propose appropriate exchange rate regime for selected OPEC members. The study is divided into two parts. The first part demonstrates the impact of trade balance changes on national income and other macroeconomic variables using a Keynesian framework. The second part involves using conventional trade models to search for the appropriate exchange rate regime to minimize the fluctuations in trade balance of each selective country. The study's findings are: first, fluctuations in trade balances had negative effects on the economics of Algeria, Kuwait, Libya, Saudi Arabia, and the United Arab Emirates. Second, the current exchange rate regime of no sample country is optimal in minimizing trade balance fluctuations. Third, in contrast to expectations, U.S. dollar peg did not stabilize the trade balance of any OPEC member. Finally, the results show that the sample OPEC economies could have enjoyed faster - though with different degree - economic growth if they had pegged their currencies to the derived optimal exchange rate regime. These optimal exchange rate regimes are: the SDR for Algeria and the United Arab Emirates, the purchasing power parity for Libya and Saudi Arabia, and the real Yen for Kuwait.

Optimized dose distribution of a high dose rate vaginal cylinder

International Nuclear Information System (INIS)

Li Zuofeng; Liu, Chihray; Palta, Jatinder R.

1998-01-01

Purpose: To present a comparison of optimized dose distributions for a set of high-dose-rate (HDR) vaginal cylinders calculated by a commercial treatment-planning system with benchmark calculations using Monte-Carlo-calculated dosimetry data. Methods and Materials: Optimized dose distributions using both an isotropic and an anisotropic dose calculation model were obtained for a set of HDR vaginal cylinders. Mathematical optimization techniques available in the computer treatment-planning system were used to calculate dwell times and positions. These dose distributions were compared with benchmark calculations with TG43 formalism and using Monte-Carlo-calculated data. The same dwell times and positions were used for a quantitative comparison of dose calculated with three dose models. Results: The isotropic dose calculation model can result in discrepancies as high as 50%. The anisotropic dose calculation model compared better with benchmark calculations. The differences were more significant at the apex of the vaginal cylinder, which is typically used as the prescription point. Conclusion: Dose calculation models available in a computer treatment-planning system must be evaluated carefully to ensure their correct application. It should also be noted that when optimized dose distribution at a distance from the cylinder surface is calculated using an accurate dose calculation model, the vaginal mucosa dose becomes significantly higher, and therefore should be carefully monitored

Utility of two types of MR cisternography for patency evaluation of aqueduct and third ventriculostomy site: Three dimentsional sagittal fast spin echo sequence and steady-state coherent fast gradient echo sequence

Energy Technology Data Exchange (ETDEWEB)

Park, Jung Hyun; Kim, Eun Hee; Park, Jong Bin; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheol Kyu; Bae, Yun Jung; Lee, Kyung Mi [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2015-07-15

We aimed to evaluate the utility of two types of MR cisternography [fast spin echo sequence and steady-state coherent gradient echo (GRE) sequence] in addition to phase contrast-cine imaging (PC-cine), for assessing patency at the aqueduct and third ventriculostomy site. 43 patients (35 patients with suspected aqueductal stenosis and 8 patients with third ventriculostomy) were retrospectively analyzed. PC-cine, 3 dimensional sagittal fast spin echo sequence [driven-equilibrium imaging (DRIVE) or volumetric isotrophic T2-weighted acquisition (T2 VISTA)] and steady-state coherent fast GRE sequence (balanced turbo field echo; bTFE) imaging were performed in all patients. The patency of the aqueduct or third ventriculostomy site was scored. Some pitfalls of each sequence were also analyzed in individual cases. 93% of all cases showed consistent scores in PC-cine, DRIVE/T2 VISTA, and bTFE imaging. DRIVE/T2 VISTA imaging provided functional information of cerebrospinal fluid flow with flow-related artifacts, while bTFE imaging allowed direct visualization of the aqueduct or ventriculostomy site. However, evaluation of anatomical structures was difficult in three cases with strong flow-related artifacts on DRIVE/T2 VISTA and in 2 cases with susceptibility artifacts on bTFE. Both DRIVE/T2 VISTA and bTFE imaging have complementary roles in evaluating the patency of the aqueduct and 3rd ventriculostomy site.

Utility of two types of MR cisternography for patency evaluation of aqueduct and third ventriculostomy site: Three dimentsional sagittal fast spin echo sequence and steady-state coherent fast gradient echo sequence

International Nuclear Information System (INIS)

Park, Jung Hyun; Kim, Eun Hee; Park, Jong Bin; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheol Kyu; Bae, Yun Jung; Lee, Kyung Mi

2015-01-01

We aimed to evaluate the utility of two types of MR cisternography [fast spin echo sequence and steady-state coherent gradient echo (GRE) sequence] in addition to phase contrast-cine imaging (PC-cine), for assessing patency at the aqueduct and third ventriculostomy site. 43 patients (35 patients with suspected aqueductal stenosis and 8 patients with third ventriculostomy) were retrospectively analyzed. PC-cine, 3 dimensional sagittal fast spin echo sequence [driven-equilibrium imaging (DRIVE) or volumetric isotrophic T2-weighted acquisition (T2 VISTA)] and steady-state coherent fast GRE sequence (balanced turbo field echo; bTFE) imaging were performed in all patients. The patency of the aqueduct or third ventriculostomy site was scored. Some pitfalls of each sequence were also analyzed in individual cases. 93% of all cases showed consistent scores in PC-cine, DRIVE/T2 VISTA, and bTFE imaging. DRIVE/T2 VISTA imaging provided functional information of cerebrospinal fluid flow with flow-related artifacts, while bTFE imaging allowed direct visualization of the aqueduct or ventriculostomy site. However, evaluation of anatomical structures was difficult in three cases with strong flow-related artifacts on DRIVE/T2 VISTA and in 2 cases with susceptibility artifacts on bTFE. Both DRIVE/T2 VISTA and bTFE imaging have complementary roles in evaluating the patency of the aqueduct and 3rd ventriculostomy site

Reverse redistribution of thallium-201: a sign of nontransmural myocardial infarction with patency of the infarct-related coronary artery

International Nuclear Information System (INIS)

Weiss, A.T.; Maddahi, J.; Lew, A.S.; Shah, P.K.; Ganz, W.; Swan, H.J.; Berman, D.S.

1986-01-01

The pattern of reverse redistribution on the day 10 poststreptokinase resting thallium-201 myocardial scintigrams is a common finding in patients who have undergone streptokinase therapy in evolving myocardial infarction. To investigate this phenomenon, 67 patients who underwent streptokinase therapy were studied pre- and 10 days poststreptokinase therapy resting thallium-201 studies, poststreptokinase therapy resting radionuclide ventriculography and coronary arteriography (60 of the 67 patients). Of the 67 patients, 50 (75%) showed the reverse redistribution pattern on the day 10 thallium-201 study (Group I), 9 (13%) had a nonreversible defect (Group II) and the remaining 8 (12%) had a normal study or showed a reversible defect (Group III). The reverse redistribution pattern was associated with patency of the infarct-related artery (100%), quantitative improvement in resting thallium-201 defect size from day 1 to day 10 study (94%) and normal or near normal wall motion on day 10 radionuclide ventriculography (80% of segments with marked and 54% of those with mild reverse redistribution). In contrast, nonreversible defects were associated with significantly less frequent patency of the infarct-related artery (67%, p = 0.01), improvement in defect size (11%, p less than 0.001) and normal or near normal wall motion (21%, p less than 0.05). Group III patients were similar to Group I with respect to these variables. The quantitated thallium-201 percent washout was higher in the regions with the reverse redistribution pattern (49 +/- 15%) compared with the contralateral normal zone (24 +/- 15%, p less than 0.001)

Rate Optimization of Two-Way Relaying with Wireless Information and Power Transfer

Directory of Open Access Journals (Sweden)

Thinh Phu Do

2017-11-01

Full Text Available We consider the simultaneous wireless information and power transfer in two-phase decode-and-forward two-way relaying networks, where a relay harvests the energy from the signal to be relayed through either power splitting or time splitting. Here, we formulate the resource allocation problems optimizing the time-phase and signal splitting ratios to maximize the sum rate of the two communicating devices. The joint optimization problems are shown to be convex for both the power splitting and time splitting approaches after some transformation if required to be solvable with an existing solver. To lower the computational complexity, we also present the suboptimal methods optimizing the splitting ratio for the fixed time-phase and derive a closed-form solution for the suboptimal method based on the power splitting. The results demonstrate that the power splitting approaches outperform their time splitting counterparts and the suboptimal power splitting approach provides a performance close to the optimal one while reducing the complexity significantly.

Prediction on corrosion rate of pipe in nuclear power system based on optimized grey theory

International Nuclear Information System (INIS)

Chen Yonghong; Zhang Dafa; Chen Dengke; Jiang Wei

2007-01-01

For the prediction of corrosion rate of pipe in nuclear power system, the pre- diction error from the grey theory is greater, so a new method, optimized grey theory was presented in the paper. A comparison among predicted results from present and other methods was carried out, and it is seem that optimized grey theory is correct and effective for the prediction of corrosion rate of pipe in nuclear power system, and it provides a fundamental basis for the maintenance of pipe in nuclear power system. (authors)

Reward rate optimization in two-alternative decision making: empirical tests of theoretical predictions.

Science.gov (United States)

Simen, Patrick; Contreras, David; Buck, Cara; Hu, Peter; Holmes, Philip; Cohen, Jonathan D

2009-12-01

The drift-diffusion model (DDM) implements an optimal decision procedure for stationary, 2-alternative forced-choice tasks. The height of a decision threshold applied to accumulating information on each trial determines a speed-accuracy tradeoff (SAT) for the DDM, thereby accounting for a ubiquitous feature of human performance in speeded response tasks. However, little is known about how participants settle on particular tradeoffs. One possibility is that they select SATs that maximize a subjective rate of reward earned for performance. For the DDM, there exist unique, reward-rate-maximizing values for its threshold and starting point parameters in free-response tasks that reward correct responses (R. Bogacz, E. Brown, J. Moehlis, P. Holmes, & J. D. Cohen, 2006). These optimal values vary as a function of response-stimulus interval, prior stimulus probability, and relative reward magnitude for correct responses. We tested the resulting quantitative predictions regarding response time, accuracy, and response bias under these task manipulations and found that grouped data conformed well to the predictions of an optimally parameterized DDM.

[Is smoking cigarettes affects the nasal patency in the light of the project ECAP (Epidemiology of Allergic Diseases in Poland) in the Polish population in 2006-2009?].

Science.gov (United States)

Krzych-Fałta, Edyta; Samoliński, Bołestaw

2013-01-01

The purpose of the study was an attempt to estimate the impact of tobacco smoke on the nasal patency in the light of the ECAP study. The subjects in the study was a group of 4674 people, including 1291 children aged 6-7 years (643 girls and 648 boys), 1293 children aged 13-14 years (625 girls, 668 boys) and 2090 adults (1284 women, 806 men). The research method used in the study was the measurement of the peak nasal flow using a peak flow meter with a dedicated mask used in rhinomanometry tests, with a measurement scale of 20-350 l/min. The study was carried out in 2006-2007, in the following cities Katowice, Wrocław, Kraków, Lublin, Warszawa, Bydgoszcz, Gdańsk, and in the rural areas of the former Zamojskie province. For the purposes of the study, the average PNIF levels were calculated for the subjects in terms of the following criteria: age: In the case of the children aged 6-7 years (n=1291), the average PNIF level was 52.4 I/min. For the children aged 13-14 years (n=1291), the average level was 94.7 l/min., and in the case of adults (n=2090)--approx. 108.0 l/min. gender: The nasal patency level was definitely higher in the male subjects than in the female subjects in all the age groups. passive smokers: 105.3 l/min (n=1202) and active smokers: 119.1 l/min (n=885). The possible effect of tobacco smoke on nasal patency in the population included in the study is not a direct risk factor in breathing disorders.

Optimal Foreign Exchange Rate Intervention in Lévy Markets

Directory of Open Access Journals (Sweden)

Masimba Aspinas Mutakaya

2014-01-01

Full Text Available This paper considers an exchange rate problem in Lévy markets, where the Central Bank has to intervene. We assume that, in the absence of control, the exchange rate evolves according to Brownian motion with a jump component. The Central Bank is allowed to intervene in order to keep the exchange rate as close as possible to a prespecified target value. The interventions by the Central Bank are associated with costs. We present the situation as an impulse control problem, where the objective of the bank is to minimize the intervention costs. In particular, the paper extends the model by Huang, 2009, to incorporate a jump component. We formulate and prove an optimal verification theorem for the impulse control. We then propose an impulse control and construct a value function and then verify that they solve the quasivariational inequalities. Our results suggest that if the expected number of jumps is high the Central Bank will intervene more frequently and with large intervention amounts hence the intervention costs will be high.

Estimation of an optimal chemotherapy utilisation rate for cancer: setting an evidence-based benchmark for quality cancer care.

Science.gov (United States)

Jacob, S A; Ng, W L; Do, V

2015-02-01

There is wide variation in the proportion of newly diagnosed cancer patients who receive chemotherapy, indicating the need for a benchmark rate of chemotherapy utilisation. This study describes an evidence-based model that estimates the proportion of new cancer patients in whom chemotherapy is indicated at least once (defined as the optimal chemotherapy utilisation rate). The optimal chemotherapy utilisation rate can act as a benchmark for measuring and improving the quality of care. Models of optimal chemotherapy utilisation were constructed for each cancer site based on indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient- and tumour-related attributes for which chemotherapy was indicated were obtained, using population-based data where possible. Treatment indications and epidemiological data were merged to calculate the optimal chemotherapy utilisation rate. Monte Carlo simulations and sensitivity analyses were used to assess the effect of controversial chemotherapy indications and variations in epidemiological data on our model. Chemotherapy is indicated at least once in 49.1% (95% confidence interval 48.8-49.6%) of all new cancer patients in Australia. The optimal chemotherapy utilisation rates for individual tumour sites ranged from a low of 13% in thyroid cancers to a high of 94% in myeloma. The optimal chemotherapy utilisation rate can serve as a benchmark for planning chemotherapy services on a population basis. The model can be used to evaluate service delivery by comparing the benchmark rate with patterns of care data. The overall estimate for other countries can be obtained by substituting the relevant distribution of cancer types. It can also be used to predict future chemotherapy workload and can be easily modified to take into account future changes in cancer incidence, presentation stage or chemotherapy indications. Copyright © 2014 The Royal College of Radiologists. Published by

Heparin-bonded, expanded polytetrafluoroethylene-lined stent graft in the treatment of femoropopliteal artery disease: 1-year results of the VIPER (Viabahn Endoprosthesis with Heparin Bioactive Surface in the Treatment of Superficial Femoral Artery Obstructive Disease) trial.

Science.gov (United States)

Saxon, Richard R; Chervu, Arun; Jones, Paul A; Bajwa, Tanvir K; Gable, Dennis R; Soukas, Peter A; Begg, Richard J; Adams, John G; Ansel, Gary M; Schneider, Darren B; Eichler, Charles M; Rush, Michael J

2013-02-01

To evaluate the performance of a heparin-bonded, expanded polytetrafluoroethylene (ePTFE)-lined nitinol endoprosthesis in the treatment of long-segment occlusive disease of the femoropopliteal artery (FPA) and to identify factors associated with loss of patency. In a single-arm, prospective, 11-center study (VIPER [Gore Viabahn Endoprosthesis with Heparin Bioactive Surface in the Treatment of Superficial Femoral Artery Obstructive Disease] trial), 119 limbs (113 patients; 69 men; mean age, 67 y), including 88 with Rutherford category 3-5 disease and 72 with Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) C or D lesions of the FPA, underwent stent graft implantation. The mean lesion length was 19 cm; 56% of lesions were occlusions. Follow-up evaluations included color duplex ultrasonography in all patients, with patency defined as a peak systolic velocity ratio20% was 70% (P = .047). Primary patency was not significantly affected by device diameter (5 vs 6 vs 7 mm) or lesion length (≤20 cm vs>20 cm). The 30-day major adverse event rate was 0.8%. The heparin-bonded, ePTFE/nitinol stent graft provided clinical improvement and a primary patency rate of 73% at 1 year in the treatment of long-segment FPA disease. Careful sizing of the device relative to vessel landing zones is essential for achieving optimal outcomes. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

Prediction of pilot opinion ratings using an optimal pilot model. [of aircraft handling qualities in multiaxis tasks

Science.gov (United States)

Hess, R. A.

1977-01-01

A brief review of some of the more pertinent applications of analytical pilot models to the prediction of aircraft handling qualities is undertaken. The relative ease with which multiloop piloting tasks can be modeled via the optimal control formulation makes the use of optimal pilot models particularly attractive for handling qualities research. To this end, a rating hypothesis is introduced which relates the numerical pilot opinion rating assigned to a particular vehicle and task to the numerical value of the index of performance resulting from an optimal pilot modeling procedure as applied to that vehicle and task. This hypothesis is tested using data from piloted simulations and is shown to be reasonable. An example concerning a helicopter landing approach is introduced to outline the predictive capability of the rating hypothesis in multiaxis piloting tasks.

An artificial intelligence (AI) NOx/heat rate optimization system for Ontario Hydro`s fossil generating stations

Energy Technology Data Exchange (ETDEWEB)

Luk, J.; Frank, A.; Bodach, P. [Ontario Hydro, Toronto, ON (Canada); Warriner, G. [Radian International, Tucker, GA (United States); Noblett, J. [Radian International, Austin, TX (United States); Slatsky, M. [Southern Company, Birmingham, AL (United States)

1999-08-01

Artificial intelligence (AI)-based software packages which can optimize power plant operations that improves heat rate and also reduces nitrogen oxide emissions are now commonly available for commercial use. This paper discusses the implementation of the AI-based NOx and Heat Rate Optimization System at Ontario Hydro`s generation stations, emphasizing the current AI Optimization Project at Units 5 and 6 of the Lakeview Generating Station. These demonstration programs are showing promising results in NOx reduction and plant performance improvement. The availability of the plant Digital Control System (DCS) in implementing AI optimization in a closed-loop system was shown to be an important criterion for success. Implementation of AI technology at other Ontario Hydro fossil generating units as part of the overall NOx emission reduction system is envisaged to coincide with the retrofit of the original plant control system with the latest DCS systems. 14 refs., 3 figs.

A Three-Stage Optimization Algorithm for the Stochastic Parallel Machine Scheduling Problem with Adjustable Production Rates

Directory of Open Access Journals (Sweden)

Rui Zhang

2013-01-01

Full Text Available We consider a parallel machine scheduling problem with random processing/setup times and adjustable production rates. The objective functions to be minimized consist of two parts; the first part is related with the due date performance (i.e., the tardiness of the jobs, while the second part is related with the setting of machine speeds. Therefore, the decision variables include both the production schedule (sequences of jobs and the production rate of each machine. The optimization process, however, is significantly complicated by the stochastic factors in the manufacturing system. To address the difficulty, a simulation-based three-stage optimization framework is presented in this paper for high-quality robust solutions to the integrated scheduling problem. The first stage (crude optimization is featured by the ordinal optimization theory, the second stage (finer optimization is implemented with a metaheuristic called differential evolution, and the third stage (fine-tuning is characterized by a perturbation-based local search. Finally, computational experiments are conducted to verify the effectiveness of the proposed approach. Sensitivity analysis and practical implications are also discussed.

Optimization and phase matching of fiber-laser-driven high-order harmonic generation at high repetition rate.

Science.gov (United States)

Cabasse, Amélie; Machinet, Guillaume; Dubrouil, Antoine; Cormier, Eric; Constant, Eric

2012-11-15

High-repetition-rate sources are very attractive for high-order harmonic generation (HHG). However, due to their pulse characteristics (low energy, long duration), those systems require a tight focusing geometry to achieve the necessary intensity to generate harmonics. In this Letter, we investigate theoretically and experimentally the optimization of HHG in this geometry, to maximize the extreme UV (XUV) photon flux and improve the conversion efficiency. We analyze the influence of atomic gas media (Ar, Kr, or Xe), gas pressure, and interaction geometries (a gas jet and a finite and a semi-infinite gas cell). Numerical simulations allow us to define optimal conditions for HHG in this tight focusing regime and to observe the signature of on-axis phase matching. These conditions are implemented experimentally using a high-repetition-rate Yb-doped fiber laser system. We achieve optimization of emission with a recorded XUV photon flux of 4.5×10(12) photons/s generated in Xe at 100 kHz repetition rate.

The Impact of Anastomotic Angle for Re-Occlusion of Brachioaxillary Graft Arteriovenous Fistula after Percutaneous Thromboaspiration

Energy Technology Data Exchange (ETDEWEB)

Kim, Keon Young; Jin, Gong Yong; Hwang, Seung Bae; Choi, Eun Jung; Song, Ji Soo; Han, Young Min; Kwon, Keun Sang [Chonbuk National University Hospital and Medical School, Jeonju (Korea, Republic of)

2013-03-15

The purpose of this study is to evaluate the factors that affect graft patency in brachioaxillary graft arteriovenous fistula patients. A retrospective study was conducted on 33 patients (20 men, 13 women; mean age, 67.5 years; mean interval to first stenosis, 17 months), who had performed percutaneous angioplasty for first episode of stenosis after brachioaxillary graft surgery. We evaluated the relevant factors affecting the graft patency after first episode of stenosis, such as age, sex, underlying disease (hypertension, diabetes mellitus, hyperlipidemia, cardiovascular disease, cerebrovascular attack), anastomotic angle between graft and axillary vein, and anastomotic angle between the graft and brachial artery. Kaplan-Meier method and log rank test and receiver operating characteristics curve analysis were used in statistical analysis. Graft patency rates after 1 month, 6 months, and 12 months were 75.8%, 39.4%, and 9.1%. There was a correlation between graft-axillary vein anastomotic angle and patency rates (r = 0.372, p = 0.033); larger the venous anastomotic angle, the longer patency rate. However, it does not come up with significant results in patency rates on age, sex, underlying disease, and graft-brachial artery angle. In patients with brachioaxillary graft arteriovenous fistula, as venous anastomotic angle more obtuse, the graft patency may be longer.

Multidetector-row computed tomography coronary angiography. Optimization of image reconstruction phase according to the heart rate

International Nuclear Information System (INIS)

Nagatani, Yukihiro; Takahashi, Masashi; Takazakura, Ryutaro; Nitta, Norihisa; Murata, Kiyoshi; Ushio, Noritoshi; Matsuo, Shinro; Yamamoto, Takashi; Horie, Minoru

2007-01-01

The purpose of this study was to optimize the image reconstruction phase of multidetector-row computed tomography (MDCT) coronary angiography according to the heart rate is crucial. Scan data were reconstructed for 10 different phases in 58 sequential patients who under went 8-row cardiac MDCT. The obtained images were scored and compared in terms of motion artifacts and visibility of the vessels, and moreover, electrocardiogram (ECG) record-based evaluations were added for clarification of the temporal relationships among these 10 phases. In the cases with lower heart rates ( 65 beats/mm), they were obtained in the late systolic period. As the heart rate increased, the optimal image reconstruction phase changed from mid diastole to late systole. However, it is recommended to try to decrease the heart rate of patients before data acquisition. (author)

The optimal fraction size in high-dose-rate brachytherapy: dependency on tissue repair kinetics and low-dose rate

International Nuclear Information System (INIS)

Sminia, Peter; Schneider, Christoph J.; Fowler, Jack F.

2002-01-01

Background and Purpose: Indications of the existence of long repair half-times on the order of 2-4 h for late-responding human normal tissues have been obtained from continuous hyperfractionated accelerated radiotherapy (CHART). Recently, these data were used to explain, on the basis of the biologically effective dose (BED), the potential superiority of fractionated high-dose rate (HDR) with large fraction sizes of 5-7 Gy over continuous low-dose rate (LDR) irradiation at 0.5 Gy/h in cervical carcinoma. We investigated the optimal fraction size in HDR brachytherapy and its dependency on treatment choices (overall treatment time, number of HDR fractions, and time interval between fractions) and treatment conditions (reference low-dose rate, tissue repair characteristics). Methods and Materials: Radiobiologic model calculations were performed using the linear-quadratic model for incomplete mono-exponential repair. An irradiation dose of 20 Gy was assumed to be applied either with HDR in 2-12 fractions or continuously with LDR for a range of dose rates. HDR and LDR treatment regimens were compared on the basis of the BED and BED ratio of normal tissue and tumor, assuming repair half-times between 1 h and 4 h. Results: With the assumption that the repair half-time of normal tissue was three times longer than that of the tumor, hypofractionation in HDR relative to LDR could result in relative normal tissue sparing if the optimum fraction size is selected. By dose reduction while keeping the tumor BED constant, absolute normal tissue sparing might therefore be achieved. This optimum HDR fraction size was found to be largely dependent on the LDR dose rate. On the basis of the BED NT/TUM ratio of HDR over LDR, 3 x 6.7 Gy would be the optimal HDR fractionation scheme for replacement of an LDR scheme of 20 Gy in 10-30 h (dose rate 2-0.67 Gy/h), while at a lower dose rate of 0.5 Gy/h, four fractions of 5 Gy would be preferential, still assuming large differences between tumor

Cut-off Grade Optimization for Maximizing the Output Rate

Directory of Open Access Journals (Sweden)

A. Khodayari

2012-12-01

Full Text Available In the open-pit mining, one of the first decisions that must be made in production planning stage, after completing the design of final pit limits, is determining of the processing plant cut-off grade. Since this grade has an essential effect on operations, choosing the optimum cut-off grade is of considerable importance. Different goals may be used for determining optimum cut-off grade. One of these goals may be maximizing the output rate (amount of product per year, which is very important, especially from marketing and market share points of view. Objective of this research is determining the optimum cut-off grade of processing plant in order to maximize output rate. For performing this optimization, an Operations Research (OR model has been developed. The object function of this model is output rate that must be maximized. This model has two operational constraints namely mining and processing restrictions. For solving the model a heuristic method has been developed. Results of research show that the optimum cut-off grade for satisfying pre-stated goal is the balancing grade of mining and processing operations, and maximum production rate is a function of the maximum capacity of processing plant and average grade of ore that according to the above optimum cut-off grade must be sent to the plant.

Optimization of the RF cavity heat load and trip rates for CEBAF at 12 GeV

Energy Technology Data Exchange (ETDEWEB)

Zhang, He [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Roblin, Yves R. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Freyberger, Arne P. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Krafft, Geoffrey A. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Terzic, Balsa P. [Old Dominion Univ., Norfolk, VA (United States)

2017-05-01

The Continuous Electron Beam Accelerator Facility at JLab has 200 RF cavities in the north linac and the south linac respectively after the 12 GeV upgrade. The purpose of this work is to simultaneously optimize the heat load and the trip rate for the cavities and to reconstruct the pareto-optimal front in a timely manner when some of the cavities are turned down. By choosing an efficient optimizer and strategically creating the initial gradients, the pareto-optimal front for no more than 15 cavities down can be re-established within 20 seconds.

Measurement of glomerular filtration rate by impulse synthesis: Clinical validation and optimization

International Nuclear Information System (INIS)

Palagi, B.; Verga, P.; Broggi, A.; Picozzi, R.; Villa, F.; Guzzini, F.; Cozzi, C.; Tomasi, A.

1988-01-01

Impulse synthesis is a technique which relies upon the logic of continuous infusion but extracts the clearance value from single-injection data by shifting and adding them until an asymptotic value is attained. This study has been aimed at validating and optimizing clinically the measurement of glomerular filtration rate by impulse synthesis. A single intravenous injection of 51 Cr-EDTA has been made in 32 patients and plasma activity monitored over the next 6 h. Glomerular filtration rate computed by a single-exponential fit method (GFR-SEF) has been shown to be significantly (p [de

On-rate based optimization of structure-kinetic relationship--surfing the kinetic map.

Science.gov (United States)

Schoop, Andreas; Dey, Fabian

2015-10-01

In the lead discovery process residence time has become an important parameter for the identification and characterization of the most efficacious compounds in vivo. To enable the success of compound optimization by medicinal chemistry toward a desired residence time the understanding of structure-kinetic relationship (SKR) is essential. This article reviews various approaches to monitor SKR and suggests using the on-rate as the key monitoring parameter. The literature is reviewed and examples of compound series with low variability as well as with significant changes in on-rates are highlighted. Furthermore, findings of kinetic on-rate changes are presented and potential underlying rationales are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prediction of Optimal Designs for Material Removal Rate and Surface Roughness Characteristics

Directory of Open Access Journals (Sweden)

Maheswara Rao Ch

2016-12-01

Full Text Available The present work involves in finding the optimal combination of cutting parameters, in dry turning of EN19 steel using a tungsten carbide tool of nose radius 0.4 mm. The experiments were conducted on a CNC turret lathe as per the designed L9 (3^3 orthogonal array. In order to optimize the Material Removal Rate (MRR, Arithmetic Average Roughness (Ra and Average Peak-to-Valley Height Roughness (Rz individually, Single objective Taguchi method has been employed. From the results, the optimal combination of cutting parameters for MRR is found at: 225 m/min, 0.15 mm/rev and 0.6 mm. Optimal combination of Ra and Rz is found at: 225 m/min, 0.05 mm/rev and 0.6 mm. Analysis of variance (ANOVA is used to find the influence of cutting parameters on the responses. ANOVA results revealed that speed and feed has high influence on MRR. Speed has high influence in affecting the Roughness parameters. Linear regression models for the responses were prepared using the MINITAB-16 software. From the results, it is found that the models prepared are more significant and accurate.

Subzero water permeability parameters and optimal freezing rates for sperm cells of the southern platyfish, Xiphophorus maculatus.

Science.gov (United States)

Pinisetty, D; Huang, C; Dong, Q; Tiersch, T R; Devireddy, R V

2005-06-01

This study reports the subzero water transport characteristics (and empirically determined optimal rates for freezing) of sperm cells of live-bearing fishes of the genus Xiphophorus, specifically those of the southern platyfish Xiphophorus maculatus. These fishes are valuable models for biomedical research and are commercially raised as ornamental fish for use in aquariums. Water transport during freezing of X. maculatus sperm cell suspensions was obtained using a shape-independent differential scanning calorimeter technique in the presence of extracellular ice at a cooling rate of 20 degrees C/min in three different media: (1) Hanks' balanced salt solution (HBSS) without cryoprotective agents (CPAs); (2) HBSS with 14% (v/v) glycerol, and (3) HBSS with 10% (v/v) dimethyl sulfoxide (DMSO). The sperm cell was modeled as a cylinder with a length of 52.35 microm and a diameter of 0.66 microm with an osmotically inactive cell volume (Vb) of 0.6 V0, where V0 is the isotonic or initial cell volume. This translates to a surface area, SA to initial water volume, WV ratio of 15.15 microm(-1). By fitting a model of water transport to the experimentally determined volumetric shrinkage data, the best fit membrane permeability parameters (reference membrane permeability to water at 0 degrees C, Lpg or Lpg [cpa] and the activation energy, E(Lp) or E(Lp) [cpa]) were found to range from: Lpg or Lpg [cpa] = 0.0053-0.0093 microm/minatm; E(Lp) or E(Lp) [cpa] = 9.79-29.00 kcal/mol. By incorporating these membrane permeability parameters in a recently developed generic optimal cooling rate equation (optimal cooling rate, [Formula: see text] where the units of B(opt) are degrees C/min, E(Lp) or E(Lp) [cpa] are kcal/mol, L(pg) or L(pg) [cpa] are microm/minatm and SA/WV are microm(-1)), we determined the optimal rates of freezing X. maculatus sperm cells to be 28 degrees C/min (in HBSS), 47 degrees C/min (in HBSS+14% glycerol) and 36 degrees C/min (in HBSS+10% DMSO). Preliminary empirical

The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial.

Science.gov (United States)

Lindholt, J S; Gottschalksen, B; Johannesen, N; Dueholm, D; Ravn, H; Christensen, E D; Viddal, B; Flørenes, T; Pedersen, G; Rasmussen, M; Carstensen, M; Grøndal, N; Fasting, H

2011-05-01

To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study. Eleven Scandinavian centres enrolled 569 patients with chronic functional or critical lower limb ischaemia who were scheduled to undergo femoro-femoral bypass or femoro-poplitaeal bypass. The patients were randomised 1:1 stratified by centre. Patency was assessed by duplex ultrasound scanning. A total of 546 patients (96%) completed the study with adequate follow-up. Perioperative bleeding was, on average, 370 ml with PTFE grafts and 399 ml with Heparin-bonded PTFE grafts (p = 0.32). Overall, primary patency after 1 year was 86.4% for Hb-PTFE grafts and 79.9% for PTFE grafts (OR = 0.627, 95% CI: 0.398; 0.989, p = 0.043). Secondary patency was 88% in Hb-PTFE grafts and 81% in PTFE grafts (OR = 0.569 (0.353; 0.917, p = 0.020)). Subgroup analyses revealed that significant reduction in risk (50%) was observed when Hb-PTFE was used for femoro-poplitaeal bypass (OR = 0.515 (0.281; 0.944, p = 0.030)), and a significant reduction in risk (50%) was observed with Hb-PTFE in cases with critical ischaemia (OR = 0.490 (0.249; 0.962, p = 0.036)). The Hb-PTFE graft significantly reduced the overall risk of primary graft failure by 37%. Risk reduction was 50% in femoro-poplitaeal bypass cases and in cases with critical ischaemia. Copyright © 2011. Published by Elsevier Ltd.

Conversion Rate Optimization through Evolutionary Computation

OpenAIRE

Miikkulainen, Risto; Iscoe, Neil; Shagrin, Aaron; Cordell, Ron; Nazari, Sam; Schoolland, Cory; Brundage, Myles; Epstein, Jonathan; Dean, Randy; Lamba, Gurmeet

2017-01-01

Conversion optimization means designing a web interface so that as many users as possible take a desired action on it, such as register or purchase. Such design is usually done by hand, testing one change at a time through A/B testing, or a limited number of combinations through multivariate testing, making it possible to evaluate only a small fraction of designs in a vast design space. This paper describes Sentient Ascend, an automatic conversion optimization system that uses evolutionary op...

One-week postoperative patency of lower extremity in situ bypass graft comparing epidural and general anesthesia

DEFF Research Database (Denmark)

Wiis, Julie Therese; Jensen-Gadegaard, Peter; Altintas, Ümit

2014-01-01

BACKGROUND: The purpose of this study was to determine whether anesthesia affects graft patency after lower extremity arterial in situ bypass surgery. METHODS: This investigation was a retrospective study using a national database on vascular surgical patients at a single medical institution. We...... under epidural (n = 386) or general (n = 499) anesthesia. Thirty-day mortality (3.4% for epidural anesthesia versus 4.4% general anesthesia; P = 0.414) and comorbidity were comparable in the 2 groups. Graft occlusion within 7 days after surgery was reported in 93 patients, with a similar incidence...... in the epidural (10.1%) and general (10.8%) anesthesia groups (P = 0.730). When examining a subgroup of patients (n = 242) exposed to surgery on smaller vessels (femorodistal in situ bypass procedures, n = 253), the incidence of graft occlusion was also similar in the 2 groups at 14.0% and 9.4%, respectively (P...

Clinical Results of Arteriovenous Fistulas Constructed Using Autologous Vessels in End-Stage Renal Disease Patients on Hemodialysis

Directory of Open Access Journals (Sweden)

Ki Tae Kim

2018-04-01

Full Text Available Background: For hemodialysis patients with end-stage renal disease (ESRD, it is important to construct an efficient vascular access with a superior patency rate. This study investigated the factors influencing the efficiency of arteriovenous fistulas (AVFs constructed using an autologous vessel and evaluated the necessity of ultrasonography as a preoperative tool for AVF construction. Methods: A retrospective analysis was performed of 250 patients in whom an AVF was constructed using an autologous vessel due to ESRD at our institution from January 2009 to April 2016. Results: The 1-, 3-, and 5-year patency rates for all subjects were 87.6%, 85.6%, and 84.4%, respectively. The patients who underwent a preoperative evaluation of their vessels via ultrasonography had better patency rates than those who did not. Superior patency rates were found in patients under 65 years of age or with an anastomotic vein diameter of 3 mm or more. The 1-year patency rate and the diameter of the anastomotic vein showed a positive relationship. Conclusion: Ultrasonography is strongly recommended for AVF construction, and efforts should be made to increase the patency rate in patients over 65. Superior clinical results can be expected when an AVF is made using an autologous vessel with an anastomotic vein diameter of at least 3 mm.

Making the Most of the "Daphnia" Heart Rate Lab: Optimizing the Use of Ethanol, Nicotine & Caffeine

Science.gov (United States)

Corotto, Frank; Ceballos, Darrel; Lee, Adam; Vinson, Lindsey

2010-01-01

Students commonly test the effects of chemical agents on the heart rate of the crustacean "Daphnia" magna, but the procedure has never been optimized. We determined the effects of three concentrations of ethanol, nicotine, and caffeine and of a control solution on heart rate in "Daphnia." Ethanol at 5% and 10% (v/v) reduced mean heart rate to…

Eph-B4 regulates adaptive venous remodeling to improve arteriovenous fistula patency

OpenAIRE

Protack, Clinton D.; Foster, Trenton R.; Hashimoto, Takuya; Yamamoto, Kota; Lee, Monica Y.; Kraehling, Jan R.; Bai, Hualong; Hu, Haidi; Isaji, Toshihiko; Santana, Jeans M.; Wang, Mo; Sessa, William C.; Dardik, Alan

2017-01-01

Low rates of arteriovenous fistula (AVF) maturation prevent optimal fistula use for hemodialysis; however, the mechanism of venous remodeling in the fistula environment is not well understood. We hypothesized that the embryonic venous determinant Eph-B4 mediates AVF maturation. In human AVF and a mouse aortocaval fistula model, Eph-B4 protein expression increased in the fistula vein; expression of the arterial determinant Ephrin-B2 also increased. Stimulation of Eph-B-mediated signaling with ...

Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

International Nuclear Information System (INIS)

Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung

2003-01-01

To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

Energy Technology Data Exchange (ETDEWEB)

Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

2003-10-01

To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

Optimal carbon emissions trajectories when damages depend on the rate or level of global warming

International Nuclear Information System (INIS)

Peck, S.C.; Teisberg, T.J.

1994-01-01

The authors extend earlier work with the Carbon Emissions Trajectory Assessment model (CETA) to consider a number of issues relating to the nature of optimal carbon emissions trajectories. They first explore model results when warming costs are associated with the rate of temperature rise, rather than with its level, as in earlier work. It is found that optimal trajectories are more strongly affected by the degree of non-linearity in the warming cost function than by whether the cost function is driven by the warming level or the warming rate. The authors briefly explore the implications of simple uncertainty and risk aversion for optimal emissions trajectories to be somewhat lower, but that the effect is not noticeable in the near term and not dramatic in the long term; the long term effect on the shadow price of carbon is more marked, however. Finally, they experiment with scaling up the warming cost functions until optimal policies are approximately the same as a policy of stabilising emissions at the 1990 level. Based on the results of this experiment, it is concluded that damages would have to be very high to justify anything like a stabilization policy; and even in this case, a policy allowing intertemporal variation in emissions would be better. 18 refs., 15 figs

Treating peripheral arterial disease percutaneously with atherectomy.

Science.gov (United States)

Schwartz, Bryan G; Kloner, Robert A; Burstein, Steven; Economides, Christina; Mayeda, Guy S

2012-06-01

To determine clinical outcomes of patients who underwent percutaneous revascularization (PR) with multiple devices. PR cases at a private, tertiary referral hospital were reviewed retrospectively. Limb salvage and patency rates were calculated by the Kaplan Meier method. Historical and procedural factors were analyzed by multivariate Cox proportional hazards models. We identified 66 patients and 87 limbs with 261 lesions, including 38 patients with critical limb ischemia (CLI) (51 limbs, 171 lesions). PR incorporated multiple devices (2.0 ± 1.2 devices/lesion, 2.4 ± 1.6 devices/procedure), including balloon angioplasty (57%), excisional atherectomy (54%), orbital atherectomy (44%), and stenting (13%). Last imaged patency was at 18 ± 13 months and last clinical follow-up was 22 ± 12 months. Thirty-five of 87 limbs had ≥1 repeat PR. In 51 limbs with CLI, limb salvage was 75% at 3 years. Independent predictors of amputation were higher creatinine (P=.01; hazard ratio [HR], 1.4), Rutherford category (P=.03; HR, 3.5), and history of coronary artery bypass graft (CABG) (P=.03; HR, 8.9). Overall patency remained 75% through 3 years. Loss of patency or primary patency (patency without repeat PR) was predicted by higher creatinine, Rutherford category, chronic total occlusion, history of CABG, female gender, current and past smoking. Use of excisional atherectomy maintained overall patency (P=.01; HR, 0.36). An aggressive approach to PR with frequent use of atherectomy resulted in high rates of limb salvage and patency. Smoking cessation and excisional atherectomy may improve patency rates.

Joint sensor location/power rating optimization for temporally-correlated source estimation

KAUST Repository

Bushnaq, Osama M.

2017-12-22

The optimal sensor selection for scalar state parameter estimation in wireless sensor networks is studied in the paper. A subset of N candidate sensing locations is selected to measure a state parameter and send the observation to a fusion center via wireless AWGN channel. In addition to selecting the optimal sensing location, the sensor type to be placed in these locations is selected from a pool of T sensor types such that different sensor types have different power ratings and costs. The sensor transmission power is limited based on the amount of energy harvested at the sensing location and the type of the sensor. The Kalman filter is used to efficiently obtain the MMSE estimator at the fusion center. Sensors are selected such that the MMSE estimator error is minimized subject to a prescribed system budget. This goal is achieved using convex relaxation and greedy algorithm approaches.

Looking for the optimal rate of recombination for evolutionary dynamics

Science.gov (United States)

Saakian, David B.

2018-01-01

We consider many-site mutation-recombination models of evolution with selection. We are looking for situations where the recombination increases the mean fitness of the population, and there is an optimal recombination rate. We found two fitness landscapes supporting such nonmonotonic behavior of the mean fitness versus the recombination rate. The first case is related to the evolution near the error threshold on a neutral-network-like fitness landscape, for moderate genome lengths and large population. The more realistic case is the second one, in which we consider the evolutionary dynamics of a finite population on a rugged fitness landscape (the smooth fitness landscape plus some random contributions to the fitness). We also give the solution to the horizontal gene transfer model in the case of asymmetric mutations. To obtain nonmonotonic behavior for both mutation and recombination, we need a specially designed (ideal) fitness landscape.

Factors associated with outcome of endovascular treatment of iliac occlusive disease: a single-center experience

Directory of Open Access Journals (Sweden)

Rafael de Athayde Soares

2018-04-01

Full Text Available Abstract Background Endovascular treatment (ET of iliac occlusive disease (IOD is well established in literature. Use of stents in IOD has achieved long-term limb salvage and patency rates similar to those of open surgery, with lower morbidity and mortality rates. Objectives To report the long-term outcomes, particularly limb salvage and patency rates, of ET for IOD and the factors associated with these outcomes. Methods This retrospective cohort study included patients with IOD who underwent iliac angioplasty (IA, between January 2009 and January 2015. Patients with critical limb ischemia or incapacitating claudication were included. Results In total, 48 IA procedures were performed in 46 patients, with an initial technical success rate of 95.83%. Failure occurred in two patients, who were excluded, leaving 44 patients and 46 IA. The primary patency, secondary patency, limb salvage, and survival rates at 1200 days were 88%, 95.3%, 86.3%, and 69.9%, respectively. Univariate and multivariate Cox regression revealed that the primary patency rate was significantly worse in patients with TASC type C/D than in patients with TASC type A/B (p = 0.044. Analysis of factors associated with major amputation using Cox regression showed that the rate of limb loss was greater in patients with TASC type C/D (p = 0.043. Male gender was associated with reduced survival (p = 0.011. Conclusions TASC type C/D was associated with a higher number of reinterventions and with worse limb loss and primary patency rates. Male gender was associated with a worse survival rate after ET of IOD.

An Evaluation of the Use of Simulated Annealing to Optimize Thinning Rates for Single Even-Aged Stands

Directory of Open Access Journals (Sweden)

Kai Moriguchi

2015-01-01

Full Text Available We evaluated the potential of simulated annealing as a reliable method for optimizing thinning rates for single even-aged stands. Four types of yield models were used as benchmark models to examine the algorithm’s versatility. Thinning rate, which was constrained to 0–50% every 5 years at stand ages of 10–45 years, was optimized to maximize the net present value for one fixed rotation term (50 years. The best parameters for the simulated annealing were chosen from 113 patterns, using the mean of the net present value from 39 runs to ensure the best performance. We compared the solutions with those from coarse full enumeration to evaluate the method’s reliability and with 39 runs of random search to evaluate its efficiency. In contrast to random search, the best run of simulated annealing for each of the four yield models resulted in a better solution than coarse full enumeration. However, variations in the objective function for two yield models obtained with simulated annealing were significantly larger than those of random search. In conclusion, simulated annealing with optimized parameters is more efficient for optimizing thinning rates than random search. However, it is necessary to execute multiple runs to obtain reliable solutions.

The Effect of a Reconstruction Technique and Heart Rate in the Evaluation of Optimal Trigger Delay Using Multiphase Reconstruction

International Nuclear Information System (INIS)

Cho, Young Jun

2008-01-01

To evaluate the mean optimal trigger delays and the difference between the absolute delay and the relative delay as a function of heart rate, using multiphase reconstruction. A total of 30 patients consecutively underwent a 64-slice MDCT examination. Optimal trigger delays at four planes (the bifurcation of the left main coronary artery, aortic valve, mitral valve and cardiac apex) were measured using multiphase reconstruction based on the absolute and relative delay. For this reason, patients were divided into three groups according to heart rate (group I, < 65 bpm; group II, 65-74 bpm; group III, ≥ 75 bpm), and the mean optimal trigger delays and the difference between the absolute delay and the relative delay were evaluated at the four planes for each group. The mean optimal trigger delay for the relative delay and absolute delay ranged from 46% to 66% and from 327 to 700 msec, respectively. The differences in the mean optimal trigger delay using the relative and the absolute delay at the four planes were 1% and 4 msec (group I), 3% and 27 msec (group II), and 14% and 46 msec (group III). In group III, the difference of the mean optimal trigger delay based on the relative delay, increased significantly compared to the absolute delay (p = 0.040). For the patients analyzed, the results suggest that as the heart rate increased, the mean optimal trigger delays shifted from the mid-diastolic phase to the end-systolic phase and the differences in the mean optimal trigger delay at the four planes were significantly greater for the relative delay

A Computational Framework to Optimize Subject-Specific Hemodialysis Blood Flow Rate to Prevent Intimal Hyperplasia

Science.gov (United States)

Mahmoudzadeh, Javid; Wlodarczyk, Marta; Cassel, Kevin

2017-11-01

Development of excessive intimal hyperplasia (IH) in the cephalic vein of renal failure patients who receive chronic hemodialysis treatment results in vascular access failure and multiple treatment complications. Specifically, cephalic arch stenosis (CAS) is known to exacerbate hypertensive blood pressure, thrombosis, and subsequent cardiovascular incidents that would necessitate costly interventional procedures with low success rates. It has been hypothesized that excessive blood flow rate post access maturation which strongly violates the venous homeostasis is the main hemodynamic factor that orchestrates the onset and development of CAS. In this article, a computational framework based on a strong coupling of computational fluid dynamics (CFD) and shape optimization is proposed that aims to identify the effective blood flow rate on a patient-specific basis that avoids the onset of CAS while providing the adequate blood flow rate required to facilitate hemodialysis. This effective flow rate can be achieved through implementation of Miller's surgical banding method after the maturation of the arteriovenous fistula and is rooted in the relaxation of wall stresses back to a homeostatic target value. The results are indicative that this optimized hemodialysis blood flow rate is, in fact, a subject-specific value that can be assessed post vascular access maturation and prior to the initiation of chronic hemodialysis treatment as a mitigative action against CAS-related access failure. This computational technology can be employed for individualized dialysis treatment.

Prosthetic above-knee femoropopliteal bypass grafting: five-year results of a randomized trial.

Science.gov (United States)

Green, R M; Abbott, W M; Matsumoto, T; Wheeler, J R; Miller, N; Veith, F J; Money, S; Garrett, H E

2000-03-01

This trial was designed to identify factors affecting patency rates of primary prosthetic above-knee femoropopliteal bypass grafts at 5 years. A multi-institutional, prospective trial randomized 240 patients to compare patency rates of Gore-tex and Hemashield above-knee femoropopliteal bypass grafts at 5 years. Univariate comparisons of patency between levels of each prognostic variable were made with the Kaplan-Meier method. Variables that had a univariate P value less than.25 or those known to be important were submitted to a Cox regression analysis. The patient survival rate at 5 years was 59.4%. There were no differences in primary or secondary patency rates at 5 years between the two graft materials (primary, 45% vs 43% and secondary, 68% vs 68%). The risk for graft occlusion was significantly increased for patients younger than 65 years (2.1; P =.001) and for grafts with a diameter less than 7 mm (1.65; P =.0219). Variables with no apparent independent effect on patency rates were smoking status, runoff, diabetes mellitus, sex, presenting symptoms, and postoperative treatment with aspirin or Coumadin. Noninvasive test results were not predictive of subsequent graft function. Although the type of prosthetic used for above-knee femoropopliteal bypass grafts does not affect 5-year patency rates, age and graft size do influence results. These factors should be considered before a prosthetic bypass grafting procedure. Furthermore, these data should serve as a contemporary standard, with which evolving and conventional procedures can be compared.

Safety and Efficacy of Percutaneous Biliary Covered Stent Placement in Patients with Malignant Biliary Hilar Obstruction; Correlation with Liver Function

Energy Technology Data Exchange (ETDEWEB)

Hyun, Hyeran; Choi, Sun Young, E-mail: medmath@hanmail.net [School of Medicine Ewha Womans University, Department of Radiology and Medical Research Institute (Korea, Republic of); Kim, Kyung Ah [St. Vincent’s Hospital, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Ko, Soo Bin [College of Arts and Science Case Western Reserve University, Department of Biology (United States)

2016-09-15

PurposeTo estimate the safety and efficacy of percutaneous ePTFE-covered biliary stent placement and the relationship between underlying liver function and stent patency in patients with malignant hilar obstruction.Materials and MethodsFrom March 2012 to June 2015, 41 patients [22 females, 19 males; mean age 69.8 (range 34–94) years] with malignant biliary obstruction underwent percutaneous biliary stent placement (31 patients with unilateral, 10 patients with bilateral side-by-side). Cumulative patient survival and stent patency rate curves were derived using the Kaplan–Meier method. A Cox model was used to explore the relationship between liver function and patient survival, and also biliary stent patency. Pearson correlation coefficient was used to analyze the relationship between patient survival and stent patency.ResultsTechnical success rate was 100 % and clinical success rate was 95 %. During follow-up, four complications occurred (two bilomas and two cases of acute cholecystitis) and were treated successfully with percutaneous drainage. No other complication occurred. Mean serum bilirubin level was 11.34 ± 7.35 mg/dL before drainage and 5.00 ± 4.83 mg/dL 2 weeks after stent placement. The median patent survival duration was 147 days (95 % CI, 69.6–224.4 days). The median stent patency duration was 101 days (95 % CI, 70.0–132.0 days). The cumulative stent patency rates at 1, 3, 6, and 12 months were 97, 57.6, 30.3, and 17.0 %, respectively. Child–Pugh score was correlated significantly with patient survival (P = 0.011) and stent patency (P = 0.007). MELD score was correlated significantly with stent patency (P = 0.044). There was a correlation between patient survival and stent patency (r = 0.778, P < 0.001).ConclusionPercutaneous placement of ePTFE-covered biliary stent was a safe and an effective method for malignant biliary obstruction. Underlying liver function seemed to be one of the important factors affecting

Safety and Efficacy of Percutaneous Biliary Covered Stent Placement in Patients with Malignant Biliary Hilar Obstruction; Correlation with Liver Function

International Nuclear Information System (INIS)

Hyun, Hyeran; Choi, Sun Young; Kim, Kyung Ah; Ko, Soo Bin

2016-01-01

PurposeTo estimate the safety and efficacy of percutaneous ePTFE-covered biliary stent placement and the relationship between underlying liver function and stent patency in patients with malignant hilar obstruction.Materials and MethodsFrom March 2012 to June 2015, 41 patients [22 females, 19 males; mean age 69.8 (range 34–94) years] with malignant biliary obstruction underwent percutaneous biliary stent placement (31 patients with unilateral, 10 patients with bilateral side-by-side). Cumulative patient survival and stent patency rate curves were derived using the Kaplan–Meier method. A Cox model was used to explore the relationship between liver function and patient survival, and also biliary stent patency. Pearson correlation coefficient was used to analyze the relationship between patient survival and stent patency.ResultsTechnical success rate was 100 % and clinical success rate was 95 %. During follow-up, four complications occurred (two bilomas and two cases of acute cholecystitis) and were treated successfully with percutaneous drainage. No other complication occurred. Mean serum bilirubin level was 11.34 ± 7.35 mg/dL before drainage and 5.00 ± 4.83 mg/dL 2 weeks after stent placement. The median patent survival duration was 147 days (95 % CI, 69.6–224.4 days). The median stent patency duration was 101 days (95 % CI, 70.0–132.0 days). The cumulative stent patency rates at 1, 3, 6, and 12 months were 97, 57.6, 30.3, and 17.0 %, respectively. Child–Pugh score was correlated significantly with patient survival (P = 0.011) and stent patency (P = 0.007). MELD score was correlated significantly with stent patency (P = 0.044). There was a correlation between patient survival and stent patency (r = 0.778, P < 0.001).ConclusionPercutaneous placement of ePTFE-covered biliary stent was a safe and an effective method for malignant biliary obstruction. Underlying liver function seemed to be one of the important factors affecting

Optimal Monetary Policy and Exchange Rate in a Small Open Economy with Unemployment

Directory of Open Access Journals (Sweden)

Hyuk-Jae Rhee

2014-09-01

Full Text Available In this paper, we consider a small open economy under the New Keynesian model with unemployment of Gali (2011a, b to discuss the design of the monetary policy. Our findings can be summarized in three parts. First, even with the existence of unemployment, the optimal policy is to minimize variance of domestic price inflation, wage inflation, and the output gap when both domestic price and wage are sticky. Second, stabilizing unemployment rate is important in reducing the welfare loss incurred by both technology and labor supply shocks. Therefore, introducing the unemployment rate as an another argument into the Taylor-rule type interest rate rule will be welfare-enhancing. Lastly, controlling CPI inflation is the best option when the policy is not allowed to respond to unemployment rate. Once the unemployment rate is controlled, however, stabilizing power of CPI inflation-based Taylor rule is diminished.

Self-Expandable Stent Placement in Infrapopliteal Arteries After Unsuccessful Angioplasty Failure: One-Year Follow-up

International Nuclear Information System (INIS)

Peregrin, J. H.; Smirova, S.; Koznar, B.; Novotny, J.; Kovac, J.; Lastovickova, J.; Skibova, J.

2008-01-01

The purpose of this prospective study was to evaluate whether stent placement in infrapopliteal arteries is helpful in failed percutaneous transluminal angioplasty (PTA). Infrapopliteal PTA was performed in 70 arteries of 66 patients with chronic critical lower limb ischemia. The group comprised 55 males and 11 females, with an average age of 63.4 (range, 42-82) years. Diabetes mellitus was present in 92.4% of patients. Only the palpable anterior tibial and posterior tibial arteries were evaluated. Stents (Xpert stent; Abbot Vascular, Redwood City, CA, USA) were placed in 16 arteries where PTA was not successful (the failure was defined as residual stenosis >30% after PTA). In 54 arteries simple PTA was performed and was technically successful. Twenty-four nondilated arteries with no significant stenosis served as a comparison group. The 12-month patency rate was evaluated according to a combination of palpation and Doppler ultrasound. In all cases stent placement restored the flow in the artery immediately after unsuccessful PTA. Twelve-month follow-up showed a patency rate of 82% in the PTA group, 78% in the stent group, and 69% in the comparison group. We conclude that stent placement in the case of unsuccessful infrapopliteal PTA changed technical failure to success and restored flow in the dilated artery. At 12-month follow-up the patency rate of infrapopliteal arteries stented for PTA failure did not differ significantly either from nonstented arteries with an optimal PTA result or from a comparison group of nonintervened arteries.

Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patients

Directory of Open Access Journals (Sweden)

Liberato Manuel José

2012-08-01

Full Text Available Abstract Background Endoscopic biliary drainage of hilar cholangiocarcinoma is controversial with respect to the optimal types of stents and the extent of drainage. This study evaluated endoscopic palliation in patients with hilar cholangiocarcinoma using self-expandable metallic stents (SEMS and plastic stents (PS.We also compared unilateral and bilateral stent placement according to the Bismuth classification. Methods Data on 480 patients receiving endoscopic biliary drainage for hilar cholangiocarcinoma between September 1995 and December 2010 were retrospectively reviewed to evaluate the following outcome parameters: technical success (TS, functional success (FS, early and late complications, stent patency and survival. Patients were followed from stent insertion until death or stent occlusion. Patients were divided into 3 groups according to the Bismuth classification (Group 1, type I; Group 2, type II; Group 3, type > III. Results The initial stent insertion was successful in 450 (93.8% patients. TS was achieved in 204 (88.3% patients treated with PS and in 246 (98.8% patients palliated with SEMS (p P P  Conclusions SEMS insertion for the palliation of hilar cholangiocarcinoma offers higher technical and clinical success rates in the ITT analysis as well as lower complication rates and a superior cumulative stent patency when compared with PS placement in all Bismuth classifications. The cumulative patency of bilateral SEMS or PS stents was significantly higher than that of unilateral SEMS or PS stents, with lower occlusion rates in Bismuth II patients.

Results of subclavian to carotid artery bypass for occlusive disease of the common carotid artery: A retrospective cohort study.

Science.gov (United States)

Illuminati, Giulio; Pizzardi, Giulia; Calio, Francesco G; Masci, Federica; Pasqua, Rocco; Frezzotti, Francesca; Peschillo, Simone

2018-05-01

Optimal treatment of significant atherosclerosis of the common carotid artery (CCA) is not well-defined. The purpose of this study was to evaluate the long-term results of prosthetic subclavian to carotid bypass for occlusive disease of the CCA. From January 1994 to December 2015, 45 patients, mean age 67 years, underwent an ipsilateral subclavian to carotid bypass for occlusive disease of the CCA. Thirty-eight patients (84%) presented with neurologic symptoms, including transitory ischemic attacks in 29 cases and minor strokes in 9 cases. The graft material consisted of a 7 mm polytetrafluoroethylene conduit, and the distal anastomosis was done on the carotid bulb in 21 patients, on the internal carotid artery in 19 cases, and on the distal CCA in 5 cases. Median length of follow-up was 58 months. Study endpoints were the combined postoperative stroke/mortality rate, graft infection, overall late survival, freedom from ipsilateral stroke, and graft patency. Postoperative stroke/mortality rate was 2%. No graft infection was observed throughout follow-up. At 60 months, overall survival, freedom from stroke, and graft patency were 71% (standard error [SE] = 0.07), 98% (SE = 0.02), and 95.5% (SE = 0.06), respectively. Subclavian to carotid bypass allows very good patency rates and excellent protection from postoperative and late stroke, remaining a benchmark for any other treatment method. Copyright © 2018. Published by Elsevier Ltd.

Oesophageal strictures caused by the ingestion of corrosive agents: effectiveness of balloon dilatation in children

Energy Technology Data Exchange (ETDEWEB)

Doo, E.-Y. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of); Shin, J.H. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)], E-mail: jhshin@amc.seoul.kr; Kim, J.H.; Song, H.-Y. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)

2009-03-15

Aim: To evaluate the safety and clinical effectiveness of balloon dilatation in children for oesophageal strictures caused by the ingestion of corrosive agents. Materials and methods: The study comprised 11 children (median age 6 years; range 1-14 years) with oesophageal strictures caused by corrosive agents, who underwent a total of 36 balloon dilatation sessions. The technical and clinical success, recurrence of dysphagia, complications, and primary and secondary patency rates were retrospectively evaluated. Results: Technical success was achieved in 91% of patients and in 97% of balloon dilatation sessions. Clinical success (defined as improved food intake and reduced dysphagia within 1 month of the first balloon dilatation session) was achieved in 64% of patients (7/11). During the mean 35-month follow-up period (range 1-89 months), 10 (91%) patients experienced recurrence. Oesophageal rupture (types 1 or 2) occurred in 45% of patients and in 31% of balloon dilatation sessions. Primary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 36, 27, 14, 14, 14, and 14%, respectively. Secondary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 82, 82, 82, 56, 42, and 42%, respectively. The secondary patency rate was higher than the primary patency rate (p < 0.05). Conclusion: The present study examined oesophageal balloon dilatation for paediatric oesophageal strictures caused by the ingestion of corrosive agents. Although the technical success rate was high and there were no deaths, the clinical success rate was low owing to a high recurrence rate. However, repeated balloon dilatations resulted in an acceptable secondary patency rate.

The application of imperialist competitive algorithm for optimization of deposition rate in submerged arc welding process using TiO2 nano particle

International Nuclear Information System (INIS)

Ghaderi, Mohammad Reza; Eslampanah, Amirhossein; Ghaderi, Kianoosh; Aghakhani, Masood

2015-01-01

We used a novel optimization algorithm based on the imperialist competitive algorithm (ICA) to optimize the deposition rate in the submerged arc welding (SAW) process. This algorithm offers some advantages such as simplicity, accuracy and time saving. Experiments were conducted based on a five factor, five level rotatable central composite design (RCCD) to collect welding data for deposition rate as a function of welding current, arc voltage, contact tip to plate distance, welding speed and thickness of TiO 2 nanoparticles coated on the plates of mild steel. Furthermore, regression equation for deposition rate was obtained using least squares method. The regression equation as the cost function was optimized using ICA. Ultimately, the levels of input variables to achieve maximum deposition rate were obtained using ICA. Computational results indicate that the proposed algorithm is quite effective and powerful in optimizing the cost function.

Activity of the Recommended and Optimized Rates of Pyridate on Chickpea - Mesorhizobium mediterraneum Symbiosis

Directory of Open Access Journals (Sweden)

Mehdi PARSA

2014-03-01

Full Text Available Crop-rhizobium symbiosis can be influenced by leaching of herbicides which is unavoidable after their application. Due to an adjuvant which might help to develop the low-use-rate of herbicide, an experiment was carried out to compare the impact of the recommended rate (1200 g active ingredient ha-1 and the optimized rate (282.15 g active ingredient ha-1 of pyridate on the biological properties of eight chickpea cultivars inoculated with Mesorhizobium mediterraneum, grown in pots. Based on the required rate of herbicide to give 95% control of common lambsquarters (Chenopodium album L. value, the efficacy of pyridate improved up to 3.87-fold by adding methylated rapeseed oil to spray solution. The ‘Desi’ cultivar had significantly higher nodulation than ‘Kabuli’ cultivar. In general, toxicity of the recommended rate was higher than the optimized rate. With the exception of root dry weight, all of the measured parameters were significantly affected by the recommended rate of pyridate in varying degrees. The symbiotic properties of chickpea cultivars were affected more than 10% at the recommended dose. The reduced nodulation ranged from 29% to 73% among cultivars exposed to pyridate at the recommended dose. The ‘Desi’ cultivar was more sensitive than the ‘Kabuli’ to the recommended rate of pyridate. We may conclude that effective low-use-rate of pyridate via applying of activator adjuvants should be noted.

Fiber Bragg grating based notch filter for bit-rate-transparent NRZ to PRZ format conversion with two-degree-of-freedom optimization

International Nuclear Information System (INIS)

Cao, Hui; Zuo, Jun; Xiong, Bangyun; Cheng, Jianqun; Shu, Xuewen; Shen, Fangcheng; Liu, Xin; Atai, Javid

2015-01-01

We propose a novel notch-filtering scheme for bit-rate transparent all-optical NRZ-to-PRZ format conversion. The scheme is based on a two-degree-of-freedom optimally designed fiber Bragg grating. It is shown that a notch filter optimized for any specific operating bit rate can be used to realize high-Q-factor format conversion over a wide bit rate range without requiring any tuning. (paper)

Patency of the infarct-related coronary artery--a pertinent factor in late recovery of myocardial fatty acid metabolism among patients receiving thrombolytic therapy?

Science.gov (United States)

Walamies, M; Virtanen, V; Koskinen, M; Uusitalo, A

1994-09-01

The decrease in mortality among patients receiving thrombolytic therapy for myocardial infarction is greater than would be expected from the improvement in left ventricular contractile function alone; thus some additional advantage of recanalization of the infarct-related coronary artery probably exists. Changes in the post-infarction myocardial metabolic state with respect to artery patency have not been studied with a gamma camera previously. A single-photon emission tomography scan using the fatty acid analogue para-123I-iodophenylpentadecanoic acid was performed at rest before hospital discharge on nine patients with first anterior myocardial infarction. All patients had received intravenous thrombolytic therapy at the beginning of the insult. The semiquantitative analysis of the left ventricle included a total of 44 segments in each patient. The test was repeated 3 months later, with the patients divided into two groups: six patients had an angiographically patent left anterior descending coronary artery (group A), and three an occluded artery (group B). In group A the number of myocardial segments with abnormal (acid uptake was initially 20.2 +/- 4.7 (mean +/- SD) and was reduced to 11.3 +/- 6.1 during the follow-up (95% confidence interval of the decrease 16.0-1.7 segments). In group B the number of these aberrant segments was fairly constant (21.7 +/- 13.1, initial test, and 21.3 +/- 13.3, retest). Our preliminary results suggest that even when thrombolytic therapy fails to prevent myocardial infarction, myocardial fatty acid metabolism has a better change of recovering if the relevant coronary artery has regained its patency.(ABSTRACT TRUNCATED AT 250 WORDS)

A Distributed Flow Rate Control Algorithm for Networked Agent System with Multiple Coding Rates to Optimize Multimedia Data Transmission

Directory of Open Access Journals (Sweden)

Shuai Zeng

2013-01-01

Full Text Available With the development of wireless technologies, mobile communication applies more and more extensively in the various walks of life. The social network of both fixed and mobile users can be seen as networked agent system. At present, kinds of devices and access network technology are widely used. Different users in this networked agent system may need different coding rates multimedia data due to their heterogeneous demand. This paper proposes a distributed flow rate control algorithm to optimize multimedia data transmission of the networked agent system with the coexisting various coding rates. In this proposed algorithm, transmission path and upload bandwidth of different coding rate data between source node, fixed and mobile nodes are appropriately arranged and controlled. On the one hand, this algorithm can provide user nodes with differentiated coding rate data and corresponding flow rate. On the other hand, it makes the different coding rate data and user nodes networked, which realizes the sharing of upload bandwidth of user nodes which require different coding rate data. The study conducts mathematical modeling on the proposed algorithm and compares the system that adopts the proposed algorithm with the existing system based on the simulation experiment and mathematical analysis. The results show that the system that adopts the proposed algorithm achieves higher upload bandwidth utilization of user nodes and lower upload bandwidth consumption of source node.

Combining agreement and frequency rating scales to optimize psychometrics in measuring behavioral health functioning.

Science.gov (United States)

Marfeo, Elizabeth E; Ni, Pengsheng; Chan, Leighton; Rasch, Elizabeth K; Jette, Alan M

2014-07-01

The goal of this article was to investigate optimal functioning of using frequency vs. agreement rating scales in two subdomains of the newly developed Work Disability Functional Assessment Battery: the Mood & Emotions and Behavioral Control scales. A psychometric study comparing rating scale performance embedded in a cross-sectional survey used for developing a new instrument to measure behavioral health functioning among adults applying for disability benefits in the United States was performed. Within the sample of 1,017 respondents, the range of response category endorsement was similar for both frequency and agreement item types for both scales. There were fewer missing values in the frequency items than the agreement items. Both frequency and agreement items showed acceptable reliability. The frequency items demonstrated optimal effectiveness around the mean ± 1-2 standard deviation score range; the agreement items performed better at the extreme score ranges. Findings suggest an optimal response format requires a mix of both agreement-based and frequency-based items. Frequency items perform better in the normal range of responses, capturing specific behaviors, reactions, or situations that may elicit a specific response. Agreement items do better for those whose scores are more extreme and capture subjective content related to general attitudes, behaviors, or feelings of work-related behavioral health functioning. Copyright © 2014 Elsevier Inc. All rights reserved.

Decreasing-Rate Pruning Optimizes the Construction of Efficient and Robust Distributed Networks.

Directory of Open Access Journals (Sweden)

Saket Navlakha

2015-07-01

Full Text Available Robust, efficient, and low-cost networks are advantageous in both biological and engineered systems. During neural network development in the brain, synapses are massively over-produced and then pruned-back over time. This strategy is not commonly used when designing engineered networks, since adding connections that will soon be removed is considered wasteful. Here, we show that for large distributed routing networks, network function is markedly enhanced by hyper-connectivity followed by aggressive pruning and that the global rate of pruning, a developmental parameter not previously studied by experimentalists, plays a critical role in optimizing network structure. We first used high-throughput image analysis techniques to quantify the rate of pruning in the mammalian neocortex across a broad developmental time window and found that the rate is decreasing over time. Based on these results, we analyzed a model of computational routing networks and show using both theoretical analysis and simulations that decreasing rates lead to more robust and efficient networks compared to other rates. We also present an application of this strategy to improve the distributed design of airline networks. Thus, inspiration from neural network formation suggests effective ways to design distributed networks across several domains.

Impact of Optimized Flow Pattern on Pollutant Removal and Biogas Production Rate Using Wastewater Anaerobic Fermentation

Directory of Open Access Journals (Sweden)

Ruyi Huang

2015-06-01

Full Text Available This paper introduces a new-type of antigravity mixing method, which was applied in the biogas production process, using organic wastewater fermentation. It was found that the digesters with two designs, a high-position, centralized pressure outlet and a high-position, dispersed pressure outlets, both lead to an increase in biogas production rates by 89% and 125%, respectively. The biogas production peak appeared 1 day and 7 days earlier, and the COD removal rates were raised by 27% and 42%, respectively. The results indicated that the optimized flow field had a significant impact. This work also explains the mechanism of flow field optimization using computational fluid dynamics (CFD software for the simulation of the flow field form in the hydraulic mixing.

A Methodology for the Optimization of Flow Rate Injection to Looped Water Distribution Networks through Multiple Pumping Stations

Directory of Open Access Journals (Sweden)

Christian León-Celi

2016-12-01

Full Text Available The optimal function of a water distribution network is reached when the consumer demands are satisfied using the lowest quantity of energy, maintaining the minimal pressure required at the same time. One way to achieve this is through optimization of flow rate injection based on the use of the setpoint curve concept. In order to obtain that, a methodology is proposed. It allows for the assessment of the flow rate and pressure head that each pumping station has to provide for the proper functioning of the network while the minimum power consumption is kept. The methodology can be addressed in two ways: the discrete method and the continuous method. In the first method, a finite set of combinations is evaluated between pumping stations. In the continuous method, the search for the optimal solution is performed using optimization algorithms. In this paper, Hooke–Jeeves and Nelder–Mead algorithms are used. Both the hydraulics and the objective function used by the optimization are solved through EPANET and its Toolkit. Two case studies are evaluated, and the results of the application of the different methods are discussed.

Comparison of FLIXENE™ and standard PTFE arteriovenous graft for early haemodialysis.

Science.gov (United States)

Chiang, Nathaniel; Hulme, Katherine Ria; Haggart, Paul Charles; Vasudevan, Thodur

2014-01-01

The purpose is to compare the outcomes of FLIXENE™ arteriovenous graft (AVG) to standard polytetrafluoroethylene (PTFE) AVG for early haemodialysis. This is a prospective observational study of all AVGs placed over a 40-month period between 2008 and 2011 at our vascular unit. Primary outcome was to examine early cannulation rates for FLIXENE™. Secondary outcomes included patency rates, usability of grafts, complications in particular infections, interventions and death in comparison to standard PTFE grafts. Forty-five FLIXENE™ and 19 standard PTFE AVGs were placed in the study period; 89% of FLIXENE™ grafts were used for dialysis, with 78% cannulated within 3 days. At 18 months, primary patency (FLIXENE™ 34% vs standard PTFE 24%), primary assisted patency (35% vs 36%) and secondary patency rate (51% vs 48%) were not statistically different; 20.2% of FLIXENE™ grafts were infected at 18 months requiring explantation compared with 40.3% of standard PTFE grafts (p=0.14). FLIXENE™ can be cannulated for dialysis within 3 days. It has similar patency and complication rates as other prosthetic grafts in the market. In patients who have no access and require urgent dialysis, FLIXENE™ is a viable option.

Covered Metallic Stents With an Anti-Migration Design vs. Uncovered Stents for the Palliation of Malignant Gastric Outlet Obstruction: A Multicenter, Randomized Trial

Science.gov (United States)

Lee, Hyuk; Min, Byung-Hoon; Lee, Jeong Hoon; Shin, Cheol Min; Kim, Younjoo; Chung, Hyunsoo; Lee, Sang Hyub

2015-01-01

OBJECTIVES: Previous studies reported comparable stent patency between covered self-expandable metallic stents (SEMS) and uncovered SEMS (UCS) for palliation of malignant gastric outlet obstruction (GOO). The aim of this study was to evaluate the efficacy and safety of the newly developed WAVE-covered SEMS (WCS), which has an anti-migration design, compared with UCS in gastric cancer patients with symptomatic GOO. METHODS: A total of 102 inoperable gastric cancer patients with symptomatic GOO were prospectively enrolled from five referral centers and randomized to undergo UCS or WCS placement. Stent patency and recurrence of obstructive symptoms were assessed at 8 weeks and 16 weeks after stent placement. RESULTS: At the 8-week follow-up, both stent patency rates (72.5% vs. 62.7%) and re-intervention rates (19.6% vs. 19.6%) were comparable between the WCS and the UCS groups. Both stent stenosis (2.4% vs. 8.1%) and migration rates (9.5% vs. 5.4%) were comparable between WCS and UCS groups. At the 16-week follow-up, however, the WCS group had a significantly higher stent patency rate than the UCS group (68.6% vs. 41.2%). Re-intervention rates in the WCS and UCS groups were 23.5% and 39.2%, respectively. Compared with the UCS group, the WCS group had a significantly lower stent restenosis rate (7.1% vs. 37.8%) and a comparable migration rate (9.5% vs. 5.4%). Overall stent patency was significantly longer in the WCS group than in the UCS group. No stent-associated significant adverse events occurred in either the WCS or UCS groups. In the multivariate analysis, WCS placement and chemotherapy were identified as independent predictors of 16-week stent patency. CONCLUSIONS: WCS group showed comparable migration rate and significantly more durable long-term stent patency compared with UCS group for the palliation of GOO in patients with inoperable gastric cancer. PMID:26372507

Wireless Powered Relaying Networks Under Imperfect Channel State Information: System Performance and Optimal Policy for Instantaneous Rate

Directory of Open Access Journals (Sweden)

D. T. Do

2017-09-01

Full Text Available In this investigation, we consider wireless powered relaying systems, where energy is scavenged by a relay via radio frequency (RF signals. We explore hybrid time switching-based and power splitting-based relaying protocol (HTPSR and compare performance of Amplify-and-Forward (AF with Decode-and-Forward (DF scheme under imperfect channel state information (CSI. Most importantly, the instantaneous rate, achievable bit error rate (BER are determined in the closed-form expressions under the impact of imperfect CSI. Through numerical analysis, we evaluate system insights via different parameters such as power splitting (PS and time switching (TS ratio of the considered HTPSR which affect outage performance and BER. It is noted that DF relaying networks outperform AF relaying networks. Besides that, the numerical results are given to prove the optimization problems of PS and TS ratio to obtain optimal instantaneous rate.

Efficacy of SMART Stent Placement for Salvage Angioplasty in Hemodialysis Patients with Recurrent Vascular Access Stenosis

Directory of Open Access Journals (Sweden)

Shingo Hatakeyama

2011-01-01

Full Text Available Vascular access stenosis is a major complication in hemodialysis patients. We prospectively observed 50 patients in whom 50 nitinol shape-memory alloy-recoverable technology (SMART stents were used as salvage therapy for recurrent peripheral venous stenosis. Twenty-five stents each were deployed in native arteriovenous fistula (AVF and synthetic arteriovenous polyurethane graft (AVG cases. Vascular access patency rates were calculated by Kaplan-Meier analysis. The primary patency rates in AVF versus AVG at 3, 6, and 12 months were 80.3% versus 75.6%, 64.9% versus 28.3%, and 32.3% versus 18.9%, respectively. The secondary patency rates in AVF versus AVG at 3, 6, and 12 months were 88.5% versus 75.5%, 82.6% versus 61.8%, and 74.4% versus 61.8%, respectively. Although there were no statistically significant difference in patency between AVF and AVG, AVG showed poor tendency in primary and secondary patency. The usefulness of SMART stents was limited in a short period of time in hemodialysis patients with recurrent vascular access stenosis.

[Value of preserved saphenous vein graft for the creation of access ports in hemodialyzed patients: report of 309 cases].

Science.gov (United States)

Schneider, Marc; Barrou, Benoît; Cluzel, Philippe; Hamani, Aziz; Bitker, Marc-Olivier; Richard, François

2003-09-01

Biological grafts are rarely used for the creation of vascular access, despite their many advantages. Our group prefers to use distal vascular accesses with interposition of a biological graft when direct access cannot be achieved. The objective of this study was to determine the long-term patency and the complication rate of a series of 309 vascular access procedures using a preserved saphenous (PS) vein homograft. 410 (27%) of the 1,500 vascular access procedures performed by our group required the use of a graft, including 376 PS vein homografts (25%). This retrospective study comprised complete data collection for 309 arteriovenous fistulas (AVF) using preserved saphenous (PS) vein graft in the forearm performed in 267 patients between 1985 and 2000. Primary patency was defined as the interval between creation of the vascular access and the first complication requiring surgical or radiological correction; secondary patency was defined as the interval between creation and loss of the graft, with or without revision of the fistula. Survival rates were calculated according to the Kaplan-Meier method. Inter-group comparison was performed by the Logrank test and analysis of variance was performed by logistic regression. Primary patency rates were 77%, 40% and 27% at 1,2 and 5 years, respectively. Secondary patency rates were 79% and 47% at 1 year and 5 years, respectively. The thrombosis rate was 42%. Two episodes of thrombosis occurred in 25% of grafts and 3 episodes were observed in 10% of cases. Infection rates were 1.9% postoperatively and 5% after dialysis, respectively. An aneurysm occurred on 10% of grafts. The operator's experience (RR = 1.58; p creation of vascular accesses with similar patency rates to those of prosthetic grafts. Vein grafts present a number of advantages, particularly a greater ease of use facilitating distal implantation of the graft and a low infection rate.

The application of imperialist competitive algorithm for optimization of deposition rate in submerged arc welding process using TiO{sub 2} nano particle

Energy Technology Data Exchange (ETDEWEB)

Ghaderi, Mohammad Reza; Eslampanah, Amirhossein; Ghaderi, Kianoosh [Islamic Azad University, Sanandaj (Iran, Islamic Republic of); Aghakhani, Masood [Razi University, Kermanshah (Iran, Islamic Republic of)

2015-01-15

We used a novel optimization algorithm based on the imperialist competitive algorithm (ICA) to optimize the deposition rate in the submerged arc welding (SAW) process. This algorithm offers some advantages such as simplicity, accuracy and time saving. Experiments were conducted based on a five factor, five level rotatable central composite design (RCCD) to collect welding data for deposition rate as a function of welding current, arc voltage, contact tip to plate distance, welding speed and thickness of TiO{sub 2} nanoparticles coated on the plates of mild steel. Furthermore, regression equation for deposition rate was obtained using least squares method. The regression equation as the cost function was optimized using ICA. Ultimately, the levels of input variables to achieve maximum deposition rate were obtained using ICA. Computational results indicate that the proposed algorithm is quite effective and powerful in optimizing the cost function.

Design and optimization of a large flow rate booster pump in SWRO energy recovery system

International Nuclear Information System (INIS)

Lai, Z N; Wu, P; Wu, D Z; Wang, L Q

2013-01-01

Seawater reverse osmosis (SWRO) is a high energy-consumption industry, so energy efficiency is an important issue. Energy recovery systems, which contain a pressure exchanger and a booster pump, are widely used in SWRO plants. As a key part of energy recovery system, the difficulty of designing booster pumps lies in high inlet pressure, high medium causticity and large flow rate. High inlet pressure adds difficulties to seal design, and large flow rate and high efficiency requirement bring high demand for hydraulic design. In this paper, a 625 m 3 /h booster pump is designed and optimized according to the CFD (Computational Fluid Dynamics) simulation results. The impeller and volute is well designed, a new type of high pressure mechanical seal is applied and axial force is well balanced. After optimization based on blade redesign, the efficiency of the pump was improved. The best efficiency reaches more than 85% at design point according to the CFD simulation result

Design and optimization of a large flow rate booster pump in SWRO energy recovery system

Science.gov (United States)

Lai, Z. N.; Wu, P.; Wu, D. Z.; Wang, L. Q.

2013-12-01

Seawater reverse osmosis (SWRO) is a high energy-consumption industry, so energy efficiency is an important issue. Energy recovery systems, which contain a pressure exchanger and a booster pump, are widely used in SWRO plants. As a key part of energy recovery system, the difficulty of designing booster pumps lies in high inlet pressure, high medium causticity and large flow rate. High inlet pressure adds difficulties to seal design, and large flow rate and high efficiency requirement bring high demand for hydraulic design. In this paper, a 625 m3/h booster pump is designed and optimized according to the CFD (Computational Fluid Dynamics) simulation results. The impeller and volute is well designed, a new type of high pressure mechanical seal is applied and axial force is well balanced. After optimization based on blade redesign, the efficiency of the pump was improved. The best efficiency reaches more than 85% at design point according to the CFD simulation result.

TU-CD-304-10: Development and Optimization of “Compton Lens” Collimator Design for Increased Dose Rate in SRS

Energy Technology Data Exchange (ETDEWEB)

Shepard, A; Bender, E [The University of Wisconsin-Madison, Madison, WI (United States)

2015-06-15

Purpose: To provide a proof of concept for a new collimator design to increase the dose rate at isocenter for stereotactic radiosurgery (SRS) treatments by taking advantage of off axis Compton scattered photons which are attenuated in current collimators. Methods: A fundamentally new collimator design was developed and optimized by introducing a series of slits to a standard block collimator. The introduction of slits allowed for initially off axis radiation that was scattered in the direction of the target to contribute to the target dose. For optimization, the design was broken into two parts: an upper interaction plate where primary scattering occurs, and a lower “Compton slit” region which allows for scattered photons traveling toward the target to reach isocenter. To optimize the design, a series of simulations were performed using MCNP6 in which several key parameters were adjusted and the output was compared to a standard collimator. Key parameters modified included the collimator material, cone size, and interaction plate thickness. The effects of using energies different than the traditional 6 MV beam were also explored. Results: An optimized collimator design utilizing a solid interaction plate with a Cesium-137 beam and a 4 mm cone size resulted in a dose rate increase on the order of 5% relative to standard collimators in use. Currently, designs incorporating a Cesium-137 source are the most feasible due to necessary size and weight concerns for 6 MV beams. Conclusion: Preliminary designs provide a proof of concept and indicate a potential to improve upon the dose rate of current collimators while not largely compromising the sharp dose falloff inherent to SRS. Further optimization into the geometry and positioning of the interaction plate, as well as slit optimization, will likely lead to further dose rate increases than were observed in this study. Funding for this work was provided by the Wisconsin Alumni Research Foundation (WARF). Authors have

Examination of the optimal operation of building scale combined heat and power systems under disparate climate and GHG emissions rates

International Nuclear Information System (INIS)

Howard, B.; Modi, V.

2017-01-01

Highlights: • CHP attributable reductions, not viable by electric generation alone, are defined. • Simplified operating strategy heuristics are optimal under specific circumstances. • Phosphoric acid fuel cells yield the largest reductions except in the extremes. • Changes in baseline emissions affect the optimal system capacity and operating hours. - Abstract: This work aims to elucidate notions concerning the ideal operation and greenhouse gas (GHG) emissions benefits of combined heat and power (CHP) systems by investigating how various metrics change as a function of the GHG emissions from the underlying electricity source, building use type and climate. Additionally, a new term entitled “CHP Attributable” reductions is introduced to quantify the benefits from the simultaneous use of thermal and electric energy, removing benefits achieved solely from fuel switching and generating electricity more efficiently. The GHG emission benefits from implementing internal combustion engine, microturbines, and phosphoric acid (PA) fuel cell based CHP systems were evaluated through an optimization approach considering energy demands of prototypical hospital, office, and residential buildings in varied climates. To explore the effect of electric GHG emissions rates, the ideal operation of the CHP systems was evaluated under three scenarios: “High” GHG emissions rates, “Low” GHG emissions rates, and “Current” GHG emissions rate for a specific location. The analysis finds that PA fuel cells achieve the highest GHG emission reductions in most cases considered, though there are exceptions. Common heuristics, such as electric load following and thermal load following, are the optimal operating strategy under specific conditions. The optimal CHP capacity and operating hours both vary as a function of building type, climate and GHG emissions rates from grid electricity. GHG emissions reductions can be as high as 49% considering a PA fuel cell for a

Hypothenar hammer syndrome: long-term follow-up after ulnar artery reconstruction with the lateral circumflex femoral artery.

Science.gov (United States)

de Niet, A; Van Uchelen, J H

2017-06-01

In symptomatic patients with hypothenar hammer syndrome, the occluded part of the ulnar artery can be reconstructed with an autologous graft. Venous grafts are used frequently, but they are known for their low patency rate. Arterial grafts show better patency rates than venous grafts in coronary bypass surgery. We performed 11 ulnar artery reconstructions with the descending branch of the lateral circumflex femoral artery and compared these with previously performed venous reconstructions. All patients with an arterial graft reconstruction had a patent graft at a mean follow-up of 63 months. In addition, nine out of 11 patients reported improvement in their symptoms. The patency rate of venous reconstructions in hypothenar hammer syndrome is significantly lower. Arterial grafting for hypothenar hammer syndrome has superior patency compared with venous grafting; we recommend it as the surgical treatment of choice for symptomatic hypothenar hammer syndrome. 4.

Clinical Outcome Following Infra-Inguinal Percutaneous Transluminal Angioplasy for Critical Limb Ischemia

International Nuclear Information System (INIS)

Matsagas, Miltiadis I.; Rivera, Marco A.; Tran, Tan; Mitchell, Adam; Robless, Peter; Davies, Alun H.; Geroulakos, George

2003-01-01

Objective: The aim of this study was to assess the efficacy and durability of infra-inguinal PTA in patients with CLI, in terms of clinical outcome. Design:Retrospective study of 50 consecutive patients with CLI that were exclusively treated by infra-inguinal PTA. Methods: The indications for intervention were rest pain in seven (14%) patients,non-healing ulcers in 27 (54%), and gangrenous lesions in 16 (32%).Thirty-three (66%) of these patients presented with a single arterial lesion, and the remaining 17 (34%) with multilevel arterial lesions.Kaplan-Meier analysis was used to assess survival, patency,limb-salvage rates, and amputation-free survival. Results: A total of 67 endovascular procedures were performed and 59 (88.1%) of them were considered to be technically successful. The median follow-up period was 12 months (interquartilerange: 17 months). The 30-day mortality was 4%, while the cumulative survival rates at 12, 24, and 36 months were 73%, 67%, and 59%,respectively. The cumulative primary patency rates at 12 and 24 months were 63% and 52%, respectively, and remained unchanged thereafter.The estimated secondary patency rate was 72% at 36 months. There was only one below-knee amputation in the patients that were treated exclusively with infra-inguinal PTA. The cumulative amputation-free survival at the same period was estimated at 60%. Conclusions: Infra-inguinal PTA had a good early and late outcome in this series of patients with a limited life expectancy.These results are comparable to historical results of surgical revascularization in the treatment of CLI. There is need for a randomized study to determine the primary optimal interventional approach for patients with CLI

Optimizing the data acquisition rate for a remotely controllable structural monitoring system with parallel operation and self-adaptive sampling

International Nuclear Information System (INIS)

Sheng, Wenjuan; Guo, Aihuang; Liu, Yang; Azmi, Asrul Izam; Peng, Gang-Ding

2011-01-01

We present a novel technique that optimizes the real-time remote monitoring and control of dispersed civil infrastructures. The monitoring system is based on fiber Bragg gating (FBG) sensors, and transfers data via Ethernet. This technique combines parallel operation and self-adaptive sampling to increase the data acquisition rate in remote controllable structural monitoring systems. The compact parallel operation mode is highly efficient at achieving the highest possible data acquisition rate for the FBG sensor based local data acquisition system. Self-adaptive sampling is introduced to continuously coordinate local acquisition and remote control for data acquisition rate optimization. Key issues which impact the operation of the whole system, such as the real-time data acquisition rate, data processing capability, and buffer usage, are investigated. The results show that, by introducing parallel operation and self-adaptive sampling, the data acquisition rate can be increased by several times without affecting the system operating performance on both local data acquisition and remote process control

Dynamic Material Removal Rate and Tool Replacement Optimization with Calculus of Variations

Science.gov (United States)

Lan, Tian-Syung; Lo, Chih-Yao; Chiu, Min-Chie; Yeh, Long-Jyi

This study mathematically presents an optimum material removal control model, where the Material Removal Rate (MRR) is comprehensively introduced, to accomplish the dynamic machining control and tool life determination of a cutting tool under an expected machining quantity. To resolve the incessant cutting-rate control problem, Calculus of Variations is implemented for the optimum solution. Additionally, the decision criteria for selecting the dynamic solution are suggested and the sensitivity analyses for key variables in the optimal solution are fully discussed. The versatility of this study is furthermore exemplified through a numerical illustration from the real-world industry with BORLAND C++ BUILDER. It is shown that the theoretical and simulated results are in good agreement. This study absolutely explores the very promising solution to dynamically organize the MRR in minimizing the machining cost of a cutting tool for the contemporary machining industry.

Simultaneous optimization of the cavity heat load and trip rates in linacs using a genetic algorithm

Directory of Open Access Journals (Sweden)

Balša Terzić

2014-10-01

Full Text Available In this paper, a genetic algorithm-based optimization is used to simultaneously minimize two competing objectives guiding the operation of the Jefferson Lab’s Continuous Electron Beam Accelerator Facility linacs: cavity heat load and radio frequency cavity trip rates. The results represent a significant improvement to the standard linac energy management tool and thereby could lead to a more efficient Continuous Electron Beam Accelerator Facility configuration. This study also serves as a proof of principle of how a genetic algorithm can be used for optimizing other linac-based machines.

On Optimizing H. 264/AVC Rate Control by Improving R-D Model and Incorporating HVS Characteristics

Directory of Open Access Journals (Sweden)

Jiang Gangyi

2010-01-01

Full Text Available The state-of-the-art JVT-G012 rate control algorithm of H.264 is improved from two aspects. First, the quadratic rate-distortion (R-D model is modified based on both empirical observations and theoretical analysis. Second, based on the existing physiological and psychological research findings of human vision, the rate control algorithm is optimized by incorporating the main characteristics of the human visual system (HVS such as contrast sensitivity, multichannel theory, and masking effect. Experiments are conducted, and experimental results show that the improved algorithm can simultaneously enhance the overall subjective visual quality and improve the rate control precision effectively.

Impact of top end anastomosis design on patency and flow stability in coronary artery bypass grafting.

Science.gov (United States)

Koyama, Sachi; Kitamura, Tadashi; Itatani, Keiichi; Yamamoto, Tadashi; Miyazaki, Shohei; Oka, Norihiko; Nakashima, Kouki; Horai, Tetsuya; Ono, Minoru; Miyaji, Kagami

2016-05-01

For coronary artery bypass grafting (CABG), free grafts such as a saphenous vein or radial artery are often used for grafts to the lateral and posterior walls. However, the relationship between top-end anastomosis design and long-term patency remains unknown. Because coronary artery blood flow is dominant during diastole, top-end anastomosis may work better if the graft is directed towards the apex, whereas the shortest graft pathway appears to be most efficient. Using computational fluid dynamic models, we evaluated the hemodynamic variables that were affected by the angle of the top-end anastomosis. We created three-dimensional geometries of the aortic root with coronary arteries that involved 75 % stenosis in the obtuse marginal and postero-lateral branches. Two bypass models under vasodilator administration were created: in a"Model A", the top-end anastomosis is parallel to the long axis of the ascending aorta and the graft passed over the conus directed towards the apex; in a "Model B", the top-end anastomosis is directed toward the shortest pathway, and form near the right angles to the long axis of the ascending aorta. Wall shear stress (WSS) and its fluctuation, an oscillatory shear index (OSI) were evaluated to predict fibrosis progression at the anastomosis site and graft flow. Graft flow was 197.3 ml/min and 207.3 ml/min in the "Model A" and "Model B", respectively. The minimal WSS value inside the graft with the "Model A" and "Model B" was 0.53 Pa and 4.09 Pa, respectively, and the OSI value was 0.46 and 0.04, respectively. The top-end anastomosis of a free graft should be directed vertically towards the aorta to achieve the shortest graft pathway to maintain a high graft flow rate and to avoid the risks of endothelial fibrosis and plaque progression over the long-term after CABG.

Minimax Rate-optimal Estimation of High-dimensional Covariance Matrices with Incomplete Data.

Science.gov (United States)

Cai, T Tony; Zhang, Anru

2016-09-01

Missing data occur frequently in a wide range of applications. In this paper, we consider estimation of high-dimensional covariance matrices in the presence of missing observations under a general missing completely at random model in the sense that the missingness is not dependent on the values of the data. Based on incomplete data, estimators for bandable and sparse covariance matrices are proposed and their theoretical and numerical properties are investigated. Minimax rates of convergence are established under the spectral norm loss and the proposed estimators are shown to be rate-optimal under mild regularity conditions. Simulation studies demonstrate that the estimators perform well numerically. The methods are also illustrated through an application to data from four ovarian cancer studies. The key technical tools developed in this paper are of independent interest and potentially useful for a range of related problems in high-dimensional statistical inference with missing data.

Minimax Rate-optimal Estimation of High-dimensional Covariance Matrices with Incomplete Data*

Science.gov (United States)

Cai, T. Tony; Zhang, Anru

2016-01-01

Missing data occur frequently in a wide range of applications. In this paper, we consider estimation of high-dimensional covariance matrices in the presence of missing observations under a general missing completely at random model in the sense that the missingness is not dependent on the values of the data. Based on incomplete data, estimators for bandable and sparse covariance matrices are proposed and their theoretical and numerical properties are investigated. Minimax rates of convergence are established under the spectral norm loss and the proposed estimators are shown to be rate-optimal under mild regularity conditions. Simulation studies demonstrate that the estimators perform well numerically. The methods are also illustrated through an application to data from four ovarian cancer studies. The key technical tools developed in this paper are of independent interest and potentially useful for a range of related problems in high-dimensional statistical inference with missing data. PMID:27777471

Construction Performance Optimization toward Green Building Premium Cost Based on Greenship Rating Tools Assessment with Value Engineering Method

Science.gov (United States)

Latief, Yusuf; Berawi, Mohammed Ali; Basten, Van; Riswanto; Budiman, Rachmat

2017-07-01

Green building concept becomes important in current building life cycle to mitigate environment issues. The purpose of this paper is to optimize building construction performance towards green building premium cost, achieving green building rating tools with optimizing life cycle cost. Therefore, this study helps building stakeholder determining building fixture to achieve green building certification target. Empirically the paper collects data of green building in the Indonesian construction industry such as green building fixture, initial cost, operational and maintenance cost, and certification score achievement. After that, using value engineering method optimized green building fixture based on building function and cost aspects. Findings indicate that construction performance optimization affected green building achievement with increasing energy and water efficiency factors and life cycle cost effectively especially chosen green building fixture.

Estimation of the optimal brachytherapy utilisation rate in the treatment of vaginal cancer and comparison with patterns of care

International Nuclear Information System (INIS)

Thompson, Stephen R.; Delaney, Geoff P.; Gabriel, Gabriel S.; Barton, Michael B.; Jacob, Susannah

2012-01-01

Having previously modelled the optimal proportion of uterine cervix and corpus cancers that should be treated with brachytherapy (BT), we aimed to complete the assessment of the role of BT for gynaecological cancers by estimating the optimal proportion of vaginal cancer cases that should be treated with BT, the optimal BT utilisation (BTU) rate for vaginal cancer. We compared this with actual vaginal BTU and assessed quality of BT for vaginal cancer by a Patterns-of-Care Study (POCS). Evidence-based guidelines were used to construct an optimal BTU decision tree for vaginal cancer. Searches of the epidemiological literature to ascertain the proportion of patients who fulfilled the criteria for BT were conducted. The robustness of the model was tested by sensitivity analyses and by peer review. A retrospective POCS of BT in New South Wales (NSW) for 2003 was conducted, and actual BTU for vaginal cancer was determined. Differences between optimal and actual BTU were assessed. Quality of BT for vaginal cancer was compared with published benchmarks. The optimal vaginal cancer BTU rate was estimated to be 85% (range 81–87%). In NSW in 2003, actual vaginal cancer BTU was only 42% (95% confidence interval 22–62%). In NSW, only nine patients were treated, all with intra-vaginal cylinders, and two of four to lower than recommended doses. BT for vaginal cancers is under utilised in NSW compared with the proposed optimal models of care. BT quality may have been suboptimal and this may relate to the rarity of this disease.

Effects of a Capital Investment and a Discount Rate on the Optimal Operational Duration of an HLW Repository

International Nuclear Information System (INIS)

Kim, Sung Ki; Lee, Min Soo; Choi, Heui Joo; Choi, Jong Won

2008-01-01

This study aims to estimate the effects of a capital investment and a discount rate on the optimal operational duration of an HLW repository. According to the previous researches of the KRS(Korea Reference System) for an HLW repository, the amounts of 7,068,200 C$K and 2,636.2 MEUR are necessary to construct and operate surface and underground facilities. Since these huge costs can be a burden to some national economies, a study for a cost optimization should be performed. So we aim to drive the dominant cost driver for an optimal operational duration. A longer operational duration may be needed to dispose of more spent fuels continuously from a nuclear power plant, or to attain a retrievability of an HLW repository at a depth of 500 m below the ground level in a stable plutonic rock body. In this sense, an extended operational duration for an HLW repository affects the overall disposal costs of a repository. In this paper, only the influence of a capital investment and a discount rate was estimated from the view of optimized economics. Because these effects must be significant factors to minimize the overall disposal costs based on minimizing the sum of operational costs and capital investments

Development of An Optimization Method for Determining Automation Rate in Nuclear Power Plants

International Nuclear Information System (INIS)

Lee, Seung Min; Seong, Poong Hyun; Kim, Jong Hyun

2014-01-01

Since automation was introduced in various industrial fields, it has been known that automation provides positive effects like greater efficiency and fewer human errors, and negative effect defined as out-of-the-loop (OOTL). Thus, before introducing automation in nuclear field, the estimation of the positive and negative effects of automation on human operators should be conducted. In this paper, by focusing on CPS, the optimization method to find an appropriate proportion of automation is suggested by integrating the suggested cognitive automation rate and the concepts of the level of ostracism. The cognitive automation rate estimation method was suggested to express the reduced amount of human cognitive loads, and the level of ostracism was suggested to express the difficulty in obtaining information from the automation system and increased uncertainty of human operators' diagnosis. The maximized proportion of automation that maintains the high level of attention for monitoring the situation is derived by an experiment, and the automation rate is estimated by the suggested automation rate estimation method. It is expected to derive an appropriate inclusion proportion of the automation system avoiding the OOTL problem and having maximum efficacy at the same time

Comprehensive Comparison of the Performance of Autogenous Brachial-Basilic Transposition Arteriovenous Fistula and Prosthetic Forearm Loop Arteriovenous Graft in a Multiethnic Asian Hemodialysis Population

Directory of Open Access Journals (Sweden)

Koy Min Chue

2016-01-01

Full Text Available Aim. For patients who have exhausted cephalic vein arteriovenous fistula (AVF options, controversy exists on whether brachial-basilic AVF with transposition (BBTAVF or a forearm arteriovenous graft (AVG should be the next vascular access of choice. This study compared the outcomes of these two modalities. Methods. A retrospective study of 122 Asian multiethnic patients who underwent either a BBTAVF (81 or an AVG (41. Maturation time and intervention rates were analyzed. Functional primary, secondary, and overall patency rates were evaluated. Results. The maturation time for BBTAVFs was significantly longer than AVGs. There was also a longer deliberation time before surgeons abandon a failing BBTAVF compared to an AVG. Both functional primary and secondary patency rates were significantly higher in the BBTAVF group at 1-year follow-up: 73.2% versus 34.1% (p<0.001 and 71.8% versus 54.3% (p=0.022, respectively. AVGs also required more interventions to maintain patency. When maturation rates were considered, the overall patency of AVGs was initially superior in the first 25 weeks after creation and then became inferior afterwards. Conclusion. BBTAVFs had superior primary and functional patency and required less salvage interventions. The forearm AVG might have a role in patients who require early vascular access due to complications from central venous catheters or with limited life expectancy.

Optimal Blood Suppression inversion time based on breathing rates and heart rates to improve renal artery visibility in spatial labeling with multiple inversion pulses: A preliminary study

Energy Technology Data Exchange (ETDEWEB)

Pei, Yi Gang; Li, Fang; Long, Xue Ying; Liu, Hui; Wang, Xiao Yi; Liu, Jin Kang; Li, Wen Zheng [Dept. of Radiology, Xiangya Hospital, Central South University, Changsha (China); Shen, Hao [GE Healthcare, Waukesha (United States)

2016-02-15

To determine whether an optimal blood suppression inversion time (BSP TI) can boost arterial visibility and whether the optimal BSP TI is related to breathing rate (BR) and heart rate (HR) for hypertension subjects in spatial labeling with multiple inversion pulses (SLEEK). This prospective study included 10 volunteers and 93 consecutive hypertension patients who had undergone SLEEK at 1.5T MRI system. Firstly, suitable BSP TIs for displaying clearly renal artery were determined in 10 volunteers. Secondly, non-contrast enhanced magnetic resonance angiography with the suitable BSP TIs were performed on those hypertension patients. Then, renal artery was evaluated and an optimal BSP TI to increase arterial visibility was determined for each patient. Patients' BRs and HRs were recorded and their relationships with the optimal BSP TI were analyzed. The optimal BSP TI was negatively correlated with BR (r1 = -0.536, P1 < 0.001; and r2 = -0.535, P2 < 0.001) and HR (r1 = -0.432, P1 = 0.001; and r2 = -0.419, P2 = 0.001) for 2 readers (κ = 0.93). For improving renal arterial visibility, BSP TI = 800 ms could be applied as the optimal BSP TI when the 95% confidence interval were 17-19/min (BR1) and 74-82 bpm (HR1) for reader#1 and 17-19/min (BR2) and 74-83 bpm (HR2) for reader#2; BSP TI = 1100 ms while 14-15/min (BR1, 2) and 71-76 bpm (HR1, 2) for both readers; and BSP TI = 1400 ms when 13-16/min (BR1) and 63-68 bpm (HR1) for reader#1 and 14-15/min (BR2) and 64-70 bpm (HR2) for reader#2. In SLEEK, BSP TI is affected by patients' BRs and HRs. Adopting the optimal BSP TI based on BR and HR can improve the renal arterial visibility and consequently the working efficiency.

An automated optimization tool for high-dose-rate (HDR) prostate brachytherapy with divergent needle pattern

Science.gov (United States)

Borot de Battisti, M.; Maenhout, M.; de Senneville, B. Denis; Hautvast, G.; Binnekamp, D.; Lagendijk, J. J. W.; van Vulpen, M.; Moerland, M. A.

2015-10-01

Focal high-dose-rate (HDR) for prostate cancer has gained increasing interest as an alternative to whole gland therapy as it may contribute to the reduction of treatment related toxicity. For focal treatment, optimal needle guidance and placement is warranted. This can be achieved under MR guidance. However, MR-guided needle placement is currently not possible due to space restrictions in the closed MR bore. To overcome this problem, a MR-compatible, single-divergent needle-implant robotic device is under development at the University Medical Centre, Utrecht: placed between the legs of the patient inside the MR bore, this robot will tap the needle in a divergent pattern from a single rotation point into the tissue. This rotation point is just beneath the perineal skin to have access to the focal prostate tumor lesion. Currently, there is no treatment planning system commercially available which allows optimization of the dose distribution with such needle arrangement. The aim of this work is to develop an automatic inverse dose planning optimization tool for focal HDR prostate brachytherapy with needle insertions in a divergent configuration. A complete optimizer workflow is proposed which includes the determination of (1) the position of the center of rotation, (2) the needle angulations and (3) the dwell times. Unlike most currently used optimizers, no prior selection or adjustment of input parameters such as minimum or maximum dose or weight coefficients for treatment region and organs at risk is required. To test this optimizer, a planning study was performed on ten patients (treatment volumes ranged from 8.5 cm3to 23.3 cm3) by using 2-14 needle insertions. The total computation time of the optimizer workflow was below 20 min and a clinically acceptable plan was reached on average using only four needle insertions.

Global parameter optimization for maximizing radioisotope detection probabilities at fixed false alarm rates

Energy Technology Data Exchange (ETDEWEB)

Portnoy, David, E-mail: david.portnoy@jhuapl.edu [Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD 20723 (United States); Feuerbach, Robert; Heimberg, Jennifer [Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD 20723 (United States)

2011-10-01

Today there is a tremendous amount of interest in systems that can detect radiological or nuclear threats. Many of these systems operate in extremely high throughput situations where delays caused by false alarms can have a significant negative impact. Thus, calculating the tradeoff between detection rates and false alarm rates is critical for their successful operation. Receiver operating characteristic (ROC) curves have long been used to depict this tradeoff. The methodology was first developed in the field of signal detection. In recent years it has been used increasingly in machine learning and data mining applications. It follows that this methodology could be applied to radiological/nuclear threat detection systems. However many of these systems do not fit into the classic principles of statistical detection theory because they tend to lack tractable likelihood functions and have many parameters, which, in general, do not have a one-to-one correspondence with the detection classes. This work proposes a strategy to overcome these problems by empirically finding parameter values that maximize the probability of detection for a selected number of probabilities of false alarm. To find these parameter values a statistical global optimization technique that seeks to estimate portions of a ROC curve is proposed. The optimization combines elements of simulated annealing with elements of genetic algorithms. Genetic algorithms were chosen because they can reduce the risk of getting stuck in local minima. However classic genetic algorithms operate on arrays of Booleans values or bit strings, so simulated annealing is employed to perform mutation in the genetic algorithm. The presented initial results were generated using an isotope identification algorithm developed at Johns Hopkins University Applied Physics Laboratory. The algorithm has 12 parameters: 4 real-valued and 8 Boolean. A simulated dataset was used for the optimization study; the 'threat' set of

Global parameter optimization for maximizing radioisotope detection probabilities at fixed false alarm rates

International Nuclear Information System (INIS)

Portnoy, David; Feuerbach, Robert; Heimberg, Jennifer

2011-01-01

Today there is a tremendous amount of interest in systems that can detect radiological or nuclear threats. Many of these systems operate in extremely high throughput situations where delays caused by false alarms can have a significant negative impact. Thus, calculating the tradeoff between detection rates and false alarm rates is critical for their successful operation. Receiver operating characteristic (ROC) curves have long been used to depict this tradeoff. The methodology was first developed in the field of signal detection. In recent years it has been used increasingly in machine learning and data mining applications. It follows that this methodology could be applied to radiological/nuclear threat detection systems. However many of these systems do not fit into the classic principles of statistical detection theory because they tend to lack tractable likelihood functions and have many parameters, which, in general, do not have a one-to-one correspondence with the detection classes. This work proposes a strategy to overcome these problems by empirically finding parameter values that maximize the probability of detection for a selected number of probabilities of false alarm. To find these parameter values a statistical global optimization technique that seeks to estimate portions of a ROC curve is proposed. The optimization combines elements of simulated annealing with elements of genetic algorithms. Genetic algorithms were chosen because they can reduce the risk of getting stuck in local minima. However classic genetic algorithms operate on arrays of Booleans values or bit strings, so simulated annealing is employed to perform mutation in the genetic algorithm. The presented initial results were generated using an isotope identification algorithm developed at Johns Hopkins University Applied Physics Laboratory. The algorithm has 12 parameters: 4 real-valued and 8 Boolean. A simulated dataset was used for the optimization study; the 'threat' set of spectra

Global parameter optimization for maximizing radioisotope detection probabilities at fixed false alarm rates

Science.gov (United States)

Portnoy, David; Feuerbach, Robert; Heimberg, Jennifer

2011-10-01

Today there is a tremendous amount of interest in systems that can detect radiological or nuclear threats. Many of these systems operate in extremely high throughput situations where delays caused by false alarms can have a significant negative impact. Thus, calculating the tradeoff between detection rates and false alarm rates is critical for their successful operation. Receiver operating characteristic (ROC) curves have long been used to depict this tradeoff. The methodology was first developed in the field of signal detection. In recent years it has been used increasingly in machine learning and data mining applications. It follows that this methodology could be applied to radiological/nuclear threat detection systems. However many of these systems do not fit into the classic principles of statistical detection theory because they tend to lack tractable likelihood functions and have many parameters, which, in general, do not have a one-to-one correspondence with the detection classes. This work proposes a strategy to overcome these problems by empirically finding parameter values that maximize the probability of detection for a selected number of probabilities of false alarm. To find these parameter values a statistical global optimization technique that seeks to estimate portions of a ROC curve is proposed. The optimization combines elements of simulated annealing with elements of genetic algorithms. Genetic algorithms were chosen because they can reduce the risk of getting stuck in local minima. However classic genetic algorithms operate on arrays of Booleans values or bit strings, so simulated annealing is employed to perform mutation in the genetic algorithm. The presented initial results were generated using an isotope identification algorithm developed at Johns Hopkins University Applied Physics Laboratory. The algorithm has 12 parameters: 4 real-valued and 8 Boolean. A simulated dataset was used for the optimization study; the "threat" set of spectra

Detection of imminent vein graft occlusion: what is the optimal surveillance program?

Science.gov (United States)

Tinder, Chelsey N; Bandyk, Dennis F

2009-12-01

The prediction of infrainguinal vein bypass failure remains an inexact judgment. Patient demographics, technical factors, and vascular laboratory graft surveillance testing are helpful in identifying a high-risk graft cohort. The optimal surveillance program to detect the bypass at risk for imminent occlusion continues to be developed, but required elements are known and include clinical assessment for new or changes in limb ischemia symptoms, measurement of ankle and/or toe systolic pressure, and duplex ultrasound imaging of the bypass graft. Duplex ultrasound assessment of bypass hemodynamics may be the most accurate method to detect imminent vein graft occlusion. The finding of low graft flow during intraoperative assessment or at a scheduled surveillance study predicts failure; and if associated with an occlusive lesion, a graft revision can prolong patency. The most common abnormality producing graft failure is conduit stenosis caused by myointimal hyperplasia; and the majority can be repaired by an endovascular intervention. Frequency of testing to detect the failing bypass should be individualized to the patient, the type of arterial bypass, and prior duplex ultrasound scan findings. The focus of surveillance is on identification of the low-flow arterial bypass and timely repair of detected critical stenosis defined by duplex velocity spectra criteria of a peak systolic velocity 300 cm/s and peak systolic velocity ratio across the stenosis >3.5-correlating with >70% diameter-reducing stenosis. When conducted appropriately, a graft surveillance program should result in an unexpected graft failure rate of <3% per year.

High-resolution MRI of the labyrinth. Optimization of scan parameters with 3D-FSE

International Nuclear Information System (INIS)

Sakata, Motomichi; Harada, Kuniaki; Shirase, Ryuji; Kumagai, Akiko; Ogasawara, Masashi

2005-01-01

The aim of our study was to optimize the parameters of high-resolution MRI of the labyrinth with a 3D fast spin-echo (3D-FSE) sequence. We investigated repetition time (TR), echo time (TE), Matrix, field of view (FOV), and coil selection in terms of CNR (contrast-to-noise ratio) and SNR (signal-to-noise ratio) by comparing axial images and/or three-dimensional images. The optimal 3D-FSE sequence parameters were as follows: 1.5 Tesla MR unit (Signa LX, GE Medical Systems), 3D-FSE sequence, dual 3-inch surface coil, acquisition time=12.08 min, TR=5000 msec, TE=300 msec, 3 number of excitations (NEX), FOV=12 cm, matrix=256 x 256, slice thickness=0.5 mm/0.0 sp, echo train=64, bandwidth=±31.5 kHz. High-resolution MRI of the labyrinth using the optimized 3D-FSE sequence parameters permits visualization of important anatomic details (such as scala tympani and scala vestibuli), making it possible to determine inner ear anomalies and the patency of cochlear turns. To obtain excellent heavily T2-weighted axial and three-dimensional images in the labyrinth, high CNR, SNR, and spatial resolution are significant factors at the present time. Furthermore, it is important not only to optimize the scan parameters of 3D-FSE but also to select an appropriate coil for high-resolution MRI of the labyrinth. (author)

Redundancy allocation problem of a system with increasing failure rates of components based on Weibull distribution: A simulation-based optimization approach

International Nuclear Information System (INIS)

Guilani, Pedram Pourkarim; Azimi, Parham; Niaki, S.T.A.; Niaki, Seyed Armin Akhavan

2016-01-01

The redundancy allocation problem (RAP) is a useful method to enhance system reliability. In most works involving RAP, failure rates of the system components are assumed to follow either exponential or k-Erlang distributions. In real world problems however, many systems have components with increasing failure rates. This indicates that as time passes by, the failure rates of the system components increase in comparison to their initial failure rates. In this paper, the redundancy allocation problem of a series–parallel system with components having an increasing failure rate based on Weibull distribution is investigated. An optimization method via simulation is proposed for modeling and a genetic algorithm is developed to solve the problem. - Highlights: • The redundancy allocation problem of a series–parallel system is aimed. • Components possess an increasing failure rate based on Weibull distribution. • An optimization method via simulation is proposed for modeling. • A genetic algorithm is developed to solve the problem.

Self-optimized construction of transition rate matrices from accelerated atomistic simulations with Bayesian uncertainty quantification

Science.gov (United States)

Swinburne, Thomas D.; Perez, Danny

2018-05-01

A massively parallel method to build large transition rate matrices from temperature-accelerated molecular dynamics trajectories is presented. Bayesian Markov model analysis is used to estimate the expected residence time in the known state space, providing crucial uncertainty quantification for higher-scale simulation schemes such as kinetic Monte Carlo or cluster dynamics. The estimators are additionally used to optimize where exploration is performed and the degree of temperature acceleration on the fly, giving an autonomous, optimal procedure to explore the state space of complex systems. The method is tested against exactly solvable models and used to explore the dynamics of C15 interstitial defects in iron. Our uncertainty quantification scheme allows for accurate modeling of the evolution of these defects over timescales of several seconds.

Estimation of the Optimal Brachytherapy Utilization Rate in the Treatment of Gynecological Cancers and Comparison With Patterns of Care

International Nuclear Information System (INIS)

Thompson, Stephen R.; Delaney, Geoff P.; Gabriel, Gabriel S.; Jacob, Susannah; Das, Prabir; Barton, Michael B.

2013-01-01

Purpose: We aimed to estimate the optimal proportion of all gynecological cancers that should be treated with brachytherapy (BT)—the optimal brachytherapy utilization rate (BTU)—to compare this with actual gynecological BTU and to assess the effects of nonmedical factors on access to BT. Methods and Materials: The previously constructed inter/multinational guideline-based peer-reviewed models of optimal BTU for cancers of the uterine cervix, uterine corpus, and vagina were combined to estimate optimal BTU for all gynecological cancers. The robustness of the model was tested by univariate and multivariate sensitivity analyses. The resulting model was applied to New South Wales (NSW), the United States, and Western Europe. Actual BTU was determined for NSW by a retrospective patterns-of-care study of BT; for Western Europe from published reports; and for the United States from Surveillance, Epidemiology, and End Results data. Differences between optimal and actual BTU were assessed. The effect of nonmedical factors on access to BT in NSW were analyzed. Results: Gynecological BTU was as follows: NSW 28% optimal (95% confidence interval [CI] 26%-33%) compared with 14% actual; United States 30% optimal (95% CI 26%-34%) and 10% actual; and Western Europe 27% optimal (95% CI 25%-32%) and 16% actual. On multivariate analysis, NSW patients were more likely to undergo gynecological BT if residing in Area Health Service equipped with BT (odds ratio 1.76, P=.008) and if residing in socioeconomically disadvantaged postcodes (odds ratio 1.12, P=.05), but remoteness of residence was not significant. Conclusions: Gynecological BT is underutilized in NSW, Western Europe, and the United States given evidence-based guidelines. Access to BT equipment in NSW was significantly associated with higher utilization rates. Causes of underutilization elsewhere were undetermined. Our model of optimal BTU can be used as a quality assurance tool, providing an evidence-based benchmark against

Brachytherapy optimization using radiobiological-based planning for high dose rate and permanent implants for prostate cancer treatment

Science.gov (United States)

Seeley, Kaelyn; Cunha, J. Adam; Hong, Tae Min

2017-01-01

We discuss an improvement in brachytherapy--a prostate cancer treatment method that directly places radioactive seeds inside target cancerous regions--by optimizing the current standard for delivering dose. Currently, the seeds' spatiotemporal placement is determined by optimizing the dose based on a set of physical, user-defined constraints. One particular approach is the ``inverse planning'' algorithms that allow for tightly fit isodose lines around the target volumes in order to reduce dose to the patient's organs at risk. However, these dose distributions are typically computed assuming the same biological response to radiation for different types of tissues. In our work, we consider radiobiological parameters to account for the differences in the individual sensitivities and responses to radiation for tissues surrounding the target. Among the benefits are a more accurate toxicity rate and more coverage to target regions for planning high-dose-rate treatments as well as permanent implants.

Content Adaptive Lagrange Multiplier Selection for Rate-Distortion Optimization in 3-D Wavelet-Based Scalable Video Coding

Directory of Open Access Journals (Sweden)

Ying Chen

2018-03-01

Full Text Available Rate-distortion optimization (RDO plays an essential role in substantially enhancing the coding efficiency. Currently, rate-distortion optimized mode decision is widely used in scalable video coding (SVC. Among all the possible coding modes, it aims to select the one which has the best trade-off between bitrate and compression distortion. Specifically, this tradeoff is tuned through the choice of the Lagrange multiplier. Despite the prevalence of conventional method for Lagrange multiplier selection in hybrid video coding, the underlying formulation is not applicable to 3-D wavelet-based SVC where the explicit values of the quantization step are not available, with on consideration of the content features of input signal. In this paper, an efficient content adaptive Lagrange multiplier selection algorithm is proposed in the context of RDO for 3-D wavelet-based SVC targeting quality scalability. Our contributions are two-fold. First, we introduce a novel weighting method, which takes account of the mutual information, gradient per pixel, and texture homogeneity to measure the temporal subband characteristics after applying the motion-compensated temporal filtering (MCTF technique. Second, based on the proposed subband weighting factor model, we derive the optimal Lagrange multiplier. Experimental results demonstrate that the proposed algorithm enables more satisfactory video quality with negligible additional computational complexity.

Electrolyte Engineering: Optimizing High-Rate Double-Layer Capacitances of Micropore- and Mesopore-Rich Activated Carbon.

Science.gov (United States)

Chen, Ting-Hao; Yang, Cheng-Hsien; Su, Ching-Yuan; Lee, Tai-Chou; Dong, Quan-Feng; Chang, Jeng-Kuei

2017-09-22

Various types of electrolyte cations as well as binary cations are used to optimize the capacitive performance of activated carbon (AC) with different pore structures. The high-rate capability of micropore-rich AC, governed by the mobility of desolvated cations, can outperform that of mesopore-rich AC, which essentially depends on the electrolyte conductivity. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Evaluation of Geometrically Optimized Single- and Double-plane Interstitial High Dose Rate Implants with Respect to Conformality and Homogeneity

International Nuclear Information System (INIS)

Major, Tibor; Polgar, Csaba; Fodor, Janos; Takacsi-nagy, Zoltan; Mangel, Laszlo; Nemeth, Gyoergy

2003-01-01

The use of a stepping source in high dose rate brachytherapy supported with dwell-time optimization makes it possible to deviate from the classical dosimetry systems. Dose distributions of single- and double-plane implants were analysed for conformality and homogeneity at idealized target volumes. The Paris system was used for catheter positioning and target volume determination. Geometric optimization and individual dose prescription were applied. Volumetric indices and dose parameters were calculated at optimal active length, which was found to be equal to target volume length. The mean conformality, homogeneity, external volume and overdose volume indices were 0.78, 0.67, 0.22 and 0.13, respectively. The average minimum target and reference doses were 69% and 86%, respectively. Comparisons between the volumetric indices of geometrical optimized and non-optimized implants were also performed, and a significant difference was found regarding any index. The geometrical optimization resulted in superior conformality and slightly inferior homogeneity. At geometrically optimized implants, the active length can be reduced compared to non-optimized implants. Volumetric parameters and dose-volume histogram-based individual dose prescription are recommended for quantitative assessment of interstitial implants

Evaluation of the 4-French Pulsar-18 Self-expanding Nitinol Stent in Long Femoropopliteal Lesions.

Science.gov (United States)

Lichtenberg, Michael; Hailer, Birgit; Kaeunicke, Matthias; Stahlhoff, Wilhelm-Friedrich; Boese, Dirk; Breuckmann, Frank

2014-01-01

To evaluate the patency and the freedom of target lesion revascularization of the 4-French Pulsar-18 self-expandable (SE) nitinol stent for the treatment of long femoropopliteal occlusive disease in a two-center, prospective, all-comers registry with a follow-up period of 12 months. This registry enrolled 36 patients with symptomatic femoropopliteal long lesions for recanalization and implantation of the 4-French Pulsar-18 SE nitinol stent. Routine follow-up examination including duplex ultrasound was performed after 6 and 12 months. Primary patency was defined as no binary restenosis on duplex ultrasound (Peak systolic velocitiy ration (PSVR) Pulsar-18 SE nitinol stent for endovascular intervention of femoropopliteal disease with a mean lesion length of 182.3 ± 51.8 mm showed promising primary patency and fTLR rates after 6 and 12 months. Diabetes and renal insufficiency had no negative impact on the patency rate.

Calculation of Residual Dose Rates and Intervention Scenarios for the LHC Beam Cleaning Insertions-Constraints and Optimization

CERN Document Server

Brugger, Markus; Assmann, R W; Forkel-Wirth, Doris; Menzel, Hans Gregor; Roesler, Stefan; Vincke, Helmut H

2005-01-01

Radiation protection of the personnel who will perform interventions in the LHC Beam Cleaning Insertions is mandatory and includes the design of equipment and the establishment of work procedures. Residual dose rates due to activated equipment are expected to reach significant values such that any maintenance has to be planned and optimized in advance. Three-dimensional maps of dose equivalent rates at different cooling times after operation of the LHC have been calculated with FLUKA. The simulations are based on an explicit calculation of induced radioactivity and of the transport of the radiation from the radioactive decay. The paper summarizes the results for the Beam Cleaning Insertions and discusses the estimation of individual and collective doses received by personnel during critical interventions, such as the exchange of a collimator or the installation of Phase 2. The given examples outline the potential and the need to optimize, in an iterative way, the design of components as well as the layout of ...

Application of multivariate adaptive regression spine-assisted objective function on optimization of heat transfer rate around a cylinder

Energy Technology Data Exchange (ETDEWEB)

Dey, Prasenjit; Dad, Ajoy K. [Mechanical Engineering Department, National Institute of Technology, Agartala (India)

2016-12-15

The present study aims to predict the heat transfer characteristics around a square cylinder with different corner radii using multivariate adaptive regression splines (MARS). Further, the MARS-generated objective function is optimized by particle swarm optimization. The data for the prediction are taken from the recently published article by the present authors [P. Dey, A. Sarkar, A.K. Das, Development of GEP and ANN model to predict the unsteady forced convection over a cylinder, Neural Comput. Appl. (2015). Further, the MARS model is compared with artificial neural network and gene expression programming. It has been found that the MARS model is very efficient in predicting the heat transfer characteristics. It has also been found that MARS is more efficient than artificial neural network and gene expression programming in predicting the forced convection data, and also particle swarm optimization can efficiently optimize the heat transfer rate.

The human error rate assessment and optimizing system HEROS - a new procedure for evaluating and optimizing the man-machine interface in PSA

International Nuclear Information System (INIS)

Richei, A.; Hauptmanns, U.; Unger, H.

2001-01-01

A new procedure allowing the probabilistic evaluation and optimization of the man-machine system is presented. This procedure and the resulting expert system HEROS, which is an acronym for Human Error Rate Assessment and Optimizing System, is based on the fuzzy set theory. Most of the well-known procedures employed for the probabilistic evaluation of human factors involve the use of vague linguistic statements on performance shaping factors to select and to modify basic human error probabilities from the associated databases. This implies a large portion of subjectivity. Vague statements are expressed here in terms of fuzzy numbers or intervals which allow mathematical operations to be performed on them. A model of the man-machine system is the basis of the procedure. A fuzzy rule-based expert system was derived from ergonomic and psychological studies. Hence, it does not rely on a database, whose transferability to situations different from its origin is questionable. In this way, subjective elements are eliminated to a large extent. HEROS facilitates the importance analysis for the evaluation of human factors, which is necessary for optimizing the man-machine system. HEROS is applied to the analysis of a simple diagnosis of task of the operating personnel in a nuclear power plant

Optimizing the Bankruptcy Rates of Corporate Enterprises

Directory of Open Access Journals (Sweden)

Vasyliev Oleksii V.

2017-10-01

Full Text Available An important issue in forecasting the probability of bankruptcy is the formation of an optimal set of financial-economic performance indicators with high forecast capacity. The article is aimed at optimizing the indicator system, which can be used to build a model for diagnosing the probability of corporate failures. The known methods and models for diagnosing bankruptcy were analyzed and it was found that they were based on the financial performance indicators, which use empirical data only. A set of financial performance indicators has been formed that can be used to forecast probability of corporate bankruptcy or to plan for anti-crisis measures. The practical significance of the study suggests developing a theoretical basis for solving issues arising in the diagnostics of probability of bankruptcy of corporate enterprises. Prospect for further research in this direction is to develop an integrated indicator using the fuzzy logic theory, taking into account the qualitative and quantitative performance indicators of enterprise.

Optimal Fare, Vacancy Rate, and Subsidies under Log-Linear Demand with the Consideration of Externalities for a Cruising Taxi Market

Directory of Open Access Journals (Sweden)

Chun-Hsiao Chu

2017-01-01

Full Text Available Externality is an important issue for formulating the regulation policy of a taxi market. However, this issue is rarely taken into account in the current policy-making process, and it has not been adequately explored in prior research. This study extends the model proposed by Chang and Chu in 2009 with the aim of exploring the effect of externality on the optimization of the regulation policy of a cruising taxi market. A closed-form solution for optimizing the fare, vacancy rate, and subsidy of the market is derived. The results show that when the externality of taxi trips is taken into consideration, the optimal vacancy rate should be lower and the subsidy should be higher than they are under current conditions where externality is not considered. The results of the sensitivity analysis on the occupied and vacant distance indicate that the relation of the vacant distance to the marginal external cost is more sensitive than the occupied distance. The result of the sensitivity analysis on the subsidy shows the existence of a negative relationship between the marginal external cost and the optimal subsidy.

Freeze-dried microarterial allografts

International Nuclear Information System (INIS)

Raman, J.; Hargrave, J.C.

1990-01-01

Rehydrated freeze-dried microarterial allografts were implanted to bridge arterial defects using New Zealand White rabbits as the experimental model. Segments of artery from the rabbit ear and thigh were harvested and preserved for a minimum of 2 weeks after freeze-drying. These allografts, approximately 1 mm in diameter and ranging from 1.5 to 2.5 cm in length, were rehydrated and then implanted in low-pressure and high-pressure arterial systems. Poor patency was noted in low-pressure systems in both allografts and autografts, tested in 12 rabbits. In the high-pressure arterial systems, allografts that were freeze-dried and reconstituted failed in a group of 10 rabbits with an 8-week patency rate of 30 percent. Gamma irradiation in an effort to reduce infection and antigenicity of grafts after freeze-drying was associated with a patency rate of 10 percent at 8 weeks in this system in another group of 10 rabbits. Postoperative cyclosporin A therapy was associated with a patency rate of 22.2 percent in the high-pressure arterial system in a 9-rabbit group. Control autografts in this system in a group of 10 rabbits showed a 100 percent patency at 8 weeks. Microarterial grafts depend on perfusion pressure of the vascular bed for long-term patency. Rehydrated freeze-dried microarterial allografts do not seem to function well in lengths of 1 to 2.5 cm when implanted in a high-pressure arterial system. Freeze-dried arterial allografts are probably not antigenic

A critical view of the peripheral atherectomy data in the treatment of infrainguinal arterial disease.

Science.gov (United States)

Quevedo, Henry C; Arain, Salman A; Ali, Gholam; Abi Rafeh, Nidal

2014-01-01

Revascularization of the peripheral arteries remains technically challenging. By decreasing the volume of the atherosclerotic plaque, debulking procedures may confer superior primary patency after revascularization. To assess the impact of atherectomy on primary patency rates at 12 months compared to balloon angioplasty and/or stent placement alone in patients with infrainguinal arterial disease. A database search for "directional," "orbital," "rotational," and "laser atherectomy" in peripheral arterial disease (PAD) was performed. Studies were screened according to the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) critical appraisal tool and summarized by population, methodology, and outcomes (primary patency and major adverse events). Only two randomized studies were found. Most of the data were obtained from single-arm studies and registries. The primary patency with directional atherectomy approaches 60% at 12 months as a stand-alone technique, whereas orbital atherectomy in conjunction with balloon angioplasty and stenting achieved primary patency rates of 90%. Laser atherectomy is universally employed with balloon angioplasty and stenting for in-stent restenosis lesions with a primary patency rate of 64%. Although there are data for the safe use of rotational atherectomy, robust data to support its effectiveness are lacking. The combination of drug-coated balloons and atherectomy for the treatment of heavily calcified lesions in patients with critical limb ischemia is under evaluation. Despite the successful procedural outcomes reported in clinical registries, the available data do not support the use of atherectomy alone in PAD. Larger randomized controlled studies are warranted to define its role in contemporary endovascular practice.

Predictors of Shunt Dysfunction and Overall Survival in Patients with Variceal Bleeding Treated with Transjugular Portosystemic Shunt Creation Using the Fluency Stent Graft.

Science.gov (United States)

Wan, Yue-Meng; Li, Yu-Hua; Xu, Ying; Wu, Hua-Mei; Li, Ying-Chun; Wu, Xi-Nan; Yang, Jin-Hui

2018-01-16

Transjugular intrahepatic portosystemic shunt (TIPS) is an established method for portal hypertension. This study was to investigate the long-term safety, technical success, and patency of TIPS, and to determine the risk factors and clinical impacts of shunt dysfunction. A total of 154 consecutive patients undergoing embolotherapy of gastric coronary vein and/or short gastric vein and TIPS creation were prospectively studied. Follow-up data included technical success, patency and revision of TIPS, and overall survival of patients. During the study, the primary and secondary technical success rates were 98.7% and 100%, respectively. Sixty-three patients developed shunt dysfunction, 30 with shunt stenosis and 33 with shunt occlusion. The cumulative 60-month primary, primary assisted, and secondary patency rates were 19.6%, 43.0%, and 93.4%, respectively. The cumulative 60-month overall survival rates were similar between the TIPS dysfunction group and the TIPS non-dysfunction group (68.6% vs. 58.6%, P = .096). Baseline portal vein thrombosis (P value of 8.5 had 77.8% sensitivity and 64.8% specificity. The long-term safety, technical success, and patency of TIPS were good; baseline portal vein thrombosis, use of bare stents, and PPG were significantly associated with shunt dysfunction; shunt dysfunction has little impact on patients' long-term survival because of high secondary patency rates. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Percutaneous placement of self-expandable metallic biliary stents in malignant extrahepatic strictures: indications of transpapillary and suprapapillary methods

Energy Technology Data Exchange (ETDEWEB)

Lee, Deok Hee; Yu, Jeong Sik; Kim, Ki Hwang [Yonsei University College of Medicine, Seoul (Korea, Republic of); Hwang, Jae Cheol [Ulsan University Hospital, Seoul (Korea, Republic of)

2000-06-01

To compare the efficacy of suprapapillary and transpapillary methods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied. Stents were placed in 59 patients. Strictures were categorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared. Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapapillary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p = 0.37) or method (p = 0 . 6 2 ). For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.

Operational and Strategic Implementation of Dynamic Line Rating for Optimized Wind Energy Generation Integration

Energy Technology Data Exchange (ETDEWEB)

Gentle, Jake Paul [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2016-12-01

One primary goal of rendering today’s transmission grid “smarter” is to optimize and better manage its power transfer capacity in real time. Power transfer capacity is affected by three main elements: stability, voltage limits, and thermal ratings. All three are critical, but thermal ratings represent the greatest opportunity to quickly, reliably and economically utilize the grid’s true capacity. With the “Smarter Grid”, new solutions have been sought to give operators a better grasp on real time conditions, allowing them to manage and extend the usefulness of existing transmission infrastructure in a safe and reliable manner. The objective of the INL Wind Program is to provide industry a Dynamic Line Rating (DLR) solution that is state of the art as measured by cost, accuracy and dependability, to enable human operators to make informed decisions and take appropriate actions without human or system overloading and impacting the reliability of the grid. In addition to mitigating transmission line congestion to better integrate wind, DLR also offers the opportunity to improve the grid with optimized utilization of transmission lines to relieve congestion in general. As wind-generated energy has become a bigger part of the nation’s energy portfolio, researchers have learned that wind not only turns turbine blades to generate electricity, but can cool transmission lines and increase transfer capabilities significantly, sometimes up to 60 percent. INL’s DLR development supports EERE and The Wind Energy Technology Office’s goals by informing system planners and grid operators of available transmission capacity, beyond typical Static Line Ratings (SLR). SLRs are based on a fixed set of conservative environmental conditions to establish a limit on the amount of current lines can safely carry without overheating. Using commercially available weather monitors mounted on industry informed custom brackets developed by INL in combination with Computational

Operational and Strategic Implementation of Dynamic Line Rating for Optimized Wind Energy Generation Integration

International Nuclear Information System (INIS)

Gentle, Jake Paul

2016-01-01

One primary goal of rendering today's transmission grid 'smarter' is to optimize and better manage its power transfer capacity in real time. Power transfer capacity is affected by three main elements: stability, voltage limits, and thermal ratings. All three are critical, but thermal ratings represent the greatest opportunity to quickly, reliably and economically utilize the grid's true capacity. With the 'Smarter Grid', new solutions have been sought to give operators a better grasp on real time conditions, allowing them to manage and extend the usefulness of existing transmission infrastructure in a safe and reliable manner. The objective of the INL Wind Program is to provide industry a Dynamic Line Rating (DLR) solution that is state of the art as measured by cost, accuracy and dependability, to enable human operators to make informed decisions and take appropriate actions without human or system overloading and impacting the reliability of the grid. In addition to mitigating transmission line congestion to better integrate wind, DLR also offers the opportunity to improve the grid with optimized utilization of transmission lines to relieve congestion in general. As wind-generated energy has become a bigger part of the nation's energy portfolio, researchers have learned that wind not only turns turbine blades to generate electricity, but can cool transmission lines and increase transfer capabilities significantly, sometimes up to 60 percent. INL's DLR development supports EERE and The Wind Energy Technology Office's goals by informing system planners and grid operators of available transmission capacity, beyond typical Static Line Ratings (SLR). SLRs are based on a fixed set of conservative environmental conditions to establish a limit on the amount of current lines can safely carry without overheating. Using commercially available weather monitors mounted on industry informed custom brackets developed by INL in combination with Computational Fluid Dynamics (CFD

The National Bank of Ukraine Communication Strategy Optimization within the Framework of Impact on Exchange Rate Expectations of Economic Agents

Directory of Open Access Journals (Sweden)

Roksolana Holub

2017-09-01

Full Text Available An important challenge in terms of smoothing excessive exchange rate volatility under the conditions of flexible exchange rate arrangement is optimization of the communication strategy of the country’s monetary regulator. Over the past two decades, communication (information support has become an increasingly important aspect of monetary policy. Communication enables influence of the volatility of financial markets, improvement of the predictability of monetary policy, and helps to achieve macroeconomic objectives. Nevertheless, as of today, consensus on the issue into what the optimal strategy of the central bank communication is has not been reached, either in Ukraine, nor in developed countries yet. Considering the abovementioned, the methodical approaches to improve the central bank’s communication strategies, based on the use of its verbal interventions in the context of smoothing out excessive cyclical volatility of exchange rates of the national currency, are determined in this article. It is suggested to consider the growth of the factor “information signal/information noise” as a criterion of the central bank’s optimal communication strategy. It is proved that the monetary regulator’s main task should be the continual provision of information concerning a fundamentally justified level of the exchange rate and the level of deviation of the actual rate of the national currency from its fundamental-equilibrium level, as of a given time, to the national foreign exchange market participants. The methodological approach to the improvement of information support of forecasting fundamentally specified value of the national currency is outlined.

Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

International Nuclear Information System (INIS)

Bhat, Rajesh; McBride, Kieran; Chakraverty, Sam; Vikram, Raghunandan; Severn, Alison

2007-01-01

Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reduction ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series

Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion

International Nuclear Information System (INIS)

Ozkan, Ugur; Oguzkurt, Levent; Tercan, Fahri

2010-01-01

The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis (≤30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a

Incidence, risk factors, treatment and prognosis of popliteal artery embolization in the superficial femoral artery interventions.

Directory of Open Access Journals (Sweden)

Weiwei Wu

Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb

Optimized synthesis of nano-sized LiFePO4/C particles with excellent rate capability for lithium ion batteries

International Nuclear Information System (INIS)

Liu, Houbin; Miao, Cui; Meng, Yan; He, Yan-Bing; Xu, Qiang; Zhang, Xinhe; Tang, Zhiyuan

2014-01-01

Olivine-type LiFePO 4 /C composite with excellent rate capability and cycling stability is synthesized by an optimized ethylene glycol assisted solution-phase method. In an attempt to improve the electrochemical performance, the size of LiFePO 4 /C particle is reduced by optimizing the reaction time and temperature. The results show that the LiFePO 4 /C synthesized at 130 °C for 5 h consists of well-distributed nano-particles of size about 50 nm in diameter and 100 nm in length, which is uniformly coated with a carbon layer about 3.0 nm in thickness. The material synthesized at 130 °C exhibits the least charge-transfer resistance than the LiFePO 4 /C synthesized at 120 and 140 °C. The specific capacity of optimized LiFePO 4 /C at discharge rate of 0.1 C can reach to 166.5 mAhg −1 , nearly to the theoretical capacity. Even at high rate of 5, 10, 20 and 30 C, the specific capacities of 132.3, 120.4, 97.3 and 66.6 mAhg −1 are achieved, respectively, with no significant capacity fading after 100 cycles. This is a promising method used in industrialization to synthesize LiFePO 4 /C composite with excellent performance

Testing the limits of optimality: the effect of base rates in the Monty Hall dilemma.

Science.gov (United States)

Herbranson, Walter T; Wang, Shanglun

2014-03-01

The Monty Hall dilemma is a probability puzzle in which a player tries to guess which of three doors conceals a desirable prize. After an initial selection, one of the nonchosen doors is opened, revealing that it is not a winner, and the player is given the choice of staying with the initial selection or switching to the other remaining door. Pigeons and humans were tested on two variants of the Monty Hall dilemma, in which one of the three doors had either a higher or a lower chance of containing the prize than did the other two options. The optimal strategy in both cases was to initially choose the lowest-probability door available and then switch away from it. Whereas pigeons learned to approximate the optimal strategy, humans failed to do so on both accounts: They did not show a preference for low-probability options, and they did not consistently switch. An analysis of performance over the course of training indicated that pigeons learned to perform a sequence of responses on each trial, and that sequence was one that yielded the highest possible rate of reinforcement. Humans, in contrast, continued to vary their responses throughout the experiment, possibly in search of a more complex strategy that would exceed the maximum possible win rate.

Robust and Optimal Control of Magnetic Microparticles inside Fluidic Channels with Time-Varying Flow Rates

Directory of Open Access Journals (Sweden)

Islam S.M. Khalil

2016-06-01

Full Text Available Targeted therapy using magnetic microparticles and nanoparticles has the potential to mitigate the negative side-effects associated with conventional medical treatment. Major technological challenges still need to be addressed in order to translate these particles into in vivo applications. For example, magnetic particles need to be navigated controllably in vessels against flowing streams of body fluid. This paper describes the motion control of paramagnetic microparticles in the flowing streams of fluidic channels with time-varying flow rates (maximum flow is 35 ml.hr−1. This control is designed using a magnetic-based proportional-derivative (PD control system to compensate for the time-varying flow inside the channels (with width and depth of 2 mm and 1.5 mm, respectively. First, we achieve point-to-point motion control against and along flow rates of 4 ml.hr−1, 6 ml.hr−1, 17 ml.hr−1, and 35 ml.hr−1. The average speeds of single microparticle (with average diameter of 100 μm against flow rates of 6 ml.hr−1 and 30 ml.hr−1 are calculated to be 45 μm.s−1 and 15 μm.s−1, respectively. Second, we implement PD control with disturbance estimation and compensation. This control decreases the steady-state error by 50%, 70%, 73%, and 78% at flow rates of 4 ml.hr−1, 6 ml.hr−1, 17 ml.hr−1, and 35 ml.hr−1, respectively. Finally, we consider the problem of finding the optimal path (minimal kinetic energy between two points using calculus of variation, against the mentioned flow rates. Not only do we find that an optimal path between two collinear points with the direction of maximum flow (middle of the fluidic channel decreases the rise time of the microparticles, but we also decrease the input current that is supplied to the electromagnetic coils by minimizing the kinetic energy of the microparticles, compared to a PD control with disturbance compensation.

Modeling metabolic networks in C. glutamicum: a comparison of rate laws in combination with various parameter optimization strategies

Directory of Open Access Journals (Sweden)

Oldiges Marco

2009-01-01

Full Text Available Abstract Background To understand the dynamic behavior of cellular systems, mathematical modeling is often necessary and comprises three steps: (1 experimental measurement of participating molecules, (2 assignment of rate laws to each reaction, and (3 parameter calibration with respect to the measurements. In each of these steps the modeler is confronted with a plethora of alternative approaches, e. g., the selection of approximative rate laws in step two as specific equations are often unknown, or the choice of an estimation procedure with its specific settings in step three. This overall process with its numerous choices and the mutual influence between them makes it hard to single out the best modeling approach for a given problem. Results We investigate the modeling process using multiple kinetic equations together with various parameter optimization methods for a well-characterized example network, the biosynthesis of valine and leucine in C. glutamicum. For this purpose, we derive seven dynamic models based on generalized mass action, Michaelis-Menten and convenience kinetics as well as the stochastic Langevin equation. In addition, we introduce two modeling approaches for feedback inhibition to the mass action kinetics. The parameters of each model are estimated using eight optimization strategies. To determine the most promising modeling approaches together with the best optimization algorithms, we carry out a two-step benchmark: (1 coarse-grained comparison of the algorithms on all models and (2 fine-grained tuning of the best optimization algorithms and models. To analyze the space of the best parameters found for each model, we apply clustering, variance, and correlation analysis. Conclusion A mixed model based on the convenience rate law and the Michaelis-Menten equation, in which all reactions are assumed to be reversible, is the most suitable deterministic modeling approach followed by a reversible generalized mass action kinetics

NLP modeling for the optimization of LiBr-H_2O absorption refrigeration systems with exergy loss rate, heat transfer area, and cost as single objective functions

International Nuclear Information System (INIS)

Mussati, Sergio F.; Gernaey, Krist V.; Morosuk, Tatiana; Mussati, Miguel C.

2016-01-01

Highlights: • A NLP model is used for simultaneous optimization of sizes and operating conditions. • Total exergy loss rate and transfer area are optimized as single objective functions. • Theoretical and practical bounds for cost optimization problems are computed. • A systematic solution strategy is proposed for total annual cost optimization. • Relevance of components is ranked by heat transfer area, exergy loss rate, and cost. - Abstract: Based on a nonlinear mathematical programming model, the sizes and operating conditions of the process units of single-effect absorption refrigeration systems operating with a LiBr–H_2O solution are optimized for a specified cooling capacity by minimizing three single objective functions: the total exergy loss rate, the total heat transfer area, and the total annual cost of the system. It was found that the optimal solution obtained by minimization of the total exergy loss rate provides “theoretical” upper bounds not only for the total heat transfer area of the system but also for each process unit and all stream temperatures, while the optimal solution obtained by minimization of the total heat transfer area provides the lower bounds for these model variables, to solve a cost optimization problem. The minimization of the total exergy loss rate by varying parametrically the available total heat transfer area between these bounds was also performed, allowing to see how the optimal distribution of the available total heat transfer area among the system components, as well as the operating conditions (stream temperature, pressure, composition, and mass flow rate) and heat loads, vary qualitatively and quantitatively with increasing available total heat transfer area. These optimization results allowed to find a “practical” value of the total heat transfer area, i.e. no benefits can be obtained by increasing the available total heat transfer area above this value since the minimal total exergy loss value cannot

NLP modeling for the optimization of LiBr-H2O absorption refrigeration systems with exergy loss rate, heat transfer area, and cost as single objective functions

DEFF Research Database (Denmark)

Mussati, Sergio F.; Gernaey, Krist; Morosuk, Tatiana

2016-01-01

exergy loss rate, the total heat transfer area, and the total annual cost of the system. It was found that the optimal solution obtained by minimization of the total exergy loss rate provides “theoretical” upper bounds not only for the total heat transfer area of the system but also for each process unit...... and all stream temperatures, while the optimal solution obtained by minimization of the total heat transfer area provides the lower bounds for these model variables, to solve a cost optimization problem. The minimization of the total exergy loss rate by varying parametrically the available total heat...... transfer area between these bounds was also performed, allowing to see how the optimal distribution of the available total heat transfer area among the system components, as well as the operating conditions (stream temperature, pressure, composition, and mass flow rate) and heat loads, vary qualitatively...

Credit Rating via Dynamic Slack-Based Measure And It´s Optimal Investment Strategy

Directory of Open Access Journals (Sweden)

A. Delavarkhalafi

2015-01-01

Full Text Available In this paper we check the credit rating of firms applied for a loan. In this regard we introduce a model, named Dynamic Slack-Based Measure (DSBM for measuring credit rating of applicant companies. Selection of financial ratios that represent the financial state of a company -in the best possible way- is one of the most challenging parts of any credit rating analysis. At first, ranking needs to identify the appropriate variables. Therefore we introduce five financial variables to provide a ranking. As noted above, we assess the performance of these firms. Then we introduce the dynamic model of SBM and theorems, also we discuss the overall structure of DSBM. Then we will present the implementation and the simulation model. After that, we propose a stochastic controlled dynamic system model to express the optimal strategy. Banks expect companies selected with DSBM model, act in accordance with this strategy. This stochastic dynamic system is originated from the balance sheets of firms applying for a loan. Finally we evaluate the performance of the system and strategy problem.

Optimal taxation with home production

OpenAIRE

Olovsson, Conny

2014-01-01

Optimal taxes for Europe and the U.S. are derived in a realistically calibrated model in which agents buy consumption goods and services and use home capital and labor to produce household services. The optimal tax rate on services is substantially lower than the tax rate on goods. Specifically, the planner cannot tax home production directly and instead lowers the tax rate on market services to increase the relative price of home production. The optimal tax rate on the return to home capital...

Optimal inflation for the U.S.

OpenAIRE

Roberto M. Billi

2007-01-01

What is the correctly measured inflation rate that monetary policy should aim for in the long-run? This paper characterizes the optimal inflation rate for the U.S. economy in a New Keynesian sticky-price model with an occasionally binding zero lower bound on the nominal interest rate. Real-rate and mark-up shocks jointly determine the optimal inflation rate to be positive but not large. Even allowing for the possibility of extreme model misspecification, the optimal inflation rate is robustly...

In vivo argon laser vascular welding using thermal feedback: open and closed loop patency and collagen crosslinking

Energy Technology Data Exchange (ETDEWEB)

Small, W., LLNL

1997-02-28

An in vivo study of vascular welding with a fiber-delivered argon laser was conducted using a canine model. Longitudinal arteriotomies and venotomies were treated on femoral vein and artery. Laser energy was delivered to the vessel wall via a 400 {micro}m optical fiber. The surface temperature at the center of the laser spot was monitored in real time using a hollow glass optical fiber-based two-color infrared thermometer. The surface temperature was limited by either a room-temperature saline drip or direct feedback control of the laser using a mechanical shutter to alternately pass and block the laser. Acute patency was evaluated either visually (leak/no leak) or by in vivo burst pressure measurements. Biochemical assays were performed to investigate the possible laser-induced formation or destruction of enzymatically mediated covalent crosslinks between collagen molecules. Viable welds were created both with and without the use of feedback control. Tissues maintained at 50 C using feedback control had an elevated crosslink count compared to controls, while those irradiated without feedback control experienced a decrease. Differences between the volumetric heating associated with open and closed loop protocols may account for the different effects on collagen crosslinks. Covalent mechanisms may play a role in argon laser vascular fusion.

Outcomes of Prosthetic Hemodialysis Grafts after Deployment of Bare Metal versus Covered Stents at the Venous Anastomosis

Energy Technology Data Exchange (ETDEWEB)

Kim, Charles Y., E-mail: charles.kim@duke.edu; Tandberg, Daniel J.; Rosenberg, Michael D.; Miller, Michael J.; Suhocki, Paul V.; Smith, Tony P. [Duke University Medical Center, Division of Vascular and Interventional Radiology (United States)

2012-08-15

Purpose: To compare postintervention patency rates after deployment of bare metal versus covered stents across the venous anastomosis of prosthetic arteriovenous (AV) grafts. Methods: Review of our procedural database over a 6 year period revealed 377 procedures involving stent deployment in an AV access circuit. After applying strict inclusion criteria, our study group consisted of 61 stent deployments in 58 patients (median age 58 years, 25 men, 33 women) across the venous anastomosis of an upper extremity AV graft circuit that had never been previously stented. Both patent and thrombosed AV access circuits were retrospectively analyzed. Within the bare metal stent group, 20 of 32 AV grafts were thrombosed at initial presentation compared to 18 of 29 AV grafts in the covered stent group. Results: Thirty-two bare metal stents and 29 covered stents were deployed across the venous anastomosis. The 3, 6, and 12 months primary access patency rates for bare metal stents were not significantly different than for covered stents: 50, 41, and 22 % compared to 59, 52, and 29 %, respectively (p = 0.21). The secondary patency rates were also not significantly different: 78, 78, and 68 % for bare metal stents compared to 76, 69, and 61 % for covered stents, respectively (p = 0.85). However, covered stents demonstrated a higher primary stent patency rate than bare metal stents: 100, 85, and 70 % compared to 75, 67, and 49 % at 3, 6, and 12 months (p < 0.01). Conclusion: The primary and secondary access patency rates after deployment of bare metal versus covered stents at the venous anastomosis were not significantly different. However, bare metal stents developed in-stent stenoses significantly sooner.

Outcomes of Prosthetic Hemodialysis Grafts after Deployment of Bare Metal versus Covered Stents at the Venous Anastomosis

International Nuclear Information System (INIS)

Kim, Charles Y.; Tandberg, Daniel J.; Rosenberg, Michael D.; Miller, Michael J.; Suhocki, Paul V.; Smith, Tony P.

2012-01-01

Purpose: To compare postintervention patency rates after deployment of bare metal versus covered stents across the venous anastomosis of prosthetic arteriovenous (AV) grafts. Methods: Review of our procedural database over a 6 year period revealed 377 procedures involving stent deployment in an AV access circuit. After applying strict inclusion criteria, our study group consisted of 61 stent deployments in 58 patients (median age 58 years, 25 men, 33 women) across the venous anastomosis of an upper extremity AV graft circuit that had never been previously stented. Both patent and thrombosed AV access circuits were retrospectively analyzed. Within the bare metal stent group, 20 of 32 AV grafts were thrombosed at initial presentation compared to 18 of 29 AV grafts in the covered stent group. Results: Thirty-two bare metal stents and 29 covered stents were deployed across the venous anastomosis. The 3, 6, and 12 months primary access patency rates for bare metal stents were not significantly different than for covered stents: 50, 41, and 22 % compared to 59, 52, and 29 %, respectively (p = 0.21). The secondary patency rates were also not significantly different: 78, 78, and 68 % for bare metal stents compared to 76, 69, and 61 % for covered stents, respectively (p = 0.85). However, covered stents demonstrated a higher primary stent patency rate than bare metal stents: 100, 85, and 70 % compared to 75, 67, and 49 % at 3, 6, and 12 months (p < 0.01). Conclusion: The primary and secondary access patency rates after deployment of bare metal versus covered stents at the venous anastomosis were not significantly different. However, bare metal stents developed in-stent stenoses significantly sooner.

Optimal Rate Allocation in Cluster-Tree WSNs

Directory of Open Access Journals (Sweden)

Jose Lopez Vicario

2011-03-01

Full Text Available In this paper, we propose a solution to the problem of guaranteed time slot allocation in cluster-tree WSNs. Our design uses the so-called Network Utility Maximization (NUM approach as far as we aim to provide a fair distribution of the available resources. From the point of view of implementation, we extend here the authors’ proposed Coupled-Decompositions Method (CDM in order to compute the NUM problem inside the cluster tree topology and we prove the optimality of this new extended version of the method. As a result, we obtain a distributed solution that reduces the total amount of signalling information in the network up to a factor of 500 with respect to the classical techniques, that is, primal and dual decomposition. This is possible because the CDM finds the optimal solution with a small number of iterations. Furthermore, when we compare our solution to the standard-proposed First Come First Serve (FCFS policy, we realize that FCFS becomes pretty unfair as the traffic load in the network increases and thus, a fair allocation of resources can be considered whenever the price to pay in terms of signalling and computational complexity is controlled.

THE OPTIMAL RATE OF R&D EXPENDITURES ÎN GDP – BETWEEN THEORY AND PRACTICE

Directory of Open Access Journals (Sweden)

Steliana SANDU

2010-12-01

Full Text Available The relation between economic growth, competitiveness, productivity, on one hand, and investment in research and development (R&D, on the other, has been the research subject of numerous scientific studies. The significant contribution of the investment in R&D to productivity growth, competitiveness and economic growth is generally acknowledged. Some authors have attempted to empirically and theoretically estimate the optimal level of R&D investment at the micro and mezo level, following different paths, according to their option for the aggregation level of analysis or to the different indicators selected as most relevant. Yet, the identification of the R&D investment level that maximizes the productivity growth rate at macroeconomic level seems to have been rather marginal to the general research interest. Available scientific papers estimate it by relating the share of R&D spending in GDP to productivity, expressed through the Total Factor Productivity or labour productivity per hour worked. This paper looks into the correlation between the spending for research and development in some EU countries, as a share of GDP, underlining the relative positions to the optimal interval for R&D investment, according to Mario Coccia estimations, and the corresponding rates of labour productivity growth, during the 2000-2009 period. Special attention will be given to Romania’s positioning in European context, in order to identify potential solutions to future improvement.

Minimum variance optimal rate allocation for multiplexed H.264/AVC bitstreams.

Science.gov (United States)

Tagliasacchi, Marco; Valenzise, Giuseppe; Tubaro, Stefano

2008-07-01

Consider the problem of transmitting multiple video streams to fulfill a constant bandwidth constraint. The available bit budget needs to be distributed across the sequences in order to meet some optimality criteria. For example, one might want to minimize the average distortion or, alternatively, minimize the distortion variance, in order to keep almost constant quality among the encoded sequences. By working in the rho-domain, we propose a low-delay rate allocation scheme that, at each time instant, provides a closed form solution for either the aforementioned problems. We show that minimizing the distortion variance instead of the average distortion leads, for each of the multiplexed sequences, to a coding penalty less than 0.5 dB, in terms of average PSNR. In addition, our analysis provides an explicit relationship between model parameters and this loss. In order to smooth the distortion also along time, we accommodate a shared encoder buffer to compensate for rate fluctuations. Although the proposed scheme is general, and it can be adopted for any video and image coding standard, we provide experimental evidence by transcoding bitstreams encoded using the state-of-the-art H.264/AVC standard. The results of our simulations reveal that is it possible to achieve distortion smoothing both in time and across the sequences, without sacrificing coding efficiency.

Frequent change of procedure during coronary artery bypass surgery suggests insufficient preoperative diagnostic strategy

DEFF Research Database (Denmark)

Eckardt, Rozy; Kjeldsen, Bo Juel; Thayssen, Per

2007-01-01

We sought to evaluate how often and in what way surgeons change peroperatively their preoperative coronary artery bypass grafting strategy and to what degree these changes affect postoperative graft patency. A series of 109 patients with stable angina pectoris and at least one occluded coronary...... a discrepancy in 22% of the patients, resulting in a lower or higher number of grafts than pre-operatively estimated. The difference in shift rates between the three sites, left anterior descending, left circumflex, and right coronary artery, was significant (P=0.014). Patency rates were highest when only...... preoperatively planned grafts were inserted. When shifts occurred, no matter in which direction, it resulted in a decreased patency rate of the inserted grafts. This finding was significant for LAD (P=0.037). Our findings might indicate the necessity of future studies with the use of scintigraphy or fractional...

Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter

Energy Technology Data Exchange (ETDEWEB)

Kang, Pyeong Guk; Hong, Hyun Pyo; Choi, Yoon Jung; Lee, Min Hee; Park, Hae Won; Chung, Eun Chul [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Kim, Sam Soo [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)

2010-03-15

To evaluate the feasibility, effectiveness, and safety of self-expandable metallic stent for the palliative treatment of obstructing left-sided colorectal cancer under fluoroscopic guidance, and to compare results according to the stent diameter. Under fluoroscopic guidance, 31 self-expandable metallic stents were placed into 25 patients for palliative purposes. The rates of technical success, clinical success, complications associated with stent insertion, patient survival, and primary stent patency were evaluated. The results were also compared between two groups: 13 patients using stents with a diameter of 22 mm and 12 patients using stents with a diameter of 26 mm. The technical and clinical success rates were 93.5 and 90.3%, respectively. The complications included severe abdominal pain (6.5%), minor rectal bleeding (9.7%), stent migration (9.7%), and tumor ingrowth or overgrowth (9.7%). No statistical differences in technical were detected between the two groups for the clinical success rate and complication rates. The mean survival time was 5.5 +- 1.4 months. The primary stent patency rates were 91.3% at 5 months, 85.2% at 10 months, and 77.4% at 15 months. The mean period of stent patency was 12.4 +- 2.6 months. The mean period of primary stent patency was 16.4 +- 2.6 months in the 26 mm stent group, and significantly higher than 5.4 +- 1.4 months in the 22 mm stent group (p=0.031). A self-expandable metallic stent under fluoroscopic guidance, for the palliative treatment of obstructing left-sided colorectal cancer, was feasible and effective, and yielded good clinical results. The period of primary stent patency of the 26 mm stent group was longer than the 22 mm stent group, and the complication rate was not significantly different between the two stent groups

Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter

International Nuclear Information System (INIS)

Kang, Pyeong Guk; Hong, Hyun Pyo; Choi, Yoon Jung; Lee, Min Hee; Park, Hae Won; Chung, Eun Chul; Kim, Sam Soo

2010-01-01

To evaluate the feasibility, effectiveness, and safety of self-expandable metallic stent for the palliative treatment of obstructing left-sided colorectal cancer under fluoroscopic guidance, and to compare results according to the stent diameter. Under fluoroscopic guidance, 31 self-expandable metallic stents were placed into 25 patients for palliative purposes. The rates of technical success, clinical success, complications associated with stent insertion, patient survival, and primary stent patency were evaluated. The results were also compared between two groups: 13 patients using stents with a diameter of 22 mm and 12 patients using stents with a diameter of 26 mm. The technical and clinical success rates were 93.5 and 90.3%, respectively. The complications included severe abdominal pain (6.5%), minor rectal bleeding (9.7%), stent migration (9.7%), and tumor ingrowth or overgrowth (9.7%). No statistical differences in technical were detected between the two groups for the clinical success rate and complication rates. The mean survival time was 5.5 ± 1.4 months. The primary stent patency rates were 91.3% at 5 months, 85.2% at 10 months, and 77.4% at 15 months. The mean period of stent patency was 12.4 ± 2.6 months. The mean period of primary stent patency was 16.4 ± 2.6 months in the 26 mm stent group, and significantly higher than 5.4 ± 1.4 months in the 22 mm stent group (p=0.031). A self-expandable metallic stent under fluoroscopic guidance, for the palliative treatment of obstructing left-sided colorectal cancer, was feasible and effective, and yielded good clinical results. The period of primary stent patency of the 26 mm stent group was longer than the 22 mm stent group, and the complication rate was not significantly different between the two stent groups

A hybrid evolutionary algorithm for multi-objective anatomy-based dose optimization in high-dose-rate brachytherapy

International Nuclear Information System (INIS)

Lahanas, M; Baltas, D; Zamboglou, N

2003-01-01

Multiple objectives must be considered in anatomy-based dose optimization for high-dose-rate brachytherapy and a large number of parameters must be optimized to satisfy often competing objectives. For objectives expressed solely in terms of dose variances, deterministic gradient-based algorithms can be applied and a weighted sum approach is able to produce a representative set of non-dominated solutions. As the number of objectives increases, or non-convex objectives are used, local minima can be present and deterministic or stochastic algorithms such as simulated annealing either cannot be used or are not efficient. In this case we employ a modified hybrid version of the multi-objective optimization algorithm NSGA-II. This, in combination with the deterministic optimization algorithm, produces a representative sample of the Pareto set. This algorithm can be used with any kind of objectives, including non-convex, and does not require artificial importance factors. A representation of the trade-off surface can be obtained with more than 1000 non-dominated solutions in 2-5 min. An analysis of the solutions provides information on the possibilities available using these objectives. Simple decision making tools allow the selection of a solution that provides a best fit for the clinical goals. We show an example with a prostate implant and compare results obtained by variance and dose-volume histogram (DVH) based objectives

Dynamic optimization of CELSS crop photosynthetic rate by computer-assisted feedback control

Science.gov (United States)

Chun, C.; Mitchell, C. A.

1997-01-01

A procedure for dynamic optimization of net photosynthetic rate (Pn) for crop production in Controlled Ecological Life-Support Systems (CELSS) was developed using leaf lettuce as a model crop. Canopy Pn was measured in real time and fed back for environmental control. Setpoints of photosynthetic photon flux (PPF) and CO_2 concentration for each hour of the crop-growth cycle were decided by computer to reach a targeted Pn each day. Decision making was based on empirical mathematical models combined with rule sets developed from recent experimental data. Comparisons showed that dynamic control resulted in better yield per unit energy input to the growth system than did static control. With comparable productivity parameters and potential for significant energy savings, dynamic control strategies will contribute greatly to the sustainability of space-deployed CELSS.

Stent placement with the monorail technique for treatment of mesenteric artery stenosis.

Science.gov (United States)

Schaefer, Philipp J; Schaefer, Fritz K W; Hinrichsen, Holger; Jahnke, Thomas; Charalambous, Nikolas; Heller, Martin; Mueller-Huelsbeck, Stefan

2006-04-01

To analyze the immediate and midterm success of stenting of mesenteric arteries by a monorail technique in patients with chronic mesenteric ischemia. In this prospective case series, 19 patients (11 male, 8 female; mean age, 62.9 +/- 10.4 y; range, 36-82 y) with 23 symptomatic stenoses of mesenteric arteries were treated with stent placement by a monorail technique in a radiologic intervention center over a period of 4.5 years. Clinical examinations and duplex sonography were used to evaluate the stents' patency and clinical success. Kaplan-Meier graphs were calculated to analyze the patency and freedom-from-symptom rate. Initial technical success rate was 22/23 (96%). Mean follow-up was 17 months (range, 1-58 mo). Primary patency and primary clinical success rates were 82% and 78%, respectively. According to Kaplan-Meier tables, the patency rates were 96%, 87%, 76%, and 61% at 0, 1, 15, and 24 months, respectively, and the freedom-from-symptom rates were 95%, 90%, 72%, and 54% at 0, 1, 24, and 30 months, respectively. No peri-interventional complications occurred. Two patients died of cardiac failure in the hospital within 30 days after intervention; deaths were not related to the intervention. Stent placement by a monorail technique in mesenteric arteries is an effective and safe treatment for symptomatic stenoses in patients with chronic mesenteric ischemia after a mean follow-up of 17 months.

Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction.

Science.gov (United States)

Inatomi, Osamu; Bamba, Shigeki; Shioya, Makoto; Mochizuki, Yosuke; Ban, Hiromitsu; Tsujikawa, Tomoyuki; Saito, Yasuharu; Andoh, Akira; Fujiyama, Yoshihide

2013-02-14

Although endoscopic biliary stents have been accepted as part of palliative therapy for cases of malignant hilar obstruction, the optimal endoscopic management regime remains controversial. In this study, we evaluated the safety and efficacy of placing a threaded stent above the sphincter of Oddi (threaded inside plastic stents, threaded PS) and compared the results with those of other stent types. Patients with malignant hilar obstruction, including those requiring biliary drainage for stent occlusion, were selected. Patients received either one of the following endoscopic indwelling stents: threaded PS, conventional plastic stents (conventional PS), or metallic stents (MS). Duration of stent patency and the incident of complication were compared in these patients. Forty-two patients underwent placement of endoscopic indwelling stents (threaded PS = 12, conventional PS = 17, MS = 13). The median duration of threaded PS patency was significantly longer than that of conventional PS patency (142 vs. 32 days; P = 0.04, logrank test). The median duration of threaded PS and MS patency was not significantly different (142 vs. 150 days, P = 0.83). Stent migration did not occur in any group. Among patients who underwent threaded PS placement as a salvage therapy after MS obstruction due to tumor ingrowth, the median duration of MS patency was significantly shorter than that of threaded PS patency (123 vs. 240 days). Threaded PS are safe and effective in cases of malignant hilar obstruction; moreover, it is a suitable therapeutic option not only for initial drainage but also for salvage therapy.

Optimal learning with Bernstein online aggregation

DEFF Research Database (Denmark)

Wintenberger, Olivier

2017-01-01

batch version achieves the fast rate of convergence log (M) / n in deviation. The BOA procedure is the first online algorithm that satisfies this optimal fast rate. The second order refinement is required to achieve the optimality in deviation as the classical exponential weights cannot be optimal, see...... is shown to be sufficiently small to assert the fast rate in the iid setting when the loss is Lipschitz and strongly convex. We also introduce a multiple learning rates version of BOA. This fully adaptive BOA procedure is also optimal, up to a log log (n) factor....

Optimal PMU Placement By Improved Particle Swarm Optimization

DEFF Research Database (Denmark)

Rather, Zakir Hussain; Liu, Leo; Chen, Zhe

2013-01-01

This paper presents an improved method of binary particle swarm optimization (IBPSO) technique for optimal phasor measurement unit (PMU) placement in a power network for complete system observability. Various effective improvements have been proposed to enhance the efficiency and convergence rate...... of conventional particle swarm optimization method. The proposed method of IBPSO ensures optimal PMU placement with and without consideration of zero injection measurements. The proposed method has been applied to standard test systems like 17 bus, IEEE 24-bus, IEEE 30-bus, New England 39-bus, IEEE 57-bus system...

Learning optimal embedded cascades.

Science.gov (United States)

Saberian, Mohammad Javad; Vasconcelos, Nuno

2012-10-01

The problem of automatic and optimal design of embedded object detector cascades is considered. Two main challenges are identified: optimization of the cascade configuration and optimization of individual cascade stages, so as to achieve the best tradeoff between classification accuracy and speed, under a detection rate constraint. Two novel boosting algorithms are proposed to address these problems. The first, RCBoost, formulates boosting as a constrained optimization problem which is solved with a barrier penalty method. The constraint is the target detection rate, which is met at all iterations of the boosting process. This enables the design of embedded cascades of known configuration without extensive cross validation or heuristics. The second, ECBoost, searches over cascade configurations to achieve the optimal tradeoff between classification risk and speed. The two algorithms are combined into an overall boosting procedure, RCECBoost, which optimizes both the cascade configuration and its stages under a detection rate constraint, in a fully automated manner. Extensive experiments in face, car, pedestrian, and panda detection show that the resulting detectors achieve an accuracy versus speed tradeoff superior to those of previous methods.

Portfolio Optimization and Mortgage Choice

Directory of Open Access Journals (Sweden)

Maj-Britt Nordfang

2017-01-01

Full Text Available This paper studies the optimal mortgage choice of an investor in a simple bond market with a stochastic interest rate and access to term life insurance. The study is based on advances in stochastic control theory, which provides analytical solutions to portfolio problems with a stochastic interest rate. We derive the optimal portfolio of a mortgagor in a simple framework and formulate stylized versions of mortgage products offered in the market today. This allows us to analyze the optimal investment strategy in terms of optimal mortgage choice. We conclude that certain extreme investors optimally choose either a traditional fixed rate mortgage or an adjustable rate mortgage, while investors with moderate risk aversion and income prefer a mix of the two. By matching specific investor characteristics to existing mortgage products, our study provides a better understanding of the complex and yet restricted mortgage choice faced by many household investors. In addition, the simple analytical framework enables a detailed analysis of how changes to market, income and preference parameters affect the optimal mortgage choice.

Distributed Cooperative Optimal Control for Multiagent Systems on Directed Graphs: An Inverse Optimal Approach.

Science.gov (United States)

Zhang, Huaguang; Feng, Tao; Yang, Guang-Hong; Liang, Hongjing

2015-07-01

In this paper, the inverse optimal approach is employed to design distributed consensus protocols that guarantee consensus and global optimality with respect to some quadratic performance indexes for identical linear systems on a directed graph. The inverse optimal theory is developed by introducing the notion of partial stability. As a result, the necessary and sufficient conditions for inverse optimality are proposed. By means of the developed inverse optimal theory, the necessary and sufficient conditions are established for globally optimal cooperative control problems on directed graphs. Basic optimal cooperative design procedures are given based on asymptotic properties of the resulting optimal distributed consensus protocols, and the multiagent systems can reach desired consensus performance (convergence rate and damping rate) asymptotically. Finally, two examples are given to illustrate the effectiveness of the proposed methods.

Economic assessment of pulsed dose-rate (P.D.R.) brachytherapy with optimized dose distribution for cervix carcinoma

International Nuclear Information System (INIS)

Remonnay, R.; Morelle, M.; Pommier, P.; Carrere, M.O.; Remonnay, R.; Morelle, M.; Pommier, P.; Pommier, P.; Haie-Meder, C.; Quetin, P.; Kerr, C.; Delannes, M.; Castelain, B.; Peignaux, K.; Kirova, Y.; Romestaing, P.; Williaume, D.; Krzisch, C.; Thomas, L.; Lang, P.; Baron, M.H.; Cussac, A.; Lesaunier, F.; Maillard, S.; Barillot, I.; Charra-Brunaud, C.; Peiffert, D.

2010-01-01

Purpose: Our study aims at evaluating the cost of pulsed dose-rate (P.D.R.) brachytherapy with optimized dose distribution versus traditional treatments (iridium wires, cesium, non-optimized P.D.R.). Issues surrounding reimbursement were also explored. Materials and methods: This prospective, multi-centre, non-randomized study conducted in the framework of a project entitled 'Support Program for Costly Diagnostic and Therapeutic Innovations' involved 21 hospitals. Patients with cervix carcinoma received either classical brachytherapy or the innovation. The direct medical costs of staff and equipment, as well as the costs of radioactive sources, consumables and building renovation were evaluated from a hospital point of view using a micro costing approach. Subsequent costs per brachytherapy were compared between the four strategies. Results: The economic study included 463 patients over two years. The main resources categories associated with P.D.R. brachytherapy (whether optimized or not) were radioactive sources (1053 Euros) and source projectors (735 Euros). Optimized P.D.R. induced higher cost of imagery and dosimetry (respectively 130 Euros and 367 Euros) than non-optimized P.D.R. (47 Euros and 75 Euros). Extra costs of innovation over the less costly strategy (iridium wires) reached more than 2100 Euros per treatment, but could be reduced by half in the hypothesis of 40 patients treated per year (instead of 24 in the study). Conclusion: Aside from staff, imaging and dosimetry, the current hospital reimbursements largely underestimated the cost of innovation related to equipment and sources. (authors)

High Dynamic Optimized Carrier Loop Improvement for Tracking Doppler Rates

Directory of Open Access Journals (Sweden)

Amirhossein Fereidountabar

2015-01-01

Full Text Available Mathematical analysis and optimization of a carrier tracking loop are presented. Due to fast changing of the carrier frequency in some satellite systems, such as Low Earth Orbit (LEO or Global Positioning System (GPS, or some planes like Unmanned Aerial Vehicles (UAVs, high dynamic tracking loops play a very important role. In this paper an optimized tracking loop consisting of a third-order Phase Locked Loop (PLL assisted by a second-order Frequency Locked Loop (FLL for UAVs is proposed and discussed. Based on this structure an optimal loop has been designed. The main advantages of this approach are the reduction of the computation complexity and smaller phase error. The paper shows the simulation results, comparing them with a previous work.

Transesterification of waste cooking oil: Process optimization and conversion rate evaluation

International Nuclear Information System (INIS)

Abd Rabu, R.; Janajreh, I.; Honnery, D.

2013-01-01

Highlights: ► The highest purity of the produced biodiesel determined by gas chromatography was 95%. ► Produced biodiesel samples fell within the requirements of American standard for biodiesel. ► The reaction order is 1st order with a rate constant of 0.01 min -1 in the above point min -1 . - Abstract: Biodiesel is a mono-alkyl ester of vegetable oil, animal fat, and recycled cooking oil. It is gaining importance in the quest of finding sustainable fuel as it is compatible with petrodiesel and its synthesis process is becoming more commercially deployable. It is commonly prepared by the transesterification of triglycerides or the esterification of free fatty acid with methanol by stirring and accelerated by the presence of base or acidic catalyst. In this work biodiesel was produced by transesterification of waste cooking oil (WCO) following different process settings with the objective to achieve maximum yield and purity. Due to immiscibility and reaction reversibility, high purity WCO biodiesel of 95% was produced at 12:1 alcohol to oil molar ratio at 1% w/w NaOH catalyst and under continuous mixing of 2 h at 60 °C. Chemical kinetics was determined for the optimal process and found to follow 1st order reaction rate with a rate constant ranges from 0.0035 to 0.0106 min −1 . The activation energy was also evaluated by running the experiment at three different temperatures and found to be near 25,496 J/mol. The distillation curve and properties of the resulted fuel was also assessed and were compared plausibly to ASTM biodiesel standards. Furthermore, the emitted soot from a diffusion wick flame was measured via opacity meter and clearly show the advantage of the biodiesel with a nearly an order of magnitude lower.

Optimal decisions of sharing rate and ticket price of different transportation modes in inter-city transportation corridor

Directory of Open Access Journals (Sweden)

Zhaoping Tang

2015-11-01

Full Text Available Purpose: The paper concerns competition of different transportation modes coexist in inter-city transportation corridor. The purpose of this paper is to express the competitive relationship by building mathematical model and obtain the best sharing rate and the optimal ticket price of different transportation modes. Design/methodology/approach: Firstly, analyzing influencing factors of passenger choice about transportation modes, we designed an utility function of transportation modes. Secondly, referring to the game theory and logit modle, a non-cooperative game model between railway and highway was built. Finally, the model was applied to Nanchang-Jiujiang transportation corridor in China for an empirical analysis. Findings: The results indicate that the proposed non-cooperative game model is rational and reliable, and it supplies a scientific method to determine the optimal ticket price and passenger sharing rate of different transportation modes, and can be applied to the competition study on different transportation modes in inter-city transportation corridor. Originality/value: The main contribution of this paper is to built the non-cooperative game model, which can consider the needs of different travelers, and achieve reasonable passenger divergence of different transportation modes and coordinated development of whole transport market.

Optimal chest compression rate in cardiopulmonary resuscitation: a prospective, randomized crossover study using a manikin model.

Science.gov (United States)

Lee, Seong Hwa; Ryu, Ji Ho; Min, Mun Ki; Kim, Yong In; Park, Maeng Real; Yeom, Seok Ran; Han, Sang Kyoon; Park, Seong Wook

2016-08-01

When performing cardiopulmonary resuscitation (CPR), the 2010 American Heart Association guidelines recommend a chest compression rate of at least 100 min, whereas the 2010 European Resuscitation Council guidelines recommend a rate of between 100 and 120 min. The aim of this study was to examine the rate of chest compression that fulfilled various quality indicators, thereby determining the optimal rate of compression. Thirty-two trainee emergency medical technicians and six paramedics were enrolled in this study. All participants had been trained in basic life support. Each participant performed 2 min of continuous compressions on a skill reporter manikin, while listening to a metronome sound at rates of 100, 120, 140, and 160 beats/min, in a random order. Mean compression depth, incomplete chest recoil, and the proportion of correctly performed chest compressions during the 2 min were measured and recorded. The rate of incomplete chest recoil was lower at compression rates of 100 and 120 min compared with that at 160 min (P=0.001). The numbers of compressions that fulfilled the criteria for high-quality CPR at a rate of 120 min were significantly higher than those at 100 min (P=0.016). The number of high-quality CPR compressions was the highest at a compression rate of 120 min, and increased incomplete recoil occurred with increasing compression rate. However, further studies are needed to confirm the results.

Iliocaval Confluence Stenting for Chronic Venous Obstructions

Energy Technology Data Exchange (ETDEWEB)

Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

2015-10-15

PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

Optimization of operating parameters and rate of uranium bioleaching from a low-grade ore

International Nuclear Information System (INIS)

Rashidi, A.; Roosta-Azad, R.; Safdari, S.J.

2014-01-01

In this study the bioleaching of a low-grade uranium ore containing 480 ppm uranium has been reported. The studies involved extraction of uranium using Acidithiobacillus ferrooxidans derived from the uranium mine samples. The maximum specific growth rate (μ max ) and doubling time (t d ) were obtained 0.08 h -1 and 8.66 h, respectively. Parameters such as Fe 2+ concentration, particle size, temperature and pH were optimized. The effect of pulp density (PD) was also studied. Maximum uranium bio-dissolution of 100 ± 5 % was achieved under the conditions of pH 2.0, 5 % PD and 35 deg C in 48 h with the particles of d 80 = 100 μm. The optimum concentration of supplementary Fe 2+ was dependent to the PD. This value was 0 and 10 g of FeSO 4 ·7H 2 O/l at the PD of 5 and 15 %, respectively. The effects of time, pH and PD on the bioleaching process were studied using central composite design. New rate equation was improved for the uranium leaching rate. The rate of leaching is controlled with the concentrations of ferric and ferrous ions in solution. This study shows that uranium bioleaching may be an important process for the Saghand U mine at Yazd (Iran). (author)

Optimizing contaminant desorption and bioavailability in dense slurry systems. 2. PAH bioavailability and rates of degradation.

Science.gov (United States)

Kim, Han S; Weber, Walter J

2005-04-01

The effects of mechanical mixing on rates of polycyclic aromatic hydrocarbon (PAH) biodegradation in dense geosorbent slurry (67% solids content, w/w) systems were evaluated using laboratory-scale intermittently mixed batch bioreactors. A PAH-contaminated soil and a phenanthrene-sorbed mineral sorbent (alpha-Al2O3) were respectively employed as slurry solids in aerobic and anaerobic biodegradation studies. Both slurries exhibited a characteristic behavior of pseudoplastic non-Newtonian fluids, and the impeller revolution rate and its diameter had dramatic impacts on power and torque requirements in their laminar flow mixing. Rates of phenanthrene biodegradation were markedly enhanced by relatively low-level auger mixing under both aerobic and anaerobic (denitrifying) conditions. Parameters for empirical models correlating biodegradation rate coefficient (k(b)) values to the degree of mixing were similar to those for correlations between mass transfer (desorption) rate coefficient (k(r)) values for rapidly desorbing fractions of soil organic matter and degree of mixing reported in a companion study, supporting a conclusion that performance-efficient and cost-effective enhancements of PAH mass transfer (desorption) and its biodegradation processes can be achieved by the introduction of optimal levels of reactor-scale mechanical mixing.

Radiological evaluation of the patency of duodenal-esophageal anastomosis during a long postoperative follow-up: effectiveness of an alkaline reflux model in rats

Directory of Open Access Journals (Sweden)

Cavazzola L

2011-08-01

Full Text Available André Vicente Bigolin1, João Vicente Grossi2, Juliano Hermes Maeso Montes1, Roberto Nicola1, Leandro Totti Cavazzola11School of Medicine, Lutheran University of Brazil, Canoas; 2Hospital de Pronto Socorro de Porto Alegre, Department of Surgery, Porto Alegre, Rio Grande do Sul, BrazilBackground: Performing experimental studies has played an important role in acquiring knowledge about esophageal carcinogenesis. In this context, the choice of a more reliable experimental model requires proof of its effectiveness in order to lend greater credibility to the results. The objective of this study was to evaluate the patency of duodenal-esophageal anastomosis during long-term postoperative follow-up in rats.Methods: This was an experimental study in which 45 female Wistar rats were used. A side-to-side anastomosis was performed, going from the anterior side of the esophagus to the second duodenal portion. A standardized radiological technique was used to carry out a contrasted radiological study of the esophagus, stomach, and duodenum during weeks 4, 12, 20, and 30 after surgery. Different contrast media were used, and the animals were divided into groups, ie, group 1 (100% barium sulfate, group 2 (50% barium sulfate, and group 3 (60% aqueous iodinated contrast media. Contrast radiographs were taken in each group at weeks 4, 12, 20, and 30 after the surgical procedure. The radiographic images were evaluated by two radiologists who were blinded regarding the contrast groups. Macroscopic evaluation of each animal was compared with the radiological findings.Results: Postoperative mortality was 13.33%. The remaining animals were divided into study groups. All the contrast radiological examinations showed evidence of the location of the esophagus, stomach, and proximal portion of the intestine, and demonstrated the laterolateral relationship of the distal esophagus and the duodenum in the epigastric region. Patency of the anastomosis was observed at each

Breaking the Barrier to Slow Water Exchange Rates for Optimal Magnetic Resonance Detection of paraCEST Agents.

Science.gov (United States)

Fernando, W Shirangi; Martins, André F; Zhao, Piyu; Wu, Yunkou; Kiefer, Garry E; Platas-Iglesias, Carlos; Sherry, A Dean

2016-03-21

EuDOTA-tetraamide complexes as paraCEST agents offer an attractive platform for designing biological sensors and responsive agents. The early versions of these agents showed low sensitivity at temperature and power levels suitable for in vivo applications partly due to non-optimal water exchange rates. Here we report two new EuDOTA derivatives having glutamyl-phosphonate side arms that display the slowest water exchange rates of any other paraCEST agent reported so far. The advantages of such systems are demonstrated experimentally both in vitro and in vivo and DFT calculations were performed to help understand the physical-chemical reasons for this interesting behavior.

Directional Atherectomy With Antirestenotic Therapy vs Drug-Coated Balloon Angioplasty Alone for Isolated Popliteal Artery Lesions.

Science.gov (United States)

Stavroulakis, Konstantinos; Schwindt, Arne; Torsello, Giovanni; Stachmann, Arne; Hericks, Christiane; Bosiers, Michel J; Beropoulis, Efthymios; Stahlhoff, Stefan; Bisdas, Theodosios

2017-04-01

To report a single-center study comparing drug-coated balloon (DCB) angioplasty vs directional atherectomy with antirestenotic therapy (DAART) for isolated lesions of the popliteal artery. Seventy-two patients were treated with either DCB angioplasty alone (n=31) or with DAART (n=41) for isolated popliteal artery stenotic disease between October 2009 and December 2015. The majority of patients presented with lifestyle-limiting claudication (74% vs 86%, respectively). Vessel calcification (29% vs 29%, respectively), mean lesion length (47 vs 42 mm, respectively), and number of runoff vessels were comparable between the groups. The primary outcome measure was primary patency; secondary outcomes were technical success (<30% residual stenosis or bailout stenting), secondary patency, and freedom from clinically driven target lesion revascularization (TLR). The technical success rate following DCB was 84% vs 93% (p=0.24) after DAART. The 12-month primary patency rate was significantly higher in the DAART group (65% vs 82%; hazard ratio 2.64, 95% confidence interval 1.09 to 6.37, p=0.021), while freedom from TLR did not differ between the 2 treatment strategies (82% vs 94%, p=0.072). Secondary patency at 12 months was identical for both groups (96% vs 96%). Although not statistically significant, bailout stenting was more common after DCB angioplasty (16% vs 5% for DAART, p=0.13) and aneurysmal degeneration of the popliteal artery was seen more often after DAART (7% vs 0% for DCB alone, p=0.25). Popliteal artery injury was observed in 2 patients treated using DAART (5% vs 0% for DCB alone, p=0.5), whereas distal embolization rates were comparable between the groups (3% for DCB alone vs 5% for DAART, p=0.99). In this study, the use of DAART was associated with a higher primary patency rate compared with DCB angioplasty for isolated popliteal lesions. Nonetheless, both treatment options were associated with excellent 12-month secondary patency. Aneurysmal degeneration of

Optimal taxation with household production

DEFF Research Database (Denmark)

Kleven, Henrik Jacobsen; Richter, Wolfram F.; Sørensen, Peter Birch

2000-01-01

on consumer services even if such services are complements to leisure. Second, we find that when services and other goods are equally substitutable for leisure, so that uniform commodity taxation would be optimal in the absence of home production, the optimal tax structure will certainly involve a relatively......This paper suggests that the optimal tax system should favour market-produced services which are close substitutes for home-produced services. First, we modify the classical Corlett-Hague rule for optimal commodity taxation by showing that it may be optimal to impose a relatively low tax rate...... low tax rate on consumer services...

Robustness of IPSA optimized high-dose-rate prostate brachytherapy treatment plans to catheter displacements.

Science.gov (United States)

Poder, Joel; Whitaker, May

2016-06-01

Inverse planning simulated annealing (IPSA) optimized brachytherapy treatment plans are characterized with large isolated dwell times at the first or last dwell position of each catheter. The potential of catheter shifts relative to the target and organs at risk in these plans may lead to a more significant change in delivered dose to the volumes of interest relative to plans with more uniform dwell times. This study aims to determine if the Nucletron Oncentra dwell time deviation constraint (DTDC) parameter can be optimized to improve the robustness of high-dose-rate (HDR) prostate brachytherapy plans to catheter displacements. A set of 10 clinically acceptable prostate plans were re-optimized with a DTDC parameter of 0 and 0.4. For each plan, catheter displacements of 3, 7, and 14 mm were retrospectively applied and the change in dose volume histogram (DVH) indices and conformity indices analyzed. The robustness of clinically acceptable prostate plans to catheter displacements in the caudal direction was found to be dependent on the DTDC parameter. A DTDC value of 0 improves the robustness of planning target volume (PTV) coverage to catheter displacements, whereas a DTDC value of 0.4 improves the robustness of the plans to changes in hotspots. The results indicate that if used in conjunction with a pre-treatment catheter displacement correction protocol and a tolerance of 3 mm, a DTDC value of 0.4 may produce clinically superior plans. However, the effect of the DTDC parameter in plan robustness was not observed to be as strong as initially suspected.

Enhanced Solubility and Dissolution Rate of Lacidipine Nanosuspension: Formulation Via Antisolvent Sonoprecipitation Technique and Optimization Using Box-Behnken Design.

Science.gov (United States)

Kassem, Mohamed A A; ElMeshad, Aliaa N; Fares, Ahmed R

2017-05-01

Lacidipine (LCDP) is a highly lipophilic calcium channel blocker of poor aqueous solubility leading to poor oral absorption. This study aims to prepare and optimize LCDP nanosuspensions using antisolvent sonoprecipitation technique to enhance the solubility and dissolution of LCDP. A three-factor, three-level Box-Behnken design was employed to optimize the formulation variables to obtain LCDP nanosuspension of small and uniform particle size. Formulation variables were as follows: stabilizer to drug ratio (A), sodium deoxycholate percentage (B), and sonication time (C). LCDP nanosuspensions were assessed for particle size, zeta potential, and polydispersity index. The formula with the highest desirability (0.969) was chosen as the optimized formula. The values of the formulation variables (A, B, and C) in the optimized nanosuspension were 1.5, 100%, and 8 min, respectively. Optimal LCDP nanosuspension had particle size (PS) of 273.21 nm, zeta potential (ZP) of -32.68 mV and polydispersity index (PDI) of 0.098. LCDP nanosuspension was characterized using x-ray powder diffraction, differential scanning calorimetry, and transmission electron microscopy. LCDP nanosuspension showed saturation solubility 70 times that of raw LCDP in addition to significantly enhanced dissolution rate due to particle size reduction and decreased crystallinity. These results suggest that the optimized LCDP nanosuspension could be promising to improve oral absorption of LCDP.

Impact of 'optimized' treatment planning for tandem and ring, and tandem and ovoids, using high dose rate brachytherapy for cervical cancer

International Nuclear Information System (INIS)

Noyes, William R.; Peters, Nancy E.; Thomadsen, Bruce R.; Fowler, Jack F.; Buchler, Dolores A.; Stitt, Judith A.; Kinsella, Timothy J.

1995-01-01

Purpose: Different treatment techniques are used in high dose rate (HDR) remote afterloading intracavitary brachytherapy for uterine cervical cancer. We have investigated the differences between 'optimized' and 'nonoptimized' therapy using both a tandem and ring (T/R) applicator, and a tandem and ovoids (T/O), applicator. Methods and Materials: HDR afterloading brachytherapy using the Madison System for Stage IB cervical cancer was simulated for 10 different patients using both a T/R applicator and a T/O applicator. A treatment course consists of external beam irradiation and five insertions of HDR afterloading brachytherapy. Full dosimetry calculations were performed at the initial insertion for both applicators and used as a reference for the following four insertions of the appropriate applicator. Forty dosimetry calculations were performed to determine the dose delivered to Point M (similar to Point A), Point E (obturator lymph nodes), vaginal surface, bladder, and rectum. 'Optimized' doses were specified to Point M and to the vaginal surface. 'Nonoptimized' doses were specified to Point M only. Using the linear-quadratic equation, calculations have been performed to convert the delivered dose using HDR to the biologically equivalent doses at the conventional low dose rate (LDR) at 0.60 Gy/h. Results: Major differences between 'optimized' and 'nonoptimized' LDR equivalent doses were found at the vaginal surface, bladder, and rectum. Overdoses at the vaginal surface, bladder, and rectum were calculated to be 208%, nil, and 42%, respectively, for the T/R applicator with 'nonoptimization'. However, for the T/O applicator, the overdoses were smaller, being nil, 32%, and 27%, respectively, with 'nonoptimization'. Conclusion: Doses given in high dose rate intracavitary brachytherapy border on tissue tolerance. 'Optimization' of either applicator decreases the risk of a dose that may have potential for complications. Optimization of a tandem and ovoids best ensures

Optimal multicasting in a multi-line-rate ethernet-over-WDM network

Science.gov (United States)

Harve, Shruthi; Batayneh, Marwan; Mukherjee, Biswanath

2009-11-01

Ethernet is the dominant transport technology for Local Area Networks. Efforts are now under way to use carrier-grade Ethernet in backbone networks of different service providers. With the advent of applications such as IPTV and Videoon- Demand, there is need for techniques to route multicast traffic over the Ethernet backbone networks. Here, we address the problem of Routing and Wavelength Assignment (RWA) of a set of multicast requests in a Multi-Line-Rate Ethernet backbone network with the objective of minimizing the cost of setting up the network, in terms of the Service Provider's Capital Expenditure (CAPEX). We present an Auxiliary Graph based heuristic algorithm that routes each multicast request on a light-tree structure, and assigns minimum cost wavelengths along the route. We compare the properties of the algorithm to the optimal solution given by a mathematical model formulated as an Integer Linear Program (ILP), and show that they compare very well. We also find that the algorithm is most cost-effective when the incoming requests are processed in descending order of their bandwidth requirements.

Impact of Chaos Functions on Modern Swarm Optimizers.

Directory of Open Access Journals (Sweden)

E Emary

Full Text Available Exploration and exploitation are two essential components for any optimization algorithm. Much exploration leads to oscillation and premature convergence while too much exploitation slows down the optimization algorithm and the optimizer may be stuck in local minima. Therefore, balancing the rates of exploration and exploitation at the optimization lifetime is a challenge. This study evaluates the impact of using chaos-based control of exploration/exploitation rates against using the systematic native control. Three modern algorithms were used in the study namely grey wolf optimizer (GWO, antlion optimizer (ALO and moth-flame optimizer (MFO in the domain of machine learning for feature selection. Results on a set of standard machine learning data using a set of assessment indicators prove advance in optimization algorithm performance when using variational repeated periods of declined exploration rates over using systematically decreased exploration rates.

Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

Energy Technology Data Exchange (ETDEWEB)

Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

2011-11-15

As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

International Nuclear Information System (INIS)

Shah, Chirag; Vicini, Frank A.

2011-01-01

As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

Subintimal angioplasty for the treatment of long segment occlusion of superficial femoral artery: the midterm results

International Nuclear Information System (INIS)

Lou Wensheng; Gu Jianping; He Xu; Chen Liang; Chen Guoping; Su Haobo; Song Jinhua; Wang Tao; Xu Ke

2011-01-01

Objective: To discuss the clinical value of subintimal angioplasty in treating long segment occlusion of superficial femoral artery and to observe its midterm results. Methods: Subintimal angioplasty was performed in 45 patients with long segment occlusion of superficial femoral artery, whose clinical presentation was intermittent claudication or critical limb ischemia. The primary patency, limb salvage and factors influencing long-term patency were observed, and the clinical data were analyzed. Results: Of the total 45 cases, the subintimal angioplasty was successfully accomplished in 43. The success rate of antegrade approach technique via the superficial femoral artery was 80% (n=36), the occlusion was recanalized by using retrograde approach technique via ipsilateral popliteal artery in 7 case. The total technical success rate was 95.6%. The primary patency in 43 successful cases at 6, 12, 24 and 36 months was 85.7%, 69.0% 57.3% and 50.9%, respectively. No statistically significant difference in primary patency existed between the group of intermittent claudication and the group of critical limb ischemia (P>0.05). Statistically significant prediction factors for primary patency included the number of the run off vessels below the knee and the length of the occlusion (P<0.05). Conclusion: Subintimal angioplasty is an effective procedure for the treatment of long segment occlusions of superficial femoral artery with satisfactory mid-term results. (authors)

Optimization in the nuclear fuel cycle I: Temporal variation of dose rate; Optimização no ciclo do combustível nuclear I: variação temporal da taxa de dose

Energy Technology Data Exchange (ETDEWEB)

Pereira, W.S., E-mail: pereiras@gmail.com [Universidade Veiga de Ameida (UVA), Rio de Janeiro, RJ (Brazil); Silva, A.X.; Lopes, J.M.; Carmo, A.S.; Fernandes, T.S.; Mello, C.R., E-mail: lararapls@hotmail.com, E-mail: Ademir@nuclear.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); Kelecom, A. [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil)

2017-07-01

Radioprotection aims to protect man and the environment from the harmful effects of radiation. Radioprotection is based on three fundamental principles: justification, dose limitation and optimization. Optimization is a complementary principle to dose limitation and should be applied in all phases of development, and even in unregulated situations. The aim of this work is to use the exposure rate as a tool to optimize radioprotection. The exposure rate at a nuclear facility was monitored at 15 points for one year and statistical tools for data analysis were proposed as auxiliary tools for the process of optimizing the dose rates measured at the facility. A total of 9,125 exposure-rate measures were performed during 2014. The monthly averages were organized by sampling point and by month of the year. No statistical difference was observed in the monthly variation of the dose rate. Therefore, this variable can not be used in the optimization process in this nuclear installation.

Optimal management strategies in variable environments: Stochastic optimal control methods

Science.gov (United States)

Williams, B.K.

1985-01-01

Dynamic optimization was used to investigate the optimal defoliation of salt desert shrubs in north-western Utah. Management was formulated in the context of optimal stochastic control theory, with objective functions composed of discounted or time-averaged biomass yields. Climatic variability and community patterns of salt desert shrublands make the application of stochastic optimal control both feasible and necessary. A primary production model was used to simulate shrub responses and harvest yields under a variety of climatic regimes and defoliation patterns. The simulation results then were used in an optimization model to determine optimal defoliation strategies. The latter model encodes an algorithm for finite state, finite action, infinite discrete time horizon Markov decision processes. Three questions were addressed: (i) What effect do changes in weather patterns have on optimal management strategies? (ii) What effect does the discounting of future returns have? (iii) How do the optimal strategies perform relative to certain fixed defoliation strategies? An analysis was performed for the three shrub species, winterfat (Ceratoides lanata), shadscale (Atriplex confertifolia) and big sagebrush (Artemisia tridentata). In general, the results indicate substantial differences among species in optimal control strategies, which are associated with differences in physiological and morphological characteristics. Optimal policies for big sagebrush varied less with variation in climate, reserve levels and discount rates than did either shadscale or winterfat. This was attributed primarily to the overwintering of photosynthetically active tissue and to metabolic activity early in the growing season. Optimal defoliation of shadscale and winterfat generally was more responsive to differences in plant vigor and climate, reflecting the sensitivity of these species to utilization and replenishment of carbohydrate reserves. Similarities could be seen in the influence of both

Fabrication of microfluidic architectures for optimal flow rate and concentration measurement for lab on chip application

Science.gov (United States)

Adam, Tijjani; Hashim, U.

2017-03-01

Optimum flow in micro channel for sensing purpose is challenging. In this study, The optimizations of the fluid sample flows are made through the design and characterization of the novel microfluidics' architectures to achieve the optimal flow rate in the micro channels. The biocompatibility of the Polydimetylsiloxane (Sylgard 184 silicon elastomer) polymer used to fabricate the device offers avenue for the device to be implemented as the universal fluidic delivery system for bio-molecules sensing in various bio-medical applications. The study uses the following methodological approaches, designing a novel microfluidics' architectures by integrating the devices on a single 4 inches silicon substrate, fabricating the designed microfluidic devices using low-cost solution soft lithography technique, characterizing and validating the flow throughput of urine samples in the micro channels by generating pressure gradients through the devices' inlets. The characterization on the urine samples flow in the micro channels have witnessed the constant flow throughout the devices.

In situ saphenous vein bypass for limb salvage.

Science.gov (United States)

Sarcina, A; Carlesi, R; Bellosta, R; Agrifoglio, G

1993-02-01

A total of 130 infrapopliteal in situ saphenous vein bypasses were performed in 128 patients between January 1980 and June 1991. The indication for surgery was critical ischaemia with impending limb loss in 121 patients; seven suffered from severe claudication. The distal anastomosis was to the popliteal artery below the knee in 60 cases (46.2%) and in 70 (53.8%) to the tibioperoneal arteries. The results, in terms of secondary patency and limb salvage rates, of the first 68 procedures (1980-1985) and subsequent 62 (1986-June 1991) were compared. In the first period, a secondary patency rate of 42.6% and a limb salvage rate of 67.0% were obtained, compared with 71.3 and 80.8% respectively in the second. These differences are significant for patency (P < 0.005) and limb salvage (P < 0.01). These results show that the in situ technique can give acceptable results but a learning period with a high percentage of early failures is to be expected.

Optimal JPWL Forward Error Correction Rate Allocation for Robust JPEG 2000 Images and Video Streaming over Mobile Ad Hoc Networks

Directory of Open Access Journals (Sweden)

Benoit Macq

2008-07-01

Full Text Available Based on the analysis of real mobile ad hoc network (MANET traces, we derive in this paper an optimal wireless JPEG 2000 compliant forward error correction (FEC rate allocation scheme for a robust streaming of images and videos over MANET. The packet-based proposed scheme has a low complexity and is compliant to JPWL, the 11th part of the JPEG 2000 standard. The effectiveness of the proposed method is evaluated using a wireless Motion JPEG 2000 client/server application; and the ability of the optimal scheme to guarantee quality of service (QoS to wireless clients is demonstrated.

Topology optimization based on the harmony search method

International Nuclear Information System (INIS)

Lee, Seung-Min; Han, Seog-Young

2017-01-01

A new topology optimization scheme based on a Harmony search (HS) as a metaheuristic method was proposed and applied to static stiffness topology optimization problems. To apply the HS to topology optimization, the variables in HS were transformed to those in topology optimization. Compliance was used as an objective function, and harmony memory was defined as the set of the optimized topology. Also, a parametric study for Harmony memory considering rate (HMCR), Pitch adjusting rate (PAR), and Bandwidth (BW) was performed to find the appropriate range for topology optimization. Various techniques were employed such as a filtering scheme, simple average scheme and harmony rate. To provide a robust optimized topology, the concept of the harmony rate update rule was also implemented. Numerical examples are provided to verify the effectiveness of the HS by comparing the optimal layouts of the HS with those of Bidirectional evolutionary structural optimization (BESO) and Artificial bee colony algorithm (ABCA). The following conclu- sions could be made: (1) The proposed topology scheme is very effective for static stiffness topology optimization problems in terms of stability, robustness and convergence rate. (2) The suggested method provides a symmetric optimized topology despite the fact that the HS is a stochastic method like the ABCA. (3) The proposed scheme is applicable and practical in manufacturing since it produces a solid-void design of the optimized topology. (4) The suggested method appears to be very effective for large scale problems like topology optimization.

Topology optimization based on the harmony search method

Energy Technology Data Exchange (ETDEWEB)

Lee, Seung-Min; Han, Seog-Young [Hanyang University, Seoul (Korea, Republic of)

2017-06-15

A new topology optimization scheme based on a Harmony search (HS) as a metaheuristic method was proposed and applied to static stiffness topology optimization problems. To apply the HS to topology optimization, the variables in HS were transformed to those in topology optimization. Compliance was used as an objective function, and harmony memory was defined as the set of the optimized topology. Also, a parametric study for Harmony memory considering rate (HMCR), Pitch adjusting rate (PAR), and Bandwidth (BW) was performed to find the appropriate range for topology optimization. Various techniques were employed such as a filtering scheme, simple average scheme and harmony rate. To provide a robust optimized topology, the concept of the harmony rate update rule was also implemented. Numerical examples are provided to verify the effectiveness of the HS by comparing the optimal layouts of the HS with those of Bidirectional evolutionary structural optimization (BESO) and Artificial bee colony algorithm (ABCA). The following conclu- sions could be made: (1) The proposed topology scheme is very effective for static stiffness topology optimization problems in terms of stability, robustness and convergence rate. (2) The suggested method provides a symmetric optimized topology despite the fact that the HS is a stochastic method like the ABCA. (3) The proposed scheme is applicable and practical in manufacturing since it produces a solid-void design of the optimized topology. (4) The suggested method appears to be very effective for large scale problems like topology optimization.

Optimal placement of FACTS devices using optimization techniques: A review

Science.gov (United States)

Gaur, Dipesh; Mathew, Lini

2018-03-01

Modern power system is dealt with overloading problem especially transmission network which works on their maximum limit. Today’s power system network tends to become unstable and prone to collapse due to disturbances. Flexible AC Transmission system (FACTS) provides solution to problems like line overloading, voltage stability, losses, power flow etc. FACTS can play important role in improving static and dynamic performance of power system. FACTS devices need high initial investment. Therefore, FACTS location, type and their rating are vital and should be optimized to place in the network for maximum benefit. In this paper, different optimization methods like Particle Swarm Optimization (PSO), Genetic Algorithm (GA) etc. are discussed and compared for optimal location, type and rating of devices. FACTS devices such as Thyristor Controlled Series Compensator (TCSC), Static Var Compensator (SVC) and Static Synchronous Compensator (STATCOM) are considered here. Mentioned FACTS controllers effects on different IEEE bus network parameters like generation cost, active power loss, voltage stability etc. have been analyzed and compared among the devices.

Percutaneous intervention in the menagement of insufficient native arteriovenous hemodialysis fistulae

International Nuclear Information System (INIS)

Kim, Hye Jung; Seong, Chang Kyu; Kwon, Jae Hyun; Kim, Young Hwan; Park, Noh Hyuck; Kim, Tae Hun; Kim, Yong Joo; Kang, Duck Sik; Shin, Tae Beom

2002-01-01

To determine the effectiveness and patency of percutaneous intervention in insufficient native arteriovenous hemodialysis fistulae (AVFs). Between March 1997 and September 2001, 67 cases of insufficient native AVFs resulted from central vein lesion, PTA was performed in 48 cases, and thrombolytic therapy with or without PTA in 11. In eight of the cases, in which central vein stenosis had led to the insufficency, percutaneous transluminal angioplasty (PTA) was performed, and in three of the eight, a stent was inserted. Angiography findings and complications, as well as success and patency rates in the non-thrombosis and thrombosis group, were evaluated; the central vein lesion group was analysed separately. Among 84 lesions observed at angiography, three were 54 cases of stenosis, 17 of occlusion, and 13 of combined thrombosis. The lesions were located in a proximal vein (n=51), distal vein (n=14), artery (n=6), and at the site of anastomosis (n=13). In the central vein lesion group (n=8), seven cases of stenosis and one of occlusion were noted. The overall procedural success rate was 79.1% (53/67). That is, in patients with no central vein lesion, the procedural success rate of PTA of native AVFs was 85.4% (41/48) and the patency rates of this were 83.1% at 6 months and 67.4% at 12 months. In cases of thrombolysis with/without PTA, the procedural success rate was 54.5% (6/11) and the patency rates were 83.3% at 6 months and 62.5% at 12 months. Finally, in patients with a central vein lesion, the procedural success rate was 75% (6/8) and the patency rates were 80% at 6 months and 30% at 12 months. There was one case of pseudoaneurysm formation at the puncture site of the brachial artery, which was used as the access route for intervention; one embolism in the brachial artery; and three cases of vascular spasm and two of hematoma which did not require active treatment. Percutaneous intervention offers effective and safe management of insufficient AVFs. The procedural

Anatomy-based inverse optimization in high-dose-rate brachytherapy combined with hypofractionated external beam radiotherapy for localized prostate cancer: Comparison of incidence of acute genitourinary toxicity between anatomy-based inverse optimization and geometric optimization

International Nuclear Information System (INIS)

Akimoto, Tetsuo; Katoh, Hiroyuki; Kitamoto, Yoshizumi; Shirai, Katsuyuki; Shioya, Mariko; Nakano, Takashi

2006-01-01

Purpose: To evaluate the advantages of anatomy-based inverse optimization (IO) in planning high-dose-rate (HDR) brachytherapy. Methods and Materials: A total of 114 patients who received HDR brachytherapy (9 Gy in two fractions) combined with hypofractionated external beam radiotherapy (EBRT) were analyzed. The dose distributions of HDR brachytherapy were optimized using geometric optimization (GO) in 70 patients and by anatomy-based IO in the remaining 44 patients. The correlation between the dose-volume histogram parameters, including the urethral dose and the incidence of acute genitourinary (GU) toxicity, was evaluated. Results: The averaged values of the percentage of volume receiving 80-150% of the prescribed minimal peripheral dose (V 8 -V 15 ) of the urethra generated by anatomy-based IO were significantly lower than the corresponding values generated by GO. Similarly, the averaged values of the minimal dose received by 5-50% of the target volume (D 5 -D 5 ) obtained using anatomy-based IO were significantly lower than those obtained using GO. Regarding acute toxicity, Grade 2 or worse acute GU toxicity developed in 23% of all patients, but was significantly lower in patients for whom anatomy-based IO (16%) was used than in those for whom GO was used (37%), consistent with the reduced urethral dose (p <0.01). Conclusion: The results of this study suggest that anatomy-based IO is superior to GO for dose optimization in HDR brachytherapy for prostate cancer

Optimizing the recovery rate of Mycobacterium species from gastric ...

African Journals Online (AJOL)

Sitwala

... whether the BACTEC. MGIT 960 culture system will optimize the ... Asia . The emergence of the human immuno deficiency virus (HIV) has changed the face of ... former Soviet Union, China and India ..... sputum. Southeastern Asia Journal of.

Prognostic Factors Influencing the Patency of Hemodialysis Vascular Access: Literature Review and Novel Therapeutic Modality by Far Infrared Therapy

Directory of Open Access Journals (Sweden)

Chih-Ching Lin

2009-03-01

Full Text Available In Taiwan, more than 85% of patients with end-stage renal disease undergo maintenance hemodialysis (HD. The native arteriovenous fistula (AVF accounts for a prevalence of more than 80% of the vascular access in our patients. Some mechanical factors may affect the patency of hemodialysis vascular access, such as surgical skill, puncture technique and shear stress on the vascular endothelium. Several medical factors have also been identified to be associated with vascular access prognosis in HD patients, including stasis, hypercoagulability, endothelial cell injury, medications, red cell mass and genotype polymorphisms of transforming growth factor-β1 and methylene tetrahydrofolate reductase. According to our previous study, AVF failure was associated with a longer dinucleotide (GTn repeat (n ≥ 30 in the promoter of the heme oxygenase-1 (HO-1 gene. Our recent study also demonstrated that far-infrared therapy, a noninvasive and convenient therapeutic modality, can improve access flow, inflammatory status and survival of the AVF in HD patients through both its thermal and non-thermal (endothelial-improving, anti-inflammatory, antiproliferative, antioxidative effects by upregulating NF-E2-related factor-2-dependent HO-1 expression, leading to the inhibition of expression of E-selectin, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1.

Factors Associated with Continuous Low Dose Heparin Infusion for Central Venous Catheter Patency in Critically Ill Children Worldwide

Science.gov (United States)

Onyeama, Sara-Jane N; Hanson, Sheila J; Dasgupta, Mahua; Hoffmann, Raymond G; Faustino, Edward Vincent S

2016-01-01

Objective To identify patient, hospital and central venous catheter (CVC) factors that may influence the use of low dose heparin infusion (LDHI) for CVC patency in critically ill-children. Design Secondary analysis of an international multicenter observational study. Setting 59 Pediatric Intensive Care Units (PICUs) over four study dates in 2012, involving 7 countries. Patients Children less than 18 years of age with a CVC, admitted to a participating unit and enrolled in the completed PROTRACT study were included. All overflow patients were excluded. Interventions None. Measurements and Main Results Of the 2,484 patients in the PROTRACT study, 1,312 patients had a CVC. 507 of those patients used LDHI. The frequency of LDHI was compared across various patient, hospital and CVC factors using chi-squared, Mann-Whitney and Fisher's exact tests. In the multivariate analysis, age was not a significant factor for LDHI use. Patients with pulmonary hypertension had decreased LDHI use while those with active surgical or trauma diagnoses had increased LDHI use. All central CVC insertion sites were more likely to use LDHI when compared to peripherally inserted CVCs. The Asia-Pacific region showed increased LDHI use, along with community hospitals and smaller ICUs (LDHI in critically ill children. Further study is needed to evaluate the efficacy and persistence of LDHI use. PMID:27362853

A fast inverse treatment planning strategy facilitating optimized catheter selection in image-guided high-dose-rate interstitial gynecologic brachytherapy.

Science.gov (United States)

Guthier, Christian V; Damato, Antonio L; Hesser, Juergen W; Viswanathan, Akila N; Cormack, Robert A

2017-12-01

Interstitial high-dose rate (HDR) brachytherapy is an important therapeutic strategy for the treatment of locally advanced gynecologic (GYN) cancers. The outcome of this therapy is determined by the quality of dose distribution achieved. This paper focuses on a novel yet simple heuristic for catheter selection for GYN HDR brachytherapy and their comparison against state of the art optimization strategies. The proposed technique is intended to act as a decision-supporting tool to select a favorable needle configuration. The presented heuristic for catheter optimization is based on a shrinkage-type algorithm (SACO). It is compared against state of the art planning in a retrospective study of 20 patients who previously received image-guided interstitial HDR brachytherapy using a Syed Neblett template. From those plans, template orientation and position are estimated via a rigid registration of the template with the actual catheter trajectories. All potential straight trajectories intersecting the contoured clinical target volume (CTV) are considered for catheter optimization. Retrospectively generated plans and clinical plans are compared with respect to dosimetric performance and optimization time. All plans were generated with one single run of the optimizer lasting 0.6-97.4 s. Compared to manual optimization, SACO yields a statistically significant (P ≤ 0.05) improved target coverage while at the same time fulfilling all dosimetric constraints for organs at risk (OARs). Comparing inverse planning strategies, dosimetric evaluation for SACO and "hybrid inverse planning and optimization" (HIPO), as gold standard, shows no statistically significant difference (P > 0.05). However, SACO provides the potential to reduce the number of used catheters without compromising plan quality. The proposed heuristic for needle selection provides fast catheter selection with optimization times suited for intraoperative treatment planning. Compared to manual optimization, the

A randomized comparison of the Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial: One-year angiographic results and mid-term clinical outcomes.

Science.gov (United States)

Kim, Ki-Bong; Hwang, Ho Young; Hahn, Seokyung; Kim, Jun Sung; Oh, Se Jin

2014-09-01

The Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial was designed to evaluate the noninferiority of the saphenous vein (SV) compared with the right internal thoracic artery ([R]ITA) used as a Y-composite graft. A total of 224 patients who had undergone off-pump revascularization for multivessel coronary artery disease using the SV or RITA as a Y-composite graft based on the in situ left ITA were assigned randomly to the SV Y-composite graft (SV group, n = 112) or free RITA Y-composite graft (RITA group, n = 112). The primary endpoint was the 1-year angiographic patency rate of the second limb conduits (SV or RITA). Postoperative 1-year coronary angiograms were performed in 215 patients (SV group, 108; RITA group, 107). The overall graft patency rate was 97.4% (745 of 765) at 1 year (97.9% in the SV group vs 96.9% in the RITA group, P = .362). The primary endpoint of the study, the 1-year patency rate of the SV composite grafts, was 97.1% (238 of 245) and was noninferior to that of the RITA composite grafts (97.1% [198 of 204]) with a 95% lower confidence limit of -2.6% (P RITA composite grafts in terms of the 1-year angiographic patency rates. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Interventional recanalization of artificial arteriovenous fistula and graft for hemodialysis: angioplasty and pulsed-spray thrombolysis with Urokinase

International Nuclear Information System (INIS)

Shin, Sung Wook; Do, Young Soo; Park, Hong Seok and others

1998-01-01

To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) and pul-sed-spray pharmaco-mechanical thrombolysis (PSPMT) using urokinase for the management of insufficient hemodialysis access. Between September 1996 and May 1998, 21 insufficient hemodialysis accesses were treated in 16 patients(3 artificial arteriovenous fistulae, AVF; and 13 arteriovenous graft, AVG). PTA and PSPMT were performed in 6 and 15 cases, respectively, and success and long-term patency rates were evaluated. The overall success rate of PTA and PSPMT for insufficient hemodialysis access was 76. 2%(16/21). The success rates of PTA and PSPMT were 83.3%(5/6) and 73.3%(11/15), respectively. The primary patency rates of PSPMT were 69±12.8% at 6 months and 38±18.6% at 12 months. One of the two initially successful PTAs had been patent for 7 months, and the second PTA was performed at that time due to venous stenosis. The other was patent for 15 months throughout the follow-up period. PTA and PSPMT are effective primary methods for the treatment of insufficient hemodialysis access;success and patency rates were high, and the procedures can be performed repeatedly.=20

Short-term outcomes of excisional atherectomy in lower limb arterial disease.

Science.gov (United States)

Werner-Gibbings, Keagan; Dubenec, Steven

2017-06-01

Endovascular interventions are increasingly utilized in managing occlusive peripheral vascular disease. Angioplasty and stenting remain the mainstay of endovascular management; however, newer treatment modalities such as excisional atherectomy provide the clinician with additional treatment options. While demonstrating promising results in available trials, a paucity of data exist regarding peripheral atherectomy. The purpose of this retrospective clinical study was to assess the efficacy and safety of excisional atherectomy with the TurboHawk atherectomy device (Covidien/ev3, Plymouth, MN, USA) in the treatment of lower limb peripheral vascular disease and to evaluate the learning curve involved in the institution of a new treatment modality. A retrospective analysis was performed on all patients undergoing atherectomy for symptomatic lower limb peripheral vascular disease by a single clinician between November 2011 and June 2013. Forty-seven vessels on 28 legs in 24 patients were treated during the period. Atherectomy was possible in 98% of cases. The 6- and 12-month primary patency was 72.6 and 58.9%, respectively. The primary-assisted patency was 93.2% at 6 months and 74.6% at 12 months. There were significantly greater patency rates in the TransAtlantic Inter-Society Consensus A + B lesions and a non-significant trend towards improved patency rates in claudicants versus critical limb ischaemia. There were four instances of embolization and four cases of dissection. Excisional atherectomy provides a further option for the minimally invasive management of peripheral vascular disease. It has similar patency rates to established endovascular therapies and should be considered among the treatment options in patients with favourable pathology. © 2014 Royal Australasian College of Surgeons.

Optimal Policy of Cross-Layer Design for Channel Access and Transmission Rate Adaptation in Cognitive Radio Networks

Science.gov (United States)

He, Hao; Wang, Jun; Zhu, Jiang; Li, Shaoqian

2010-12-01

In this paper, we investigate the cross-layer design of joint channel access and transmission rate adaptation in CR networks with multiple channels for both centralized and decentralized cases. Our target is to maximize the throughput of CR network under transmission power constraint by taking spectrum sensing errors into account. In centralized case, this problem is formulated as a special constrained Markov decision process (CMDP), which can be solved by standard linear programming (LP) method. As the complexity of finding the optimal policy by LP increases exponentially with the size of action space and state space, we further apply action set reduction and state aggregation to reduce the complexity without loss of optimality. Meanwhile, for the convenience of implementation, we also consider the pure policy design and analyze the corresponding characteristics. In decentralized case, where only local information is available and there is no coordination among the CR users, we prove the existence of the constrained Nash equilibrium and obtain the optimal decentralized policy. Finally, in the case that the traffic load parameters of the licensed users are unknown for the CR users, we propose two methods to estimate the parameters for two different cases. Numerical results validate the theoretic analysis.

Optimal Policy of Cross-Layer Design for Channel Access and Transmission Rate Adaptation in Cognitive Radio Networks

Directory of Open Access Journals (Sweden)

Jiang Zhu

2010-01-01

Full Text Available In this paper, we investigate the cross-layer design of joint channel access and transmission rate adaptation in CR networks with multiple channels for both centralized and decentralized cases. Our target is to maximize the throughput of CR network under transmission power constraint by taking spectrum sensing errors into account. In centralized case, this problem is formulated as a special constrained Markov decision process (CMDP, which can be solved by standard linear programming (LP method. As the complexity of finding the optimal policy by LP increases exponentially with the size of action space and state space, we further apply action set reduction and state aggregation to reduce the complexity without loss of optimality. Meanwhile, for the convenience of implementation, we also consider the pure policy design and analyze the corresponding characteristics. In decentralized case, where only local information is available and there is no coordination among the CR users, we prove the existence of the constrained Nash equilibrium and obtain the optimal decentralized policy. Finally, in the case that the traffic load parameters of the licensed users are unknown for the CR users, we propose two methods to estimate the parameters for two different cases. Numerical results validate the theoretic analysis.

Transaction fees and optimal rebalancing in the growth-optimal portfolio

Science.gov (United States)

Feng, Yu; Medo, Matúš; Zhang, Liang; Zhang, Yi-Cheng

2011-05-01

The growth-optimal portfolio optimization strategy pioneered by Kelly is based on constant portfolio rebalancing which makes it sensitive to transaction fees. We examine the effect of fees on an example of a risky asset with a binary return distribution and show that the fees may give rise to an optimal period of portfolio rebalancing. The optimal period is found analytically in the case of lognormal returns. This result is consequently generalized and numerically verified for broad return distributions and returns generated by a GARCH process. Finally we study the case when investment is rebalanced only partially and show that this strategy can improve the investment long-term growth rate more than optimization of the rebalancing period.

Percutaneous transluminal angioplasty of infrarenal arteries in intermittent claudication

DEFF Research Database (Denmark)

Henriksen, L O; Jørgensen, B; Holstein, P E

1988-01-01

Percutaneous transluminal angioplasty was performed on 55 iliac and 31 femoropopliteal arteries in 71 patients with intermittent claudication (23 women, 48 men). The two-year patency rate was 80% after iliac and 41% after femoropopliteal angioplasty. In 17 femoropopliteal cases with lesions greater...... than or equal to 5 cm the 2-year patency rate was only 32%, but the corresponding figure for shorter lesions was 53%. Complicating haematoma appeared in 10% of the cases and the arterial state deteriorated in one patient. There was no distal embolization. Percutaneous transluminal angioplasty...

Catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis via the ipsilateral great saphenous vein approach: a comparative clinical study

International Nuclear Information System (INIS)

Su Haobo; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Song Jinhua; Wang Tao

2011-01-01

Objective: To investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study. Methods: The prospective study included 93 cases of IFVT proved by venography. All patients were divided into three groups randomly. In group A, 31 patients received CDT via the ipsilateral great saphenous vein. In group B, 27 patients received CDT via the ipsilateral popliteal vein. In group C, 35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein. Urokinase was adopted as the thrombolytic agent in all cases. The assessment of the curative effect include therapeutic effective rate, rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis. The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test. The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method). Therapeutic effective rate and complication rate were assessed using Chi-square test. Results: The total effective rate of the three groups were 90.3% (28/31), 92.6% (25/27) and 68.6% (24/35) respectively. The limbs edema reduction rate were (83.5±21.1)%, (82.4±20.1)%, and (67.0±23.3)% respectively (F= 6.059, P=0.003). The venous patency rate after thrombolysis were (61.2±20.2)%, (55.7±20.5)%, and (44.2±23.6)% respectively. There was no significant difference between group A and B in therapeutic effective rate (χ 2 =0.09, P=0.759), rate of edema reduction (P=0.822) and venous patency (P=0.343) . There was a significant difference statistically in therapeutic effective rate (χ 2 =4.65, P=0.031), rate of edema reduction (P=0.002) and venous patency (P=0.002) between group A and C. Compared with group A and B, the

PTA and Stenting of Benign Venous Stenoses in the Pelvis: Long-Term Results

International Nuclear Information System (INIS)

Wohlgemuth, Walter A.; Weber, Hermann; Loeprecht, Henning; Tietze, Wolfram; Bohndorf, Klaus

2000-01-01

Purpose: To provide follow-up data on endovascular intervention for venous stenoses in the pelvis.Methods: Between 1985 and 1995, 35 patients presented with 42 stenoses of the pelvic veins after operative thrombectomy and creation of an arteriovenous fistula, combined with intraoperative venous angioscopy. All patients underwent angioplasty and, if unsuccessful, percutaneous insertion of an endovascular stent (n = 7).Results: Angioplasty with and without endovascular stenting was technically successful in 34 of 35 patients (97%). Average length of the stenoses was 20.6 mm (range 10-90 mm), average diameter before dilation 4.1 mm (range 2-6 mm), and average diameter after dilation 10.1 mm (range 5-18 mm). Intraoperative angioscopy showed pathologic findings (intimal laceration or residual thrombotic material) in 14 patients. After an average follow-up period of 4.13 years, 24 (69%) patients had patent veins. The difference in the primary patency rate between patients with angioscopically abnormal veins (6 of 14 patients, corresponding to a patency rate of 43%) and patients with angioscopically normal veins after thrombectomy (18 of 21 patients, corresponding to a patency rate of 86%) was statistically significant (p < 0.01, log rank test).Conclusions: Percutaneous transluminal angioplasty and/or stenting are good treatment modalities for pelvic vein stenosis following surgical thrombectomy. Angioscopically abnormal veins have a poorer long-term patency, regardless of the type of intervention

Study on the optimal moisture adding rate of brown rice during germination by using segmented moisture conditioning method.

Science.gov (United States)

Cao, Yinping; Jia, Fuguo; Han, Yanlong; Liu, Yang; Zhang, Qiang

2015-10-01

The aim of this study was to find out the optimal moisture adding rate of brown rice during the process of germination. The process of water addition in brown rice could be divided into three stages according to different water absorption speeds in soaking process. Water was added with three different speeds in three stages to get the optimal water adding rate in the whole process of germination. Thus, the technology of segmented moisture conditioning which is a method of adding water gradually was put forward. Germinated brown rice was produced by using segmented moisture conditioning method to reduce the loss of water-soluble nutrients and was beneficial to the accumulation of gamma aminobutyric acid. The effects of once moisture adding amount in three stages on the gamma aminobutyric acid content in germinated brown rice and germination rate of brown rice were investigated by using response surface methodology. The optimum process parameters were obtained as follows: once moisture adding amount of stage I with 1.06 %/h, once moisture adding amount of stage II with 1.42 %/h and once moisture adding amount of stage III with 1.31 %/h. The germination rate under the optimum parameters was 91.33 %, which was 7.45 % higher than that of germinated brown rice produced by soaking method (84.97 %). The content of gamma aminobutyric acid in germinated brown rice under the optimum parameters was 29.03 mg/100 g, which was more than two times higher than that of germinated brown rice produced by soaking method (12.81 mg/100 g). The technology of segmented moisture conditioning has potential applications for studying many other cereals.

Rate-optimal Bayesian intensity smoothing for inhomogeneous Poisson processes

NARCIS (Netherlands)

Belitser, E.; Andrade Serra, De P.J.; Zanten, van J.H.

2013-01-01

We apply nonparametric Bayesian methods to study the problem of estimating the intensity function of an inhomogeneous Poisson process. We exhibit a prior on intensities which both leads to a computationally feasible method and enjoys desirable theoretical optimality properties. The prior we use is

An optimized clarithromycin-free 14-day triple therapy for Helicobacter pylori eradication achieves high cure rates in Uruguay.

Science.gov (United States)

Dacoll, Cristina; Sánchez-Delgado, Jordi; Balter, Henia; Pazos, Ximena; Di Pace, María; Sandoya, Gabriela; Cohen, Henry; Calvet, Xavier

Strong acid inhibition increases cure rates with triple therapy and 14-day are more effective than 7-day treatments. The combination of amoxicillin plus metronidazole at full doses has been shown to overcome metronidazole resistance and to achieve good eradication rates even in patients harboring resistant strains. No previous studies have been reported in Latin-America with this optimized triple-therapy scheme. The aim of the present study was to assess the eradication rate and tolerance of a new first-line treatment regimen associating strong acid inhibition, amoxicillin and metronidazole. Patients from the Clínica de Gastroenterología of the Hospital de Clínicas (Montevideo, Uruguay) were included. Hp status was mainly assessed by at least one of the following: histologyor urea breath test (UBT). A 14-day treatment was prescribed comprising esomeprazole 40mg twice a day plus amoxicillin 1g and metronidazole 500mg, both three times a day. H. pylori cure was assessed by UBT. Forty-one patients were enrolled. Mean age was 53.3±13 years and 17.1% of patients were male. Main indications for treatment were: functional dyspepsia (27.5%), gastritis (45%), gastric or duodenal erosions (20%), gastric ulcer (5%) and intestinal metaplasia (2.5%). H. pylori eradication was achieved in 33 of the 37 patients who returned for follow-up. Eradication rates were 80.5% (95% CI: 68.4-92.6) by intention-to-treat (ITT) analysis and 89.2% (95% CI; 79.2-99.2) per protocol (PP). No major side effects were reported; 26 patients (65.8%) complained of mild side effects (nausea, diarrhea and headache). Cure rates of this triple therapy including esomeprazole, amoxicillin and metronidazole were 81% per ITT and the treatment was well tolerated. These optimal results with a simple clarithromycin-free triple therapy are better than described for standard triple therapy but there is still room for improvement to reach the desired target of 90% per ITT. Copyright © 2017 Elsevier España, S

Prediction and optimization of the recovery rate in centrifugal separation of platelet-rich plasma (PRP)

Science.gov (United States)

Piao, Linfeng; Park, Hyungmin; Jo, Chris

2016-11-01

We present a theoretical model of the recovery rate of platelet and white blood cell in the process of centrifugal separation of platelet-rich plasma (PRP). For the practically used conditions in the field, the separation process is modeled as a one-dimensional particle sedimentation; a quasi-linear partial differential equation is derived based on the kinematic-wave theory. This is solved to determine the interface positions between supernatant-suspension and suspension-sediment, used to estimate the recovery rate of the plasma. While correcting the Brown's hypothesis (1989) claiming that the platelet recovery is linearly proportional to that of plasma, we propose a new correlation model for prediction of the platelet recovery, which is a function of the volume of whole blood, centrifugal acceleration and time. For a range of practical parameters, such as hematocrit, volume of whole blood and centrifugation (time and acceleration), the predicted recovery rate shows a good agreement with available clinical data. We propose that this model is further used to optimize the preparation method of PRP that satisfies the customized case. Supported by a Grant (MPSS-CG-2016-02) through the Disaster and Safety Management Institute funded by Ministry of Public Safety and Security of Korean government.

Reintroduction of rare arable plants by seed transfer. What are the optimal sowing rates?

Science.gov (United States)

Lang, Marion; Prestele, Julia; Fischer, Christina; Kollmann, Johannes; Albrecht, Harald

2016-08-01

During the past decades, agro-biodiversity has markedly declined and some species are close to extinction in large parts of Europe. Reintroduction of rare arable plant species in suitable habitats could counteract this negative trend. The study investigates optimal sowing rates of three endangered species (Legousia speculum-veneris (L.) Chaix, Consolida regalis Gray, and Lithospermum arvense L.), in terms of establishment success, seed production, and crop yield losses.A field experiment with partial additive design was performed in an organically managed winter rye stand with study species added in ten sowing rates of 5-10,000 seeds m(-2). They were sown as a single species or as a three-species mixture (pure vs. mixed sowing) and with vs. without removal of spontaneous weeds. Winter rye was sown at a fixed rate of 350 grains m(-2). Performance of the study species was assessed as plant establishment and seed production. Crop response was determined as grain yield.Plant numbers and seed production were significantly affected by the sowing rate, but not by sowing type (pure vs. mixed sowing of the three study species), and weed removal. All rare arable plant species established and reproduced at sowing rates >25 seeds m(-2), with best performance of L. speculum-veneris. Negative density effects occurred to some extent for plant establishment and more markedly for seed production.The impact of the three study species on crop yield followed sigmoidal functions. Depending on the species, a yield loss of 10% occurred at >100 seeds m(-2). Synthesis and applications: The study shows that reintroduction of rare arable plants by seed transfer is a suitable method to establish them on extensively managed fields, for example, in organic farms with low nutrient level and without mechanical weed control. Sowing rates of 100 seeds m(-2) for C. regalis and L. arvense, and 50 seeds m(-2) for L. speculum-veneris are recommended, to achieve successful establishment

Predictors of patency after two-stitch invagination vaso-epididymal anastomosis for idiopathic obstructive azoospermia

Directory of Open Access Journals (Sweden)

G Gautam

2005-01-01

Full Text Available Objectives: Anastomotic patency with return of sperm in the ejaculate following microsurgical vasoepididymostomy (VEA is not universal and may be delayed. The ability to predict the result of VEA based on preoperative or intra-operative parameters would enable the surgeon to offer the best treatment to the infertile couple. We used the two-stitch invagination technique of VEA in patients of idiopathic obstructive azoospermia and prospectively analyzed factors that could predict a patent anastomosis. While such studies have previously been done for patients undergoing VEA for secondary infertility following a vasectomy, to the best of our knowledge this is the first study analyzing these parameters for patients with primary infertility and idiopathic obstruction. Methods and materials: Over a 2-year period, 29 men underwent the 2-suture invagination VEA for idiopathic obstructive azoospermia. Twenty-four patients provided at least one postoperative semen sample. Preoperative and intra-operative parameters were compared between patients with a patent anastomosis with sperm in ejaculate (n = 12 and those with no sperm in the ejaculate (n = 12 using the t-test, Fisher′s exact test or chi-square test, as appropriate and a multivariate statistical analysis to determine any significant difference. Results: The mean follow up of the 24 patients was 7.6 months (2-30 months. A significantly greater number of patients with patent anastomosis had motile epididymal sperms (P = 0.034 and higher surgeon′s technical satisfaction with the procedure (P = 0.034. However, this difference was seen only on a univariate analysis and did not persist when a multivariate analysis was used. Conclusions: The presence of motile sperms in the epididymal fluid and a high level of technical satisfaction with the anastomosis may indicate a higher likelihood of success following a vaso-epididymal anastomosis for idiopathic obstruction. However, these parameters are not

Ecological optimization for generalized irreversible Carnot refrigerators

International Nuclear Information System (INIS)

Chen Lingen; Zhu Xiaoqin; Sun Fengrui; Wu Chih

2005-01-01

The optimal ecological performance of a Newton's law generalized irreversible Carnot refrigerator with the losses of heat resistance, heat leakage and internal irreversibility is derived by taking an ecological optimization criterion as the objective, which consists of maximizing a function representing the best compromise between the exergy output rate and exergy loss rate (entropy production rate) of the refrigerator. Numerical examples are given to show the effects of heat leakage and internal irreversibility on the optimal performance of generalized irreversible refrigerators

Optimally decoding the input rate from an observation of the interspike intervals

Energy Technology Data Exchange (ETDEWEB)

Feng Jianfeng [COGS, University of Sussex at Brighton (United Kingdom) and Computational Neuroscience Laboratory, Babraham Institute, Cambridge (United Kingdom)]. E-mail: jf218@cam.ac.uk

2001-09-21

A neuron extensively receives both inhibitory and excitatory inputs. What is the ratio r between these two types of input so that the neuron can most accurately read out input information (rate)? We explore the issue in this paper provided that the neuron is an ideal observer - decoding the input information with the attainment of the Cramer-Rao inequality bound. It is found that, in general, adding certain amounts of inhibitory inputs to a neuron improves its capability of accurately decoding the input information. By calculating the Fisher information of an integrate-and-fire neuron, we determine the optimal ratio r for decoding the input information from an observation of the efferent interspike intervals. Surprisingly, the Fisher information can be zero for certain values of the ratio, seemingly implying that it is impossible to read out the encoded information at these values. By analysing the maximum likelihood estimate of the input information, it is concluded that the input information is in fact most easily estimated at the points where the Fisher information vanishes. (author)

Optimal classifier selection and negative bias in error rate estimation: an empirical study on high-dimensional prediction

Directory of Open Access Journals (Sweden)

Boulesteix Anne-Laure

2009-12-01

Full Text Available Abstract Background In biometric practice, researchers often apply a large number of different methods in a "trial-and-error" strategy to get as much as possible out of their data and, due to publication pressure or pressure from the consulting customer, present only the most favorable results. This strategy may induce a substantial optimistic bias in prediction error estimation, which is quantitatively assessed in the present manuscript. The focus of our work is on class prediction based on high-dimensional data (e.g. microarray data, since such analyses are particularly exposed to this kind of bias. Methods In our study we consider a total of 124 variants of classifiers (possibly including variable selection or tuning steps within a cross-validation evaluation scheme. The classifiers are applied to original and modified real microarray data sets, some of which are obtained by randomly permuting the class labels to mimic non-informative predictors while preserving their correlation structure. Results We assess the minimal misclassification rate over the different variants of classifiers in order to quantify the bias arising when the optimal classifier is selected a posteriori in a data-driven manner. The bias resulting from the parameter tuning (including gene selection parameters as a special case and the bias resulting from the choice of the classification method are examined both separately and jointly. Conclusions The median minimal error rate over the investigated classifiers was as low as 31% and 41% based on permuted uninformative predictors from studies on colon cancer and prostate cancer, respectively. We conclude that the strategy to present only the optimal result is not acceptable because it yields a substantial bias in error rate estimation, and suggest alternative approaches for properly reporting classification accuracy.

Evaluation of air flow rates through spargers for optimization of KNGR IRWST and SDVS design

International Nuclear Information System (INIS)

Jung, J. S.; Rha, I. S.; Jang, Y. S.; Koh, H. J.; Park, J. N.; Lee, S. W.

1999-01-01

In KNGR in the event of POSRVs actuation water, air and steam discharged from the RCS impose the dynamic loads on IRWST walls and submerged structures. The largest load is air clearing load. The main factors having an effect on the air clearing load are steam mass flux, the pressure and air volume in the POSRV discharge line. It is practically difficult to make the amount of air mass and its flow rates discharged through each sparger evenly distributed because several spargers are branched from one horizontal header. For an optimization of KNGR IRWST and SDVS design to minimize the T/H loads, the pressure in the discharge pipe and the air mass flow rates through spargers are evaluated using RELAP5/MOD3 code with changing the POSRV opening time and line and sparger arrangement. It is shown that as the opening time is the longer, the pressure in the discharge line is decreased and difference of the amount of air mass between spargers is reduced. And sparger headers with three spargers show better performance rather than those with six ones

Combined-stent covered technique and single covered stent technique for transjugular intrahepatic porto-systemic shunt: a prospective randomized controlled study

International Nuclear Information System (INIS)

Wang Changming; Li Xuan; Fu Jun; Lu Xianjun; Luan Jingyuan; Li Tianrun; Zhao Jun; Dong Guoxiang

2014-01-01

Objective: To compare the technique of combined stents with that of single stent-graft for the construction of transjugular intrahepatic porto-systemic shunt (TIPS) and to discuss their clinical outcomes. Methods: During the period from April 2011 to Dec. 2012, a total of 30 patients with upper gastrointestinal bleeding due to portal hypertension were admitted to the hospital. TIPS procedure was carried out in all the 30 patients. The patients were randomly allocated into either combined-stent group (n=17) or stent-graft group (control group, n=13) on the basis of a computer-generated randomization sequence. The PSC quality control, the patency rate of portal vein branches and the shunts, the incidence of encephalopathy and the survival rate of the two groups were documented and analyzed. Results: Technical success rate was 100%. After the treatment, in both groups the PSG became significantly lower than the PSG determined before the treatment (P<0.000). According to quality control chart, the of combined stents was superior to stent-graft technique in effectively controlling PSG. Five days after TIPS, the ammonia level in the combined- stent group was significantly decreased (P=0.029), while in the control group the ammonia level showed no significant changes (P=0.065). One patient died shortly after TIPS. The median follow- up time was 181 days. During the follow-up period death occurred in 3 cases in each group. The difference in the survival rate between the two groups was no significant (P=0.906). Of the three patients who developed encephalopathy, two were in the combined-stent group and one was in the control group. After medication the symptoms of encephalopathy were relieved. The patency rate of the shunts was 100% and the re-bleeding rate was 0% for both groups. The patency rate of portal vein branches was significantly higher in the combined-stent group than that in the control group (P=0.039). Conclusion: For the construction of TIPS, the technique of

Warfarin improves the outcome of infrainguinal vein bypass grafting at high risk for failure.

Science.gov (United States)

Sarac, T P; Huber, T S; Back, M R; Ozaki, C K; Carlton, L M; Flynn, T C; Seeger, J M

1998-09-01

Patients with marginal venous conduit, poor arterial runoff, and prior failed bypass grafts are at high risk for infrainguinal graft occlusion and limb loss. We sought to evaluate the effects of anticoagulation therapy after autogenous vein infrainguinal revascularization on duration of patency, limb salvage rates, and complication rates in this subset of patients. This randomized prospective trial was performed in a university tertiary care hospital and in a Veterans Affairs Hospital. Fifty-six patients who were at high risk for graft failure were randomized to receive aspirin (24 patients, 27 bypass grafts) or aspirin and warfarin (WAR; 32 patients, 37 bypass grafts). All patients received 325 mg of aspirin each day, and the patients who were randomized to warfarin underwent anticoagulation therapy with heparin immediately after surgery and then were started on warfarin therapy to maintain an international normalized ratio between 2 and 3. Perioperative blood transfusions and complications were compared with the Student t test or with the chi2 test. Graft patency rates, limb salvage rates, and survival rates were compared with the Kaplan-Meier method and the log-rank test. Sixty-one of the 64 bypass grafts were performed for rest pain or tissue loss, and 3 were performed for short-distance claudication. There were no differences between the groups in ages, indications, bypass graft types, risk classifications (ie, conduit, runoff, or graft failure), or comorbid conditions (except diabetes mellitus). The cumulative 5-year survival rate was similar between the groups. The incidence rate of postoperative hematoma (32% vs 3.7%; P = .004) was greater in the WAR group, but no differences were seen between the WAR group and the aspirin group in the number of packed red blood cells transfused, in the incidence rate of overall nonhemorrhagic wound complications, or in the overall complication rate (62% vs 52%). The immediate postoperative primary graft patency rates (97

Effects of low dose aspirin (50 mg/day), low dose aspirin plus dipyridamole, and oral anticoagulant agents after internal mammary artery bypass grafting: patency and clinical outcome at 1 year. CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands. Prevention of Coronary Artery Bypass Graft Occlusion by Aspirin, Dipyridamole and Acenocoumarol/Phenprocoumon Study

NARCIS (Netherlands)

van der Meer, J.; Brutel de la Rivière, A.; van Gilst, W. H.; Hillege, H. L.; Pfisterer, M.; Kootstra, G. J.; Dunselman, P. H.; Mulder, B. J.; Lie, K. I.

1994-01-01

This study was performed to compare the efficacy and safety of aspirin, aspirin plus dipyridamole, and oral anticoagulant agents in the prevention of internal mammary artery graft occlusion. Antithrombotic drugs increase vein graft patency after coronary artery bypass surgery. Their benefit after

[CHALLENGING THE OPTIMAL NUMBER OF RETRIEVED OOCYTES AND ITS IMPACT ON PREGNANCY AND LIVE BIRTH RATES IN IVF/ICSI CYCLES].

Science.gov (United States)

Blais, Idit; Lahav-Baratz, Shirly; Koifman, Mara; Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

2015-06-01

Large numbers of retrieved oocytes are associated with higher chances of having cryopreservation of embryos. However, the process entailed exposes women to increased risk for ovarian hyperstimulation syndrome. Furthermore, mild ovary stimulation protocols are more patient-friendly and with less adverse effects. Only limited reports exist on the significance of the number of retrieved oocytes achieved in a single stimulation cycle. To investigate the optimal number of retrieved oocytes to achieve pregnancy and live birth. This retrospective analysis included 1590 IVF cycles. Oocytes maturation, fertilization, cleavage, as well as pregnancy and live birth rates were analyzed according to the number of retrieved oocytes. Oocyte maturation, fertilization and cleavage rates were lower in cycles with more than 10 retrieved oocytes compared with other groups. Live birth rates were highest when the number of retrieved oocytes was 11-15. Retrieval of more than 15 oocytes was not associated with a significant increase in chances of conception and birth. The better oocyte quality with 10 or less oocytes retrieved could be the result of a possible interference with the natural selection, or the minimized exposure of growing follicles to the potentially negative effects of ovarian stimulation. Although the average number of available embryos was higher when more than 10 oocytes were retrieved, achievement of more than 15 oocytes did not improve IVF outcome in terms of pregnancy and delivery rates. Analysis of 1590 IVF cycles including the frozen-thawed transfers shows that the best outcomes were achieved with an optimal number of 11-15 oocytes.

Endovascular Treatment for Iliac Vein Compression Syndrome: a Comparison between the Presence and Absence of Secondary Thrombosis

Energy Technology Data Exchange (ETDEWEB)

Lou, Wen Sheng; Gu, Jian Ping; He, Xu; Chen, Liang; Su, Hao Bo; Chen, Guo Ping; Song, Jing Hua; Wang, Tao [Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing (China)

2009-04-15

To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective

Percutaneous Palliation of Pancreatic Head Cancer: Randomized Comparison of ePTFE/FEP–Covered Versus Uncovered Nitinol Biliary Stents

International Nuclear Information System (INIS)

Krokidis, Miltiadis; Fanelli, Fabrizio; Orgera, Gianluigi; Tsetis, Dimitrios; Mouzas, Ioannis; Bezzi, Mario; Kouroumalis, Elias; Pasariello, Roberto; Hatzidakis, Adam

2011-01-01

The purpose of this study was to compare the clinical effectiveness of expanded polytetrafluoroethylene/fluorinated-ethylene-propylene (ePTFE/FEP)–covered stents with that of uncovered nitinol stents for the palliation of malignant jaundice caused by inoperable pancreatic head cancer. Eighty patients were enrolled in a prospective randomized study. Bare nitinol stents were used in half of the patients, and ePTFE/FEP–covered stents were used in the remaining patients. Patency, survival, complications, and mean cost were calculated in both groups. Mean patency was 166.0 ± 13.11 days for the bare-stent group and 234.0 ± 20.87 days for the covered-stent group (p = 0.007). Primary patency rates at 3, 6, and 12 months were 77.5, 69.8, and 69.8% for the bare-stent group and 97.5, 92.2, and 87.6% for the covered-stent group, respectively. Mean secondary patency was 123.7 ± 22.5 days for the bare-stent group and 130.3 ± 21.4 days for the covered-stent group. Tumour ingrowth occurred exclusively in the bare-stent group in 27.5% of cases (p = 0.002). Median survival was 203.2 ± 11.8 days for the bare-stent group and 247.0 ± 20 days for the covered-stent group (p = 0.06). Complications and mean cost were similar in both groups. Regarding primary patency and ingrowth rate, ePTFE/FEP–covered stents have shown to be significantly superior to bare nitinol stents for the palliation of malignant jaundice caused by inoperable pancreatic head cancer and pose comparable cost and complications. Use of a covered stent does not significantly influence overall survival rate; nevertheless, the covered endoprosthesis seems to offer result in fewer reinterventions and better quality of patient life.

Predictors of Long-Term Results After Treatment of Iliac Artery Obliteration by Transluminal Angioplasty and Stent Deployment

International Nuclear Information System (INIS)

Funovics, M.A.; Lackner, B.; Cejna, M.; Peloschek, P.; Sailer, J.; Philipp, M.O.; Maca, T.; Ahmadi, A.; Minar, E.; Lammer, J.

2002-01-01

Purpose: To investigate initial and long-term success rate after percutaneous treatment of iliac artery occlusion with angioplasty and stent deployment. To investigate the influence of vascular comorbidity, lesion length, stent placement and lesion coverage as possible predictors of outcome. Methods: Between January 1994 and December 1999, 80 iliac recanalizations were performed on 78 patients, median age 61.1 ±11.5 (SD) years. All patients were followed up by clinical examinations, duplex ultrasound and intravenous digital subtraction angiography. Mean follow-up time was 2.0 ± 1.53 (SD) years.Multivariate Cox regression analysis was used to determine the influence of cofactors on patency. Results: One, 2 and 4 years after recanalization, primary patency was 78.1%, 74.5% and 64.0%; secondary patency was 88.8%, 88.8% and 77.9%, respectively.Patients with shorter occlusions, complete lesion coverage and patent ipsilateral femoral arteries had significantly longer patency rates.Complications included inguinal hematoma (n=1), technical failure (n=3) aortic dissection (n=1), embolic occlusions (n=7), gluteal claudication (n=1) and genital necrosis after subsequent urethral surgery in one patient with contralateral occlusion and ipsilateral overstenting of the internal iliac artery with subsequent stenosis. Complications were of permanent clinical significance in seven of 78 (9%) of the patients. In 17 (22%) cases, percutaneous reintervention was performed with angioplasty in the stent (n=16) or deployment of a new stent (n=1). Conclusion: Endoluminal stent placement has its place in an interdisciplinary therapeutic approach as a viable therapeutic alternative to major transabdominal bypass surgery and can be performed with comparable complication rates. Patients with short occlusions, patent femoral arteries, and stents covering the entire occlusion have significant longer patency

Study on the optimization of the deposition rate of planetary GaN-MOCVD films based on CFD simulation and the corresponding surface model

Science.gov (United States)

Li, Jian; Fei, Ze-yuan; Xu, Yi-feng; Wang, Jie; Fan, Bing-feng; Ma, Xue-jin; Wang, Gang

2018-02-01

Metal-organic chemical vapour deposition (MOCVD) is a key technique for fabricating GaN thin film structures for light-emitting and semiconductor laser diodes. Film uniformity is an important index to measure equipment performance and chip processes. This paper introduces a method to improve the quality of thin films by optimizing the rotation speed of different substrates of a model consisting of a planetary with seven 6-inch wafers for the planetary GaN-MOCVD. A numerical solution to the transient state at low pressure is obtained using computational fluid dynamics. To evaluate the role of the different zone speeds on the growth uniformity, single factor analysis is introduced. The results show that the growth rate and uniformity are strongly related to the rotational speed. Next, a response surface model was constructed by using the variables and the corresponding simulation results. The optimized combination of the matching of different speeds is also proposed as a useful reference for applications in industry, obtained by a response surface model and genetic algorithm with a balance between the growth rate and the growth uniformity. This method can save time, and the optimization can obtain the most uniform and highest thin film quality.

Office hysteroscopic-guided selective tubal chromopertubation: acceptability, feasibility and diagnostic accuracy of this new diagnostic non-invasive technique in infertile women.

Science.gov (United States)

Carta, Gaspare; Palermo, Patrizia; Pasquale, Chiara; Conte, Valeria; Pulcinella, Ruggero; Necozione, Stefano; Cofini, Vincenza; Patacchiola, Felice

2018-06-01

The aim of this study was to evaluate accuracy, tolerability and side effects of office hysteroscopic-guided chromoperturbations in infertile women without anaesthesia. Forty-nine infertile women underwent the procedure to evaluate tubal patency and the uterine cavity. Women with unilateral or bilateral tubal stenosis at hysteroscopy with chromoperturbation, and women with bilateral tubal patency who did not conceive during the period of six months, underwent laparoscopy with chromoperturbation. The results obtained from hysteroscopy and laparoscopy in the assessment of tubal patency were compared. Sensitivity, specificity, accuracy, positive-predictive value and negative-predictive value were used to describe diagnostic performance. Pain and tolerance were assessed during procedure using a visual analogue scale (VAS). Side effects or late complications and pregnancy rate were also recorded three and six months after the procedure. The specificity was 87.8% (95% CI: 73.80-95.90), sensitivity was 85.7% (95% CI 57.20-98.20), positive and negative predictive values were 70.6% (95% CI: 44.00-89) and 94.7% (95% CI: 82.30-99.40), respectively. Pregnancy rate (PR) within six months after performance of hysteroscopy with chromoperturbation was 27%. Office hysteroscopy-guided selective chromoperturbation in infertile patients is a valid technique to evaluate tubal patency and uterine cavity.

The use of coronary stent in hepatic artery stenosis after orthotopic liver transplantation

International Nuclear Information System (INIS)

Huang Mingsheng; Shan Hong; Jiang Zaibo; Li Zhengran; Zhu Kangshun; Guan Shouhai; Qian Jiesheng; Chen Guihua; Lu Minqiang; Yang Yang

2006-01-01

Purpose: This retrospective study was undertaken to evaluate the effectiveness of coronary stent placement in hepatic artery stenosis after orthotopic liver transplantation (OLT). Materials and methods: Of 430 consecutive adult orthotopic liver transplant recipients between November 2003 and September 2005, 17 had hepatic artery stenosis (HAS). Fourteen of them underwent coronary stent placement in the HAS. The technical results, complications, hepatic artery patency and clinical outcome were reviewed. Results: Technical and immediate success was 100%. After a mean follow-up of 159.4 days (range, 9-375 days), all patients obtained patent hepatic arteries except 2 patients occurred hepatic artery restenoses at 26 and 45 days after stent placement, respectively. Kaplan-Meier curve of patency showed cumulated stent patency at 3, 6, and 12 months of 78%, 58% and 45%, respectively. During the follow-up, 8 patients survived, 5 died of septic multiple-organ failure, 1 received retransplantation because of refractory biliary infection. Hepatic artery dissection induced by a guiding catheter occurred in one patient and was successfully treated with a coronary stent. Conclusion: Hepatic artery stenosis after OLT can be successfully treated with coronary stent placement with low complication rate and an acceptable 1-year hepatic artery patency rate

A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction

International Nuclear Information System (INIS)

Koh, Esther; Jin, Gong Yong; Hwang, Seung Bae; Choi, Eun Jung; Song, Ji Soo; Han, Young Min; Kwon, Keun Sang

2013-01-01

To compare the Y type (side-by-side) and T type (stent-in-stent) bilateral biliary metal stenting in malignant hilar obstruction in terms of treatment outcomes, including post-stenting serum bilirubin level and stent patency. 41 consecutive patients with advanced hilar malignancies who underwent percutaneous placement of bilateral metallic stents - Y (n = 23) and T types (n = 18) - were retrospectively reviewed. We evaluated stent patency after the procedure by cholangiogram and abdominal CT. Pre- and post-stenting serum bilirubin level (total, direct bilirubin) at 1 week and at 1 month were compared. Student t-test and Kaplan-Meier method were used in the statistical analysis. After comparing the median stent patency according to both types, they did not differ significantly (Y: 38 days, T: 61 days; p 0.141). There was a more decrease in the total and direct bilirubin of the T type compared to the Y type after 1 week (p = 0.013, 0.025). However, no significant difference existed between the decreasing bilirubin rates of both types after 1 month (p = 0.923, 0.742). In patients with malignant hilar obstruction, both Y and T type bilateral metallic biliary stents are effective methods. Stent patency and bilirubin decrease rates were not significantly different.

A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction

Energy Technology Data Exchange (ETDEWEB)

Koh, Esther; Jin, Gong Yong; Hwang, Seung Bae; Choi, Eun Jung; Song, Ji Soo; Han, Young Min; Kwon, Keun Sang [Dept. of Chonbuk National University Hospital and Medical School, Jeonju (Korea, Republic of)

2013-04-15

To compare the Y type (side-by-side) and T type (stent-in-stent) bilateral biliary metal stenting in malignant hilar obstruction in terms of treatment outcomes, including post-stenting serum bilirubin level and stent patency. 41 consecutive patients with advanced hilar malignancies who underwent percutaneous placement of bilateral metallic stents - Y (n = 23) and T types (n = 18) - were retrospectively reviewed. We evaluated stent patency after the procedure by cholangiogram and abdominal CT. Pre- and post-stenting serum bilirubin level (total, direct bilirubin) at 1 week and at 1 month were compared. Student t-test and Kaplan-Meier method were used in the statistical analysis. After comparing the median stent patency according to both types, they did not differ significantly (Y: 38 days, T: 61 days; p 0.141). There was a more decrease in the total and direct bilirubin of the T type compared to the Y type after 1 week (p = 0.013, 0.025). However, no significant difference existed between the decreasing bilirubin rates of both types after 1 month (p = 0.923, 0.742). In patients with malignant hilar obstruction, both Y and T type bilateral metallic biliary stents are effective methods. Stent patency and bilirubin decrease rates were not significantly different.

Long-term results of percutaneous self-expandable metallic stents in malignant biliary obstruction

International Nuclear Information System (INIS)

Kobashi, Yuko; Hoshikawa, Yoshikazu

2004-01-01

Evaluation of the long-term follow-up data of 155 patients with inoperable malignant biliary obstruction who received percutaneous placement of self expandable metallic stent (EMS) and external beam radiotherapy (EBR) combined with self-expandable metallic stent. One-hundred sixty EMS were inserted in 155 patients with inoperable malignant biliary obstruction. One-hundred forty-three patients (Group A) were inserted EMS alone. Twelve patients (Group B) underwent external radiotherapy (40∼45 Gy) after stent insertion. We compared to the Group A and Group B about survival, stent patency and administration. The mean length of survival for the entire group was 111±87 days, while the mean period of patency for all stents was 103±74. We found no statistically significant difference in patient survival or stent patency periods in regard to the level and cause of obstruction. Prolongation of actuarial survival was observed in Group B (316±231 days) as compared to Group A (126±85 days,). Mean length of survival rate and mean period of stent patency rate were not significantly different in regard to the level, cause of obstruction and each stent. External radiotherapy combined EMS could achieve effective palliation and improve the quality of life in selected patients with malignant biliary obstruction. (author)

Energy minimization of mobile video devices with a hardware H.264/AVC encoder based on energy-rate-distortion optimization

Science.gov (United States)

Kang, Donghun; Lee, Jungeon; Jung, Jongpil; Lee, Chul-Hee; Kyung, Chong-Min

2014-09-01

In mobile video systems powered by battery, reducing the encoder's compression energy consumption is critical to prolong its lifetime. Previous Energy-rate-distortion (E-R-D) optimization methods based on a software codec is not suitable for practical mobile camera systems because the energy consumption is too large and encoding rate is too low. In this paper, we propose an E-R-D model for the hardware codec based on the gate-level simulation framework to measure the switching activity and the energy consumption. From the proposed E-R-D model, an energy minimizing algorithm for mobile video camera sensor have been developed with the GOP (Group of Pictures) size and QP(Quantization Parameter) as run-time control variables. Our experimental results show that the proposed algorithm provides up to 31.76% of energy consumption saving while satisfying the rate and distortion constraints.

Evaluation of optimization strategies and the effect of initial conditions on IMAT optimization using a leaf position optimization algorithm

International Nuclear Information System (INIS)

Oliver, Mike; Jensen, Michael; Chen, Jeff; Wong, Eugene

2009-01-01

Intensity-modulated arc therapy (IMAT) is a rotational variant of intensity-modulated radiation therapy (IMRT) that can be implemented with or without angular dose rate variation. The purpose of this study is to assess optimization strategies and initial conditions using a leaf position optimization (LPO) algorithm altered for variable dose rate IMAT. A concave planning target volume (PTV) with a central cylindrical organ at risk (OAR) was used in this study. The initial IMAT arcs were approximated by multiple static beams at 5 deg. angular increments where multi-leaf collimator (MLC) leaf positions were determined from the beam's eye view to irradiate the PTV but avoid the OAR. For the optimization strategy, two arcs with arc ranges of 280 deg. and 150 deg. were employed and plans were created using LPO alone, variable dose rate optimization (VDRO) alone, simultaneous LPO and VDRO and sequential combinations of these strategies. To assess the MLC initialization effect, three single 360 deg. arc plans with different initial MLC configurations were generated using the simultaneous LPO and VDRO. The effect of changing optimization degrees of freedom was investigated by employing 3 deg., 5 deg. and 10 deg. angular sampling intervals for the two 280 deg., two 150 deg. and single arc plans using LPO and VDRO. The objective function value, a conformity index, a dose homogeneity index, mean dose to OAR and normal tissues were computed and used to evaluate the treatment plans. This study shows that the best optimization strategy for a concave target is to use simultaneous MLC LPO and VDRO. We found that the optimization result is sensitive to the choice of initial MLC aperture shapes suggesting that an LPO-based IMAT plan may not be able to overcome local minima for this geometry. In conclusion, simultaneous MLC leaf position and VDRO are needed with the most appropriate initial conditions (MLC positions, arc ranges and number of arcs) for IMAT.

A Global Optimizing Policy for Decaying Items with Ramp-Type Demand Rate under Two-Level Trade Credit Financing Taking Account of Preservation Technology

Directory of Open Access Journals (Sweden)

S. R. Singh

2013-01-01

Full Text Available An inventory system for deteriorating items, with ramp-type demand rate, under two-level trade credit policy taking account of preservation technology is considered. The objective of this study is to develop a deteriorating inventory policy when the supplier provides to the retailer a permissible delay in payments, and during this credit period, the retailer accumulates the revenue and earns interest on that revenue; also the retailer invests on the preservation technology to reduce the rate of product deterioration. Shortages are allowed and partially backlogged. Sufficient conditions of the existence and uniqueness of the optimal replenishment policy are provided, and an algorithm, for its determination, is proposed. Numerical examples draw attention to the obtained results, and the sensitivity analysis of the optimal solution with respect to leading parameters of the system is carried out.

Combined stent placement and high dose PGE1 drip infusion for chronic occlusion of the superficial femoral artery as a modality to salvage chronic critical limb ischemia

Energy Technology Data Exchange (ETDEWEB)

Ikushima, Ichiro [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan)], E-mail: iku-i@fk.enjoy.ne.jp; Hirai, Toshinori [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan); Ishii, Akihiko [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan); Yamashita, Yasuyuki [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan)

2008-04-15

Purpose: To assess the initial effect, short-term patency, and limb salvage rates of combined stent placement and high-dose prostaglandin E-1 (PGE1) drip infusion for chronic occlusion of the superficial femoral artery (SFA). Materials and methods: A total of 15 arteriosclerotic occlusive lesions of the SFA were treated in 11 consecutive patients (mean age: 78.4 years old). All cases were of category 4 or 5, based on the criteria of the Society of Vascular Surgery and Intermittent Society for Cardiovascular Surgery (SVC/ISCVS). In all cases a self-expandable stainless steel stent was implanted. PGE1 treatment was started 3-5 days before stent placement and continued for 7-10 days after the intervention. The technical success, limb salvage outcomes, patency rates, and complications were examined. Results: In all cases, the technical success rate of the procedure was 100%. After stent implantation, the clinical status of all cases was improved by at least +2, and major amputation was not required in any cases. The 12-month primary, secondary patency rates, and limb salvage rate were 57%, 100%, and 100%, respectively. Conclusion: Combined stent placement and high-dose PGE1 drip infusion is a treatment of choice for salvaging the lower limb of a patient with chronic critical ischemia.

Evaluation of the efficacy and safety of endovascular management for transplant renal artery stenosis

Directory of Open Access Journals (Sweden)

Leonardo G.M. Valle

Full Text Available OBJECTIVES: To evaluate the safety and efficacy of endovascular intervention with angioplasty and stent placement in patients with transplant renal artery stenosis. METHODS: All patients diagnosed with transplant renal artery stenosis and graft dysfunction or resistant systemic hypertension who underwent endovascular treatment with stenting from February 2011 to April 2016 were included in this study. The primary endpoint was clinical success, and the secondary endpoints were technical success, complication rate and stent patency. RESULTS: Twenty-four patients with transplant renal artery stenosis underwent endovascular treatment, and three of them required reinterventions, resulting in a total of 27 procedures. The clinical success rate was 100%. All graft dysfunction patients showed decreased serum creatinine levels and improved estimated glomerular filtration rates and creatinine levels. Patients with high blood pressure also showed improved control of systemic blood pressure and decreased use of antihypertensive drugs. The technical success rate of the procedure was 97%. Primary patency and assisted primary patency rates at one year were 90.5% and 100%, respectively. The mean follow-up time of patients was 794.04 days after angioplasty. CONCLUSION: Angioplasty with stent placement for the treatment of transplant renal artery stenosis is a safe and effective technique with good results in both the short and long term.

Endoscopic Drainage of >50% of Liver in Malignant Hilar Biliary Obstruction Using Metallic or Fenestrated Plastic Stents.

Science.gov (United States)

Kerdsirichairat, Tossapol; Arain, Mustafa A; Attam, Rajeev; Glessing, Brooke; Bakman, Yan; Amateau, Stuart K; Freeman, Martin L

2017-08-31

Endoscopic drainage of complex hilar tumors has generally resulted in poor outcomes. Drainage of >50% of liver volume has been proposed as optimal, but not evaluated using long multifenestrated plastic stents (MFPS) or self-expanding metal stents (SEMS). We evaluated outcomes of endoscopic drainage of malignant hilar strictures using optimal strategy and stents, and determined factors associated with stent patency, survival, and complications. Cross-sectional study was conducted at an academic center over 5 years. MFPS (10 French or 8.5 French) or open-cell SEMS were used for palliation of unresectable malignant hilar strictures, with imaging-targeted drainage of as many sectors as needed to drain >50% of viable liver volume. Risk factors were evaluated using regression analysis. The cumulative risk was assessed using Kaplan-Meier analysis. 77 patients with malignant hilar biliary strictures (median Bismuth IV) underwent targeted stenting (41 MFPS and 36 SEMS). Comparing MFPS vs. SEMS, technical success (95.1 vs. 97.2%, P=0.64), clinical success (75.6 vs. 83.3%, P=0.40), frequency of multiple stents (23/41 vs. 25/36, P=0.19), survival and adverse events were similar, but stent patency was significantly shorter (P50% of viable liver resulted in effective palliation in patients with complex malignant hilar biliary strictures. Patency was shorter in the MFPS group, but similar survival and complications were found when comparing MFPS and SEMS group.

Ratings of Broader Autism Phenotype and Personality Traits in Optimal Outcomes from Autism Spectrum Disorder.

Science.gov (United States)

Suh, Joyce; Orinstein, Alyssa; Barton, Marianne; Chen, Chi-Ming; Eigsti, Inge-Marie; Ramirez-Esparza, Nairan; Fein, Deborah

2016-11-01

The study examines whether "optimal outcome" (OO) children, despite no longer meeting diagnostic criteria for Autism Spectrum Disorder (ASD), exhibit personality traits often found in those with ASD. Nine zero acquaintance raters evaluated Broader Autism Phenotype (BAP) and Big Five personality traits of 22 OO individuals, 27 high functioning individuals with ASD (HFA), and 23 typically developing (TD) peers. HFA children displayed higher ratings than their peers on all BAP traits. OO were indistinguishable from TD, with the exception of greater extraversion (e.g., increased talkativeness), a potential tendency to be less emotionally stable, and pragmatic language deficits such as getting sidetracked in conversation. Overall, OO individuals are not showing BAP characteristics, but may be subject to other mild ADHD-like characteristics.

Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

International Nuclear Information System (INIS)

Das, Neelan; Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

2011-01-01

Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa ® , Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4–270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

Optimal Water Recovery with Emphasis on Flocculant Consumption Rate in the Thickener

Directory of Open Access Journals (Sweden)

Marzieh Hosseininasab

2017-11-01

Full Text Available Water plays a vital role in mineral processing as evidenced by the approximately 2 to 3 tons of water used for the treatment of one ton of ore. A major portion of this water may be recovered in thickeners. This study aimed to control the wet tailings output of the Hematite Gol-e-Gohar plant by changing  flocculant dosage and type and solid percentage in the feed in order to enhance effluent clarity and reduce water consumption. Materials and A series of settling experiments were performed using different combinations of the flocculants (A25, A26 Yazd, A26 Esfahan, A27, and A28, flocculant doses (20, 25, 30, 35, and 40 gr/ton, and solid loads in the feed (5, 7, 9, 10, and 11% to the thickener. The L25 Taguchi design method was chosen to handle the five different levels of the three factors. Adopting a 95% confidence interval, the results of analysis of variance (ANOVA revealed that flocculant consumption rate had a high effect on settling velocity (p = 0.006 while flocculant type and solid percentage in the feed had no significant effects. Moreover, it was found that A26 (Akhtar-chemistry Company, Yazd used at a rate of 40 g/ton improved the settling performance to yield an optimal water clarity. Using the findings of this study in process planning at the plant led to a considerable reduction (from the original 0.86 to 0.49 m3 in average water consumption per ton of input material so that the solid content of the thickener underflow rose from 7 to 45%.

Aircraft technology portfolio optimization using ant colony optimization

Science.gov (United States)

Villeneuve, Frederic J.; Mavris, Dimitri N.

2012-11-01

Technology portfolio selection is a combinatorial optimization problem often faced with a large number of combinations and technology incompatibilities. The main research question addressed in this article is to determine if Ant Colony Optimization (ACO) is better suited than Genetic Algorithms (GAs) and Simulated Annealing (SA) for technology portfolio optimization when incompatibility constraints between technologies are present. Convergence rate, capability to find optima, and efficiency in handling of incompatibilities are the three criteria of comparison. The application problem consists of finding the best technology portfolio from 29 aircraft technologies. The results show that ACO and GAs converge faster and find optima more easily than SA, and that ACO can optimize portfolios with technology incompatibilities without using penalty functions. This latter finding paves the way for more use of ACO when the number of constraints increases, such as in the technology and concept selection for complex engineering systems.

Computational procedure of optimal inventory model involving controllable backorder rate and variable lead time with defective units

Science.gov (United States)

Lee, Wen-Chuan; Wu, Jong-Wuu; Tsou, Hsin-Hui; Lei, Chia-Ling

2012-10-01

This article considers that the number of defective units in an arrival order is a binominal random variable. We derive a modified mixture inventory model with backorders and lost sales, in which the order quantity and lead time are decision variables. In our studies, we also assume that the backorder rate is dependent on the length of lead time through the amount of shortages and let the backorder rate be a control variable. In addition, we assume that the lead time demand follows a mixture of normal distributions, and then relax the assumption about the form of the mixture of distribution functions of the lead time demand and apply the minimax distribution free procedure to solve the problem. Furthermore, we develop an algorithm procedure to obtain the optimal ordering strategy for each case. Finally, three numerical examples are also given to illustrate the results.

A New Hybrid Whale Optimizer Algorithm with Mean Strategy of Grey Wolf Optimizer for Global Optimization

Directory of Open Access Journals (Sweden)

Narinder Singh

2018-03-01

Full Text Available The quest for an efficient nature-inspired optimization technique has continued over the last few decades. In this paper, a hybrid nature-inspired optimization technique has been proposed. The hybrid algorithm has been constructed using Mean Grey Wolf Optimizer (MGWO and Whale Optimizer Algorithm (WOA. We have utilized the spiral equation of Whale Optimizer Algorithm for two procedures in the Hybrid Approach GWO (HAGWO algorithm: (i firstly, we used the spiral equation in Grey Wolf Optimizer algorithm for balance between the exploitation and the exploration process in the new hybrid approach; and (ii secondly, we also applied this equation in the whole population in order to refrain from the premature convergence and trapping in local minima. The feasibility and effectiveness of the hybrid algorithm have been tested by solving some standard benchmarks, XOR, Baloon, Iris, Breast Cancer, Welded Beam Design, Pressure Vessel Design problems and comparing the results with those obtained through other metaheuristics. The solutions prove that the newly existing hybrid variant has higher stronger stability, faster convergence rate and computational accuracy than other nature-inspired metaheuristics on the maximum number of problems and can successfully resolve the function of constrained nonlinear optimization in reality.

Optimal natural resources management under uncertainty with catastrophic risk

Energy Technology Data Exchange (ETDEWEB)

Motoh, Tsujimura [Graduate School of Economics, Kyoto University, Yoshida-honmochi, Sakyo-ku, Kyoto 606-8501 (Japan)

2004-05-01

We examine an optimal natural resources management problem under uncertainty with catastrophic risk and investigate the optimal rate of use of a natural resource. For this purpose, we use stochastic control theory. We assume that, until a catastrophic event occurs, the stock of the natural resource is governed by a stochastic differential equation. We describe the catastrophic phenomenon as a Poisson process. From this analysis, we show the optimal rate of use of the natural resource in explicit form. Furthermore, we present comparative static results for the optimal rate of use of the natural resource.

Optimal natural resources management under uncertainty with catastrophic risk

International Nuclear Information System (INIS)

Motoh, Tsujimura

2004-01-01

We examine an optimal natural resources management problem under uncertainty with catastrophic risk and investigate the optimal rate of use of a natural resource. For this purpose, we use stochastic control theory. We assume that, until a catastrophic event occurs, the stock of the natural resource is governed by a stochastic differential equation. We describe the catastrophic phenomenon as a Poisson process. From this analysis, we show the optimal rate of use of the natural resource in explicit form. Furthermore, we present comparative static results for the optimal rate of use of the natural resource

An Ameliorative Whale Optimization Algorithm for Multi-Objective Optimal Allocation of Water Resources in Handan, China

Directory of Open Access Journals (Sweden)

Zhihong Yan

2018-01-01

Full Text Available With the deepening discrepancy between water supply and demand caused by water shortages, alleviating water shortages by optimizing water resource allocation has received extensive attention. How to allocate water resources optimally, rapidly, and effectively has become a challenging problem. Thus, this study employs a meta-heuristic swarm-based algorithm, the whale optimization algorithm (WOA. To overcome drawbacks like relatively low convergence precision and convergence rates, when applying the WOA algorithm to complex optimization problems, logistic mapping is used to initialize swarm location, and inertia weighting is employed to improve the algorithm. The resulting ameliorative whale optimization algorithm (AWOA shows substantially enhanced convergence rates and precision than the WOA and particle swarm optimization algorithms, demonstrating relatively high reliability and applicability. A water resource allocation optimization model with optimal economic efficiency and least total water shortage volume is established for Handan, China, and solved by the AWOA. The allocation results better reflect actual water usage in Handan. In 2030, the p = 50% total water shortage is forecast as 404.34 × 106 m3 or 14.8%. The shortage is mainly in the primary agricultural sector. The allocation results provide a reference for regional water resources management.

Influence of heart rate on image quality of 64-slice spiral computed coronary angiography and optimization on reconstruction of phase window

International Nuclear Information System (INIS)

Luo Xuemao; Lan Yong; Li Wei; Long Wansheng; Zhang Chaotong; Zhong Xiangyang; Yi Lan

2009-01-01

Objective: To evaluate the influence of heart rate on the image quality of 64-slice spiral computed coronary angiography (MSCTCA) and optimize the image reconstruction window. Methods: According to the heart rate, 86 patients were classified into 5 groups: group A, the heart rate ≤60 beat per minute(BMP); group B,61-70BMP, group C,71-80BMP, and group D>80BMP. The image quality of MSCTCA was scored 5 grades from 1-5 according to heart motion artifact. The influences of heart rate and reconstruction phase on the image quality of MSCTCA were evaluated. Results: Average heart rate was 64.4 ±10.1BMP. Diagnostic image quality (score>3) was attained in 277 of 344 segments at the best reconstruction interval. There was a significant corxelation between average heart rate and image quality, but there was no difference between relative delay (%) reconstruction and absolute delay (ms) reconstruction on the image quality. Conclusion: Reducing average heart rate is beneficial for improving the image quality. (authors)

SnS absorber thin films by co-evaporation: Optimization of the growth rate and influence of the annealing

Energy Technology Data Exchange (ETDEWEB)

Robles, Víctor, E-mail: victor.robles@ciemat.es; Trigo, Juan Francisco; Guillén, Cecilia; Herrero, José

2015-05-01

Tin sulfide thin films were prepared by co-evaporation on soda-lime glass substrates, for use as absorber layers. The synthesis was carried out at 350 °C substrate temperature and varying the growth rate in the 2-6 Å/s range, adjusting the deposition time in order to obtain thicknesses in the 700-1500 nm range. After evaporation, the samples were heated at 400 °C and 500 °C under various atmospheres. The evolution of the morphological, structural and optical properties has been analyzed as a function of the thickness and deposition rate, before and after annealing. For the samples grown at the lowest rate, SnS and Sn{sub 2}S{sub 3} phase mixing has been observed by X-ray diffraction. Samples with reduced thickness preferably crystallize in the SnS phase, whereas thicker layers become richer in the Sn{sub 2}S{sub 3} phase. The sulfur treatment of samples prepared at the lowest rate results in the formation of SnS{sub 2} phase. Otherwise, the samples obtained at the highest rates show single-phase SnS after heating at 400 °C in sulfur atmosphere, with gap energy values around 1.24 eV. - Highlights: • Tin sulfide thin films were deposited by co-evaporation at different growth rates. • The influence of the growth rate and post-annealing at different conditions was studied. • The SnS phase was obtained by optimizing the growth rate and the annealing process. • The SnS phase presented properties for use as absorber layer.

Magnetic resonance evaluation of luminal patency after polylactide stent implantation: an experimental study in a rabbit aorta model

International Nuclear Information System (INIS)

Hietala, Eeva-Maija; Salminen, Ulla-Stina; Harjula, Ari L.J.; Maasilta, Paula; Staahls, Anders; Vaelimaa, Tero; Kivisaari, Leena

2003-01-01

Intravascular metallic stents cause magnetic field distortions, disturbing luminal detection. Our aim was to evaluate the effect of polylactic acid (PLA) stents on magnetic resonance angiography (MRA). Biodegradable double spiral helical PLA stents (n=12) or stainless steel (SS) (n=6) stents were implanted into the infrarenal aortas of New Zealand White rabbits. All SS- and 6 PLA-stented animals as well as 6 non-operated control rabbits were imaged with gadolinium-enhanced MRA (1.5 T), and infrarenal aortic diameters (proximal, distal, and narrowest), together with the stent artifact, were measured. Six of the PLA-stented rabbits were followed up, and MRA was assessed at 2, 6, 9, and 12 months after the stent implantation. Image artifacts caused by the SS stents were visualized in all cases. The PLA stents caused no magnetic field distortion, allowing imaging of the underlying vessel including the vessel lumen. In the follow-up group of 6 rabbits with a PLA stent, 5 of 6 were patent at the end of the follow-up of 12 months. These stents allowed luminal detection at all time points, with no significant differences in aortic measurements emerging during the whole follow-up period. When immediately postoperatively scanned SS and PLA rabbits were compared with controls, no differences were observable in proximal diameters. Instead, the percentage of distal luminal loss was greater in the PLA-stented rabbits, as compared with SS stents (p<0.01). The PLA stenting in small vessels allows evaluation of luminal patency with MRA both immediately after implantation and during follow-up. (orig.)

Portfolio optimization with mean-variance model

Science.gov (United States)

Hoe, Lam Weng; Siew, Lam Weng

2016-06-01

Investors wish to achieve the target rate of return at the minimum level of risk in their investment. Portfolio optimization is an investment strategy that can be used to minimize the portfolio risk and can achieve the target rate of return. The mean-variance model has been proposed in portfolio optimization. The mean-variance model is an optimization model that aims to minimize the portfolio risk which is the portfolio variance. The objective of this study is to construct the optimal portfolio using the mean-variance model. The data of this study consists of weekly returns of 20 component stocks of FTSE Bursa Malaysia Kuala Lumpur Composite Index (FBMKLCI). The results of this study show that the portfolio composition of the stocks is different. Moreover, investors can get the return at minimum level of risk with the constructed optimal mean-variance portfolio.

Dictionary descent in optimization

OpenAIRE

Temlyakov, Vladimir

2015-01-01

The problem of convex optimization is studied. Usually in convex optimization the minimization is over a d-dimensional domain. Very often the convergence rate of an optimization algorithm depends on the dimension d. The algorithms studied in this paper utilize dictionaries instead of a canonical basis used in the coordinate descent algorithms. We show how this approach allows us to reduce dimensionality of the problem. Also, we investigate which properties of a dictionary are beneficial for t...

Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

OpenAIRE

Solev?g, Anne Lee; Schm?lzer, Georg M.

2017-01-01

Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to vent...

Percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency: efficacy of mechanical thrombectomy with using the stone basket

International Nuclear Information System (INIS)

Kim, Young Hwan; Ko, Sung Min; Kim, Mi Jung; Kwon, Jung Hyeok; Sohn, Cheol Ho; Choi, Jin Soo; Park, Kyung Sik; Kim, Yong Joo

2006-01-01

We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data regarding the procedural success rate and the patency rate were analyzed by means of Fischer's exact test, and the Kaplan-Meier method with the Log-rank test was used for statistical inter-group comparisons between the brachiocephalic and radiocephalic fistulas. Successful declotting and restoration of thrill were achieved in 30 of 36 procedures (83%). Reestablishment of normal dialysis for at least one session was achieved in 29 of 36 procedures (81%). The procedural success rate for the brachiocephalic fistulas was 94% compared with 70% for the radiocephalic fistulas, but the difference was not statistically significant (ρ = 0.104). In the cases with performing mechanical thrombectomy and using the stone basket, procedural success was achieved in 93% (13/14). The expected patency rates at 3, 6 and 12 months were 78%, 61% and 51%, respectively. The patency rates after declotting procedures were not significantly different between the brachiocephalic and radiocephlaic fistulas (ρ = 0.871). Percutaneous treatment of thrombosed native arteriovenous

Percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency: efficacy of mechanical thrombectomy with using the stone basket

Energy Technology Data Exchange (ETDEWEB)

Kim, Young Hwan; Ko, Sung Min; Kim, Mi Jung; Kwon, Jung Hyeok; Sohn, Cheol Ho; Choi, Jin Soo; Park, Kyung Sik [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andon (Korea, Republic of)

2006-06-15

We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data regarding the procedural success rate and the patency rate were analyzed by means of Fischer's exact test, and the Kaplan-Meier method with the Log-rank test was used for statistical inter-group comparisons between the brachiocephalic and radiocephalic fistulas. Successful declotting and restoration of thrill were achieved in 30 of 36 procedures (83%). Reestablishment of normal dialysis for at least one session was achieved in 29 of 36 procedures (81%). The procedural success rate for the brachiocephalic fistulas was 94% compared with 70% for the radiocephalic fistulas, but the difference was not statistically significant ({rho} = 0.104). In the cases with performing mechanical thrombectomy and using the stone basket, procedural success was achieved in 93% (13/14). The expected patency rates at 3, 6 and 12 months were 78%, 61% and 51%, respectively. The patency rates after declotting procedures were not significantly different between the brachiocephalic and radiocephlaic fistulas ({rho} = 0.871). Percutaneous treatment of thrombosed native

Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

International Nuclear Information System (INIS)

Shawyer, Andrew; Fotiadis, Nicos I.; Namagondlu, Girish; Iyer, Arun; Blunden, Mark; Raftery, Martin; Yaqoob, Magdi

2013-01-01

Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS. Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up. The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482–0.977] at 6 months and 72.7 % (95 % CI 0.390–0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587–0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156–2,282). The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.

Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

Energy Technology Data Exchange (ETDEWEB)

Shawyer, Andrew, E-mail: andrew.shawyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Fotiadis, Nicos I., E-mail: fotiadis.nicholas@gmail.com [Royal Marsden Hospital, Radiology Department, The Royal Marsden NHS Foundation Trust (United Kingdom); Namagondlu, Girish, E-mail: girish.namagondlu@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom); Iyer, Arun, E-mail: arun.iyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Blunden, Mark, E-mail: mark.blunden@bartsandthelondon.nhs.uk; Raftery, Martin, E-mail: martin.raftery@bartsandthelondon.nhs.uk; Yaqoob, Magdi, E-mail: magdi.yaqoob@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom)

2013-02-15

Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS. Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up. The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482-0.977] at 6 months and 72.7 % (95 % CI 0.390-0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587-0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156-2,282). The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.

Optimal Control Inventory Stochastic With Production Deteriorating

Science.gov (United States)

Affandi, Pardi

2018-01-01

In this paper, we are using optimal control approach to determine the optimal rate in production. Most of the inventory production models deal with a single item. First build the mathematical models inventory stochastic, in this model we also assume that the items are in the same store. The mathematical model of the problem inventory can be deterministic and stochastic models. In this research will be discussed how to model the stochastic as well as how to solve the inventory model using optimal control techniques. The main tool in the study problems for the necessary optimality conditions in the form of the Pontryagin maximum principle involves the Hamilton function. So we can have the optimal production rate in a production inventory system where items are subject deterioration.

Bit rates in audio source coding

NARCIS (Netherlands)

Veldhuis, Raymond N.J.

1992-01-01

The goal is to introduce and solve the audio coding optimization problem. Psychoacoustic results such as masking and excitation pattern models are combined with results from rate distortion theory to formulate the audio coding optimization problem. The solution of the audio optimization problem is a

Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

Energy Technology Data Exchange (ETDEWEB)

Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

2013-11-01

Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

Early Outcomes of Endoscopic Vein Harvesting during the Initial Learning Period

Directory of Open Access Journals (Sweden)

Do Yeon Kim

2015-06-01

Full Text Available Background: The endoscopic vein harvesting (EVH method has been used in coronary artery bypass surgery in many countries. We started using the EVH method recently, and investigated the results during the early learning period. Methods: Between March 2012 and June 2014, 75 patients (31 patients in the EVH method group, and 44 patients in the open method group who underwent isolated first-time coronary artery bypass grafting using vein grafts were retrospectively analyzed with respect to the early outcomes including graft patency and risk factors for leg wound complications. For assessing the patency of vein graft, we performed coronary computed tomography angiography during the immediate postoperative period and 6 months later. Results: Mean harvesting time of endoscopic method was about 15 minutes. Patency rate during the immediate operative period and the 6-month patency rate were similar between the two groups (postoperative period: EVH 100% vs. open method 94.4%, p=0.493; at 6 months: EVH 93.3% vs. open method 90.9%, p=0.791. Leg wound complications occurred more frequently in the open method group (EVH 3.2% vs. open method 13.6%, p=0.127. According to the analysis, age was an independent risk factor for leg wound complications. Conclusion: EVH is a feasible method even for beginners and can be performed satisfactorily during their learning period.

Stage, tumor growth rate and optimal dose fractionation schedules in the treatment of squamous cell carcinoma of the head and neck

International Nuclear Information System (INIS)

Sugawara, Tadashi; Morita, Mamoru; Aihara, Toshinori; Tanaka, Osamu

1983-01-01

In 77 patients with cancer of the head and neck, 45 patients received radiotherapy alone, while 32 patients with T 1 or T 2 glottic cancer received combined therapy with laryngomicrosurgery performed prior to or during the course of irradiation. These T 1 and T 2 groups were separately analyzed from other T 1 and T 2 groups as T sub(LMS). Local recurrence rates were compared concerning overall time and fraction size in following three subgroups, i.e., T sub(LMS), Tsub(1+2), and Tsub(3+4). No significant correlation was detected between total dose converted to partial tolerance (PT) and local control in all subgroups except for Tsub(3+4), in which local recurrence rate was rather higher in high PT range. Local control was significantly dependent on overall treatment time and fraction size, differently by tumor stage. Favorable fractionation schedules considered as optimal for T sub(LMS) were those in which treatment was given 5 times weekly with a daily dose rate more than 196 rad in a shorter overall time of less than 42 days. In contrast to T sub(LMS), effective schedules for Tsub(3+4) consisted of longer overall time of more than 60 days and a lower daily dose rate of less than 153 rad. In Tsub(1+2), the optimal schedule was needed to be altered according to rapidness of progression of disease characterised by duration of the complaints, which was statistically proved to be significantly shorter in Tsub(1+2) than Tsub(3+4). Rapidity-adjusted schedule consisted of a shorter over-all time of less than 49 days with a daily dose rate of more than 175 rad 5 fractions a week for a case having a duration of complaints of less than 2.9 months, and a longer overall time of more than 50 days with a daily dose rate of less than 174 rad for a case having a duration of more than 3 months. (J.P.N.)

Optimization of Adhesive Pastes for Dental Caries Prevention.

Science.gov (United States)

Sodata, Patteera; Juntavee, Apa; Juntavee, Niwut; Peerapattana, Jomjai

2017-11-01

Dental caries prevention products available on the market contain only remineralizing agents or antibacterial agents. This study aimed to develop adhesive pastes containing calcium phosphate and α-mangostin for dental caries prevention using the optimization technique. Calcium phosphate was used as a remineralizing agent, and extracted α-mangostin was used as an antibacterial agent. The effect of the independent variables, which were fumed silica, Eudragit ® EPO, polyethylene glycol, and ethyl alcohol, on the responses was investigated. The drying time, erosion rate, calcium release rate, and α-mangostin release rate were established as the measured responses. An equation and a model of the relationship were constructed. An optimal formulation was obtained, and its effect on dental caries prevention was investigated using the pH-cycling model. The quadratic equation revealed that the drying time, calcium release rate, and α-mangostin release rate tended to decrease when increasing the fumed silica and decreasing other factors. The erosion rate tended to increase when decreasing Eudragit ® EPO and increasing other factors. The observed responses of the optimal adhesive pastes were not significantly different from the predicted responses. This result demonstrated that optimization is an efficient technique in the formulation development of the adhesive pastes. In addition, the optimal adhesive pastes could enhance acid resistance activity to the tooth enamel.

Percutaneous placement of self-expandable metallic stents in patients with obstructive janudice secondary to metastalic gastric cancer after gastrectomy

Energy Technology Data Exchange (ETDEWEB)

Hong, Hyun Pyo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Seo, In Ho; Yu, Jung Rim; Mok, Young Jae; Oh, Joo Hyeong [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kwon, Se Hwan [Dept. of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Kim, Sam Soo [Dept. of Radiology, Kangwon National University College of Medicine, Chuncheon (Korea, Republic of); Kim, Seung Kwon [Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

2013-10-15

To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.

Comparative effectiveness of one-stage versus two-stage basilic vein transposition arteriovenous fistulas.

Science.gov (United States)

Ghaffarian, Amir A; Griffin, Claire L; Kraiss, Larry W; Sarfati, Mark R; Brooke, Benjamin S

2018-02-01

Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT. We identified all patients at a single large academic hospital who had undergone creation of either a one-stage or two-stage BVT between January 2007 and January 2015. Data evaluated included patient demographics, comorbidities, medication use, reasons for abandonment, and interventions performed to maintain patency. Costs were derived from the literature, and effectiveness was expressed in quality-adjusted life-years (QALYs). We analyzed primary and secondary functional patency outcomes as well as survival during follow-up between one-stage and two-stage BVT procedures using multivariate Cox proportional hazards models and Kaplan-Meier analysis with log-rank tests. The incremental cost-effectiveness ratio was used to determine cost savings. We identified 131 patients in whom 57 (44%) one-stage BVT and 74 (56%) two-stage BVT fistulas were created among 8 different vascular surgeons during the study period that each performed both procedures. There was no significant difference in the mean age, male gender, white race, diabetes, coronary disease, or medication profile among patients undergoing one- vs two-stage BVT. After fistula transposition, the median follow-up time was 8.3 months (interquartile range, 3-21 months). Primary patency rates of one-stage BVT were 56% at 12-month follow-up, whereas primary patency rates of two-stage BVT were 72% at 12-month follow-up. Patients undergoing two-stage BVT also had significantly higher rates of secondary functional patency at 12 months (57% for one-stage BVT vs 80% for two-stage BVT) and 24 months (44% for one-stage BVT vs 73% for two-stage BVT) of follow-up (P < .001 using log-rank test). However, there was no significant difference

Optimization of graffiti removal on natural stone by means of high repetition rate UV laser

International Nuclear Information System (INIS)

Fiorucci, M.P.; López, A.J.; Ramil, A.; Pozo, S.; Rivas, T.

2013-01-01

The use of laser for graffiti removal is a promising alternative to conventional cleaning methods, though irradiation parameters must be carefully selected in order to achieve the effective cleaning without damaging the substrate, especially when referring to natural stone. From a practical point of view, once a safe working window is selected, it is necessary to determine the irradiation conditions to remove large paint areas, with minimal time consumption. The aim of this paper is to present a systematic procedure to select the optimum parameters for graffiti removal by means of the 3rd harmonic of a high repetition rate nanosecond Nd:YVO 4 laser. Ablation thresholds of four spray paint colors were determined and the effect of pulse repetition frequency, beam diameter and line scan separation was analyzed, obtaining a set of values which optimize the ablation process.

Optimization of graffiti removal on natural stone by means of high repetition rate UV laser

Energy Technology Data Exchange (ETDEWEB)

Fiorucci, M.P., E-mail: m.p.fiorucci@udc.es [Centro de Investigacións Tecnolóxicas, Universidade da Coruña, 15403 Ferrol (Spain); Dpto. Enxeñaría dos Recursos Naturais e Medio Ambiente, E.T.S.E. Minas, Universidade de Vigo, 36200 Vigo (Spain); López, A.J., E-mail: ana.xesus.lopez@udc.es [Centro de Investigacións Tecnolóxicas, Universidade da Coruña, 15403 Ferrol (Spain); Ramil, A., E-mail: alberto.ramil@udc.es [Centro de Investigacións Tecnolóxicas, Universidade da Coruña, 15403 Ferrol (Spain); Pozo, S., E-mail: ipozo@uvigo.es [Dpto. Enxeñaría dos Recursos Naturais e Medio Ambiente, E.T.S.E. Minas, Universidade de Vigo, 36200 Vigo (Spain); Rivas, T., E-mail: trivas@uvigo.es [Dpto. Enxeñaría dos Recursos Naturais e Medio Ambiente, E.T.S.E. Minas, Universidade de Vigo, 36200 Vigo (Spain)

2013-08-01

The use of laser for graffiti removal is a promising alternative to conventional cleaning methods, though irradiation parameters must be carefully selected in order to achieve the effective cleaning without damaging the substrate, especially when referring to natural stone. From a practical point of view, once a safe working window is selected, it is necessary to determine the irradiation conditions to remove large paint areas, with minimal time consumption. The aim of this paper is to present a systematic procedure to select the optimum parameters for graffiti removal by means of the 3rd harmonic of a high repetition rate nanosecond Nd:YVO{sub 4} laser. Ablation thresholds of four spray paint colors were determined and the effect of pulse repetition frequency, beam diameter and line scan separation was analyzed, obtaining a set of values which optimize the ablation process.

Charge Management Optimization for Future TOU Rates: Preprint

Energy Technology Data Exchange (ETDEWEB)

Zhang, Jiucai; Markel, Tony

2016-07-01

The effectiveness of future time of use (TOU) rates to enable managed charging for providing demand response depends on the vehicle's flexibility and the benefits to owners. This paper adopts opportunity, delayed, and smart charging methods to quantify these impacts, flexibilities, and benefits. Simulation results show that delayed and smart charging methods can shift most charging events to lower TOU rate periods without compromising the charged energy and individual driver mobility needs.

Does inverse planning applied to Iridium192 high dose rate prostate brachytherapy improve the optimization of the dose afforded by the Paris system?

International Nuclear Information System (INIS)

Nickers, Philippe; Lenaerts, Eric; Thissen, Benedicte; Deneufbourg, Jean-Marie

2005-01-01

Background and purpose: The purpose of the work is to analyse for 192 Ir prostate brachytherapy (BT) some of the different steps in optimizing the dose delivered to the CTV, urethra and rectum. Materials and methods: Between 07/1998 and 12/2001, 166 patients were treated with 192 Ir wires providing a low dose rate, according to the Paris system philosophy and with the 2D version of the treatment planning Isis R . 40-45 Gy were delivered after an external beam radiotherapy of 40 Gy. The maximum tolerable doses for BT were 25 Gy to the anterior third of the rectum on the whole length of the implant (R dose) and 52 Gy to the urethra on a 1 cm length (U max ). A U max /CTV dose ratio >1.3 represented a pejorative value as the planned dose of 40-45 Gy could not be achieved. On the other side a ratio ≤1.25 was considered optimal and the intermediate values satisfactory. A R/CTV dose ratio 192 Ir sources. Results: At the end of a learning curve reaching a plateau after the first 71 patients, 90% of the implants with 192 Ir wires were stated at least satisfactory for a total rate of 82% for the whole population. When the 3D dosimetry for SST was used, the initial values >1.25 decreased significantly with optimization required on CTV contours and additional constraints on urethra while the R/CTV ratio was maintained under 0.55. For initial U max /CTV >1.3 or >1.25 but ≤1.3 indeed, the mean respective values of 1.41±0.16 and 1.28±0.01 decreased to 1.28±0.24 and 1.17±0.09 (P<0.001), allowing to increase the total dose to the CTV by 4 Gy. Conclusions: The Paris system which assumes a homogeneous distribution of a minimum number of catheters inside the CTV allowed to anticipate a satisfactory dosimetry in 82% of cases. However, this precision rate could be improved until 95% with an optimization approach based on an inverse planning philosophy. These new 3D optimization methods, ideally based on good quality implants at first allow to deliver the highest doses with

Optimized probes for dose rate measurements at local government sites and in emergency planning zones and their integration into measurement networks

International Nuclear Information System (INIS)

Kuca, Petr; Helebrant, Jan; Cespirova, Irena; Judas, Libor; Skala, Lukas

2015-01-01

The results of a security project aimed at the development of a radiation situation monitoring system using optimized probes for dose rate measurements are described. The system is suitable for use at local government sites as well as at other sites. The system includes dose rate measurement probes with the variable configuration functionality (detection part), equipment for data transfer to a central workplace (communication part) and application for collection, storage and administration of the results and their presentation at a website (presentation part). The dosimetric and other operational properties of the probes were tested and the feasibility of their integration into measurement networks using the IMS central application was examined. (orig.)

A Comparison of Bilateral Side-by-Side Metal Stents Deployed Above and Across the Sphincter of Oddi in the Management of Malignant Hilar Biliary Obstruction.

Science.gov (United States)

Cosgrove, Natalie; Siddiqui, Ali A; Adler, Douglas G; Shahid, Haroon; Sarkar, Avik; Sharma, Ashish; Kowalski, Thomas E; Loren, David; Warndorf, Matthew; Chennat, Jennifer; Munigala, Satish; Papachristou, Georgios I

2017-07-01

The optimal method for endoscopic placement of bilateral self-expanding metal stents (SEMS) for the management of malignant hilar biliary obstruction has not been determined. The aim of this study was to compare the efficacies and complication rates between SEMS placed above and across the sphincter of Oddi (SO) in patients with malignant hilar biliary obstruction. A retrospective review of patients with malignant hilar strictures who underwent bilateral SEMS placement at 3 centers was performed. Patients were divided into 2 groups: group A (above SO, n=52) or B (across SO, n=120). Patient demographics, technical success (successful SEMS placement across the stricture), functional success (decrease in pretreatment bilirubin level), complications, stent occlusion, and patient survival in the 2 groups were evaluated. We identified 172 patients with malignant hilar biliary obstruction (106 males, mean age 67 y). Significantly more early complications (1.9% vs. 11.7%, P=0.04) were seen in group B, mainly post-endoscopic retrograde cholangio-pancreatography pancreatitis. Mean SEMS patency periods were 33 weeks for group A and 29.6 weeks for group B (P=0.3). Occlusion rates were 50% and 45% for groups A and B (P=0.61); occlusion was due to tumor in-growth or overgrowth in all patients. SEMS occlusion was successfully treated endoscopically in 85% (22/26) patients in group A and 96% (52/54) in group B (P=0.24). The median survival time was 26 weeks in the group A and 29 weeks in group B (P=0.49). Bilateral side-by-side SEMS placement above or below the SO results in similar success rates, stent patency duration, and stent occlusion rates. Significantly fewer complications, with a trend toward lower rates of pancreatitis, were observed for SEMS placed above the SO.