WorldWideScience

Sample records for patient selection based

  1. Patient-based radiographic exposure factor selection: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Ching, William; Robinson, John; McEntee, Mark, E-mail: mark.mcentee@sydney.edu.au [Discipline of Medical Radiation Sciences, University of Sydney, Lidcombe, New South Wales (Australia)

    2014-09-15

    Digital technology has wider exposure latitude and post-processing algorithms which can mask the evidence of underexposure and overexposure. Underexposure produces noisy, grainy images which can impede diagnosis and overexposure results in a greater radiation dose to the patient. These exposure errors can result from inaccurate adjustment of exposure factors in response to changes in patient thickness. This study aims to identify all published radiographic exposure adaptation systems which have been, or are being, used in general radiography and discuss their applicability to digital systems. Studies in EMBASE, MEDLINE, CINAHL and SCOPUS were systematically reviewed. Some of the search terms used were exposure adaptation, exposure selection, exposure technique, 25% rule, 15% rule, DuPont™ Bit System and radiography. A manual journal-specific search was also conducted in The Radiographer and Radiologic Technology. Studies were included if they demonstrated a system of altering exposure factors to compensate for variations in patients for general radiography. Studies were excluded if they focused on finding optimal exposures for an ‘average’ patient or focused on the relationship between exposure factors and dose. The database search uncovered 11 articles and the journal-specific search uncovered 13 articles discussing systems of exposure adaptation. They can be categorised as simple one-step guidelines, comprehensive charts and computer programs. Only two papers assessed the efficacy of exposure adjustment systems. No literature compares the efficacy of exposure adaptations system for film/screen radiography with digital radiography technology nor is there literature on a digital specific exposure adaptation system.

  2. Patient-based radiographic exposure factor selection: a systematic review

    International Nuclear Information System (INIS)

    Ching, William; Robinson, John; McEntee, Mark

    2014-01-01

    Digital technology has wider exposure latitude and post-processing algorithms which can mask the evidence of underexposure and overexposure. Underexposure produces noisy, grainy images which can impede diagnosis and overexposure results in a greater radiation dose to the patient. These exposure errors can result from inaccurate adjustment of exposure factors in response to changes in patient thickness. This study aims to identify all published radiographic exposure adaptation systems which have been, or are being, used in general radiography and discuss their applicability to digital systems. Studies in EMBASE, MEDLINE, CINAHL and SCOPUS were systematically reviewed. Some of the search terms used were exposure adaptation, exposure selection, exposure technique, 25% rule, 15% rule, DuPont™ Bit System and radiography. A manual journal-specific search was also conducted in The Radiographer and Radiologic Technology. Studies were included if they demonstrated a system of altering exposure factors to compensate for variations in patients for general radiography. Studies were excluded if they focused on finding optimal exposures for an ‘average’ patient or focused on the relationship between exposure factors and dose. The database search uncovered 11 articles and the journal-specific search uncovered 13 articles discussing systems of exposure adaptation. They can be categorised as simple one-step guidelines, comprehensive charts and computer programs. Only two papers assessed the efficacy of exposure adjustment systems. No literature compares the efficacy of exposure adaptations system for film/screen radiography with digital radiography technology nor is there literature on a digital specific exposure adaptation system

  3. Using a knowledge-based planning solution to select patients for proton therapy.

    Science.gov (United States)

    Delaney, Alexander R; Dahele, Max; Tol, Jim P; Kuijper, Ingrid T; Slotman, Ben J; Verbakel, Wilko F A R

    2017-08-01

    Patient selection for proton therapy by comparing proton/photon treatment plans is time-consuming and prone to bias. RapidPlan™, a knowledge-based-planning solution, uses plan-libraries to model and predict organ-at-risk (OAR) dose-volume-histograms (DVHs). We investigated whether RapidPlan, utilizing an algorithm based only on photon beam characteristics, could generate proton DVH-predictions and whether these could correctly identify patients for proton therapy. Model PROT and Model PHOT comprised 30 head-and-neck cancer proton and photon plans, respectively. Proton and photon knowledge-based-plans (KBPs) were made for ten evaluation-patients. DVH-prediction accuracy was analyzed by comparing predicted-vs-achieved mean OAR doses. KBPs and manual plans were compared using salivary gland and swallowing muscle mean doses. For illustration, patients were selected for protons if predicted Model PHOT mean dose minus predicted Model PROT mean dose (ΔPrediction) for combined OARs was ≥6Gy, and benchmarked using achieved KBP doses. Achieved and predicted Model PROT /Model PHOT mean dose R 2 was 0.95/0.98. Generally, achieved mean dose for Model PHOT /Model PROT KBPs was respectively lower/higher than predicted. Comparing Model PROT /Model PHOT KBPs with manual plans, salivary and swallowing mean doses increased/decreased by <2Gy, on average. ΔPrediction≥6Gy correctly selected 4 of 5 patients for protons. Knowledge-based DVH-predictions can provide efficient, patient-specific selection for protons. A proton-specific RapidPlan-solution could improve results. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Selecting the patients for morning report sessions: case-based vs. conventional method.

    Science.gov (United States)

    Rabiei, Mehdi; Saeidi, Masumeh; Kiani, Mohammad Ali; Amin, Sakineh Mohebi; Ahanchian, Hamid; Jafari, Seyed Ali; Kianifar, Hamidreza

    2015-08-01

    One of the most important issues in morning report sessions is the number of patients. The aim of this study was to investigate and compare the number of cases reported in the morning report sessions in terms of case-based and conventional methods from the perspective of pediatric residents of Mashhad University of Medical Sciences. The present study was conducted on 24 pediatric residents of Mashhad University of Medical Sciences in the academic year 2014-2015. In this survey, the residents replied to a 20-question researcher-made questionnaire that had been designed to measure the views of residents regarding the number of patients in the morning report sessions using case-based and conventional methods. The validity of the questionnaire was confirmed by experts' views and its reliability by calculating Cronbach's alpha coefficients. Data were analyzed by t-test analysis. The mean age of the residents was 30.852 ± 2.506, and 66.6% of them were female. The results showed that there was no significant relationship among the variables of academic year, gender, and residents' perspective to choosing the number of patients in the morning report sessions (P > 0.05). T-test analysis showed a significant relationship among the average scores of residents in the selection of the case-based method in comparison to the conventional method (P case-based morning report was preferred compared to the conventional method. This method makes residents pay more attention to the details of patients' issues and therefore helps them to better plan how to address patient problems and improve their differential diagnosis skills.

  5. A data mining based model for selecting type of treatment for kidney stone patients

    Directory of Open Access Journals (Sweden)

    Sepehri MM

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Data mining as a multidisciplinary field is rooted in the fields such as statistics, mathematics, computer science and artificial intelligence and has been gaining momentum in scientific, managerial, and executive applications in health care. Data mining can be defined as the automated extraction of valuable, practical and hidden knowledge and information from large data. Applying data mining in medical records and data is of utmost importance for health care givers and providers and brings vital and valuable outcomes. Data mining can help doctors come up with better recommendations and plans for treatment which actually in many respects have significant impact on patients' life and satisfaction In this paper we have proposed and utilized data mining methods to extract hidden information in medical records of pelvis stone patients with ureteral stone. We have tried to design a decision support system model to be applicable for selecting type of treatment for these groups of patients."n"nMethods: We gathered needed information from Shahid Hashemi Nejad hospital. In this research we have used decision tree as a data mining tool, for selecting suitable treatment for patients with ureteral stone. This

  6. Selecting Sample Preparation Workflows for Mass Spectrometry-Based Proteomic and Phosphoproteomic Analysis of Patient Samples with Acute Myeloid Leukemia.

    Science.gov (United States)

    Hernandez-Valladares, Maria; Aasebø, Elise; Selheim, Frode; Berven, Frode S; Bruserud, Øystein

    2016-08-22

    Global mass spectrometry (MS)-based proteomic and phosphoproteomic studies of acute myeloid leukemia (AML) biomarkers represent a powerful strategy to identify and confirm proteins and their phosphorylated modifications that could be applied in diagnosis and prognosis, as a support for individual treatment regimens and selection of patients for bone marrow transplant. MS-based studies require optimal and reproducible workflows that allow a satisfactory coverage of the proteome and its modifications. Preparation of samples for global MS analysis is a crucial step and it usually requires method testing, tuning and optimization. Different proteomic workflows that have been used to prepare AML patient samples for global MS analysis usually include a standard protein in-solution digestion procedure with a urea-based lysis buffer. The enrichment of phosphopeptides from AML patient samples has previously been carried out either with immobilized metal affinity chromatography (IMAC) or metal oxide affinity chromatography (MOAC). We have recently tested several methods of sample preparation for MS analysis of the AML proteome and phosphoproteome and introduced filter-aided sample preparation (FASP) as a superior methodology for the sensitive and reproducible generation of peptides from patient samples. FASP-prepared peptides can be further fractionated or IMAC-enriched for proteome or phosphoproteome analyses. Herein, we will review both in-solution and FASP-based sample preparation workflows and encourage the use of the latter for the highest protein and phosphorylation coverage and reproducibility.

  7. Selecting Sample Preparation Workflows for Mass Spectrometry-Based Proteomic and Phosphoproteomic Analysis of Patient Samples with Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Maria Hernandez-Valladares

    2016-08-01

    Full Text Available Global mass spectrometry (MS-based proteomic and phosphoproteomic studies of acute myeloid leukemia (AML biomarkers represent a powerful strategy to identify and confirm proteins and their phosphorylated modifications that could be applied in diagnosis and prognosis, as a support for individual treatment regimens and selection of patients for bone marrow transplant. MS-based studies require optimal and reproducible workflows that allow a satisfactory coverage of the proteome and its modifications. Preparation of samples for global MS analysis is a crucial step and it usually requires method testing, tuning and optimization. Different proteomic workflows that have been used to prepare AML patient samples for global MS analysis usually include a standard protein in-solution digestion procedure with a urea-based lysis buffer. The enrichment of phosphopeptides from AML patient samples has previously been carried out either with immobilized metal affinity chromatography (IMAC or metal oxide affinity chromatography (MOAC. We have recently tested several methods of sample preparation for MS analysis of the AML proteome and phosphoproteome and introduced filter-aided sample preparation (FASP as a superior methodology for the sensitive and reproducible generation of peptides from patient samples. FASP-prepared peptides can be further fractionated or IMAC-enriched for proteome or phosphoproteome analyses. Herein, we will review both in-solution and FASP-based sample preparation workflows and encourage the use of the latter for the highest protein and phosphorylation coverage and reproducibility.

  8. Feature selection for wearable smartphone-based human activity recognition with able bodied, elderly, and stroke patients.

    Directory of Open Access Journals (Sweden)

    Nicole A Capela

    Full Text Available Human activity recognition (HAR, using wearable sensors, is a growing area with the potential to provide valuable information on patient mobility to rehabilitation specialists. Smartphones with accelerometer and gyroscope sensors are a convenient, minimally invasive, and low cost approach for mobility monitoring. HAR systems typically pre-process raw signals, segment the signals, and then extract features to be used in a classifier. Feature selection is a crucial step in the process to reduce potentially large data dimensionality and provide viable parameters to enable activity classification. Most HAR systems are customized to an individual research group, including a unique data set, classes, algorithms, and signal features. These data sets are obtained predominantly from able-bodied participants. In this paper, smartphone accelerometer and gyroscope sensor data were collected from populations that can benefit from human activity recognition: able-bodied, elderly, and stroke patients. Data from a consecutive sequence of 41 mobility tasks (18 different tasks were collected for a total of 44 participants. Seventy-six signal features were calculated and subsets of these features were selected using three filter-based, classifier-independent, feature selection methods (Relief-F, Correlation-based Feature Selection, Fast Correlation Based Filter. The feature subsets were then evaluated using three generic classifiers (Naïve Bayes, Support Vector Machine, j48 Decision Tree. Common features were identified for all three populations, although the stroke population subset had some differences from both able-bodied and elderly sets. Evaluation with the three classifiers showed that the feature subsets produced similar or better accuracies than classification with the entire feature set. Therefore, since these feature subsets are classifier-independent, they should be useful for developing and improving HAR systems across and within populations.

  9. Feature selection for wearable smartphone-based human activity recognition with able bodied, elderly, and stroke patients.

    Science.gov (United States)

    Capela, Nicole A; Lemaire, Edward D; Baddour, Natalie

    2015-01-01

    Human activity recognition (HAR), using wearable sensors, is a growing area with the potential to provide valuable information on patient mobility to rehabilitation specialists. Smartphones with accelerometer and gyroscope sensors are a convenient, minimally invasive, and low cost approach for mobility monitoring. HAR systems typically pre-process raw signals, segment the signals, and then extract features to be used in a classifier. Feature selection is a crucial step in the process to reduce potentially large data dimensionality and provide viable parameters to enable activity classification. Most HAR systems are customized to an individual research group, including a unique data set, classes, algorithms, and signal features. These data sets are obtained predominantly from able-bodied participants. In this paper, smartphone accelerometer and gyroscope sensor data were collected from populations that can benefit from human activity recognition: able-bodied, elderly, and stroke patients. Data from a consecutive sequence of 41 mobility tasks (18 different tasks) were collected for a total of 44 participants. Seventy-six signal features were calculated and subsets of these features were selected using three filter-based, classifier-independent, feature selection methods (Relief-F, Correlation-based Feature Selection, Fast Correlation Based Filter). The feature subsets were then evaluated using three generic classifiers (Naïve Bayes, Support Vector Machine, j48 Decision Tree). Common features were identified for all three populations, although the stroke population subset had some differences from both able-bodied and elderly sets. Evaluation with the three classifiers showed that the feature subsets produced similar or better accuracies than classification with the entire feature set. Therefore, since these feature subsets are classifier-independent, they should be useful for developing and improving HAR systems across and within populations.

  10. In search of patient characteristics that may guide empirically based treatment selection for personality disorder patients-a concept map approach.

    Science.gov (United States)

    van Manen, J G; Kamphuis, J H; Goossensen, A; Timman, R; Busschbach, J J V; Verheul, R

    2012-08-01

    Using the concept map method, this study aimed to summarize and describe patient characteristics pertinent to treatment selection for patients with personality disorders (PDs). Initial patient characteristics were derived from the research literature and a survey among Dutch expert clinicians. Concept mapping is a formalized conceptualization procedure that describes the underlying cognitive structures people use in complex tasks, such as treatment allocation. Based on expert opinions of 29 Dutch clinicians, a concept map was generated that yielded eight domains of patient characteristics, i.e., Severity of symptoms, Severity of personality pathology, Ego-adaptive capacities, Motivation and working alliance, Social context, Social demographic characteristics, Trauma, and Treatment history and medical condition. These domains can be ordered along two bipolar axes, running from internal to external concepts and from vulnerability to strength concepts, respectively. Our findings may serve as input for the delineation of algorithms for patient-treatment matching research in PD.

  11. Imaging‐based patient selection for intra‐arterial stroke therapy

    NARCIS (Netherlands)

    Yoo, A.J.

    2016-01-01

    Acute ischemic strokes arising from blockages of the major brain-supplying arteries put patients at risk for extensive brain injury. Left untreated, these major strokes produce significant disability and death. Fortunately, recent advances in stroke devices have improved clinical outcomes in such

  12. Classification of Alzheimer's disease patients with hippocampal shape wrapper-based feature selection and support vector machine

    Science.gov (United States)

    Young, Jonathan; Ridgway, Gerard; Leung, Kelvin; Ourselin, Sebastien

    2012-02-01

    It is well known that hippocampal atrophy is a marker of the onset of Alzheimer's disease (AD) and as a result hippocampal volumetry has been used in a number of studies to provide early diagnosis of AD and predict conversion of mild cognitive impairment patients to AD. However, rates of atrophy are not uniform across the hippocampus making shape analysis a potentially more accurate biomarker. This study studies the hippocampi from 226 healthy controls, 148 AD patients and 330 MCI patients obtained from T1 weighted structural MRI images from the ADNI database. The hippocampi are anatomically segmented using the MAPS multi-atlas segmentation method, and the resulting binary images are then processed with SPHARM software to decompose their shapes as a weighted sum of spherical harmonic basis functions. The resulting parameterizations are then used as feature vectors in Support Vector Machine (SVM) classification. A wrapper based feature selection method was used as this considers the utility of features in discriminating classes in combination, fully exploiting the multivariate nature of the data and optimizing the selected set of features for the type of classifier that is used. The leave-one-out cross validated accuracy obtained on training data is 88.6% for classifying AD vs controls and 74% for classifying MCI-converters vs MCI-stable with very compact feature sets, showing that this is a highly promising method. There is currently a considerable fall in accuracy on unseen data indicating that the feature selection is sensitive to the data used, however feature ensemble methods may overcome this.

  13. Socioemotional selectivity in cancer patients.

    Science.gov (United States)

    Pinquart, Martin; Silbereisen, Rainer K

    2006-06-01

    This study analyzed the contact preferences of newly diagnosed cancer patients and healthy control group participants. In line with the theory of socioemotional selectivity, patients were more likely than control participants to prefer contact with familiar social partners, but this difference was stronger in younger and middle-aged patients than in older patients. Across a 6-month interval, patients' contact preferences changed according to the perceived success of therapy. For example, if therapy was perceived to be successful, patients showed an increasing interest in contacts with unfamiliar social partners. Results indicate that contact preferences are adapted to the perception of limited versus extended future lifetime. Copyright (c) 2006 APA, all rights reserved.

  14. An inflammation based score can optimize the selection of patients with advanced cancer considered for early phase clinical trials.

    Directory of Open Access Journals (Sweden)

    David J Pinato

    Full Text Available Adequate organ function and good performance status (PS are common eligibility criteria for phase I trials. As inflammation is pathogenic and prognostic in cancer we investigated the prognostic performance of inflammation-based indices including the neutrophil (NLR and platelet to lymphocyte ratio (PLR.We studied inflammatory scores in 118 unselected referrals. NLR normalization was recalculated at disease reassessment. Each variable was assessed for progression-free (PFS and overall survival (OS on uni- and multivariate analyses and tested for 90 days survival (90DS prediction using receiving operator curves (ROC.We included 118 patients with median OS 4.4 months, 23% PS>1. LDH≥450 and NLR≥5 were multivariate predictors of OS (p<0.001. NLR normalization predicted for longer OS (p<0.001 and PFS (p<0.05. PS and NLR ranked as most accurate predictors of both 90DS with area under ROC values of 0.66 and 0.64, and OS with c-score of 0.69 and 0.60. The combination of NLR+PS increased prognostic accuracy to 0.72. The NLR was externally validated in a cohort of 126 subjects.We identified the NLR as a validated and objective index to improve patient selection for experimental therapies, with its normalization following treatment predicting for a survival benefit of 7 months. Prospective validation of the NLR is warranted.

  15. Evaluation of a developmental hierarchy for breast cancer cells to assess risk-based patient selection for targeted treatment.

    Science.gov (United States)

    Bliss, Sarah A; Paul, Sunirmal; Pobiarzyn, Piotr W; Ayer, Seda; Sinha, Garima; Pant, Saumya; Hilton, Holly; Sharma, Neha; Cunha, Maria F; Engelberth, Daniel J; Greco, Steven J; Bryan, Margarette; Kucia, Magdalena J; Kakar, Sham S; Ratajczak, Mariusz Z; Rameshwar, Pranela

    2018-01-10

    This study proposes that a novel developmental hierarchy of breast cancer (BC) cells (BCCs) could predict treatment response and outcome. The continued challenge to treat BC requires stratification of BCCs into distinct subsets. This would provide insights on how BCCs evade treatment and adapt dormancy for decades. We selected three subsets, based on the relative expression of octamer-binding transcription factor 4 A (Oct4A) and then analysed each with Affymetrix gene chip. Oct4A is a stem cell gene and would separate subsets based on maturation. Data analyses and gene validation identified three membrane proteins, TMEM98, GPR64 and FAT4. BCCs from cell lines and blood from BC patients were analysed for these three membrane proteins by flow cytometry, along with known markers of cancer stem cells (CSCs), CD44, CD24 and Oct4, aldehyde dehydrogenase 1 (ALDH1) activity and telomere length. A novel working hierarchy of BCCs was established with the most immature subset as CSCs. This group was further subdivided into long- and short-term CSCs. Analyses of 20 post-treatment blood indicated that circulating CSCs and early BC progenitors may be associated with recurrence or early death. These results suggest that the novel hierarchy may predict treatment response and prognosis.

  16. Surgical patient selection and counseling.

    Science.gov (United States)

    Ziegelmann, Matt; Köhler, Tobias S; Bailey, George C; Miest, Tanner; Alom, Manaf; Trost, Landon

    2017-08-01

    The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in published literature (ability to complete surgery, complications, satisfaction) and fails to account for patient desires and expectations, temporal changes, natural history of underlying diseases, or independent validation. Factors associated with satisfaction and dissatisfaction are often surgery-specific, although correlation with pre-operative expectations, revisions, and complications are common with most procedures. The process of appropriate patient selection is determined by the integration of patient and surgeon factors, including psychological capacity to handle unsatisfactory results, baseline expectations, complexity of case, and surgeon volume and experience. Using this model, a high-risk scenario includes one in which a low-volume surgeon performs a complex case in a patient with limited psychological capacity and high expectations. In contrast, a high-volume surgeon performing a routine case in a male with low expectations and abundant psychiatric reserve is more likely to achieve a successful outcome. To further help identify patients who are at high risk for dissatisfaction, a previously published mnemonic is recommended: CURSED Patient (compulsive/obsessive, unrealistic, revision, surgeon shopping, entitled, denial, and psychiatric). Appropriate patient counseling includes setting appropriate expectations, reviewing the potential and anticipated risks of surgery, post-operative instruction to limit complications, and long-term follow-up. As thorough counseling is often a time-consuming endeavor, busy practices may elect to utilize various resources including educational materials, advanced practice providers, or group visits, among others. The consequences for poor patient selection and counseling may range from poor surgical outcomes and patient dissatisfaction to lawsuits, loss of

  17. Office-based Electromyography-guided Botulinum Toxin Injection to the Cricopharyngeus Muscle: Optimal Patient Selection and Technique.

    Science.gov (United States)

    Kim, Min-Su; Kim, Go-Woon; Rho, Young-Soo; Kwon, Kee-Hwan; Chung, Eun-Jae

    2017-05-01

    This retrospective study was carried out to investigate the effectiveness and safety of office-based electromyography-guided injection of botulinum toxin in the cricopharyngeus muscle of patients who did not show upper esophageal sphincter passage in a swallowing study in spite of maximal swallowing rehabilitation. Thirty-six patients who showed no or limited ability to oral feed after maximum swallowing rehabilitation were enrolled. Video fluoroscopic swallowing study, flexible endoscopic evaluation of swallowing, disability rating scale, penetration aspiration score, and National Institutes of Health swallowing safety scale were used in the evaluation of dysphagia. Success was defined as nondependence on gastrostomy for patients who previously were dependent on gastrostomy and improvement in disability rating scale score after botulinum toxin injections. The total success rate was 63.9%. The complication rate was very low, with only 1 patient showing temporary unilateral vocal fold paralysis. Botulinum toxin injection was more effective in patients with cranial nerve IX or X palsy than in those without it ( P = .006). This procedure can be a simple, safe, and effective tool in patients with cricopharyngeal dysfunction after swallowing rehabilitation, especially for cranial nerve IX or X palsy.

  18. Phase 2 Trial of Induction Gemcitabine, Oxaliplatin, and Cetuximab Followed by Selective Capecitabine-Based Chemoradiation in Patients With Borderline Resectable or Unresectable Locally Advanced Pancreatic Cancer

    International Nuclear Information System (INIS)

    Esnaola, Nestor F.; Chaudhary, Uzair B.; O'Brien, Paul; Garrett-Mayer, Elizabeth; Camp, E. Ramsay; Thomas, Melanie B.; Cole, David J.; Montero, Alberto J.; Hoffman, Brenda J.; Romagnuolo, Joseph; Orwat, Kelly P.; Marshall, David T.

    2014-01-01

    Purpose: To evaluate, in a phase 2 study, the safety and efficacy of induction gemcitabine, oxaliplatin, and cetuximab followed by selective capecitabine-based chemoradiation in patients with borderline resectable or unresectable locally advanced pancreatic cancer (BRPC or LAPC, respectively). Methods and Materials: Patients received gemcitabine and oxaliplatin chemotherapy repeated every 14 days for 6 cycles, combined with weekly cetuximab. Patients were then restaged; “downstaged” patients with resectable disease underwent attempted resection. Remaining patients were treated with chemoradiation consisting of intensity modulated radiation therapy (54 Gy) and concurrent capecitabine; patients with borderline resectable disease or better at restaging underwent attempted resection. Results: A total of 39 patients were enrolled, of whom 37 were evaluable. Protocol treatment was generally well tolerated. Median follow-up for all patients was 11.9 months. Overall, 29.7% of patients underwent R0 surgical resection (69.2% of patients with BRPC; 8.3% of patients with LAPC). Overall 6-month progression-free survival (PFS) was 62%, and median PFS was 10.4 months. Median overall survival (OS) was 11.8 months. In patients with LAPC, median OS was 9.3 months; in patients with BRPC, median OS was 24.1 months. In the group of patients who underwent R0 resection (all of which were R0 resections), median survival had not yet been reached at the time of analysis. Conclusions: This regimen was well tolerated in patients with BRPC or LAPC, and almost one-third of patients underwent R0 resection. Although OS for the entire cohort was comparable to that in historical controls, PFS and OS in patients with BRPC and/or who underwent R0 resection was markedly improved

  19. Phase 2 Trial of Induction Gemcitabine, Oxaliplatin, and Cetuximab Followed by Selective Capecitabine-Based Chemoradiation in Patients With Borderline Resectable or Unresectable Locally Advanced Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Esnaola, Nestor F. [Department of Surgery, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Chaudhary, Uzair B.; O' Brien, Paul [Division of Hematology and Oncology, Department of Internal Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Garrett-Mayer, Elizabeth [Division of Biostatistics and Epidemiology, Department of Internal Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Camp, E. Ramsay [Department of Surgery, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Thomas, Melanie B. [Division of Hematology and Oncology, Department of Internal Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Cole, David J. [Department of Surgery, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Montero, Alberto J. [Division of Hematology and Oncology, Department of Internal Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Hoffman, Brenda J.; Romagnuolo, Joseph [Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Orwat, Kelly P. [Department of Radiation Oncology, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Marshall, David T., E-mail: marshadt@musc.edu [Department of Radiation Oncology, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States)

    2014-03-15

    Purpose: To evaluate, in a phase 2 study, the safety and efficacy of induction gemcitabine, oxaliplatin, and cetuximab followed by selective capecitabine-based chemoradiation in patients with borderline resectable or unresectable locally advanced pancreatic cancer (BRPC or LAPC, respectively). Methods and Materials: Patients received gemcitabine and oxaliplatin chemotherapy repeated every 14 days for 6 cycles, combined with weekly cetuximab. Patients were then restaged; “downstaged” patients with resectable disease underwent attempted resection. Remaining patients were treated with chemoradiation consisting of intensity modulated radiation therapy (54 Gy) and concurrent capecitabine; patients with borderline resectable disease or better at restaging underwent attempted resection. Results: A total of 39 patients were enrolled, of whom 37 were evaluable. Protocol treatment was generally well tolerated. Median follow-up for all patients was 11.9 months. Overall, 29.7% of patients underwent R0 surgical resection (69.2% of patients with BRPC; 8.3% of patients with LAPC). Overall 6-month progression-free survival (PFS) was 62%, and median PFS was 10.4 months. Median overall survival (OS) was 11.8 months. In patients with LAPC, median OS was 9.3 months; in patients with BRPC, median OS was 24.1 months. In the group of patients who underwent R0 resection (all of which were R0 resections), median survival had not yet been reached at the time of analysis. Conclusions: This regimen was well tolerated in patients with BRPC or LAPC, and almost one-third of patients underwent R0 resection. Although OS for the entire cohort was comparable to that in historical controls, PFS and OS in patients with BRPC and/or who underwent R0 resection was markedly improved.

  20. Selection of patients from myocardial perfusion scintigraphy based on fuzzy sets theory applied to clinical-epidemiological data and treadmill test results

    Energy Technology Data Exchange (ETDEWEB)

    Duarte, P.S. [Fleury - Centro de Medicina Diagnostica, Sao Paulo, SP (Brazil). Secao de Medicina Nuclear]. E-mail: paulo.duarte@fleury.com.br; Mastrocolla, L.E.; Farsky, P.S.; Sampaio, C.R.E.P.S. [Fleury - Centro de Medicina Diagnostica, Sao Paulo, SP (Brazil). Secao de Cardiologia; Tonelli, P.A. [Sao Paulo Univ., SP (Brazil). Inst. de Matematica e Estatistica; Barros, L.C. [Universidade Estadual de Campinas , SP (Brazil). Inst. de Matematica, Estatistica e Computacao Cientifica; Ortega, N.R. [Sao Paulo Univ., SP (Brazil). Informatica Medica; Pereira, J.C.R. [Sao Paulo Univ., SP (Brazil). Faculdade de Saude Publica. Dept. de Epidemiologia

    2006-01-15

    Coronary artery disease (CAD) is a worldwide leading cause of death. The standard method for evaluating critical partial occlusions is coronary arteriography, a catheterization technique which is invasive, time consuming, and costly. There are noninvasive approaches for the early detection of CAD. The basis for the noninvasive diagnosis of CAD has been laid in a sequential analysis of the risk factors, and the results of the treadmill test and myocardial perfusion scintigraphy (MPS). Many investigators have demonstrated that the diagnostic applications of MPS are appropriate for patients who have an intermediate likelihood of disease. Although this information is useful, it is only partially utilized in clinical practice due to the difficulty to properly classify the patients. Since the seminal work of Lotfi Zadeh, fuzzy logic has been applied in numerous areas. In the present study, we proposed and tested a model to select patients for MPS based on fuzzy sets theory. A group of 1053 patients was used to develop the model and another group of 1045 patients was used to test it. Receiver operating characteristic curves were used to compare the performance of the fuzzy model against expert physician opinions, and showed that the performance of the fuzzy model was equal or superior to that of the physicians. Therefore, we conclude that the fuzzy model could be a useful tool to assist the general practitioner in the selection of patients for MPS. (author)

  1. Selection of patients from myocardial perfusion scintigraphy based on fuzzy sets theory applied to clinical-epidemiological data and treadmill test results

    International Nuclear Information System (INIS)

    Duarte, P.S.; Mastrocolla, L.E.; Farsky, P.S.; Sampaio, C.R.E.P.S.; Tonelli, P.A.; Barros, L.C.; Ortega, N.R.; Pereira, J.C.R.

    2006-01-01

    Coronary artery disease (CAD) is a worldwide leading cause of death. The standard method for evaluating critical partial occlusions is coronary arteriography, a catheterization technique which is invasive, time consuming, and costly. There are noninvasive approaches for the early detection of CAD. The basis for the noninvasive diagnosis of CAD has been laid in a sequential analysis of the risk factors, and the results of the treadmill test and myocardial perfusion scintigraphy (MPS). Many investigators have demonstrated that the diagnostic applications of MPS are appropriate for patients who have an intermediate likelihood of disease. Although this information is useful, it is only partially utilized in clinical practice due to the difficulty to properly classify the patients. Since the seminal work of Lotfi Zadeh, fuzzy logic has been applied in numerous areas. In the present study, we proposed and tested a model to select patients for MPS based on fuzzy sets theory. A group of 1053 patients was used to develop the model and another group of 1045 patients was used to test it. Receiver operating characteristic curves were used to compare the performance of the fuzzy model against expert physician opinions, and showed that the performance of the fuzzy model was equal or superior to that of the physicians. Therefore, we conclude that the fuzzy model could be a useful tool to assist the general practitioner in the selection of patients for MPS. (author)

  2. Isotope selection for patients undergoing prostate brachytherapy

    International Nuclear Information System (INIS)

    Cha, Christine M.; Potters, Louis; Ashley, Richard; Freeman, Katherine; Wang Xiaohong; Waldbaum, Robert; Leibel, Steven

    1999-01-01

    Purpose: Ultrasound-guided trans perineal interstitial permanent prostate brachytherapy (TIPPB) is generally performed with either 103 Pd or 125 I. The use of 125 I for low Gleason score tumors and 103 Pd for higher Gleason scores has been suggested based on isotope dose rate and cell doubling time observed in in vitro studies. While many centers follow these isotope selection criteria, other centers have elected to use only a single isotope, regardless of Gleason score. No clinical data have been published comparing these isotopes. This study was undertaken to compare outcomes between 125 I and 103 Pd in a matched pair analysis for patients undergoing prostate brachytherapy. Methods and Materials: Six hundred forty-eight consecutively treated patients with clinically confined prostate cancer underwent TIPPB between June 1992 and February 1997. Five hundred thirty-two patients underwent TIPPB alone, whereas 116 received pelvic external beam irradiation and TIPPB. Ninety-three patients received androgen deprivation therapy prior to TIPPB. The prescribed doses for TIPPB were 160 Gy for 125 I (pre-TG43) and 120 Gy for 103 Pd. Patients treated with combination therapy received 41.4 or 45 Gy (1.8 Gy/fraction) external beam irradiation followed by a 3- to 5-week break and then received either a 120-Gy 125 I or a 90-Gy 103 Pd implant. Until November 1994, all patients underwent an 125 I implant after which the isotope selection was based on either Gleason score (Gleason score 2-5: 125 I; Gleason 5-8: 103 Pd) or isotope availability. A matched pair analysis was performed to assess any difference between isotopes. Two hundred twenty-two patients were matched according to Gleason score, prostate-specific antigen (PSA), and stage. PSA relapse-free survival (PSA-RFS) was calculated based on the American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus Group definition of failure. Kaplan-Meier actuarial survival curves were compared to assess differences in

  3. Liver Transplantation: Evolving Patient Selection Criteria

    Directory of Open Access Journals (Sweden)

    Andy S Yu

    2001-01-01

    Full Text Available The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.

  4. A prediction model to select PCOS patients suitable for IVM treatment based on anti-Mullerian hormone and antral follicle count.

    Science.gov (United States)

    Guzman, L; Ortega-Hrepich, C; Polyzos, N P; Anckaert, E; Verheyen, G; Coucke, W; Devroey, P; Tournaye, H; Smitz, J; De Vos, M

    2013-05-01

    Which baseline patient characteristics can help assisted reproductive technology practitioners to identify patients who are suitable for in-vitro maturation (IVM) treatment? In patients with polycystic ovary syndrome (PCOS) who undergo oocyte IVM in a non-hCG-triggered system, circulating anti-Müllerian hormone (AMH), antral follicle count (AFC) and total testosterone are independently related to the number of immature oocytes and hold promise as outcome predictors to guide the patient selection process for IVM. Patient selection criteria for IVM treatment have been described in normo-ovulatory patients, although patients with PCOS constitute the major target population for IVM. With this study, we assessed the independent predictive value of clinical and endocrine parameters that are related to oocyte yield in patients with PCOS undergoing IVM. Cohort study involving 124 consecutive patients with PCOS undergoing IVM whose data were prospectively collected. Enrolment took place between January 2010 and January 2012. Only data relating to the first IVM cycle of each patient were included. Patients with PCOS underwent oocyte retrieval for IVM after minimal gonadotrophin stimulation and no hCG trigger. Correlation coefficients were calculated to investigate which parameters are related to immature oocyte yield (patient's age, BMI, baseline hormonal profile and AMH, AFC). The independence of predictive parameters was tested using multivariate linear regression analysis. Finally, multivariate receiver operating characteristic (ROC) analyses for cumulus oocyte complexes (COC) yield were performed to assess the efficiency of the prediction model to select suitable candidates for IVM. Using multivariate regression analysis, circulating baseline AMH, AFC and baseline total testosterone serum concentration were incorporated into a model to predict the number of COC retrieved in an IVM cycle, with unstandardized coefficients [95% confidence interval (CI)] of 0.03 (0

  5. Factors associated with performing tuberculosis screening of HIV-positive patients in Ghana: LASSO-based predictor selection in a large public health data set

    Directory of Open Access Journals (Sweden)

    Susanne Mueller-Using

    2016-07-01

    Full Text Available Abstract Background The purpose of this study is to propose the Least Absolute Shrinkage and Selection Operators procedure (LASSO as an alternative to conventional variable selection models, as it allows for easy interpretation and handles multicollinearities. We developed a model on the basis of LASSO-selected parameters in order to link associated demographical, socio-economical, clinical and immunological factors to performing tuberculosis screening in HIV-positive patients in Ghana. Methods Applying the LASSO method and multivariate logistic regression analysis on a large public health data set, we selected relevant predictors related to tuberculosis screening. Results One Thousand Ninety Five patients infected with HIV were enrolled into this study with 691 (63.2 % of them having tuberculosis screening documented in their patient folders. Predictors found to be significantly associated with performance of tuberculosis screening can be classified into factors related to the clinician’s perception of the clinical state, as well as those related to PLHIV’s awareness. These factors include newly diagnosed HIV infections (n = 354 (32.42 %, aOR 1.84, current CD4+ T cell count (aOR 0.92, non-availability of HIV type (n = 787 (72.07 %, aOR 0.56, chronic cough (n = 32 (2.93 %, aOR 5.07, intake of co-trimoxazole (n = 271 (24.82 %, aOR 2.31, vitamin supplementation (n = 220 (20.15 %, aOR 2.64 as well as the use of mosquito bed nets (n = 613 (56.14 %, aOR 1.53. Conclusions Accelerated TB screening among newly diagnosed HIV-patients indicates that application of the WHO screening form for intensifying tuberculosis case finding among HIV-positive individuals in resource-limited settings is increasingly adopted. However, screening for TB in PLHIV is still impacted by clinician’s perception of patient’s health state and PLHIV’s health awareness. Education of staff, counselling of PLHIV and sufficient financing are

  6. Polystyrene Based Silver Selective Electrodes

    Directory of Open Access Journals (Sweden)

    Shiva Agarwal

    2002-06-01

    Full Text Available Silver(I selective sensors have been fabricated from polystyrene matrix membranes containing macrocycle, Me6(14 diene.2HClO4 as ionophore. Best performance was exhibited by the membrane having a composition macrocycle : Polystyrene in the ratio 15:1. This membrane worked well over a wide concentration range 5.0×10-6–1.0×10-1M of Ag+ with a near-Nernstian slope of 53.0 ± 1.0 mV per decade of Ag+ activity. The response time of the sensor is <15 s and the membrane can be used over a period of four months with good reproducibility. The proposed electrode works well in a wide pH range 2.5-9.0 and demonstrates good discriminating power over a number of mono-, di-, and trivalent cations. The sensor has also been used as an indicator electrode in the potentiometric titration of silver(II ions against NaCl solution. The sensor can also be used in non-aqueous medium with no significant change in the value of slope or working concentration range for the estimation of Ag+ in solution having up to 25% (v/v nonaqueous fraction.

  7. A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy

    International Nuclear Information System (INIS)

    Lim, L; Gibbs, P; Yip, D; Shapiro, JD; Dowling, R; Smith, D; Little, A; Bailey, W; Liechtenstein, M

    2005-01-01

    To prospectively evaluate the efficacy and safety of selective internal radiation (SIR) spheres in patients with inoperable liver metastases from colorectal cancer who have failed 5FU based chemotherapy. Patients were prospectively enrolled at three Australian centres. All patients had previously received 5-FU based chemotherapy for metastatic colorectal cancer. Patients were ECOG 0–2 and had liver dominant or liver only disease. Concurrent 5-FU was given at investigator discretion. Thirty patients were treated between January 2002 and March 2004. As of July 2004 the median follow-up is 18.3 months. Median patient age was 61.7 years (range 36 – 77). Twenty-nine patients are evaluable for toxicity and response. There were 10 partial responses (33%), with the median duration of response being 8.3 months (range 2–18) and median time to progression of 5.3 mths. Response rates were lower (21%) and progression free survival shorter (3.9 mths) in patients that had received all standard chemotherapy options (n = 14). No responses were seen in patients with a poor performance status (n = 3) or extrahepatic disease (n = 6). Overall treatment related toxicity was acceptable, however significant late toxicity included 4 cases of gastric ulceration. In patients with metastatic colorectal cancer that have previously received treatment with 5-FU based chemotherapy, treatment with SIR-spheres has demonstrated encouraging activity. Further studies are required to better define the subsets of patients most likely to respond

  8. Whipple procedure: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Tan-Tam C

    2016-07-01

    Full Text Available Clara Tan-Tam,1 Maja Segedi,2 Stephen W Chung2 1Department of Surgery, Bassett Healthcare, Columbia University, Cooperstown, New York, NY, USA; 2Department of Hepatobiliary and Pancreatic Surgery and Liver Transplant, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada Abstract: At the inception of pancreatic surgery by Dr Whipple in 1930s, the mortality and morbidity risk was more than 20%. With further understanding of disease processes and improvements in pancreas resection techniques, the mortality risk has decreased to less than 5%. Age and chronic illnesses are no longer a contraindication to surgical treatment. Life expectancy and quality of life at a later age have improved, making older patients more likely to receive pancreatic surgery , thereby also putting emphasis on operative patient selection to minimize complications. This review summarizes the benign and malignant illnesses that are treated with pancreas operations, and innovations and improvements in pancreatic surgery and perioperative care, and describes the careful selection process for patients who would benefit from an operation. These indications are not reserved only to Whipple operation, but to pancreatectomies as well.Keywords: pancreaticoduodenectomy, mortality, morbidity, cancer, trauma, pancreatitis

  9. A score system for complete cytoreduction in selected recurrent ovarian cancer patients undergoing secondary cytoreductive surgery: predictors- and nomogram-based analyses.

    Science.gov (United States)

    Bogani, Giorgio; Tagliabue, Elena; Signorelli, Mauro; Ditto, Antonino; Martinelli, Fabio; Chiappa, Valentina; Mosca, Lavinia; Sabatucci, Ilaria; Leone Roberti Maggiore, Umberto; Lorusso, Domenica; Raspagliesi, Francesco

    2018-05-01

    To test the applicability of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and Memorial Sloan Kettering (MSK) criteria in predicting complete cytoreduction (CC) in patients undergoing secondary cytoreductive surgery (SCS) for recurrent ovarian cancer (ROC). Data of consecutive patients undergoing SCS were reviewed. The Arbeitsgemeinschaft Gynäkologische Onkologie OVARian cancer study group (AGO-OVAR) and MSK criteria were retrospectively applied. Nomograms, based on AGO criteria, MSK criteria and both AGO and MSK criteria were built in order to assess the probability to achieve CC at SCS. Overall, 194 patients met the inclusion criteria. CC was achieved in 161 (82.9%) patients. According to the AGO-OVAR criteria, we observed that CC was achieved in 87.0% of patients with positive AGO score. However, 45 out of 71 (63.4%) patients who did not fulfilled the AGO score had CC. Similarly, CC was achieved in 87.1%, 61.9% and 66.7% of patients for whom SCS was recommended, had to be considered and was not recommended, respectively. In order to evaluate the predictive value of the AGO-OVAR and MSK criteria we built 2 separate nomograms (c-index: 0.5900 and 0.5989, respectively) to test the probability to achieve CC at SCS. Additionally, we built a nomogram using both the aforementioned criteria (c-index: 0.5857). The AGO and MSK criteria help identifying patients deserving SCS. However, these criteria might be strict, thus prohibiting a beneficial treatment in patients who do not met these criteria. Further studies are needed to clarify factors predicting CC at SCS. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  10. Patients' intention to consume prescribed and non-prescribed medicines: A study based on the theory of planned behaviour in selected European countries.

    Science.gov (United States)

    Kamekis, A; Bertsias, A; Moschandreas, J; Petelos, E; Papadakaki, M; Tsiantou, V; Saridaki, A; Symvoulakis, E K; Souliotis, K; Papadakis, N; Faresjö, T; Faresjö, A; Martinez, L; Agius, D; Uncu, Y; Sengezer, T; Samoutis, G; Vlcek, J; Abasaeed, A; Merkouris, B; Lionis, C

    2018-02-01

    Polypharmacy has a significant impact on patients' health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European Union under the Seventh Framework Programme and was entitled OTC-SOCIOMED, was to report on possible determinants of patient behaviour regarding the consumption of medicines, and particularly OTCs, in the context of primary care. A multicentre, cross-sectional study was designed and implemented in well-defined primary healthcare settings in Cyprus, the Czech Republic, France, Greece, Malta and Turkey. Patients completed a questionnaire constructed on the basis of the theory of planned behaviour (TPB), which was administered via face-to-face interviews. The percentage of patients who had consumed prescribed medicines over a 6-month period was consistently high, ranging from 79% in the Czech Republic and 82% in Turkey to 97% in Malta and 100% in Cyprus. Reported non-prescribed medicine consumption ranged from 33% in Turkey to 92% in the Czech Republic and 97% in Cyprus. TPB behavioural antecedents explained 43% of the variability of patients' intention to consume medicines in Malta and 24% in Greece, but only 3% in Turkey. Subjective norm was a significant predictor of the intention to consume medicines in all three countries (Greece, Malta and Turkey), whereas attitude towards consumption was a significant predictor of the expectation to consume medicines, if needed. This study shows that parameters such as patients' beliefs and influence from family and friends could be determining factors in explaining the high rates of medicine consumption. Factors that affect patients' behavioural intention towards medicine consumption may assist in the formulation of evidence-based policy proposals and inform initiatives and interventions aimed at increasing the appropriate use of medicines

  11. Individual treatment selection for patients with posttraumatic stress disorder.

    Science.gov (United States)

    Deisenhofer, Anne-Katharina; Delgadillo, Jaime; Rubel, Julian A; Böhnke, Jan R; Zimmermann, Dirk; Schwartz, Brian; Lutz, Wolfgang

    2018-04-16

    Trauma-focused cognitive behavioral therapy (Tf-CBT) and eye movement desensitization and reprocessing (EMDR) are two highly effective treatment options for posttraumatic stress disorder (PTSD). Yet, on an individual level, PTSD patients vary substantially in treatment response. The aim of the paper is to test the application of a treatment selection method based on a personalized advantage index (PAI). The study used clinical data for patients accessing treatment for PTSD in a primary care mental health service in the north of England. PTSD patients received either EMDR (N = 75) or Tf-CBT (N = 242). The Patient Health Questionnaire (PHQ-9) was used as an outcome measure for depressive symptoms associated with PTSD. Variables predicting differential treatment response were identified using an automated variable selection approach (genetic algorithm) and afterwards included in regression models, allowing the calculation of each patient's PAI. Age, employment status, gender, and functional impairment were identified as relevant variables for Tf-CBT. For EMDR, baseline depressive symptoms as well as prescribed antidepressant medication were selected as predictor variables. Fifty-six percent of the patients (n = 125) had a PAI equal or higher than one standard deviation. From those patients, 62 (50%) did not receive their model-predicted treatment and could have benefited from a treatment assignment based on the PAI. Using a PAI-based algorithm has the potential to improve clinical decision making and to enhance individual patient outcomes, although further replication is necessary before such an approach can be implemented in prospective studies. © 2018 Wiley Periodicals, Inc.

  12. [Selection of patients for transcatheter aortic valve implantation].

    Science.gov (United States)

    Tron, Christophe; Godin, Matthieu; Litzler, Pierre-Yves; Bauer, Fabrice; Caudron, Jérome; Dacher, Jean-Nicolas; Borz, Bogdan; Canville, Alexandre; Kurtz, Baptiste; Bessou, Jean-Paul; Cribier, Alain; Eltchaninoff, Hélène

    2012-06-01

    A good selection of patients is a crucial step before transcatheter aortic valve implantation (TAVI) in order to select the good indications and choose the access route. TAVI should be considered only in patients with symptomatic severe aortic stenosis and either contraindication or high surgical risk. Indication for TAVI should be discussed in a multidisciplinary team meeting. Echocardiography and/or CT scan are mandatory to evaluate the aortic annulus size and select the good prosthesis size. The possibility of transfemoral implantation is evaluated by angiography and CT scan, and based on the arterial diameters, but also on the presence of tortuosities and arterial calcifications. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  13. Improved patient selection by stratified surgical intervention

    DEFF Research Database (Denmark)

    Wang, Miao; Bünger, Cody E; Li, Haisheng

    2015-01-01

    BACKGROUND CONTEXT: Choosing the best surgical treatment for patients with spinal metastases remains a significant challenge for spine surgeons. There is currently no gold standard for surgical treatments. The Aarhus Spinal Metastases Algorithm (ASMA) was established to help surgeons choose...... the most appropriate surgical intervention for patients with spinal metastases. PURPOSE: The purpose of this study was to evaluate the clinical outcome of stratified surgical interventions based on the ASMA, which combines life expectancy and the anatomical classification of patients with spinal metastases...... survival times in the five surgical groups determined by the ASMA were 2.1 (TS 0-4, TC 1-7), 5.1 (TS 5-8, TC 1-7), 12.1 (TS 9-11, TC 1-7 or TS 12-15, TC 7), 26.0 (TS 12-15, TC 4-6), and 36.0 (TS 12-15, TC 1-3) months. The 30-day mortality rate was 7.5%. Postoperative neurological function was maintained...

  14. Supplier selection an MCDA-based approach

    CERN Document Server

    Mukherjee, Krishnendu

    2017-01-01

    The purpose of this book is to present a comprehensive review of the latest research and development trends at the international level for modeling and optimization of the supplier selection process for different industrial sectors. It is targeted to serve two audiences: the MBA and PhD student interested in procurement, and the practitioner who wishes to gain a deeper understanding of procurement analysis with multi-criteria based decision tools to avoid upstream risks to get better supply chain visibility. The book is expected to serve as a ready reference for supplier selection criteria and various multi-criteria based supplier’s evaluation methods for forward, reverse and mass customized supply chain. This book encompasses several criteria, methods for supplier selection in a systematic way based on extensive literature review from 1998 to 2012. It provides several case studies and some useful links which can serve as a starting point for interested researchers. In the appendix several computer code wri...

  15. Norm based Threshold Selection for Fault Detectors

    DEFF Research Database (Denmark)

    Rank, Mike Lind; Niemann, Henrik

    1998-01-01

    The design of fault detectors for fault detection and isolation (FDI) in dynamic systems is considered from a norm based point of view. An analysis of norm based threshold selection is given based on different formulations of FDI problems. Both the nominal FDI problem as well as the uncertain FDI...... problem are considered. Based on this analysis, a performance index based on norms of the involved transfer functions is given. The performance index allows us also to optimize the structure of the fault detection filter directly...

  16. Personnel Selection Based on Fuzzy Methods

    Directory of Open Access Journals (Sweden)

    Lourdes Cañós

    2011-03-01

    Full Text Available The decisions of managers regarding the selection of staff strongly determine the success of the company. A correct choice of employees is a source of competitive advantage. We propose a fuzzy method for staff selection, based on competence management and the comparison with the valuation that the company considers the best in each competence (ideal candidate. Our method is based on the Hamming distance and a Matching Level Index. The algorithms, implemented in the software StaffDesigner, allow us to rank the candidates, even when the competences of the ideal candidate have been evaluated only in part. Our approach is applied in a numerical example.

  17. Discriminative Projection Selection Based Face Image Hashing

    Science.gov (United States)

    Karabat, Cagatay; Erdogan, Hakan

    Face image hashing is an emerging method used in biometric verification systems. In this paper, we propose a novel face image hashing method based on a new technique called discriminative projection selection. We apply the Fisher criterion for selecting the rows of a random projection matrix in a user-dependent fashion. Moreover, another contribution of this paper is to employ a bimodal Gaussian mixture model at the quantization step. Our simulation results on three different databases demonstrate that the proposed method has superior performance in comparison to previously proposed random projection based methods.

  18. Selection of personalized patient therapy through the use of knowledge-based computational models that identify tumor-driving signal transduction pathways.

    Science.gov (United States)

    Verhaegh, Wim; van Ooijen, Henk; Inda, Márcia A; Hatzis, Pantelis; Versteeg, Rogier; Smid, Marcel; Martens, John; Foekens, John; van de Wiel, Paul; Clevers, Hans; van de Stolpe, Anja

    2014-06-01

    Increasing knowledge about signal transduction pathways as drivers of cancer growth has elicited the development of "targeted drugs," which inhibit aberrant signaling pathways. They require a companion diagnostic test that identifies the tumor-driving pathway; however, currently available tests like estrogen receptor (ER) protein expression for hormonal treatment of breast cancer do not reliably predict therapy response, at least in part because they do not adequately assess functional pathway activity. We describe a novel approach to predict signaling pathway activity based on knowledge-based Bayesian computational models, which interpret quantitative transcriptome data as the functional output of an active signaling pathway, by using expression levels of transcriptional target genes. Following calibration on only a small number of cell lines or cohorts of patient data, they provide a reliable assessment of signaling pathway activity in tumors of different tissue origin. As proof of principle, models for the canonical Wnt and ER pathways are presented, including initial clinical validation on independent datasets from various cancer types. ©2014 American Association for Cancer Research.

  19. Feature Selection Based on Mutual Correlation

    Czech Academy of Sciences Publication Activity Database

    Haindl, Michal; Somol, Petr; Ververidis, D.; Kotropoulos, C.

    2006-01-01

    Roč. 19, č. 4225 (2006), s. 569-577 ISSN 0302-9743. [Iberoamerican Congress on Pattern Recognition. CIARP 2006 /11./. Cancun, 14.11.2006-17.11.2006] R&D Projects: GA AV ČR 1ET400750407; GA MŠk 1M0572; GA AV ČR IAA2075302 EU Projects: European Commission(XE) 507752 - MUSCLE Institutional research plan: CEZ:AV0Z10750506 Keywords : feature selection Subject RIV: BD - Theory of Information Impact factor: 0.402, year: 2005 http://library.utia.cas.cz/separaty/historie/haindl-feature selection based on mutual correlation.pdf

  20. Selection of patients for sublingual versus subcutaneous immunotherapy.

    Science.gov (United States)

    Larenas Linnemann, Désirée E S; Blaiss, Michael S

    2014-01-01

    Allergen immunotherapy is the sole treatment for IgE-mediated allergic diseases directed at the underlying mechanism. The two widely accepted administration routes are sublingual (SLIT) and subcutaneous (SCIT). We reviewed how patients should best be selected for immunotherapy and how the optimal administration route can be defined. Before deciding SCIT or SLIT, appropriate selection of patients for allergen immunotherapy (AIT) is mandatory. To be eligible for AIT, subjects must have a clear medical history of allergic disease, with exacerbation of symptoms on exposure to one or more allergens and a corresponding positive skin or in vitro test. Then the route of administration should be based on: published evidence of clinical and immunologic efficacy (which varies per allergic disease and per allergen); mono- or multi-allergen immunotherapy, for SLIT multi-allergen immunotherapy was not effective; safety: adverse events with SLIT are more frequent, but less severe; and, costs and patient preferences, closely related to adherence issues. All these are discussed in the article.

  1. Effective selection of hypertensive patients for angiography

    International Nuclear Information System (INIS)

    van der Voorde, F.; Derkx, F.H.M.; Bossuyt, P.M.M.; Segaar, R.W.; de Wind, A.; Pieterman, H.

    1989-01-01

    The authors prospectively observed 373 severe hypertensives with either diastolic blood pressure (BP) ≥ 105 and age ≤ 40, or BP with three drugs ≥ 105 (regardless of age). Excluded were patients who were older than 75 or who had creatinine >400. History, physical examination, and laboratory data were used to identify high-yield criteria for arteriography. All patients underwent angiography as the gold standard; angiography showed 127 unilateral renal artery stenoses, 73 bilateral renal artery stenoses, and 173 (nonstenosed) essential hypertensives. The authors constructed a logistic regression model of height, weight, age, smoking, and hypertension duration, which could be used to identify 90% of stenosed patients with 50% fewer angiographies in the essential hypertensives

  2. Selection of paediatric patients for intensive care

    African Journals Online (AJOL)

    illness, particularly near-drowning, cardiomyopathy, gastro- enteritis and complicated infectious illness (Table Ill). Cardiorespiratory resuscitation prior to ICU admission was associated with increased mortality (7/11 v. 27/106,. P < 0,05, two-tailed Fisher's exact test). There were no deaths in patients with polytrauma without ...

  3. Alcohol septal ablation: patient selection and rationality of its application

    Directory of Open Access Journals (Sweden)

    М. Г. Каштанов

    2017-04-01

    Full Text Available The article looks at some aspects of selecting patients with obstructive hypertrophic cardiomyopathy for alcohol septal ablation (ASA procedure. Based on the world’s experience and in the context of evidence-based medicine, the current positions of ASA in complex treatment of obstructive hypertrophic cardiomyopathy are described. Received 29 September 2016. Accepted 9 January 2017.Funding: The study had no sponsorship.Conflict of interest: The authors declare no conflict of interest.Author contributionsData collection and analysis: Kashtanov M.G. Drafting the article: Kashtanov M.G. Critical revision: Kashtanov M.G., Idov E.M., Chernyshev S.D., Kardapoltsev L.V., Berdnikov S.V.

  4. Using Harm-Based Weights for the AHRQ Patient Safety for Selected Indicators Composite (PSI-90): Does It Affect Assessment of Hospital Performance and Financial Penalties in Veterans Health Administration Hospitals?

    Science.gov (United States)

    Chen, Qi; Rosen, Amy K; Borzecki, Ann; Shwartz, Michael

    2016-12-01

    To assess whether hospital profiles for public reporting and pay-for-performance, measured by the Agency for Healthcare Research and Quality (AHRQ) Patient Safety for Selected Indicators (PSI-90) composite measure, were affected by using the recently developed harm-based weights. Retrospective analysis of 2012-2014 data from the Veterans Health Administration (VA). The AHRQ PSI software (v5.0) was applied to obtain the original volume-based PSI-90 scores for 132 acute-care hospitals. We constructed a modified PSI-90 using the harm-based weights developed by AHRQ. We compared hospital profiles for public reporting and pay-for-performance between these two PSI-90s and assessed patterns in these changes. The volume-based and the harm-based PSI-90s were strongly correlated (r = 0.67, p hospitals changed categorization), but it had a much larger impact on pay-for-performance (e.g., 15 percent of hospitals would have faced different financial penalties under the Medicare Hospital-Acquired Condition Reduction Program). Because of changes in weights of specific PSIs, hospital profile changes occurred systematically. Use of the harm-based weights in PSI-90 has the potential to significantly change payments under pay-for-performance programs. Policy makers should carefully develop transition plans for guiding hospitals through changes in any quality metrics used for pay-for-performance. © Health Research and Educational Trust.

  5. Local anesthesia selection algorithm in patients with concomitant somatic diseases.

    Science.gov (United States)

    Anisimova, E N; Sokhov, S T; Letunova, N Y; Orekhova, I V; Gromovik, M V; Erilin, E A; Ryazantsev, N A

    2016-01-01

    The paper presents basic principles of local anesthesia selection in patients with concomitant somatic diseases. These principles are history taking; analysis of drugs interaction with local anesthetic and sedation agents; determination of the functional status of the patient; patient anxiety correction; dental care with monitoring of hemodynamics parameters. It was found that adhering to this algorithm promotes prevention of urgent conditions in patients in outpatient dentistry.

  6. Spatial memory deficits in patients after unilateral selective amygdalohippocampectomy

    NARCIS (Netherlands)

    Kessels, R.P.C.; Hendriks, M.P.H.; Schouten, J.A.; Asselen, M. van; Postma, A.

    2004-01-01

    The present study investigated the differential involvement of the right and left hippocampus in various forms of spatial memory: spatial search, positional memory versus object-location binding, and coordinate versus categorical processing. Twenty-five epilepsy patients with selective

  7. Vasectomy as a reversible form of contraception for select patients.

    Science.gov (United States)

    Samplaski, Mary K; Daniel, Ariande; Jarvi, Keith

    2014-04-01

    To provide an effective form of birth control, men may choose a reversible or permanent form of contraception. Vasectomy is presently offered as a permanent option for male contraception. We have had patients who were interested in vasectomy and reversal as a temporary birth control option. The purpose of this paper is to determine if vasectomy should be offered for selected couples as a temporary form of contraception and under which circumstances. A literature review was conducted to determine the available reversible contraceptive options, risks, failure rates and contraindications to each, and the risks and success rates of vasectomy and vasectomy reversal. Reversible contraceptives include hormonally based methods for women, non-hormonal anatomic barrier devices and spermatocidal agents. Hormone based therapies may be contraindicated in women with cardiovascular disease, hypertension, and some cancers. Non-hormonal contraceptives are generally less effective and may be unacceptable for some couples due to higher failure rates, difficulty of use and lack of acceptance. Both vasectomy and vasectomy reversal are low risk procedures. Reversal may be performed with a high degree of success, particularly with a short obstructive interval (97% patency if performed form of sterilization for most couples, there are select couples, unable or unwilling to use other forms of birth control, who would benefit from an informed discussion about using a vasectomy as a reversible form of contraception.

  8. Factors Influencing Patient Selection of a Foot and Ankle Surgeon.

    Science.gov (United States)

    Manning, Blaine T; Bohl, Daniel D; Wang, Kevin C; Hamid, Kamran S; Holmes, George B; Lee, Simon

    2017-09-01

    An increasingly consumer-centric health insurance market has empowered patients to select the providers of their choice. There is a lack of studies investigating the rationale by which patients select a foot and ankle surgeon. In the present study, 824 consecutive new patients seeking treatment from 3 foot-ankle surgeons were consecutively administered an anonymous questionnaire prior to their first appointment. It included rating the importance of 15 factors regarding specialist selection on a 1 to 10 scale, with 10 designated " Very important" and 1 designated " Not important at all." The remaining questions were multiple choice regarding patient perspectives on other surgeon aspects (appointment availability, waiting room times, clinic proximity, etc). Of 824 consecutive patients administered the survey, 305 (37%) responded. Patients rated board certification (9.24 ± 1.87) and on-site imaging availability (8.48 ± 2.37)-on a 1 to 10 scale, with 10 designated "Very important- as the 2 most important criteria in choosing a foot and ankle surgeon. Patients rated advertisements as least important. Among the patients, 91% responded that a maximum of 30 minutes should elapse between clinic check-in and seeing their physician; 61% responded that a maximum of 20 minutes should elapse between clinic check-in and seeing their physician. In the context of an increasingly consumer-driven paradigm of health care delivery and reimbursement, it is important to understand patients' preferences in specialist selection. Level III: Prospective questionnaire.

  9. MIS-based sensors with hydrogen selectivity

    Energy Technology Data Exchange (ETDEWEB)

    Li,; Dongmei, [Boulder, CO; Medlin, J William [Boulder, CO; McDaniel, Anthony H [Livermore, CA; Bastasz, Robert J [Livermore, CA

    2008-03-11

    The invention provides hydrogen selective metal-insulator-semiconductor sensors which include a layer of hydrogen selective material. The hydrogen selective material can be polyimide layer having a thickness between 200 and 800 nm. Suitable polyimide materials include reaction products of benzophenone tetracarboxylic dianhydride 4,4-oxydianiline m-phenylene diamine and other structurally similar materials.

  10. Rule-based versus probabilistic selection for active surveillance using three definitions of insignificant prostate cancer

    NARCIS (Netherlands)

    L.D.F. Venderbos (Lionne); M.J. Roobol-Bouts (Monique); C.H. Bangma (Chris); R.C.N. van den Bergh (Roderick); L.P. Bokhorst (Leonard); D. Nieboer (Daan); Godtman, R; J. Hugosson (Jonas); van der Kwast, T; E.W. Steyerberg (Ewout)

    2016-01-01

    textabstractTo study whether probabilistic selection by the use of a nomogram could improve patient selection for active surveillance (AS) compared to the various sets of rule-based AS inclusion criteria currently used. We studied Dutch and Swedish patients participating in the European Randomized

  11. Guidelines for patient selection and performance of carotid artery stenting.

    Science.gov (United States)

    Bladin, Christopher; Chambers, Brian; New, Gishel; Denton, Michael; Lawrence-Brown, Michael

    2010-06-01

    The endovascular treatment of carotid atherosclerosis with carotid artery stenting (CAS) remains controversial. Carotid endarterectomy remains the benchmark in terms of procedural mortality and morbidity. At present, there are no consensus Australasian guidelines for the safe performance of CAS. We applied a modified Delphi consensus method of iterative consultation between the College representatives on the Carotid Stenting Guidelines Committee (CSGC). Selection of patients suitable for CAS needs careful consideration of clinical and patho-anatomical criteria and cannot be directly extrapolated from clinical indicators for carotid endarterectomy (CEA). Randomized controlled trials (including pooled analyses of results) comparing CAS with CEA for treatment of symptomatic stenosis have demonstrated that CAS is more hazardous than CEA. On current evidence, the CGSC therefore recommends that CAS should not be performed in the majority of patients requiring carotid revascularisation. The evidence for CAS in patients with symptomatic severe carotid stenosis who are considered medically high risk is weak, and there is currently no evidence to support CAS as a treatment for asymptomatic carotid stenosis. The use of distal protection devices during CAS remains controversial with increased risk of clinically silent stroke. The knowledge requirements for the safe performance of CAS include an understanding of the evidence base from randomized controlled trials, carotid and aortic arch anatomy and pathology, clinical stroke syndromes, the differing treatment options for stroke and carotid atherosclerosis, and recognition and management of periprocedural complications. It is critical that all patients being considered for a carotid intervention have adequate pre-procedural neuro-imaging and an independent, standardized neurological assessment before and after the procedure. Maintenance of proficiency in CAS requires active involvement in surgical/endovascular audit and

  12. Appropriate selection for omalizumab treatment in patients with severe asthma?

    DEFF Research Database (Denmark)

    Nygaard, Leo; Henriksen, Daniel Pilsgaard; Madsen, Hanne

    2017-01-01

    Background: Omalizumab improves asthma control in patients with uncontrolled severe allergic asthma; however, appropriate patient selection is crucial. Information in this field is sparse. Objective: We aimed to estimate whether potential omalizumab candidates were appropriately selected according...... to guidelines, and the clinical effect of omalizumab treatment over time. Design: We performed a retrospective observational study on adult patients with asthma treated with omalizumab during 2006-2015 at the Department of Respiratory Medicine at Odense University Hospital (OUH), Denmark. Data were obtained...... from the Electronic Patient Journal of OUH and Odense Pharmaco-Epidemiological Database. Guideline criteria for omalizumab treatment were used to evaluate the appropriateness of omalizumab candidate selection, and the Asthma Control Test (ACT) to assess the clinical effects of omalizumab at weeks 16...

  13. Endoscopic bronchial valve treatment: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Eberhardt R

    2015-10-01

    Full Text Available Ralf Eberhardt,1,2 Daniela Gompelmann,1,2 Felix JF Herth,1,2 Maren Schuhmann1 1Pneumology and Critical Care Medicine, Thoraxklinik at the University of Heidelberg, 2Translational Lung Research Center, Member of the German Center for Lung Research, Heidelberg, Germany Abstract: As well as lung volume reduction surgery, different minimally invasive endoscopic techniques are available to achieve lung volume reduction in patients with severe emphysema and significant hyperinflation. Lung function parameters and comorbidities of the patient, as well as the extent and distribution of the emphysema are factors to be considered when choosing the patient and the intervention. Endoscopic bronchial valve placement with complete occlusion of one lobe in patients with heterogeneous emphysema is the preferred technique because of its reversibility. The presence of high interlobar collateral ventilation will hinder successful treatment; therefore, endoscopic coil placement, polymeric lung volume reduction, or bronchoscopic thermal vapor ablation as well as lung volume reduction surgery can be used for treating patients with incomplete fissures. The effect of endoscopic lung volume reduction in patients with a homogeneous distribution of emphysema is still unclear and this subgroup should be treated only in clinical trials. Precise patient selection is necessary for interventions and to improve the outcome and reduce the risk and possible complications. Therefore, the patients should be discussed in a multidisciplinary approach prior to determining the most appropriate treatment for lung volume reduction. Keywords: lung emphysema, valve treatment, collateral ventilation, patient selection, outcome

  14. Phenotypes selected during chronic lung infection in cystic fibrosis patients

    DEFF Research Database (Denmark)

    Ciofu, Oana; Mandsberg, Lotte F; Wang, Hengzhuang

    2012-01-01

    During chronic lung infection of patients with cystic fibrosis, Pseudomonas aeruginosa can survive for long periods of time under the challenging selective pressure imposed by the immune system and antibiotic treatment as a result of its biofilm mode of growth and adaptive evolution mediated by g...... the importance of biofilm prevention strategies by early aggressive antibiotic prophylaxis or therapy before phenotypic diversification during chronic lung infection of patients with cystic fibrosis....

  15. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    Science.gov (United States)

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  16. Structuring AHP-based maintenance policy selection

    NARCIS (Netherlands)

    Goossens, Adriaan; Basten, Robertus Johannes Ida; Hummel, J. Marjan; van der Wegen, Leonardus L.M.

    2015-01-01

    We aim to structure the maintenance policy selection process for ships, using the Analytic Hierarchy Process (AHP). Maintenance is an important contributor to reach the intended life-time of capital technical assets, and it is gaining increasing interest and relevance. A maintenance policy is a

  17. Cardiac resynchronization therapy : advances in optimal patient selection

    NARCIS (Netherlands)

    Bleeker, Gabe Berend

    2007-01-01

    Despite the impressive results of cardiac resynchronization theraphy (CRT) in recent large randomized trials a consistent number of patients fails to improve following CRT implantation when the established CRT selection criteria (NYHA class III-IV heart failure, LV ejection fraction ≤35 % and QRS

  18. Analysis of the presence or absence of atrophy of the subgenual and subcallosal cingulate cortices using voxel-based morphometry on MRI is useful to select prescriptions for patients with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Niida A

    2014-12-01

    atrophy is detected in both the sgACC and the scACC, concomitant administration of mood stabilizers and atypical antipsychotics acting as dopamine-system stabilizers is necessary in many cases. Conclusion: VBM on magnetic resonance imaging enabled automatic analysis of atrophy in the sgACC and scACC, and findings obtained by this procedure are useful not only for differentiation of MDD and BD patients but also for selection of prescriptions. Keywords: major depressive disorder, bipolar disorder, MRI, subgenual anterior cingulate cortex, subcallosal anterior cingulate cortex, voxel-based morphometry

  19. How do intake clinicians use patient characteristics to select treatment for patients with personality disorders?

    Science.gov (United States)

    van Manen, Janine; Kamphuis, Jan Henk; Visbach, Geny; Ziegler, Uli; Gerritsen, Ad; Van Rossum, Bert; Rijnierse, Piet; Timman, Reinier; Verheul, Roel

    2008-11-01

    Treatment selection in clinical practice is a poorly understood, often largely implicit decision process, perhaps especially for patients with personality disorders. This study, therefore, investigated how intake clinicians use information about patient characteristics to select psychotherapeutic treatment for patients with personality disorder. A structured interview with a forced-choice format was administered to 27 experienced intake clinicians working in five specialist mental health care institutes in the Netherlands. Substantial consensus was evident among intake clinicians. The results revealed that none of the presented patient characteristics were deemed relevant for the selection of the suitable treatment setting. The appropriate duration and intensity are selected using severity or personal strength variables. The theoretical orientation is selected using personal strength variables.

  20. EEG feature selection method based on decision tree.

    Science.gov (United States)

    Duan, Lijuan; Ge, Hui; Ma, Wei; Miao, Jun

    2015-01-01

    This paper aims to solve automated feature selection problem in brain computer interface (BCI). In order to automate feature selection process, we proposed a novel EEG feature selection method based on decision tree (DT). During the electroencephalogram (EEG) signal processing, a feature extraction method based on principle component analysis (PCA) was used, and the selection process based on decision tree was performed by searching the feature space and automatically selecting optimal features. Considering that EEG signals are a series of non-linear signals, a generalized linear classifier named support vector machine (SVM) was chosen. In order to test the validity of the proposed method, we applied the EEG feature selection method based on decision tree to BCI Competition II datasets Ia, and the experiment showed encouraging results.

  1. Content-based image retrieval: Color-selection exploited

    NARCIS (Netherlands)

    Broek, E.L. van den; Vuurpijl, L.G.; Kisters, P. M. F.; Schmid, J.C.M. von; Moens, M.F.; Busser, R. de; Hiemstra, D.; Kraaij, W.

    2002-01-01

    This research presents a new color selection interface that facilitates query-by-color in Content-Based Image Retrieval (CBIR). Existing CBIR color selection interfaces, are being judged as non-intuitive and difficult to use. Our interface copes with these problems of usability. It is based on 11

  2. Content-Based Image Retrieval: Color-selection exploited

    NARCIS (Netherlands)

    Moens, Marie-Francine; van den Broek, Egon; Vuurpijl, L.G.; de Brusser, Rik; Kisters, P.M.F.; Hiemstra, Djoerd; Kraaij, Wessel; von Schmid, J.C.M.

    2002-01-01

    This research presents a new color selection interface that facilitates query-by-color in Content-Based Image Retrieval (CBIR). Existing CBIR color selection interfaces, are being judged as non-intuitive and difficult to use. Our interface copes with these problems of usability. It is based on 11

  3. Tungsten based catalysts for selective deoxygenation

    NARCIS (Netherlands)

    Gosselink, R.W.|info:eu-repo/dai/nl/326164081; Stellwagen, D.R.; Bitter, J.H.|info:eu-repo/dai/nl/160581435

    2013-01-01

    Over the past decades, impending oil shortages combined with petroleum market instability have prompted a search for a new source of both transportation fuels and bulk chemicals. Renewable bio-based feedstocks such as sugars, grains, and seeds are assumed to be capable of contributing to a

  4. Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study

    Directory of Open Access Journals (Sweden)

    Lash Timothy L

    2010-01-01

    Full Text Available Abstract Background Selective serotonin reuptake inhibitors (SSRI decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association. Methods We conducted a population-based study of the risk of re-operation due to post-surgical bleeding within two weeks of primary surgery among Danish women with primary breast cancer. Patients were categorised according to their use of SSRI: never users, current users (SSRI prescription within 30 days of initial breast cancer surgery, and former users (SSRI prescription more than 30 days before initial breast cancer surgery. We calculated the risk of re-operation due to post-surgical bleeding within 14 days of initial surgery, and the relative risk (RR of re-operation comparing SSRI users with never users of SSRI adjusting for potential confounders. Results 389 of 14,464 women (2.7% were re-operated. 1592 (11% had a history of SSRI use. Risk of re-operation was 2.6% among never users, 7.0% among current SSRI users, and 2.7% among former users. Current users thus had an increased risk of re-operation due to post-operative bleeding (adjusted relative risk = 2.3; 95% confidence interval (CI = 1.4, 3.9 compared with never users. There was no increased risk of re-operation associated with former use of SSRI (RR = 0.93, 95% CI = 0.66, 1.3. Conclusions Current use of SSRI is associated with an increased risk of re-operation due to bleeding after surgery for breast cancer.

  5. Cermet based solar selective absorbers : further selectivity improvement and developing new fabrication technique

    OpenAIRE

    Nejati, Mohammadreza

    2008-01-01

    Spectral selectivity of cermet based selective absorbers were increased by inducing surface roughness on the surface of the cermet layer using a roughening technique (deposition on hot substrates) or by micro-structuring the metallic substrates before deposition of the absorber coating using laser and imprint structuring techniques. Cu-Al2O3 cermet absorbers with very rough surfaces and excellent selectivity were obtained by employing a roughness template layer under the infrared reflective l...

  6. ARTIFICIAL NEURAL NETWORKS BASED GEARS MATERIAL SELECTION HYBRID INTELLIGENT SYSTEM

    Institute of Scientific and Technical Information of China (English)

    X.C. Li; W.X. Zhu; G. Chen; D.S. Mei; J. Zhang; K.M. Chen

    2003-01-01

    An artificial neural networks(ANNs) based gear material selection hybrid intelligent system is established by analyzing the individual advantages and weakness of expert system (ES) and ANNs and the applications in material select of them. The system mainly consists of tow parts: ES and ANNs. By being trained with much data samples,the back propagation (BP) ANN gets the knowledge of gear materials selection, and is able to inference according to user input. The system realizes the complementing of ANNs and ES. Using this system, engineers without materials selection experience can conveniently deal with gear materials selection.

  7. How does PET/CT help in selecting therapy for patients with Hodgkin lymphoma?

    DEFF Research Database (Denmark)

    Hutchings, Martin

    2012-01-01

    investigating the use of PET/CT for early response-adapted therapy, with therapeutic stratification based on interim PET/CT results. Posttreatment PET/CT is a cornerstone of the revised response criteria and enables the selection of advanced-stage patients without the need for consolidation radiotherapy. Once...

  8. Beta-thalassemia- institution based analysis of ethnic and geographic distribution, effect of consanguinity and safety of chorionic villus sampling as a diagnostic, tool for pre-natal diagnosis in selected patients

    International Nuclear Information System (INIS)

    Abdullah, K.N.; Liaqat, J.; Azim, W.

    2011-01-01

    To study the ethnic and geographic distribution of Beta-thalassemia amongst the patients included and to study the effect of consanguinity in promoting this disease. Also, to establish the safety of CVS when used as a pre-natal diagnostic tool in aiding the early diagnosis of Beta-thalassemia in selected patients. Study Design: Descriptive Study. Place and Duration of Study: PNS Shifa Karachi, from Jan 2008 to Dec 2008. Patients and Methods: A total of 223 women out of 240 that were referred from all over Sindh to PNS Shifa Hospital Karachi for susceptible gene mutations participated in the study. The standard procedure that was used in this study was trans-abdominal aspiration of chorionic villi through suction needle. The samples were then sent for further analysis to the Pathology Department at PNS Shifa Hospital Karachi. Results: In our study population Beta-thalassemia was most prevalent in Sindhi 107 (48%) followed by Punjabi 46 (21%), 27 (12%) Pathan, and 43 (19%) Balochi. Out of 223 women, 95 were of thalassemia trait, while 85 were of thalassemia major. Fifty five percent of thalassemia trait and 56% of thalassemia major fetus parents were first cousins. The rate of pregnancy loss after performing CVS was 2.0% with no complications reported. Conclusion: It is concluded that highest percentage of thalassemia is in first cousins and sindhi origin families are mostly affected. However CVS is a safe and effective tool for prenatal diagnosis and subsequent counselling in selected couples. (author)

  9. Selection of components based on their importance

    International Nuclear Information System (INIS)

    Stvan, F.

    2004-12-01

    A proposal is presented for sorting components of the Dukovany nuclear power plant with respect to their importance. The classification scheme includes property priority, property criticality and property structure. Each area has its criteria with weight coefficients to calculate the importance of each component by the Risk Priority Number method. The aim of the process is to generate a list of components in order of operating and safety importance, which will help spend funds to ensure operation and safety in an optimal manner. This proposal is linked to a proposal for a simple database which should serve to enter information and perform assessments. The present stage focused on a safety assessment of components categorized in safety classes BT1, BT2 and BT3 pursuant to Decree No. 76. Assessment was performed based ona PSE study for Level 1. The database includes inputs for entering financial data, which are represented by a potential damage resulting from the given failure and by the loss of MWh in financial terms. In a next input, the failure incidence intensity and time of correction can be entered. Information regarding the property structure, represented by the degree of backup and reparability of the component, is the last input available

  10. Information Gain Based Dimensionality Selection for Classifying Text Documents

    Energy Technology Data Exchange (ETDEWEB)

    Dumidu Wijayasekara; Milos Manic; Miles McQueen

    2013-06-01

    Selecting the optimal dimensions for various knowledge extraction applications is an essential component of data mining. Dimensionality selection techniques are utilized in classification applications to increase the classification accuracy and reduce the computational complexity. In text classification, where the dimensionality of the dataset is extremely high, dimensionality selection is even more important. This paper presents a novel, genetic algorithm based methodology, for dimensionality selection in text mining applications that utilizes information gain. The presented methodology uses information gain of each dimension to change the mutation probability of chromosomes dynamically. Since the information gain is calculated a priori, the computational complexity is not affected. The presented method was tested on a specific text classification problem and compared with conventional genetic algorithm based dimensionality selection. The results show an improvement of 3% in the true positives and 1.6% in the true negatives over conventional dimensionality selection methods.

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

    Science.gov (United States)

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

    2013-11-01

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

  12. Multispectral iris recognition based on group selection and game theory

    Science.gov (United States)

    Ahmad, Foysal; Roy, Kaushik

    2017-05-01

    A commercially available iris recognition system uses only a narrow band of the near infrared spectrum (700-900 nm) while iris images captured in the wide range of 405 nm to 1550 nm offer potential benefits to enhance recognition performance of an iris biometric system. The novelty of this research is that a group selection algorithm based on coalition game theory is explored to select the best patch subsets. In this algorithm, patches are divided into several groups based on their maximum contribution in different groups. Shapley values are used to evaluate the contribution of patches in different groups. Results show that this group selection based iris recognition

  13. Outpatient desensitization in selected patients with platinum hypersensitivity reactions.

    Science.gov (United States)

    O'Malley, David M; Vetter, Monica Hagan; Cohn, David E; Khan, Ambar; Hays, John L

    2017-06-01

    Platinum-based chemotherapies are a standard treatment for both initial and recurrent gynecologic cancers. Given this widespread use, it is important to be aware of the features of platinum hypersensitivity reactions and the subsequent treatment of these reactions. There is also increasing interest in the development of desensitization protocols to allow patients with a history of platinum hypersensitivity to receive further platinum based therapy. In this review, we describe the management of platinum hypersensitivity reactions and the desensitization protocols utilized at our institution. We also describe the clinical categorizations utilized to triage patients to appropriate desensitization protocols. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Evaluation of selective attention in patients with misophonia.

    Science.gov (United States)

    Silva, Fúlvia Eduarda da; Sanchez, Tanit Ganz

    2018-03-21

    Misophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been inferred that misophonia, as well as tinnitus, is associated with hyperconnectivity between auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet. To characterize a sample of misophonic subjects and compare it with two control groups, one with tinnitus individuals (without misophonia) and the other with asymptomatic individuals (without misophonia and without tinnitus), regarding the selective attention. We evaluated 40 normal-hearing participants: 10 with misophonia, 10 with tinnitus (without misophonia) and 20 without tinnitus and without misophonia. In order to evaluate the selective attention, the dichotic sentence identification test was applied in three situations: firstly, the Brazilian Portuguese test was applied. Then, the same test was applied, combined with two competitive sounds: chewing sound (representing a sound that commonly triggers misophonia), and white noise (representing a common type of tinnitus which causes discomfort to patients). The dichotic sentence identification test with chewing sound, showed that the average of correct responses differed between misophonia and without tinnitus and without misophonia (p=0.027) and between misophonia and tinnitus (without misophonia) (p=0.002), in both cases lower in misophonia. Both, the dichotic sentence identification test alone, and with white noise, failed to show differences in the average of correct responses among the three groups (p≥0.452). The misophonia participants presented a lower percentage of correct responses in the dichotic sentence identification test with chewing sound; suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger this condition. Copyright © 2018 Associa

  15. Significance of ERBB2 overexpression in therapeutic resistance and cancer-specific survival in muscle-invasive bladder cancer patients treated with chemoradiation-based selective bladder-sparing approach.

    Science.gov (United States)

    Inoue, Masaharu; Koga, Fumitaka; Yoshida, Soichiro; Tamura, Tomoki; Fujii, Yasuhisa; Ito, Eisaku; Kihara, Kazunori

    2014-10-01

    To investigate the associations of ERBB 2 overexpression with chemoradiation therapy (CRT) resistance and cancer-specific survival (CSS) in muscle-invasive bladder cancer (MIBC) patients treated with the CRT-based bladder-sparing protocol. From 1997 to 2012, 201 patients with cT2-4aN0M0 bladder cancer were treated with CRT (40 Gy with concurrent cisplatin) following transurethral resection of bladder tumor (TURBT). Basically, patients with tumors that showed good CRT response and were amenable to segmental resection underwent partial cystectomy (PC) with pelvic lymph node dissection for bladder preservation; otherwise, radical cystectomy (RC) was recommended. Included in this study were 119 patients in whom TURBT specimens were available for immunohistochemical analysis of ERBB 2 expression. Following CRT, 30 and 65 patients underwent PC or RC, respectively; the remaining 24 patients did not undergo cystectomy. Tumors were defined as CRT-resistant when patients did not achieve complete response after CRT. Associations of ERBB 2 overexpression with CRT resistance and CSS were evaluated. CRT resistance was observed clinically in 56% (67 of 119 patients) and pathologically (in cystectomy specimens) in 55% (52 of 95 patients). ERBB 2 overexpression was observed in 45 patients (38%). On multivariate analysis, ERBB 2 overexpression was an independent predictor for CRT resistance clinically (odds ratio, 3.6; P=.002) and pathologically (odds ratio, 2.9; P=.031). ERBB 2 overexpression was associated with shorter CSS (5-year CSS rates, 56% vs 87% for the ERBB 2 overexpression group vs the others; P=.001). ERBB 2 overexpression was also an independent risk factor for bladder cancer death at all time points of our bladder-sparing protocol (pre-CRT, post-CRT, and post-cystectomy). ERBB 2 overexpression appears relevant to CRT resistance and unfavorable CSS in MIBC patients treated with the CRT-based bladder-sparing protocol. ERBB 2-targeting treatment may improve the outcomes

  16. Significance of ERBB2 Overexpression in Therapeutic Resistance and Cancer-Specific Survival in Muscle-Invasive Bladder Cancer Patients Treated With Chemoradiation-Based Selective Bladder-Sparing Approach

    International Nuclear Information System (INIS)

    Inoue, Masaharu; Koga, Fumitaka; Yoshida, Soichiro; Tamura, Tomoki; Fujii, Yasuhisa; Ito, Eisaku; Kihara, Kazunori

    2014-01-01

    Purpose: To investigate the associations of ERBB 2 overexpression with chemoradiation therapy (CRT) resistance and cancer-specific survival (CSS) in muscle-invasive bladder cancer (MIBC) patients treated with the CRT-based bladder-sparing protocol. Methods and Materials: From 1997 to 2012, 201 patients with cT2-4aN0M0 bladder cancer were treated with CRT (40 Gy with concurrent cisplatin) following transurethral resection of bladder tumor (TURBT). Basically, patients with tumors that showed good CRT response and were amenable to segmental resection underwent partial cystectomy (PC) with pelvic lymph node dissection for bladder preservation; otherwise, radical cystectomy (RC) was recommended. Included in this study were 119 patients in whom TURBT specimens were available for immunohistochemical analysis of ERBB 2 expression. Following CRT, 30 and 65 patients underwent PC or RC, respectively; the remaining 24 patients did not undergo cystectomy. Tumors were defined as CRT-resistant when patients did not achieve complete response after CRT. Associations of ERBB 2 overexpression with CRT resistance and CSS were evaluated. Results: CRT resistance was observed clinically in 56% (67 of 119 patients) and pathologically (in cystectomy specimens) in 55% (52 of 95 patients). ERBB 2 overexpression was observed in 45 patients (38%). On multivariate analysis, ERBB 2 overexpression was an independent predictor for CRT resistance clinically (odds ratio, 3.6; P=.002) and pathologically (odds ratio, 2.9; P=.031). ERBB 2 overexpression was associated with shorter CSS (5-year CSS rates, 56% vs 87% for the ERBB 2 overexpression group vs the others; P=.001). ERBB 2 overexpression was also an independent risk factor for bladder cancer death at all time points of our bladder-sparing protocol (pre-CRT, post-CRT, and post-cystectomy). Conclusions: ERBB 2 overexpression appears relevant to CRT resistance and unfavorable CSS in MIBC patients treated with the CRT-based bladder

  17. 44 CFR 321.2 - Selection of the mobilization base.

    Science.gov (United States)

    2010-10-01

    ... base. 321.2 Section 321.2 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS MAINTENANCE OF THE MOBILIZATION BASE (DEPARTMENT OF DEFENSE, DEPARTMENT OF ENERGY, MARITIME ADMINISTRATION) § 321.2 Selection of the mobilization base. (a) The Department...

  18. Automatic selective feature retention in patient specific elastic surface registration

    CSIR Research Space (South Africa)

    Jansen van Rensburg, GJ

    2011-01-01

    Full Text Available The accuracy with which a recent elastic surface registration algorithm deforms the complex geometry of a skull is examined. This algorithm is then coupled to a line based algorithm as is frequently used in patient specific feature registration...

  19. A PCT-wide collaborative clinical audit selecting recall intervals for patients according to risk.

    Science.gov (United States)

    Cannell, P J

    2011-03-26

    This audit was carried out to assess the level to which recall intervals were individually and appropriately selected for patients attending dental practices across a primary care trust (PCT) area in Essex. A retrospective audit was carried out by reference to patient records to assess various criteria, including whether patients were categorised according to risk of oral disease, whether an appropriate recall had been selected and whether a discussion regarding a recall interval had been undertaken. An educational event highlighting the issue of recall intervals was held. Subsequent to this a prospective audit was undertaken to assess relevant criteria. Prospective audit data showed a marked increase in the use of patient risk assessments for caries, periodontal disease, oral cancer and non-carious tooth surface loss (NCTSL). Recall intervals were also more often selected based on a patient's risk status and discussed with the patient compared to that observed in the retrospective audit data. This audit was successful as a tool to bring about change in the behaviour of dentists regarding their determination of appropriate recall intervals for patients. Whether that change in behaviour is long-term or transient requires further investigation.

  20. Selecting patients with young-onset colorectal cancer for mismatch repair gene analysis

    DEFF Research Database (Denmark)

    Walker, M; O'Sullivan, B; Perakath, B

    2007-01-01

    BACKGROUND: Young patients with colorectal cancer are at increased risk of carrying a germline mutation in mismatch repair (MMR) genes. This study investigated the role of clinical criteria and immunohistochemistry for MMR proteins in selecting young patients for mutation testing. METHODS: A cohort...... of 56 consecutive patients with colorectal cancer aged less than 45 years were stratified into three groups based on clinical criteria: 'Amsterdam criteria', 'high risk' and 'young onset only'. Immunohistochemistry for four MMR proteins was carried out and the rate of compliance with clinical guidelines...

  1. [New methods of patient selection for improved anticholinergic therapy].

    Science.gov (United States)

    Neuhaus, J; Schwalenberg, T; Schlichting, N; Schulze, M; Horn, L-C; Stolzenburg, J-U

    2007-09-01

    M3-specific inhibitors are currently preferred for anticholinergic therapy of OAB. However, not all of the patients profit from this regimen. This might reflect a heterogeneity of the patient group. The aim of this work is to define subgroups of patients with specific alterations of receptor expression and to profile the receptor expression individually. These receptor profiles might be used for the development of evidence-based "tailored" therapies. Detrusor probes from bladder carcinoma patients (BCa, n=9 F, n=7 male) and interstitial cystitis patients (IC, n=9 female) were examined using confocal immunofluorescence and PCR. M2, M3, P2X1-3, and H1-3 mRNAs were demonstrated in detrusor tissue. As revealed by immunofluorescence, the M2 receptor expression was significantly higher in female compared to male BCa tissues. In addition, the M2 receptor was further upregulated in IC vs BCa in female detrusor. IC patients showed specific alterations of their receptor profile. Individual receptor profiles might be used to optimize medicinal therapies.

  2. Efficient Multi-Label Feature Selection Using Entropy-Based Label Selection

    Directory of Open Access Journals (Sweden)

    Jaesung Lee

    2016-11-01

    Full Text Available Multi-label feature selection is designed to select a subset of features according to their importance to multiple labels. This task can be achieved by ranking the dependencies of features and selecting the features with the highest rankings. In a multi-label feature selection problem, the algorithm may be faced with a dataset containing a large number of labels. Because the computational cost of multi-label feature selection increases according to the number of labels, the algorithm may suffer from a degradation in performance when processing very large datasets. In this study, we propose an efficient multi-label feature selection method based on an information-theoretic label selection strategy. By identifying a subset of labels that significantly influence the importance of features, the proposed method efficiently outputs a feature subset. Experimental results demonstrate that the proposed method can identify a feature subset much faster than conventional multi-label feature selection methods for large multi-label datasets.

  3. MySQL based selection of appropriate indexing technique in ...

    African Journals Online (AJOL)

    This paper deals with selection of appropriate indexing technique applied on MySQL Database for a health care system and related performance issues using multiclass support vector machine (SVM). The patient database is generally huge and contains lot of variations. For the quick search or fast retrieval of the desired ...

  4. Readmissions for Selected Infections Due to Medical Care: Expanding the Definition of a Patient Safety Indicator

    National Research Council Canada - National Science Library

    Gallagher, Brian; Cen, Liyi; Hannan, Edward L

    2005-01-01

    Objective: Evaluate the Agency for Healthcare Research and Quality's Patient Safety Indicator that identifies patients with selected infections that result from medical care during hospital inpatient treatment...

  5. Development of Base Transceiver Station Selection Algorithm for ...

    African Journals Online (AJOL)

    TEMS) equipment was carried out on the existing BTSs, and a linear algorithm optimization program based on the spectral link efficiency of each BTS was developed, the output of this site optimization gives the selected number of base station sites ...

  6. [Selected ethical problems of oncologic patients during the terminal period].

    Science.gov (United States)

    Iwaszczyszyn, J; Kwiecińska, A

    2001-01-01

    Patient suffering from terminal disease is depended on his environment more than any other one. He often suffers from nervous break down, anxiety and fear and he is usually unprotected from the environment. Fast development of medical science and its technicisation can lead towards dehumanization and lack of psychological and spiritual care, which should be based on clear ethical principles. Main lines of ethical principles of Health Service which are included in Deontological Code of Physicians and Collection of ethical principles for a qualified nurse are the main rules how to proceed as to fulfill the rule: "benefit of a patient is the superior law." According to its speciality Palliative Medicine introduces also four general ethical principles: 1. Patient will is a rule of treatment. 2. The principle of proportion--benefits from the treatment should be higher than losses and suffering from iatrogenic acting. 3. The principle of equality--stop taking a cure does not differ from not undertaking treatment. 4. The principle of relativity--life is not an absolute good, death is not an absolute evil. Holistic acts of Palliative Medicine determines also specific ethical attitudes, especially in the following: 1. Communication between a therapist and a patient and his family (interpersonal attitudes). 2. Procedures how to lessen suffering and its interpretation according to culture, tradition and religion ("nonsense and significance of suffering"). 3. Negation of euthanasia. 4. Spiritual, psychological and social care of patients.

  7. Strategies for selecting effective patient nutrition education materials.

    Science.gov (United States)

    Clayton, Laura H

    2010-10-01

    Nutrition and diet therapy are at the center of health promotion activities and self-management of chronic diseases. To assist an individual in making informed decisions regarding his or her diet and increase adherence to dietary recommendations or treatments, healthcare professionals must select health information that is appropriate to the client's level of understanding. A systematic approach in the evaluation of patient education material, whether in print or on the World Wide Web, must focus on the information's content, literacy level, graphical displays, layout and typography, motivating principles, cultural relevance, and feasibility. Additional criteria should be evaluated when accessing Web sites and include source, site credibility, conflict of interest, disclaimer, disclosure, navigation, and interactivity information.

  8. Mortality in perforated peptic ulcer patients after selective management of stratified poor risk cases.

    Science.gov (United States)

    Rahman, M Mizanur; Islam, M Saiful; Flora, Sabrina; Akhter, S Fariduddin; Hossain, Shahid; Karim, Fazlul

    2007-12-01

    Perforated peptic ulcer disease continues to inflict high morbidity and mortality. Although patients can be stratified according to their surgical risk, optimal management has yet to be described. In this study we demonstrate a treatment option that improves the mortality among critically ill, poor risk patients with perforated peptic ulcer disease. In our study, two series were retrospectively reviewed: group A patients (n = 522) were treated in a single surgical unit at the Dhaka Medical College Hospital, Dhaka, Bangladesh during the 1980s. Among them, 124 patients were stratified as poor risk based on age, delayed presentation, peritoneal contamination, and coexisting medical problems. These criteria were the basis for selecting a group of poor risk patients (n = 84) for minimal surgical intervention (percutaneous peritoneal drainage) out of a larger group of patients, group B (n = 785) treated at Khulna Medical College Hospital during the 1990s. In group A, 479 patients underwent conventional operative management with an operative mortality of 8.97%. Among the 43 deaths, 24 patients were >60 years of age (55.8%), 12 patients had delayed presentation (27.9%), and 7 patients were in shock or had multiple coexisting medical problems (16.2%). In group B, 626 underwent conventional operative management, with 26 deaths at a mortality rate of 4.15%. Altogether, 84 patients were stratified as poor risk and were managed with minimal surgical intervention (percutaneous peritoneal drainage) followed by conservative treatment. Three of these patients died with an operative mortality of 3.5%. Minimal surgical intervention (percutaneous peritoneal drainage) can significantly lower the mortality rate among a selected group of critically ill, poor risk patients with perforated peptic ulcer disease.

  9. Supplier selection based on multi-criterial AHP method

    Directory of Open Access Journals (Sweden)

    Jana Pócsová

    2010-03-01

    Full Text Available This paper describes a case-study of supplier selection based on multi-criterial Analytic Hierarchy Process (AHP method.It is demonstrated that using adequate mathematical method can bring us “unprejudiced” conclusion, even if the alternatives (suppliercompanies are very similar in given selection-criteria. The result is the best possible supplier company from the viewpoint of chosen criteriaand the price of the product.

  10. Personnel Selection Method Based on Personnel-Job Matching

    OpenAIRE

    Li Wang; Xilin Hou; Lili Zhang

    2013-01-01

    The existing personnel selection decisions in practice are based on the evaluation of job seeker's human capital, and it may be difficult to make personnel-job matching and make each party satisfy. Therefore, this paper puts forward a new personnel selection method by consideration of bilateral matching. Starting from the employment thoughts of ¡°satisfy¡±, the satisfaction evaluation indicator system of each party are constructed. The multi-objective optimization model is given according to ...

  11. Construction Tender Subcontract Selection using Case-based Reasoning

    Directory of Open Access Journals (Sweden)

    Due Luu

    2012-11-01

    Full Text Available Obtaining competitive quotations from suitably qualified subcontractors at tender tim n significantly increase the chance of w1nmng a construction project. Amidst an increasingly growing trend to subcontracting in Australia, selecting appropriate subcontractors for a construction project can be a daunting task requiring the analysis of complex and dynamic criteria such as past performance, suitable experience, track record of competitive pricing, financial stability and so on. Subcontractor selection is plagued with uncertainty and vagueness and these conditions are difficul_t o represent in generalised sets of rules. DeciSIOns pertaining to the selection of subcontr:act?s tender time are usually based on the mtu1t1onand past experience of construction estimators. Case-based reasoning (CBR may be an appropriate method of addressing the chal_lenges of selecting subcontractors because CBR 1s able to harness the experiential knowledge of practitioners. This paper reviews the practicality and suitability of a CBR approach for subcontractor tender selection through the development of a prototype CBR procurement advisory system. In this system, subcontractor selection cases are represented by a set of attributes elicited from experienced construction estimators. The results indicate that CBR can enhance the appropriateness of the selection of subcontractors for construction projects.

  12. Cooperative Technique Based on Sensor Selection in Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    ISLAM, M. R.

    2009-02-01

    Full Text Available An energy efficient cooperative technique is proposed for the IEEE 1451 based Wireless Sensor Networks. Selected numbers of Wireless Transducer Interface Modules (WTIMs are used to form a Multiple Input Single Output (MISO structure wirelessly connected with a Network Capable Application Processor (NCAP. Energy efficiency and delay of the proposed architecture are derived for different combination of cluster size and selected number of WTIMs. Optimized constellation parameters are used for evaluating derived parameters. The results show that the selected MISO structure outperforms the unselected MISO structure and it shows energy efficient performance than SISO structure after a certain distance.

  13. Effectiveness of L2 spinal nerve infiltration for selective discogenic low back pain patients

    International Nuclear Information System (INIS)

    Ohtori, Seiji; Nakamura, Shinichiro; Koshi, Takana

    2010-01-01

    It has been reported that rat L5/6 lumbar discs are innervated mainly by L2 dorsal root ganglion neurons. We previously reported that L2 spinal nerve infiltration was effective for discogenic low back pain (DLBP) patients, although the diagnosis was based only on the results of physical examination, plain films, and magnetic resonance imaging (MRI). The purpose of the current study was to evaluate L2 spinal nerve block for DLBP patients retrospectively based on MRI findings and surgical results. A total of 62 patients with only LBP and no accompanying radicular pain were investigated. Patients had only one level of disc degeneration on MRI. When pain was provoked during discography, we performed surgery at the next stage (40 patients). In all, 22 patients were excluded owing to negative discography results. Of the 40 patients, we evaluated 25 strictly selected patients suffering from DLBP. DLBP was diagnosed when the patient experienced pain relief at least 2 years after anterior lumbar interbody fusion. Fifteen patients who did not show pain relief after surgery were used for the non-DLBP group. L2 spinal nerve infiltration using 1.5 ml of lidocaine was performed in all 40 patients before surgery. The visual analogue scale (VAS) score after L2 spinal nerve infiltration was recorded, and an association of L2 spinal nerve infiltration and DLBP was explored. Low back pain scores assessed using the VAS score, the Japanese Orthopedic Association score, and the Oswestry Disability Index score in the two groups were not significantly different. L2 spinal nerve infiltration was effective for 27 patients but not effective for 13 patients; the VAS score after 15 min and 2 h improved in the DLBP group compared with that of the non-DLBP group (P<0.05). L2 spinal nerve infiltration was more effective in DLBP patients (21 patients, 84%) than in the non-DLBP group (6 patients, 40%) (P<0.05). In the current study, L2 spinal nerve infiltration was effective in 84% of selected DLBP

  14. Selected antibacterial factors in the saliva of diabetic patients.

    Science.gov (United States)

    Malicka, Barbara; Kaczmarek, Urszula; Skośkiewicz-Malinowska, Katarzyna

    2015-03-01

    Diabetes mellitus leads to many systemic complications, including changes in the morphology, function of the salivary glands, and the composition of saliva. The study comprised a randomly selected 156 adults, of both genders, aged from 21 to 79, out of which patients with diabetes type 1 and 2, and healthy subjects forming two control age- and gender matched to the ill subjects. In unstimulated mixed saliva, total protein, peroxidase, myeloperoxidase and immunoglobulin A were measured as well as salivary flow rate. The periodontal condition was assessed with the use of GI, mSBI and PSR index. The obtained data were analysed with the use of U Mann-Whitney's test, Spearman's rang correlation and Chi-square test at a significant level of p diabetics in comparison to healthy age and gender matched control group had a lower salivary flow rate (p diabetics in comparison to control subjects had a higher level of total protein concentration (p diabetes type 1 and 2 can cause abnormalities in salivary glands function resulting in the diminishing of salivary flow rate and the increase in total protein content. Higher levels of myeloperoxidase and IgA in the saliva can be linked to worse periodontal condition in the diabetic patients. Copyright © 2014. Published by Elsevier Ltd.

  15. Clinical Decision Support Tools for Selecting Interventions for Patients with Disabling Musculoskeletal Disorders

    DEFF Research Database (Denmark)

    Gross, Douglas P; Armijo-Olivo, Susan; Shaw, William S

    2016-01-01

    Purpose We aimed to identify and inventory clinical decision support (CDS) tools for helping front-line staff select interventions for patients with musculoskeletal (MSK) disorders. Methods We used Arksey and O'Malley's scoping review framework which progresses through five stages: (1) identifying...... the research question; (2) identifying relevant studies; (3) selecting studies for analysis; (4) charting the data; and (5) collating, summarizing and reporting results. We considered computer-based, and other available tools, such as algorithms, care pathways, rules and models. Since this research crosses...

  16. Knowledge based expert system approach to instrumentation selection (INSEL

    Directory of Open Access Journals (Sweden)

    S. Barai

    2004-08-01

    Full Text Available The selection of appropriate instrumentation for any structural measurement of civil engineering structure is a complex task. Recent developments in Artificial Intelligence (AI can help in an organized use of experiential knowledge available on instrumentation for laboratory and in-situ measurement. Usually, the instrumentation decision is based on the experience and judgment of experimentalists. The heuristic knowledge available for different types of measurement is domain dependent and the information is scattered in varied knowledge sources. The knowledge engineering techniques can help in capturing the experiential knowledge. This paper demonstrates a prototype knowledge based system for INstrument SELection (INSEL assistant where the experiential knowledge for various structural domains can be captured and utilized for making instrumentation decision. In particular, this Knowledge Based Expert System (KBES encodes the heuristics on measurement and demonstrates the instrument selection process with reference to steel bridges. INSEL runs on a microcomputer and uses an INSIGHT 2+ environment.

  17. Diversified models for portfolio selection based on uncertain semivariance

    Science.gov (United States)

    Chen, Lin; Peng, Jin; Zhang, Bo; Rosyida, Isnaini

    2017-02-01

    Since the financial markets are complex, sometimes the future security returns are represented mainly based on experts' estimations due to lack of historical data. This paper proposes a semivariance method for diversified portfolio selection, in which the security returns are given subjective to experts' estimations and depicted as uncertain variables. In the paper, three properties of the semivariance of uncertain variables are verified. Based on the concept of semivariance of uncertain variables, two types of mean-semivariance diversified models for uncertain portfolio selection are proposed. Since the models are complex, a hybrid intelligent algorithm which is based on 99-method and genetic algorithm is designed to solve the models. In this hybrid intelligent algorithm, 99-method is applied to compute the expected value and semivariance of uncertain variables, and genetic algorithm is employed to seek the best allocation plan for portfolio selection. At last, several numerical examples are presented to illustrate the modelling idea and the effectiveness of the algorithm.

  18. Bevacizumab in the treatment of NSCLC: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Russo AE

    2017-12-01

    well tolerated even in those patients subpopulations excluded from pivotal trials. This review outlines the current state-of-the-art on bev use in advanced NSCLC. It also describes patient selection and future perspectives on this antiangiogenic agent. Keywords: bevacizumab, nonsquamous NSCLC, eligibility, safety, subpopulations 

  19. Performance-Based Technology Selection Filter description report

    International Nuclear Information System (INIS)

    O'Brien, M.C.; Morrison, J.L.; Morneau, R.A.; Rudin, M.J.; Richardson, J.G.

    1992-05-01

    A formal methodology has been developed for identifying technology gaps and assessing innovative or postulated technologies for inclusion in proposed Buried Waste Integrated Demonstration (BWID) remediation systems. Called the Performance-Based Technology Selection Filter, the methodology provides a formalized selection process where technologies and systems are rated and assessments made based on performance measures, and regulatory and technical requirements. The results are auditable, and can be validated with field data. This analysis methodology will be applied to the remedial action of transuranic contaminated waste pits and trenches buried at the Idaho National Engineering Laboratory (INEL)

  20. Performance-Based Technology Selection Filter description report

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, M.C.; Morrison, J.L.; Morneau, R.A.; Rudin, M.J.; Richardson, J.G.

    1992-05-01

    A formal methodology has been developed for identifying technology gaps and assessing innovative or postulated technologies for inclusion in proposed Buried Waste Integrated Demonstration (BWID) remediation systems. Called the Performance-Based Technology Selection Filter, the methodology provides a formalized selection process where technologies and systems are rated and assessments made based on performance measures, and regulatory and technical requirements. The results are auditable, and can be validated with field data. This analysis methodology will be applied to the remedial action of transuranic contaminated waste pits and trenches buried at the Idaho National Engineering Laboratory (INEL).

  1. The sequence relay selection strategy based on stochastic dynamic programming

    Science.gov (United States)

    Zhu, Rui; Chen, Xihao; Huang, Yangchao

    2017-07-01

    Relay-assisted (RA) network with relay node selection is a kind of effective method to improve the channel capacity and convergence performance. However, most of the existing researches about the relay selection did not consider the statically channel state information and the selection cost. This shortage limited the performance and application of RA network in practical scenarios. In order to overcome this drawback, a sequence relay selection strategy (SRSS) was proposed. And the performance upper bound of SRSS was also analyzed in this paper. Furthermore, in order to make SRSS more practical, a novel threshold determination algorithm based on the stochastic dynamic program (SDP) was given to work with SRSS. Numerical results are also presented to exhibit the performance of SRSS with SDP.

  2. 42 CFR 482.90 - Condition of participation: Patient and living donor selection.

    Science.gov (United States)

    2010-10-01

    ... selected to receive a transplant, the center must document in the patient's medical record the patient... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Patient and living... Condition of participation: Patient and living donor selection. The transplant center must use written...

  3. Making evidence-based selections of influenza vaccines

    OpenAIRE

    Childress, Billy-Clyde; Montney, Joshua D; Albro, Elise A

    2014-01-01

    Years ago, intramuscular influenza vaccines were the only option for those who wanted to arm themselves against the flu. Today there are alternatives, including intradermal injections and intranasal sprays. In order to select the right influenza vaccine for their patients, pharmacists, and other healthcare professionals must have a basic understanding of the immune system. Influenza vaccines elicit different levels of immune response involving innate and adaptive immunity, which are critical ...

  4. Minimal gene selection for classification and diagnosis prediction based on gene expression profile

    Directory of Open Access Journals (Sweden)

    Alireza Mehridehnavi

    2013-01-01

    Conclusion: We have shown that the use of two most significant genes based on their S/N ratios and selection of suitable training samples can lead to classify DLBCL patients with a rather good result. Actually with the aid of mentioned methods we could compensate lack of enough number of patients, improve accuracy of classifying and reduce complication of computations and so running time.

  5. Attribute based selection of thermoplastic resin for vacuum infusion process

    DEFF Research Database (Denmark)

    Prabhakaran, R.T. Durai; Lystrup, Aage; Løgstrup Andersen, Tom

    2011-01-01

    The composite industry looks toward a new material system (resins) based on thermoplastic polymers for the vacuum infusion process, similar to the infusion process using thermosetting polymers. A large number of thermoplastics are available in the market with a variety of properties suitable...... for different engineering applications, and few of those are available in a not yet polymerised form suitable for resin infusion. The proper selection of a new resin system among these thermoplastic polymers is a concern for manufactures in the current scenario and a special mathematical tool would...... be beneficial. In this paper, the authors introduce a new decision making tool for resin selection based on significant attributes. This article provides a broad overview of suitable thermoplastic material systems for vacuum infusion process available in today’s market. An illustrative example—resin selection...

  6. [Electroencephalogram Feature Selection Based on Correlation Coefficient Analysis].

    Science.gov (United States)

    Zhou, Jinzhi; Tang, Xiaofang

    2015-08-01

    In order to improve the accuracy of classification with small amount of motor imagery training data on the development of brain-computer interface (BCD systems, we proposed an analyzing method to automatically select the characteristic parameters based on correlation coefficient analysis. Throughout the five sample data of dataset IV a from 2005 BCI Competition, we utilized short-time Fourier transform (STFT) and correlation coefficient calculation to reduce the number of primitive electroencephalogram dimension, then introduced feature extraction based on common spatial pattern (CSP) and classified by linear discriminant analysis (LDA). Simulation results showed that the average rate of classification accuracy could be improved by using correlation coefficient feature selection method than those without using this algorithm. Comparing with support vector machine (SVM) optimization features algorithm, the correlation coefficient analysis can lead better selection parameters to improve the accuracy of classification.

  7. An opinion formation based binary optimization approach for feature selection

    Science.gov (United States)

    Hamedmoghadam, Homayoun; Jalili, Mahdi; Yu, Xinghuo

    2018-02-01

    This paper proposed a novel optimization method based on opinion formation in complex network systems. The proposed optimization technique mimics human-human interaction mechanism based on a mathematical model derived from social sciences. Our method encodes a subset of selected features to the opinion of an artificial agent and simulates the opinion formation process among a population of agents to solve the feature selection problem. The agents interact using an underlying interaction network structure and get into consensus in their opinions, while finding better solutions to the problem. A number of mechanisms are employed to avoid getting trapped in local minima. We compare the performance of the proposed method with a number of classical population-based optimization methods and a state-of-the-art opinion formation based method. Our experiments on a number of high dimensional datasets reveal outperformance of the proposed algorithm over others.

  8. Dose selection based on physiologically based pharmacokinetic (PBPK) approaches.

    Science.gov (United States)

    Jones, Hannah M; Mayawala, Kapil; Poulin, Patrick

    2013-04-01

    Physiologically based pharmacokinetic (PBPK) models are built using differential equations to describe the physiology/anatomy of different biological systems. Readily available in vitro and in vivo preclinical data can be incorporated into these models to not only estimate pharmacokinetic (PK) parameters and plasma concentration-time profiles, but also to gain mechanistic insight into compound properties. They provide a mechanistic framework to understand and extrapolate PK and dose across in vitro and in vivo systems and across different species, populations and disease states. Using small molecule and large molecule examples from the literature and our own company, we have shown how PBPK techniques can be utilised for human PK and dose prediction. Such approaches have the potential to increase efficiency, reduce the need for animal studies, replace clinical trials and increase PK understanding. Given the mechanistic nature of these models, the future use of PBPK modelling in drug discovery and development is promising, however some limitations need to be addressed to realise its application and utility more broadly.

  9. Automatic Peak Selection by a Benjamini-Hochberg-Based Algorithm

    KAUST Repository

    Abbas, Ahmed; Kong, Xin-Bing; Liu, Zhi; Jing, Bing-Yi; Gao, Xin

    2013-01-01

    A common issue in bioinformatics is that computational methods often generate a large number of predictions sorted according to certain confidence scores. A key problem is then determining how many predictions must be selected to include most of the true predictions while maintaining reasonably high precision. In nuclear magnetic resonance (NMR)-based protein structure determination, for instance, computational peak picking methods are becoming more and more common, although expert-knowledge remains the method of choice to determine how many peaks among thousands of candidate peaks should be taken into consideration to capture the true peaks. Here, we propose a Benjamini-Hochberg (B-H)-based approach that automatically selects the number of peaks. We formulate the peak selection problem as a multiple testing problem. Given a candidate peak list sorted by either volumes or intensities, we first convert the peaks into p-values and then apply the B-H-based algorithm to automatically select the number of peaks. The proposed approach is tested on the state-of-the-art peak picking methods, including WaVPeak [1] and PICKY [2]. Compared with the traditional fixed number-based approach, our approach returns significantly more true peaks. For instance, by combining WaVPeak or PICKY with the proposed method, the missing peak rates are on average reduced by 20% and 26%, respectively, in a benchmark set of 32 spectra extracted from eight proteins. The consensus of the B-H-selected peaks from both WaVPeak and PICKY achieves 88% recall and 83% precision, which significantly outperforms each individual method and the consensus method without using the B-H algorithm. The proposed method can be used as a standard procedure for any peak picking method and straightforwardly applied to some other prediction selection problems in bioinformatics. The source code, documentation and example data of the proposed method is available at http://sfb.kaust.edu.sa/pages/software.aspx. © 2013

  10. Automatic Peak Selection by a Benjamini-Hochberg-Based Algorithm

    KAUST Repository

    Abbas, Ahmed

    2013-01-07

    A common issue in bioinformatics is that computational methods often generate a large number of predictions sorted according to certain confidence scores. A key problem is then determining how many predictions must be selected to include most of the true predictions while maintaining reasonably high precision. In nuclear magnetic resonance (NMR)-based protein structure determination, for instance, computational peak picking methods are becoming more and more common, although expert-knowledge remains the method of choice to determine how many peaks among thousands of candidate peaks should be taken into consideration to capture the true peaks. Here, we propose a Benjamini-Hochberg (B-H)-based approach that automatically selects the number of peaks. We formulate the peak selection problem as a multiple testing problem. Given a candidate peak list sorted by either volumes or intensities, we first convert the peaks into p-values and then apply the B-H-based algorithm to automatically select the number of peaks. The proposed approach is tested on the state-of-the-art peak picking methods, including WaVPeak [1] and PICKY [2]. Compared with the traditional fixed number-based approach, our approach returns significantly more true peaks. For instance, by combining WaVPeak or PICKY with the proposed method, the missing peak rates are on average reduced by 20% and 26%, respectively, in a benchmark set of 32 spectra extracted from eight proteins. The consensus of the B-H-selected peaks from both WaVPeak and PICKY achieves 88% recall and 83% precision, which significantly outperforms each individual method and the consensus method without using the B-H algorithm. The proposed method can be used as a standard procedure for any peak picking method and straightforwardly applied to some other prediction selection problems in bioinformatics. The source code, documentation and example data of the proposed method is available at http://sfb.kaust.edu.sa/pages/software.aspx. © 2013

  11. Automatic learning-based beam angle selection for thoracic IMRT

    International Nuclear Information System (INIS)

    Amit, Guy; Marshall, Andrea; Purdie, Thomas G.; Jaffray, David A.; Levinshtein, Alex; Hope, Andrew J.; Lindsay, Patricia; Pekar, Vladimir

    2015-01-01

    Purpose: The treatment of thoracic cancer using external beam radiation requires an optimal selection of the radiation beam directions to ensure effective coverage of the target volume and to avoid unnecessary treatment of normal healthy tissues. Intensity modulated radiation therapy (IMRT) planning is a lengthy process, which requires the planner to iterate between choosing beam angles, specifying dose–volume objectives and executing IMRT optimization. In thorax treatment planning, where there are no class solutions for beam placement, beam angle selection is performed manually, based on the planner’s clinical experience. The purpose of this work is to propose and study a computationally efficient framework that utilizes machine learning to automatically select treatment beam angles. Such a framework may be helpful for reducing the overall planning workload. Methods: The authors introduce an automated beam selection method, based on learning the relationships between beam angles and anatomical features. Using a large set of clinically approved IMRT plans, a random forest regression algorithm is trained to map a multitude of anatomical features into an individual beam score. An optimization scheme is then built to select and adjust the beam angles, considering the learned interbeam dependencies. The validity and quality of the automatically selected beams evaluated using the manually selected beams from the corresponding clinical plans as the ground truth. Results: The analysis included 149 clinically approved thoracic IMRT plans. For a randomly selected test subset of 27 plans, IMRT plans were generated using automatically selected beams and compared to the clinical plans. The comparison of the predicted and the clinical beam angles demonstrated a good average correspondence between the two (angular distance 16.8° ± 10°, correlation 0.75 ± 0.2). The dose distributions of the semiautomatic and clinical plans were equivalent in terms of primary target volume

  12. Discrete Biogeography Based Optimization for Feature Selection in Molecular Signatures.

    Science.gov (United States)

    Liu, Bo; Tian, Meihong; Zhang, Chunhua; Li, Xiangtao

    2015-04-01

    Biomarker discovery from high-dimensional data is a complex task in the development of efficient cancer diagnoses and classification. However, these data are usually redundant and noisy, and only a subset of them present distinct profiles for different classes of samples. Thus, selecting high discriminative genes from gene expression data has become increasingly interesting in the field of bioinformatics. In this paper, a discrete biogeography based optimization is proposed to select the good subset of informative gene relevant to the classification. In the proposed algorithm, firstly, the fisher-markov selector is used to choose fixed number of gene data. Secondly, to make biogeography based optimization suitable for the feature selection problem; discrete migration model and discrete mutation model are proposed to balance the exploration and exploitation ability. Then, discrete biogeography based optimization, as we called DBBO, is proposed by integrating discrete migration model and discrete mutation model. Finally, the DBBO method is used for feature selection, and three classifiers are used as the classifier with the 10 fold cross-validation method. In order to show the effective and efficiency of the algorithm, the proposed algorithm is tested on four breast cancer dataset benchmarks. Comparison with genetic algorithm, particle swarm optimization, differential evolution algorithm and hybrid biogeography based optimization, experimental results demonstrate that the proposed method is better or at least comparable with previous method from literature when considering the quality of the solutions obtained. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Classification and Target Group Selection Based Upon Frequent Patterns

    NARCIS (Netherlands)

    W.H.L.M. Pijls (Wim); R. Potharst (Rob)

    2000-01-01

    textabstractIn this technical report , two new algorithms based upon frequent patterns are proposed. One algorithm is a classification method. The other one is an algorithm for target group selection. In both algorithms, first of all, the collection of frequent patterns in the training set is

  14. Robot soccer action selection based on Q learning

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    This paper researches robot soccer action selection based on Q learning . The robot learn to activate particular behavior given their current situation and reward signal. We adopt neural network to implementations of Q learning for their generalization properties and limited computer memory requirements

  15. Evaporation rate-based selection of supramolecular chirality.

    Science.gov (United States)

    Hattori, Shingo; Vandendriessche, Stefaan; Koeckelberghs, Guy; Verbiest, Thierry; Ishii, Kazuyuki

    2017-03-09

    We demonstrate the evaporation rate-based selection of supramolecular chirality for the first time. P-type aggregates prepared by fast evaporation, and M-type aggregates prepared by slow evaporation are kinetic and thermodynamic products under dynamic reaction conditions, respectively. These findings provide a novel solution reaction chemistry under the dynamic reaction conditions.

  16. Validity of selected cardiovascular field-based test among Malaysian ...

    African Journals Online (AJOL)

    Based on emerge obese problem among Malaysian, this research is formulated to validate published tests among healthy female adult. Selected test namely; 20 meter multi-stage shuttle run, 2.4km run test, 1 mile walk test and Harvard Step test were correlated with laboratory test (Bruce protocol) to find the criterion validity ...

  17. Solar Thermal AIR Collector Based on New Type Selective Coating

    Directory of Open Access Journals (Sweden)

    Musiy, R.Y.

    2014-01-01

    Full Text Available Based on the best for optical performance and selective coating solar thermal air collector, which operates by solar power on the principle of simultaneous ventilation and heating facilities, is designed. It can be used for vacation homes, museums, wooden churches, warehouses, garages, houses, greenhouses etc.

  18. Exposure level from selected base station tower around Kuala Nerus

    African Journals Online (AJOL)

    Health risk due to RF radiation exposure from base station tower (BST) has been debated for years leading to public concerns. Thus, this preliminary study aims to measure, evaluate and analyze the exposure level on three selected BST around Kuala Nerus. The measurement of exposure level in terms of voltage ...

  19. Metabolic complications of endogenous Cushing: patient selection for screening

    Directory of Open Access Journals (Sweden)

    Zh E Belaya

    2013-03-01

    Full Text Available Aims: this study evaluates the most common associations of symptoms and complications in patients with Cushing’s syndrome (CS in order to choose a potential population to be screened for CS and estimates the diagnostic accuracy of first line screening tests (cortisol, ACTH to differentiate ACTH-ectopic CS from Cushing’s disease. Materials and Methods: The clinical data of 259 patients with proven CS during 2001–2011 was analyzed. The clinical presentations of 197 patients (159 Cushing’s disease, 28 ACTH-ectopic CS and 10 cases of benign cortisol-secreting adrenal adenoma were compared according to the cause of hypercortisolism. ROC-analysis was performed to estimate the diagnostic accuracy of the first line tests (cortisol, ACTH to suggest ACTH-ectopic CS. A threshold for the test with the highest area under the curves was chosen based on the maximum sum of the sensitivity and specificity. Results: The most frequent complaints were related to fatigue, muscle weakness, weight gain and changes in appearance (facial plethora and fullness, striae. Among the complications of CS the most frequent were being overweight or obese (71%, hypertension (63%, dislipoproteinemia (41%, low traumatic fractures (43% and steroid-induced diabetes (31%. In women, 16% were older than 50, in those who were younger amenorrhea was registered in 43%. The patients with ACTH-ectopic CS had higher rate of low traumatic fractures (p=0.04, increased serum late-night cortisol, 24 hours urinary free cortisol, morning and evening ACTH and lower levels of potassium (p<0.01 for all parameters. Plasma late-night ACTH measurements showed the highest AUC (0,811 (95% CI 0,712–0,909 to differentiate ACTH-ectopic CS from Cushing’s disease. A cut off value of 108.9 pg/ml for late-night ACTH yielded a sensitivity of 60,7% and a specificity of 79%. Conclusions: patients with a coexistence of obesity, muscle weakness, fatigue, some components of metabolic syndrome and especially

  20. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

    DEFF Research Database (Denmark)

    Kappos, Ludwig; Bates, David; Edan, Gilles

    2011-01-01

    Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very......, based on additional long-term follow-up of clinical studies and post-marketing observations, including appropriate patient selection and management recommendations.......Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...... active disease. The expected benefits of natalizumab treatment have to be weighed against risks, especially the rare but serious adverse event of progressive multifocal leukoencephalopathy. In this Review, we revisit and update previous recommendations on natalizumab for treatment of patients with RRMS...

  1. Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients: a cost-effectiveness analysis.

    Science.gov (United States)

    Oostdijk, Evelien A N; de Wit, G A; Bakker, Marina; de Smet, Anne Marie G A; Bonten, M J M

    2013-03-05

    To determine costs and effects of selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) as compared with standard care (ie, no SDD/SOD (SC)) from a healthcare perspective in Dutch Intensive Care Units (ICUs). A post hoc analysis of a previously performed cluster-randomised trial (NEJM 2009;360:20). 13 Dutch ICUs. Patients with ICU-stay of >48 h that received SDD (n=2045), SOD (n=1904) or SC (n=1990). SDD or SOD. Effects were based on hospital survival, expressed as crude Life Years Gained (cLYG). The incremental cost-effectiveness ratio (ICER) was calculated, with corresponding cost acceptability curves. Sensitivity analyses were performed for discount rates, costs of SDD, SOD and mechanical ventilation. Total costs per patient were €41 941 for SC (95% CI €40 184 to €43 698), €40 433 for SOD (95% CI €38 838 to €42 029) and €41 183 for SOD (95% CI €39 408 to €42 958). SOD and SDD resulted in crude LYG of +0.04 and +0.25, respectively, as compared with SC, implying that both SDD and SOD are dominant (ie, cheaper and more beneficial) over SC. In cost-effectiveness acceptability curves probabilities for cost-effectiveness, compared with standard care, ranged from 89% to 93% for SOD and from 63% to 72% for SDD, for acceptable costs for 1 LYG ranging from €0 to €20 000. Sensitivity analysis for mechanical ventilation and discount rates did not change interpretation. Yet, if costs of the topical component of SDD and SOD would increase 40-fold to €400/day and €40/day (maximum values based on free market prices in 2012), the estimated ICER as compared with SC for SDD would be €21 590 per LYG. SOD would remain cost-saving. SDD and SOD were both effective and cost-saving in Dutch ICUs.

  2. FDG-PET improves the staging and selection of patients with recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Lonneux, Max; Reffad, Abdel-Malek; Pauwels, Stanislas; Detry, Roger; Kartheuser, Alex; Gigot, Jean-Francois

    2002-01-01

    Whole-body fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has proved effective in the diagnosis and staging of recurrent colorectal cancer. In this study, we analysed how PET affects the management of patients with recurrent colorectal cancer by permitting more accurate selection of candidates for curative resection. The data of 79 patients with known or suspected recurrent colorectal cancer were analysed. Conventional imaging modalities (CIM) and PET results were compared with regard to their accuracy in determining the extent and the resectability of tumour recurrence. Recurrence was demonstrated in 68 of the 79 patients. The data indicate that PET was superior to CIM for detection of recurrence at all sites except the liver. Based on the CIM+PET staging, surgery with curative intent was proposed in 39 patients and was indeed achieved in 31 of them (80%). PET was more accurate than CIM alone in predicting the resectability or non-resectability of the recurrence (82% vs 68%, P=0.02). It is concluded that whole-body FDG-PET is highly sensitive for both the diagnosis and the staging of patients with recurrent colorectal cancer. Its use in conjunction with conventional imaging procedures results in a more accurate selection of patients for surgical treatment with curative intent. (orig.)

  3. Transmit antenna selection based on shadowing side information

    KAUST Repository

    Yilmaz, Ferkan

    2011-05-01

    In this paper, we propose a new transmit antenna selection scheme based on shadowing side information. In the proposed scheme, single transmit antenna which has the highest shadowing coefficient is selected. By the proposed technique, usage of the feedback channel and channel estimation complexity at the receiver can be reduced. We consider independent but not identically distributed Generalized-K composite fading model, which is a general composite fading & shadowing channel model for wireless environments. Exact closed-form outage probability, moment generating function and symbol error probability expressions are derived. In addition, theoretical performance results are validated by Monte Carlo simulations. © 2011 IEEE.

  4. Transmit antenna selection based on shadowing side information

    KAUST Repository

    Yilmaz, Ferkan; Yilmaz, Ahmet Oǧuz; Alouini, Mohamed-Slim; Kucur, Oǧuz

    2011-01-01

    In this paper, we propose a new transmit antenna selection scheme based on shadowing side information. In the proposed scheme, single transmit antenna which has the highest shadowing coefficient is selected. By the proposed technique, usage of the feedback channel and channel estimation complexity at the receiver can be reduced. We consider independent but not identically distributed Generalized-K composite fading model, which is a general composite fading & shadowing channel model for wireless environments. Exact closed-form outage probability, moment generating function and symbol error probability expressions are derived. In addition, theoretical performance results are validated by Monte Carlo simulations. © 2011 IEEE.

  5. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Francisco Flávio Costa Filho

    2015-11-01

    Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

  6. Numerical Model based Reliability Estimation of Selective Laser Melting Process

    DEFF Research Database (Denmark)

    Mohanty, Sankhya; Hattel, Jesper Henri

    2014-01-01

    Selective laser melting is developing into a standard manufacturing technology with applications in various sectors. However, the process is still far from being at par with conventional processes such as welding and casting, the primary reason of which is the unreliability of the process. While...... of the selective laser melting process. A validated 3D finite-volume alternating-direction-implicit numerical technique is used to model the selective laser melting process, and is calibrated against results from single track formation experiments. Correlation coefficients are determined for process input...... parameters such as laser power, speed, beam profile, etc. Subsequently, uncertainties in the processing parameters are utilized to predict a range for the various outputs, using a Monte Carlo method based uncertainty analysis methodology, and the reliability of the process is established....

  7. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

    Directory of Open Access Journals (Sweden)

    Yen-Hsuan Hsu

    2015-06-01

    Conclusion: Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state.

  8. Improved targeted immunization strategies based on two rounds of selection

    Science.gov (United States)

    Xia, Ling-Ling; Song, Yu-Rong; Li, Chan-Chan; Jiang, Guo-Ping

    2018-04-01

    In the case of high degree targeted immunization where the number of vaccine is limited, when more than one node associated with the same degree meets the requirement of high degree centrality, how can we choose a certain number of nodes from those nodes, so that the number of immunized nodes will not exceed the limit? In this paper, we introduce a new idea derived from the selection process of second-round exam to solve this problem and then propose three improved targeted immunization strategies. In these proposed strategies, the immunized nodes are selected through two rounds of selection, where we increase the quotas of first-round selection according the evaluation criterion of degree centrality and then consider another characteristic parameter of node, such as node's clustering coefficient, betweenness and closeness, to help choose targeted nodes in the second-round selection. To validate the effectiveness of the proposed strategies, we compare them with the degree immunizations including the high degree targeted and the high degree adaptive immunizations using two metrics: the size of the largest connected component of immunized network and the number of infected nodes. Simulation results demonstrate that the proposed strategies based on two rounds of sorting are effective for heterogeneous networks and their immunization effects are better than that of the degree immunizations.

  9. Is selective internal radioembolization safe and effective for patients with inoperable hepatocellular carcinoma and venous thrombosis?

    Science.gov (United States)

    Woodall, Charles E; Scoggins, Charles R; Ellis, Susan F; Tatum, Clifton M; Hahl, Michael J; Ravindra, Kadiyala V; McMasters, Kelly M; Martin, Robert C G

    2009-03-01

    The goal of this study was to examine the safety and efficacy of selective internal radioembolization (SIR) for hepatocellular carcinoma (HCC) with portal vein or caval thrombosis (VT), or both. Recent reports have demonstrated that SIR is safe for patients with HCC, but the impact on efficacy of venous thrombosis is unknown. Prospective single-arm study of the use of Therasphere in patients with unresectable HCC enrolled from January 2004 to June 2007. Patients were categorized into three groups based on VT status and therapy. Fifty-two patients were enrolled: 20 patients without VT who received SIR, 15 patients with VT who were treated, and 17 patients (10 with VT) who were not treated because of preprocedure screening failure. Fifty-eight treatments were administered, with a median of two treatments per patient (range of one to three treatments). Child's score was different between groups. Of the VT patients treated, 67% had portal VT, 7% had cava VT, and 26% had both. There were no treatment-related deaths. There was no difference in complications among groups (p = 0.34). Treated patients without thrombosis had a median overall survival of 13.9 months versus 2.7 months for those treated with thrombosis and 5.2 months for the untreated group given best supportive care only (p = 0.01). SIR is safe in patients with HCC. Although SIR can be delivered with minimal morbidity, there might be no benefit for patients with VT. Continued emphasis on multimodality therapy in this population is needed to improve survival.

  10. Verbal learning and memory outcome in selective amygdalohippocampectomy versus temporal lobe resection in patients with hippocampal sclerosis

    DEFF Research Database (Denmark)

    Foged, Mette Thrane; Vinter, Kirsten; Stauning, Louise

    2018-01-01

    1995 and 2009 in Denmark. Exclusion criteria are the following: Intelligence below normal range, right hemisphere dominance, other native languages than Danish, dual pathology, and missing follow-up data. Thus, 56 patients were analyzed. The patients were allocated to SAH (n = 22) or TLR (n = 34) based...... resonance imaging (MRI) signs of dual pathology, selective amygdalohippocampectomy results in sustained seizure freedom and better memory function compared with patients operated with nonselective temporal lobe resection....

  11. [The role of magnetic resonance imaging to select patients for preoperative treatment in rectal cancer].

    Science.gov (United States)

    Rödel, Claus; Sauer, Rolf; Fietkau, Rainer

    2009-08-01

    Traditionally, the decision to apply preoperative treatment for rectal cancer patients has been based on the T- and N-category. Recently, the radial distance of the tumor to the circumferential resection margin (CRM) has been identified as an important risk factor for local failure. By magnetic resonance imaging (MRI) this distance can be measured preoperatively with high reliability. Thus, selected groups have started to limit the indication for preoperative therapy to tumors extending to - or growing within 1 mm from - the mesorectal fascia (CRM+). Pros and cons of this selected approach for preoperative treatment and first clinical results are presented. Prerequisites are the availability of modern high-resolution thin-section MRI technology as well as strict quality control of MRI and surgical quality of total mesorectal excision (TME). By selecting patients with CRM-positive tumors on MRI for preoperative therapy, only approximately 35% patients will require preoperative radiotherapy (RT) or radiochemotherapy (RCT). However, with histopathologic work-up of the resected specimen after primary surgery, the indication for postoperative RCT is given for a rather large percentage of patients, i.e., for pCRM+ (5-10%), intramesorectal or intramural excision (30-40%), pN+ (30-40%). Postoperative RCT, however, is significantly less effective and more toxic than preoperative RCT. A further point of concern is the assertion that patients, in whom a CRM-negative status is achieved by surgery alone, do not benefit from additional RT. Data of the Dutch TME trial and the British MRC (Medical Research Council) CR07 trial, however, suggest the reverse. To omit preoperative RT/RCT for CRM-negative tumors on MRI needs to be further investigated in prospective clinical trials. The German guidelines for the treatment of colorectal cancer 2008 continue to indicate preoperative RT/RCT based on the T- and N-category.

  12. The role of magnetic resonance imaging to select patients for preoperative treatment in rectal cancer

    International Nuclear Information System (INIS)

    Roedel, Claus; Sauer, Rolf; Fietkau, Rainer

    2009-01-01

    Background: Traditionally, the decision to apply preoperative treatment for rectal cancer patients has been based on the T- and N-category. Recently, the radial distance of the tumor to the circumferential resection margin (CRM) has been identified as an important risk factor for local failure. By magnetic resonance imaging (MRI) this distance can be measured preoperatively with high reliability. Thus, selected groups have started to limit the indication for preoperative therapy to tumors extending to - or growing within 1 mm from - the mesorectal fascia (CRM+). Methods: Pros and cons of this selected approach for preoperative treatment and first clinical results are presented. Prerequisites are the availability of modern high-resolution thin-section MRI technology as well as strict quality control of MRI and surgical quality of total mesorectal excision (TME). Results: By selecting patients with CRM-positive tumors on MRI for preoperative therapy, only approximately 35% patients will require preoperative radiotherapy (RT) or radiochemotherapy (RCT). However, with histopathologic work-up of the resected specimen after primary surgery, the indication for postoperative RCT is given for a rather large percentage of patients, i.e., for pCRM+ (5-10%), intramesorectal or intramural excision (30-40%), pN+ (30-40%). Postoperative RCT, however, is significantly less effective and more toxic than preoperative RCT. A further point of concern is the assertion that patients, in whom a CRM-negative status is achieved by surgery alone, do not benefit from additional RT. Data of the Dutch TME trial and the British MRC (Medical Research Council) CR07 trial, however, suggest the reverse. Conclusion: To omit preoperative RT/RCT for CRM-negative tumors on MRI needs to be further investigated in prospective clinical trials. The German guidelines for the treatment of colorectal cancer 2008 continue to indicate preoperative RT/RCT based on the T- and N-category. (orig.)

  13. Survival Prediction and Feature Selection in Patients with Breast Cancer Using Support Vector Regression

    Directory of Open Access Journals (Sweden)

    Shahrbanoo Goli

    2016-01-01

    Full Text Available The Support Vector Regression (SVR model has been broadly used for response prediction. However, few researchers have used SVR for survival analysis. In this study, a new SVR model is proposed and SVR with different kernels and the traditional Cox model are trained. The models are compared based on different performance measures. We also select the best subset of features using three feature selection methods: combination of SVR and statistical tests, univariate feature selection based on concordance index, and recursive feature elimination. The evaluations are performed using available medical datasets and also a Breast Cancer (BC dataset consisting of 573 patients who visited the Oncology Clinic of Hamadan province in Iran. Results show that, for the BC dataset, survival time can be predicted more accurately by linear SVR than nonlinear SVR. Based on the three feature selection methods, metastasis status, progesterone receptor status, and human epidermal growth factor receptor 2 status are the best features associated to survival. Also, according to the obtained results, performance of linear and nonlinear kernels is comparable. The proposed SVR model performs similar to or slightly better than other models. Also, SVR performs similar to or better than Cox when all features are included in model.

  14. Uniform design based SVM model selection for face recognition

    Science.gov (United States)

    Li, Weihong; Liu, Lijuan; Gong, Weiguo

    2010-02-01

    Support vector machine (SVM) has been proved to be a powerful tool for face recognition. The generalization capacity of SVM depends on the model with optimal hyperparameters. The computational cost of SVM model selection results in application difficulty in face recognition. In order to overcome the shortcoming, we utilize the advantage of uniform design--space filling designs and uniformly scattering theory to seek for optimal SVM hyperparameters. Then we propose a face recognition scheme based on SVM with optimal model which obtained by replacing the grid and gradient-based method with uniform design. The experimental results on Yale and PIE face databases show that the proposed method significantly improves the efficiency of SVM model selection.

  15. NetProt: Complex-based Feature Selection.

    Science.gov (United States)

    Goh, Wilson Wen Bin; Wong, Limsoon

    2017-08-04

    Protein complex-based feature selection (PCBFS) provides unparalleled reproducibility with high phenotypic relevance on proteomics data. Currently, there are five PCBFS paradigms, but not all representative methods have been implemented or made readily available. To allow general users to take advantage of these methods, we developed the R-package NetProt, which provides implementations of representative feature-selection methods. NetProt also provides methods for generating simulated differential data and generating pseudocomplexes for complex-based performance benchmarking. The NetProt open source R package is available for download from https://github.com/gohwils/NetProt/releases/ , and online documentation is available at http://rpubs.com/gohwils/204259 .

  16. Selected correlates of white nursing students' attitudes toward black American patients.

    Science.gov (United States)

    Morgan, B S

    1983-01-01

    Multivariate analyses were used to examine the relationships between white nursing students' attitudes toward black American patients and variables selected within a theoretical framework of prejudice which included socialization factors and personality-based factors. The variables selected were: authoritarianism and self-esteem (personality-based factors), parents' attitudes toward black Americans, peer attitudes toward black Americans, interracial contact and socioeconomic status (socialization factors). The study also examined the differences in the relationship among white nursing students enrolled in baccalaureate degree, associate degree and diploma nursing programs. Data were collected from 201 senior nursing students enrolled in the three types of nursing programs in Rhode Island during the late fall and winter of 1979-1980. Although baccalaureate degree, associate degree and diploma students were similar in terms of peer attitudes toward black Americans, fathers' attitudes toward black Americans, self-esteem and attitudes toward black American patients, they were significantly different in terms of age, socioeconomic status, mothers' attitudes toward black Americans, interracial contact and authoritarianism. The major findings of this study indicate that the socialization explanation of prejudice is more significant than the personality-based explanation. The variables socioeconomic status, interracial contact and peer attitudes toward black Americans (all socialization variables) accounted for 22.0% of the total variance in attitudes toward black American patients for the total sample of nursing students. However, this relationship was not generalizable across the three different types of nursing programs.

  17. Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Gärtner, Rune; Cronin-Fenton, Deirdre; Hundborg, Heidi Holmager

    2010-01-01

    Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association.......Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association....

  18. Attention-based Memory Selection Recurrent Network for Language Modeling

    OpenAIRE

    Liu, Da-Rong; Chuang, Shun-Po; Lee, Hung-yi

    2016-01-01

    Recurrent neural networks (RNNs) have achieved great success in language modeling. However, since the RNNs have fixed size of memory, their memory cannot store all the information about the words it have seen before in the sentence, and thus the useful long-term information may be ignored when predicting the next words. In this paper, we propose Attention-based Memory Selection Recurrent Network (AMSRN), in which the model can review the information stored in the memory at each previous time ...

  19. Risk-based audit selection of dairy farms.

    Science.gov (United States)

    van Asseldonk, M A P M; Velthuis, A G J

    2014-02-01

    Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process standards. To select farms for an audit that present higher risks, a statistical analysis was conducted to test the relationship between the outcome of farm audits and bulk milk laboratory results before the audit. The analysis comprised 28,358 farm audits and all conducted laboratory tests of bulk milk samples 12 mo before the audit. The overall outcome of each farm audit was classified as approved or rejected. Laboratory results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acids (FFA), and cleanliness of the milk (CLN). The bulk milk laboratory results were significantly related to audit outcomes. Rejected audits are likely to occur on dairy farms with higher mean levels of SCC, TBC, ADR, and BAB. Moreover, in a multivariable model, maxima for TBC, SCC, and FPD as well as standard deviations for TBC and FPD are risk factors for negative audit outcomes. The efficiency curve of a risk-based selection approach, on the basis of the derived regression results, dominated the current random selection approach. To capture 25, 50, or 75% of the population with poor process standards (i.e., audit outcome of rejected), respectively, only 8, 20, or 47% of the population had to be sampled based on a risk-based selection approach. Milk quality information can thus be used to preselect high-risk farms to be audited more frequently. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  20. Development of a thermodynamic data base for selected heavy metals

    International Nuclear Information System (INIS)

    Hageman, Sven; Scharge, Tina; Willms, Thomas

    2015-07-01

    The report on the development of a thermodynamic data base for selected heavy metals covers the description of experimental methods, the thermodynamic model for chromate, the thermodynamic model for dichromate, the thermodynamic model for manganese (II), the thermodynamic model for cobalt, the thermodynamic model for nickel, the thermodynamic model for copper (I), the thermodynamic model for copper(II), the thermodynamic model for mercury (0) and mercury (I), the thermodynamic model for mercury (III), the thermodynamic model for arsenate.

  1. The effect of morphometric atlas selection on multi-atlas-based automatic brachial plexus segmentation

    International Nuclear Information System (INIS)

    Van de Velde, Joris; Wouters, Johan; Vercauteren, Tom; De Gersem, Werner; Achten, Eric; De Neve, Wilfried; Van Hoof, Tom

    2015-01-01

    The present study aimed to measure the effect of a morphometric atlas selection strategy on the accuracy of multi-atlas-based BP autosegmentation using the commercially available software package ADMIRE® and to determine the optimal number of selected atlases to use. Autosegmentation accuracy was measured by comparing all generated automatic BP segmentations with anatomically validated gold standard segmentations that were developed using cadavers. Twelve cadaver computed tomography (CT) atlases were included in the study. One atlas was selected as a patient in ADMIRE®, and multi-atlas-based BP autosegmentation was first performed with a group of morphometrically preselected atlases. In this group, the atlases were selected on the basis of similarity in the shoulder protraction position with the patient. The number of selected atlases used started at two and increased up to eight. Subsequently, a group of randomly chosen, non-selected atlases were taken. In this second group, every possible combination of 2 to 8 random atlases was used for multi-atlas-based BP autosegmentation. For both groups, the average Dice similarity coefficient (DSC), Jaccard index (JI) and Inclusion index (INI) were calculated, measuring the similarity of the generated automatic BP segmentations and the gold standard segmentation. Similarity indices of both groups were compared using an independent sample t-test, and the optimal number of selected atlases was investigated using an equivalence trial. For each number of atlases, average similarity indices of the morphometrically selected atlas group were significantly higher than the random group (p < 0,05). In this study, the highest similarity indices were achieved using multi-atlas autosegmentation with 6 selected atlases (average DSC = 0,598; average JI = 0,434; average INI = 0,733). Morphometric atlas selection on the basis of the protraction position of the patient significantly improves multi-atlas-based BP autosegmentation accuracy

  2. Appropriateness guidelines and predictive rules to select patients for upper endoscopy: a nationwide multicenter study.

    Science.gov (United States)

    Buri, Luigi; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria Antonietta; Cipolletta, Livio; Di Giulio, Emilio; Di Matteo, Giovanni; Familiari, Luigi; Ficano, Leonardo; Loriga, Pietro; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Intraligi, Marco; Buscema, Massimo

    2010-06-01

    Selecting patients appropriately for upper endoscopy (EGD) is crucial for efficient use of endoscopy. The objective of this study was to compare different clinical strategies and statistical methods to select patients for EGD, namely appropriateness guidelines, age and/or alarm features, and multivariate and artificial neural network (ANN) models. A nationwide, multicenter, prospective study was undertaken in which consecutive patients referred for EGD during a 1-month period were enrolled. Before EGD, the endoscopist assessed referral appropriateness according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, also collecting clinical and demographic variables. Outcomes of the study were detection of relevant findings and new diagnosis of malignancy at EGD. The accuracy of the following clinical strategies and predictive rules was compared: (i) ASGE appropriateness guidelines (indicated vs. not indicated), (ii) simplified rule (>or=45 years or alarm features vs. <45 years without alarm features), (iii) logistic regression model, and (iv) ANN models. A total of 8,252 patients were enrolled in 57 centers. Overall, 3,803 (46%) relevant findings and 132 (1.6%) new malignancies were detected. Sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) of the simplified rule were similar to that of the ASGE guidelines for both relevant findings (82%/26%/0.55 vs. 88%/27%/0.52) and cancer (97%/22%/0.58 vs. 98%/20%/0.58). Both logistic regression and ANN models seemed to be substantially more accurate in predicting new cases of malignancy, with an AUC of 0.82 and 0.87, respectively. A simple predictive rule based on age and alarm features is similarly effective to the more complex ASGE guidelines in selecting patients for EGD. Regression and ANN models may be useful in identifying a relatively small subgroup of patients at higher risk of cancer.

  3. Selective angiography in fifty patients with primary hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Shou-Zhong, Wang; Xing-Rong, Chen; Gong-Xian, Wang

    1983-06-01

    Selective angiography is of great importance in the diagnosis of primary hepatocellular carcinoma. It offers information on the findings, multicentricity, localisation, extension, and type of growth. This paper discusses angiography from the methodical point of view, the findings to be obtained, the types of hepatocellular carcinoma, and the diagnostic efficiency of selective angiography in the evaluation of this type of tumour.

  4. Linear feature selection in texture analysis - A PLS based method

    DEFF Research Database (Denmark)

    Marques, Joselene; Igel, Christian; Lillholm, Martin

    2013-01-01

    We present a texture analysis methodology that combined uncommitted machine-learning techniques and partial least square (PLS) in a fully automatic framework. Our approach introduces a robust PLS-based dimensionality reduction (DR) step to specifically address outliers and high-dimensional feature...... and considering all CV groups, the methods selected 36 % of the original features available. The diagnosis evaluation reached a generalization area-under-the-ROC curve of 0.92, which was higher than established cartilage-based markers known to relate to OA diagnosis....

  5. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases.Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients.Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death.Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  6. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients. Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death. Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  7. Offload zone patient selection criteria to reduce ambulance offload delay

    NARCIS (Netherlands)

    Laan, Corine Maartje; Vanberkel, Peter T.; Boucherie, Richardus J.; Carter, Alix J.E.

    2016-01-01

    Emergency department overcrowding is a widespread problem and often leads to ambulance offload delay. If no bed is available when a patient arrives, the patient has to wait with the ambulance crew. A recent Canadian innovation is the offload zone—an area where multiple patients can wait with a

  8. Index Fund Selections with GAs and Classifications Based on Turnover

    Science.gov (United States)

    Orito, Yukiko; Motoyama, Takaaki; Yamazaki, Genji

    It is well known that index fund selections are important for the risk hedge of investment in a stock market. The`selection’means that for`stock index futures’, n companies of all ones in the market are selected. For index fund selections, Orito et al.(6) proposed a method consisting of the following two steps : Step 1 is to select N companies in the market with a heuristic rule based on the coefficient of determination between the return rate of each company in the market and the increasing rate of the stock price index. Step 2 is to construct a group of n companies by applying genetic algorithms to the set of N companies. We note that the rule of Step 1 is not unique. The accuracy of the results using their method depends on the length of time data (price data) in the experiments. The main purpose of this paper is to introduce a more`effective rule’for Step 1. The rule is based on turnover. The method consisting of Step 1 based on turnover and Step 2 is examined with numerical experiments for the 1st Section of Tokyo Stock Exchange. The results show that with our method, it is possible to construct the more effective index fund than the results of Orito et al.(6). The accuracy of the results using our method depends little on the length of time data (turnover data). The method especially works well when the increasing rate of the stock price index over a period can be viewed as a linear time series data.

  9. A fuzzy logic based PROMETHEE method for material selection problems

    Directory of Open Access Journals (Sweden)

    Muhammet Gul

    2018-03-01

    Full Text Available Material selection is a complex problem in the design and development of products for diverse engineering applications. This paper presents a fuzzy PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluation method based on trapezoidal fuzzy interval numbers that can be applied to the selection of materials for an automotive instrument panel. Also, it presents uniqueness in making a significant contribution to the literature in terms of the application of fuzzy decision-making approach to material selection problems. The method is illustrated, validated, and compared against three different fuzzy MCDM methods (fuzzy VIKOR, fuzzy TOPSIS, and fuzzy ELECTRE in terms of its ranking performance. Also, the relationships between the compared methods and the proposed scenarios for fuzzy PROMETHEE are evaluated via the Spearman’s correlation coefficient. Styrene Maleic Anhydride and Polypropylene are determined optionally as suitable materials for the automotive instrument panel case. We propose a generic fuzzy MCDM methodology that can be practically implemented to material selection problem. The main advantages of the methodology are consideration of the vagueness, uncertainty, and fuzziness to decision making environment.

  10. Object width modulates object-based attentional selection.

    Science.gov (United States)

    Nah, Joseph C; Neppi-Modona, Marco; Strother, Lars; Behrmann, Marlene; Shomstein, Sarah

    2018-04-24

    Visual input typically includes a myriad of objects, some of which are selected for further processing. While these objects vary in shape and size, most evidence supporting object-based guidance of attention is drawn from paradigms employing two identical objects. Importantly, object size is a readily perceived stimulus dimension, and whether it modulates the distribution of attention remains an open question. Across four experiments, the size of the objects in the display was manipulated in a modified version of the two-rectangle paradigm. In Experiment 1, two identical parallel rectangles of two sizes (thin or thick) were presented. Experiments 2-4 employed identical trapezoids (each having a thin and thick end), inverted in orientation. In the experiments, one end of an object was cued and participants performed either a T/L discrimination or a simple target-detection task. Combined results show that, in addition to the standard object-based attentional advantage, there was a further attentional benefit for processing information contained in the thick versus thin end of objects. Additionally, eye-tracking measures demonstrated increased saccade precision towards thick object ends, suggesting that Fitts's Law may play a role in object-based attentional shifts. Taken together, these results suggest that object-based attentional selection is modulated by object width.

  11. Primary ICD-therapy in patients with advanced heart failure: selection strategies and future trials.

    Science.gov (United States)

    Frankenstein, Lutz; Zugck, Christian; Nelles, Manfred; Schellberg, Dieter; Remppis, Andrew; Katus, Hugo

    2008-09-01

    For allocation of primary ICD-therapy, a possible lower limit of inclusion criteria--defining overly advanced heart failure--is less well investigated. Also, a multi-variable approach to stratification beyond ejection fraction (LVEF) appears warranted. We examined whether adding a selection limit of peak VO(2) based on real-life data for this high risk cohort. In our prospective clinical registry 1,926 patients with systolic CHF were recruited consecutively since 1994. Of these patients, 292 met the selection criteria described above. The mean age was 57.6 +/- 9.5 years, 83% were male, 37% had ischemic cardiomyopathy and 28% received primary ICD-therapy. All cause mortality was considered as end point. Median follow-up was 45 (18-86) months. ICD was not a significant predictor of outcome either for the entire population, or grouped according to aetiology of CHF. Still, 3-year mortality was 15% (ICD-patients) Vs. 28% (non-ICD-patients); P = 0.05; under combination medical therapy. Inversely, in ICD-patients medical combination therapy conveyed a significant survival benefit (P < 0.001). Consequently, the number-needed-to-treat was eight under combination therapy and the size estimate amounts to 300 patients for a prospective trial in this cohort. A cut-off of LVEF patients that do not draw a significant survival benefit from adjunct primary ICD-therapy. Our results indicate the need for a specific randomized trial in this cohort. The according mortality data and a size estimate are provided.

  12. Therapeutic management of stoma complications in selected patients.

    Science.gov (United States)

    Trzciński, Radzisław; Kresińska-Kaba, Teresa; Dziki, Adam

    2013-09-01

    Stoma complications occur in 21-75% of patients, and 30% of them require redo surgery within 10 years after previous surgical treatment. Medical treatment is successful in most cases with no need for surgery. However, severe stoma complications are the real challenge for medical team and require an individual approach to each patient. The aim of the study was to report stoma patients with severe complications of both ileo- and/or colostomy and present different options of medical treatment. Between March 2005 and April 2007 we treated 8 patients with severe stoma complications at the Department of General and Colorectal Surgery, Medical University of Łódź. There were 4 patients with colostomy, 3 patients with ileostomy and one patient with both ileo- and colostomy. The mean age of patients was 56,7 years (range 30-68 years). In all patients we achieved either complete stoma-related wound healing or we observed substantial progress of wound healing with medical treatment. No patient required surgery for stoma complications. Stoma complications still occur in spite of adherence to rules of stoma care and surgical technique. Most of them can be treated conservatively. Much emphasis is put on close team work comprising doctors and nurses in the treatment of severe stoma complications.

  13. Titanium-based spectrally selective surfaces for solar thermal systems

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, A D; Holmes, J P

    1983-10-01

    A study of spectrally selective surfaces based on anodic oxide films on titanium is presented. These surfaces have low values of solar absorptance, 0.77, due to the nonideal optical properties of the anodic TiO2 for antireflection of titanium. A simple chemical etching process is described which gives a textured surface with dimensions similar to the wavelengths of solar radiation, leading to spectral selectivity. The performance of this dark-etched surface can be further improved by anodising, and optimum absorbers have been produced with alpha(s) 0.935 and hemispherical emittances (400 K) 0.23. The surface texturing effects a significant improvement in alpha(s) at oblique incidence.

  14. A Reliability Based Model for Wind Turbine Selection

    Directory of Open Access Journals (Sweden)

    A.K. Rajeevan

    2013-06-01

    Full Text Available A wind turbine generator output at a specific site depends on many factors, particularly cut- in, rated and cut-out wind speed parameters. Hence power output varies from turbine to turbine. The objective of this paper is to develop a mathematical relationship between reliability and wind power generation. The analytical computation of monthly wind power is obtained from weibull statistical model using cubic mean cube root of wind speed. Reliability calculation is based on failure probability analysis. There are many different types of wind turbinescommercially available in the market. From reliability point of view, to get optimum reliability in power generation, it is desirable to select a wind turbine generator which is best suited for a site. The mathematical relationship developed in this paper can be used for site-matching turbine selection in reliability point of view.

  15. Selective versus routine patch metal allergy testing to select bar material for the Nuss procedure in 932 patients over 10years.

    Science.gov (United States)

    Obermeyer, Robert J; Gaffar, Sheema; Kelly, Robert E; Kuhn, M Ann; Frantz, Frazier W; McGuire, Margaret M; Paulson, James F; Kelly, Cynthia S

    2018-02-01

    The aim of the study was to determine the role of patch metal allergy testing to select bar material for the Nuss procedure. An IRB-approved (11-04-WC-0098) single institution retrospective, cohort study comparing selective versus routine patch metal allergy testing to select stainless steel or titanium bars for Nuss repair was performed. In Cohort A (9/2004-1/2011), selective patch testing was performed based on clinical risk factors. In Cohort B (2/2011-9/2014), all patients were patch tested. The cohorts were compared for incidence of bar allergy and resultant premature bar loss. Risk factors for stainless steel allergy or positive patch test were evaluated. Cohort A had 628 patients with 63 (10.0%) selected for patch testing, while all 304 patients in Cohort B were tested. Over 10years, 15 (1.8%) of the 842 stainless steel Nuss repairs resulted in a bar allergy, and 5 had a negative preoperative patch test. The incidence of stainless steel bar allergy (1.8% vs 1.7%, p=0.57) and resultant bar loss (0.5% vs 1.3%, p=0.23) was not statistically different between cohorts. An allergic reaction to a stainless steel bar or a positive patch test was more common in females (OR=2.3, pbar allergies occur at a low incidence with either routine or selective patch metal allergy testing. If selective testing is performed, it is advisable in females and patients with a personal or family history of metal sensitivity. A negative preoperative patch metal allergy test does not preclude the possibility of a postoperative stainless steel bar allergy. Level III Treatment Study and Study of Diagnostic Test. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Utilization of CT perfusion patient selection for mechanical thrombectomy irrespective of time: a comparison of functional outcomes and complications.

    Science.gov (United States)

    Turk, Aquilla S; Nyberg, Eric MacKenzie; Chaudry, M Imran; Turner, Raymond D; Magarik, Jordan Asher; Nicholas, Joyce S; Holmstedt, Christine A; Chalela, Julio Alejandro; Hays, Angela; Lazaridis, Christos; Chimowitz, Marc I; Turan, Tanya N; Adams, Robert J; Jauch, Edward C

    2013-11-01

    Patient selection for acute ischemic stroke has been largely driven by time-based criteria, although emerging data suggest that image-based criteria may be useful. The purpose of this study was to directly compare outcomes of patients treated within a traditional time window with those treated beyond this benchmark when CT perfusion (CTP) imaging was used as the primary selection tool. A prospectively collected database of all patients with acute ischemic stroke who received intra-arterial therapy at the Medical University of South Carolina was retrospectively analyzed, regardless of time from symptom onset. At presentation, CTP maps were qualitatively assessed. Selected patients underwent intra-arterial therapy. Functional outcome according to the modified Rankin scale (mRS) score at about 90 days was documented. 140 patients were included in the study. The median time from symptom onset to groin access was 7.0 h. Overall, 28 patients (20%) had bleeding complications, but only 10 (7.1%) were symptomatic. The average National Institute of Health Stroke Scale (NIHSS) score for patients treated ≤ 7 h from symptom onset was 17.3 and 30.2% had a mRS score of 0-2 at 90 days. Patients treated >7 h from symptom onset had an average NIHSS score of 15.1 and 45.5% achieved a mRS score of 0-2 at 90 days (p=0.104). Patients in the two groups had similar rates of symptomatic intracerebral hemorrhage (8.5% and 5.8%, respectively; p=0.745). No difference was found in the rates of good functional outcome between patients treated ≤ 7 h and those treated >7 h from symptom onset. These data suggest that imaging-based patient selection is a safe and viable methodology.

  17. Frequency selective surfaces based high performance microstrip antenna

    CERN Document Server

    Narayan, Shiv; Jha, Rakesh Mohan

    2016-01-01

    This book focuses on performance enhancement of printed antennas using frequency selective surfaces (FSS) technology. The growing demand of stealth technology in strategic areas requires high-performance low-RCS (radar cross section) antennas. Such requirements may be accomplished by incorporating FSS into the antenna structure either in its ground plane or as the superstrate, due to the filter characteristics of FSS structure. In view of this, a novel approach based on FSS technology is presented in this book to enhance the performance of printed antennas including out-of-band structural RCS reduction. In this endeavor, the EM design of microstrip patch antennas (MPA) loaded with FSS-based (i) high impedance surface (HIS) ground plane, and (ii) the superstrates are discussed in detail. The EM analysis of proposed FSS-based antenna structures have been carried out using transmission line analogy, in combination with the reciprocity theorem. Further, various types of novel FSS structures are considered in desi...

  18. Distance based control system for machine vision-based selective spraying

    NARCIS (Netherlands)

    Steward, B.L.; Tian, L.F.; Tang, L.

    2002-01-01

    For effective operation of a selective sprayer with real-time local weed sensing, herbicides must be delivered, accurately to weed targets in the field. With a machine vision-based selective spraying system, acquiring sequential images and switching nozzles on and off at the correct locations are

  19. Gene-Based Multiclass Cancer Diagnosis with Class-Selective Rejections

    Science.gov (United States)

    Jrad, Nisrine; Grall-Maës, Edith; Beauseroy, Pierre

    2009-01-01

    Supervised learning of microarray data is receiving much attention in recent years. Multiclass cancer diagnosis, based on selected gene profiles, are used as adjunct of clinical diagnosis. However, supervised diagnosis may hinder patient care, add expense or confound a result. To avoid this misleading, a multiclass cancer diagnosis with class-selective rejection is proposed. It rejects some patients from one, some, or all classes in order to ensure a higher reliability while reducing time and expense costs. Moreover, this classifier takes into account asymmetric penalties dependant on each class and on each wrong or partially correct decision. It is based on ν-1-SVM coupled with its regularization path and minimizes a general loss function defined in the class-selective rejection scheme. The state of art multiclass algorithms can be considered as a particular case of the proposed algorithm where the number of decisions is given by the classes and the loss function is defined by the Bayesian risk. Two experiments are carried out in the Bayesian and the class selective rejection frameworks. Five genes selected datasets are used to assess the performance of the proposed method. Results are discussed and accuracies are compared with those computed by the Naive Bayes, Nearest Neighbor, Linear Perceptron, Multilayer Perceptron, and Support Vector Machines classifiers. PMID:19584932

  20. Patient mental adjustment to selected types of cancer.

    Science.gov (United States)

    Religioni, Urszula; Czerw, Aleksandra; Deptała, Andrzej

    2018-02-28

    Physical symptoms related to cancer are associated with various mental conditions. An adopted attitude towards pain and disease affects the quality of life of patients and may even decide about the final outcome of therapy. The objective of the study was to assess the degree of mental adjustment of patients diagnosed with breast, lung, colorectal and prostate cancer. The analysis also covered the effect of socioeconomic factors on mental adjustment in patients in the above groups. The study included 902 patients treated on an outpatient basis at the Center of Oncology, the Maria Skłodowska-Curie Institute in Warsaw, in the year 2013. The study participants were patients diagnosed with breast, lung, colorectal and prostate carcinoma. The Paper and Pencil Interview (PAPI) technique was applied. The questionnaire interview included demographic-type questions (socioeconomic variables) and the Mini-Mental Adjustment to Cancer (mini-MAC) scale, which measures the degree of mental adjustment to disease. The highest scores in the anxious preoccupation and helplessness-hopelessness subclasses were those of the lung, colorectal, breast and prostate cancer patients. In breast and lung cancer study participants, differences between individual categories distinguished due to socioeconomic features proved statistically insignificant. However, significant dependencies were observed between mental adjustment to disease and chemotherapy in the past year; though, the results differ with respect to the primary site. The primary site affects patient adjustment to disease. Socioeconomic factors in the area of mental adaptation differentiate colorectal carcinoma patients.

  1. Core Business Selection Based on Ant Colony Clustering Algorithm

    Directory of Open Access Journals (Sweden)

    Yu Lan

    2014-01-01

    Full Text Available Core business is the most important business to the enterprise in diversified business. In this paper, we first introduce the definition and characteristics of the core business and then descript the ant colony clustering algorithm. In order to test the effectiveness of the proposed method, Tianjin Port Logistics Development Co., Ltd. is selected as the research object. Based on the current situation of the development of the company, the core business of the company can be acquired by ant colony clustering algorithm. Thus, the results indicate that the proposed method is an effective way to determine the core business for company.

  2. Multichannel Selective Femtosecond Coherent Control Based on Symmetry Properties

    International Nuclear Information System (INIS)

    Amitay, Zohar; Gandman, Andrey; Chuntonov, Lev; Rybak, Leonid

    2008-01-01

    We present and implement a new scheme for extended multichannel selective femtosecond coherent control based on symmetry properties of the excitation channels. Here, an atomic nonresonant two-photon absorption channel is coherently incorporated in a resonance-mediated (2+1) three-photon absorption channel. By proper pulse shaping, utilizing the invariance of the two-photon absorption to specific phase transformations of the pulse, the three-photon absorption is tuned independently over an order-of-magnitude yield range for any possible two-photon absorption yield. Noticeable is a set of ''two-photon dark pulses'' inducing widely tunable three-photon absorption

  3. Preoperative testing and risk assessment: perspectives on patient selection in ambulatory anesthetic procedures

    Directory of Open Access Journals (Sweden)

    Stierer TL

    2015-08-01

    at the facility also should be ascertained. Equally important to outcome are the resources and support available to the patient during their recovery after they have been discharged from the facility. This article reviews appropriate patient and procedure selection, based on elements of preoperative history and physical examination, supporting testing, and risk assessment.Keywords: ambulatory, sleep apnea, preoperative, surgery, anesthesia

  4. Carbon Nanotube-Based Ion Selective Sensors for Wearable Applications.

    Science.gov (United States)

    Roy, Soumyendu; David-Pur, Moshe; Hanein, Yael

    2017-10-11

    Wearable electronics offer new opportunities in a wide range of applications, especially sweat analysis using skin sensors. A fundamental challenge in these applications is the formation of sensitive and stable electrodes. In this article we report the development of a wearable sensor based on carbon nanotube (CNT) electrode arrays for sweat sensing. Solid-state ion selective electrodes (ISEs), sensitive to Na + ions, were prepared by drop coating plasticized poly(vinyl chloride) (PVC) doped with ionophore and ion exchanger on CNT electrodes. The ion selective membrane (ISM) filled the intertubular spaces of the highly porous CNT film and formed an attachment that was stronger than that achieved with flat Au, Pt, or carbon electrodes. Concentration of the ISM solution used influenced the attachment to the CNT film, the ISM surface morphology, and the overall performance of the sensor. Sensitivity of 56 ± 3 mV/decade to Na + ions was achieved. Optimized solid-state reference electrodes (REs), suitable for wearable applications, were prepared by coating CNT electrodes with colloidal dispersion of Ag/AgCl, agarose hydrogel with 0.5 M NaCl, and a passivation layer of PVC doped with NaCl. The CNT-based REs had low sensitivity (-1.7 ± 1.2 mV/decade) toward the NaCl solution and high repeatability and were superior to bare Ag/AgCl, metals, carbon, and CNT films, reported previously as REs. CNT-based ISEs were calibrated against CNT-based REs, and the short-term stability of the system was tested. We demonstrate that CNT-based devices implemented on a flexible support are a very attractive platform for future wearable technology devices.

  5. Patch-based visual tracking with online representative sample selection

    Science.gov (United States)

    Ou, Weihua; Yuan, Di; Li, Donghao; Liu, Bin; Xia, Daoxun; Zeng, Wu

    2017-05-01

    Occlusion is one of the most challenging problems in visual object tracking. Recently, a lot of discriminative methods have been proposed to deal with this problem. For the discriminative methods, it is difficult to select the representative samples for the target template updating. In general, the holistic bounding boxes that contain tracked results are selected as the positive samples. However, when the objects are occluded, this simple strategy easily introduces the noises into the training data set and the target template and then leads the tracker to drift away from the target seriously. To address this problem, we propose a robust patch-based visual tracker with online representative sample selection. Different from previous works, we divide the object and the candidates into several patches uniformly and propose a score function to calculate the score of each patch independently. Then, the average score is adopted to determine the optimal candidate. Finally, we utilize the non-negative least square method to find the representative samples, which are used to update the target template. The experimental results on the object tracking benchmark 2013 and on the 13 challenging sequences show that the proposed method is robust to the occlusion and achieves promising results.

  6. Tyrosinase-Based Biosensors for Selective Dopamine Detection

    Directory of Open Access Journals (Sweden)

    Monica Florescu

    2017-06-01

    Full Text Available A novel tyrosinase-based biosensor was developed for the detection of dopamine (DA. For increased selectivity, gold electrodes were previously modified with cobalt (II-porphyrin (CoP film with electrocatalytic activity, to act both as an electrochemical mediator and an enzyme support, upon which the enzyme tyrosinase (Tyr was cross-linked. Differential pulse voltammetry was used for electrochemical detection and the reduction current of dopamine-quinone was measured as a function of dopamine concentration. Our experiments demonstrated that the presence of CoP improves the selectivity of the electrode towards dopamine in the presence of ascorbic acid (AA, with a linear trend of concentration dependence in the range of 2–30 µM. By optimizing the conditioning parameters, a separation of 130 mV between the peak potentials for ascorbic acid AA and DA was obtained, allowing the selective detection of DA. The biosensor had a sensitivity of 1.22 ± 0.02 µA·cm−2·µM−1 and a detection limit of 0.43 µM. Biosensor performances were tested in the presence of dopamine medication, with satisfactory results in terms of recovery (96%, and relative standard deviation values below 5%. These results confirmed the applicability of the biosensors in real samples such as human urine and blood serum.

  7. Road Network Selection Based on Road Hierarchical Structure Control

    Directory of Open Access Journals (Sweden)

    HE Haiwei

    2015-04-01

    Full Text Available A new road network selection method based on hierarchical structure is studied. Firstly, road network is built as strokes which are then classified into hierarchical collections according to the criteria of betweenness centrality value (BC value. Secondly, the hierarchical structure of the strokes is enhanced using structural characteristic identification technique. Thirdly, the importance calculation model was established according to the relationships among the hierarchical structure of the strokes. Finally, the importance values of strokes are got supported with the model's hierarchical calculation, and with which the road network is selected. Tests are done to verify the advantage of this method by comparing it with other common stroke-oriented methods using three kinds of typical road network data. Comparision of the results show that this method had few need to semantic data, and could eliminate the negative influence of edge strokes caused by the criteria of BC value well. So, it is better to maintain the global hierarchical structure of road network, and suitable to meet with the selection of various kinds of road network at the same time.

  8. Prevalence of Dental Fear and Anxiety amongst Patients in Selected Dental Clinics in Ghana

    Science.gov (United States)

    Ofori, Marian A.; Adu-Ababio, F.; Nyako, E. A.; Ndanu, Tom A.

    2009-01-01

    Objective: To find out the prevalence of dental anxiety and fear amongst patients in various selected dental clinics in Accra, Ghana. Study design: Dental patients (n = 279) who had either been exposed to dental treatments or had no prior dental exposure, attending four selected dental clinics in Accra were randomly sampled. They were interviewed…

  9. The use of the waiting list in a fair selection of patients for nursing home care

    NARCIS (Netherlands)

    Meiland, F. J.; Danse, J. A.; Hoos, A. M.; Wendte, J. F.; Gunning-Schepers, L. J.

    1996-01-01

    When health care resources are scarce, waiting lists may be used as a distribution measure in order to enhance the fair allocation of resources through selection of patients. In this study, the structure and use of a waiting list for a fair selection of patients for nursing home admission was

  10. Cost Analysis of Selected Patient Categories within a Dermatology Department Using an ABC Approach

    Science.gov (United States)

    Papadaki, Šárka; Popesko, Boris

    2016-01-01

    Background: Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. Methods: The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. Results: The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Conclusions: Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of

  11. Cost Analysis of Selected Patient Categories Within A Dermatology Department Using an ABC Approach.

    Science.gov (United States)

    Papadaki, Šárka; Popesko, Boris

    2015-11-17

    Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the

  12. Fuzzy Axiomatic Design approach based green supplier selection

    DEFF Research Database (Denmark)

    Kannan, Devika; Govindan, Kannan; Rajendran, Sivakumar

    2015-01-01

    proposes a multi-criteria decision-making (MCDM) approach called Fuzzy Axiomatic Design (FAD) to select the best green supplier for Singapore-based plastic manufacturing company. At first, the environmental criteria was developed along with the traditional criteria based on the literature review......Abstract Green Supply Chain Management (GSCM) is a developing concept recently utilized by manufacturing firms of all sizes. All industries, small or large, seek improvements in the purchasing of raw materials, manufacturing, allocation, transportation efficiency, in curbing storage time, importing...... responsible in addition to being efficiently managed. A significant way to implement responsible GSCM is to reconsider, in innovative ways, the purchase and supply cycle, and a preliminary step would be to ensure that the supplier of goods successfully incorporates green criteria. Therefore, this paper...

  13. Tunable antenna radome based on graphene frequency selective surface

    Science.gov (United States)

    Qu, Meijun; Rao, Menglou; Li, Shufang; Deng, Li

    2017-09-01

    In this paper, a graphene-based frequency selective surface (FSS) is proposed. The proposed FSS exhibits a tunable bandpass filtering characteristic due to the alterable conductivity of the graphene strips which is controlled by chemical potential. Based on the reconfigurable bandpass property of the proposed FSS, a cylindrical antenna radome is designed using the FSS unit cells. A conventional omnidirectional dipole can realize a two-beam directional pattern when it is placed into the proposed antenna radome. Forward and backward endfire radiations of the dipole loaded with the radome is realized by properly adjusting the chemical potential. The proposed antenna radome is extremely promising for beam-scanning in terahertz and mid-infrared plasmonic devices and systems when the gain of a conventional antenna needs to be enhanced.

  14. SELECTION OF RECIPIENTS FOR HEART TRANSPLANTATION BASED ON URGENCY STATUS

    Directory of Open Access Journals (Sweden)

    O. A. Sujayeva

    2014-01-01

    Full Text Available The article provides the overview of current international recommendations dedicated to selection of heart transplantation recipients based on urgency status. Authors found that cardiopulmonary bicycle stress test allowed to reveal additional criteria of high death risk within 1 year. These additional criteria were: the maximal oxygen consumption VO2max < 30% of the expected considering the age; VD/VT (ratio of physiologic dead space over tidal volume increasing during the test; maximal tolerance to physical loading ≤50 Wt and/or < 20% of the expected considering the age. Authors created mathematical model for prediction of death within 1 year based on above mentioned data. Special software estimating the probability of death within 1 year was also created.

  15. Treatment selection for stage IIIA Hodgkin's disease patients

    International Nuclear Information System (INIS)

    Prosnitz, L.R.; Cooper, D.; Cox, E.B.; Kapp, D.S.; Farber, L.R.

    1985-01-01

    Two treatment policies for the therapy of patients with Stage IIIA Hodgkin's disease are compared. From 1969-1976, 49 newly diagnosed and pathologically staged IIIA patients received total nodal irradiation (TNI) alone (no liver irradiation). Although actuarial survival was 80% at 5 years and 68% at 10 years, actuarial freedom from relapse was only 38% at 5 years. Accordingly, a new treatment policy was instituted in 1976. Patients with either CS IIIA disease, multiple splenic nodules, IIIA with a large mediastinal mass or III 2 , received combined modality therapy (combination chemotherapy and irradiation). All others received TNI. Thirty-six patients have been treated under the new program. The actuarial survival is 90% at 5 years and the relapse-free survival is 87%, suggesting the superiority of this approach. Complications from the treatments are discussed

  16. The influence of extrinsic motivation on competition-based selection.

    Science.gov (United States)

    Sänger, Jessica; Wascher, Edmund

    2011-10-10

    The biased competition approach to visuo-spatial attention proposes that the selection of competing information is effected by the saliency of the stimulus as well as by an intention-based bias of attention towards behavioural goals. Wascher and Beste (2010) [32] showed that the detection of relevant information depends on its relative saliency compared to irrelevant conflicting stimuli. Furthermore the N1pc, N2pc and N2 of the EEG varied with the strength of the conflict. However, this system could also be modulated by rather global mechanisms like attentional effort. The present study investigates such modulations by testing the influence of extrinsic motivation on the selection of competing stimuli. Participants had to detect a luminance change in various conditions among others against an irrelevant orientation change. Half of the participants were motivated to maximize their performance by the announcement of a monetary reward for correct responses. Participants who were motivated had lower error rates than participants who were not motivated. The event-related lateralizations of the EEG showed no motivation-related effect on the N1pc, which reflects the initial saliency driven orientation of attention towards the more salient stimulus. The subsequent N2pc was enhanced in the motivation condition. Extrinsic motivation was also accompanied by enhanced fronto-central negativities. Thus, the data provide evidence that the improvement of selection performance when participants were extrinsically motivated by announcing a reward was not due to changes in the initial saliency based processing of information but was foremost mediated by improved higher-level mechanisms. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Selection of Vendor Based on Intuitionistic Fuzzy Analytical Hierarchy Process

    Directory of Open Access Journals (Sweden)

    Prabjot Kaur

    2014-01-01

    Full Text Available Business environment is characterized by greater domestic and international competitive position in the global market. Vendors play a key role in achieving the so-called corporate competition. It is not easy however to identify good vendors because evaluation is based on multiple criteria. In practice, for VSP most of the input information about the criteria is not known precisely. Intuitionistic fuzzy set is an extension of the classical fuzzy set theory (FST, which is a suitable way to deal with impreciseness. In other words, the application of intuitionistic fuzzy sets instead of fuzzy sets means the introduction of another degree of freedom called nonmembership function into the set description. In this paper, we proposed a triangular intuitionistic fuzzy number based approach for the vendor selection problem using analytical hierarchy process. The crisp data of the vendors is represented in the form of triangular intuitionistic fuzzy numbers. By applying AHP which involves decomposition, pairwise comparison, and deriving priorities for the various levels of the hierarchy, an overall crisp priority is obtained for ranking the best vendor. A numerical example illustrates our method. Lastly a sensitivity analysis is performed to find the most critical criterion on the basis of which vendor is selected.

  18. Selectively Encrypted Pull-Up Based Watermarking of Biometric data

    Science.gov (United States)

    Shinde, S. A.; Patel, Kushal S.

    2012-10-01

    Biometric authentication systems are becoming increasingly popular due to their potential usage in information security. However, digital biometric data (e.g. thumb impression) are themselves vulnerable to security attacks. There are various methods are available to secure biometric data. In biometric watermarking the data are embedded in an image container and are only retrieved if the secrete key is available. This container image is encrypted to have more security against the attack. As wireless devices are equipped with battery as their power supply, they have limited computational capabilities; therefore to reduce energy consumption we use the method of selective encryption of container image. The bit pull-up-based biometric watermarking scheme is based on amplitude modulation and bit priority which reduces the retrieval error rate to great extent. By using selective Encryption mechanism we expect more efficiency in time at the time of encryption as well as decryption. Significant reduction in error rate is expected to be achieved by the bit pull-up method.

  19. Transumbilical breast augmentation (TUBA): patient selection, technique, and clinical experience.

    Science.gov (United States)

    Pound, E C; Pound, E C

    2001-07-01

    The TUBA procedure offers another approach to placing inflatable breast implants in the subglandular or submuscular position. It is an easy procedure to learn and to perform, using only a few relatively inexpensive specialized instruments. It also can be modified to use preexisting scars on the abdomen as the access point. The authors believe that complications seem to occur less with TUBA patients than with patients having breast augmentation by other approaches, an observation shared by other plastic surgeons offering the TUBA procedure. Limitations include the fact that only inflatable implants can be used. Also, with increasing distance from the breast, there is less control over manipulation of the pocket. Fortunately, the authors have not found this to be a problem in achieving symmetry. Furthermore, bleeding tends to be minimal with this approach. Nevertheless, should technical difficulties arise, conversion to a standard breast incision is an easy back-up option and should be discussed with the patient before surgery. Interest in the TUBA approach to breast augmentation continues to grow. Patients appreciate the lack of scarring on the breast and the short recovery that allows them to resume their normal lifestyle quickly. The authors' caseload has increased considerably over the past 8 years through word-of-mouth advertising from satisfied patients. Other plastic surgeons who offer this approach agree that patient demand for this operation continues to grow dramatically in their practices.

  20. Selection of oncoplastic surgical technique in Asian breast cancer patients

    Directory of Open Access Journals (Sweden)

    Eui Sun Shin

    2018-01-01

    Full Text Available Background Oncoplastic surgery is being increasingly performed in Korean women; however, unlike Westerners, Korean women usually have small to moderate-sized breasts. To achieve better outcomes in reconstructed breasts, several factors should be considered to determine the optimal surgical method. Methods A total of 108 patients who underwent oncoplastic surgery from January 2013 to December 2016 were retrospectively investigated. We used various methods, including glandular tissue reshaping, latissimus dorsi (LD flap transposition, and reduction oncoplasty, to restore the breast volume and symmetry. Results The mean weight of the tumor specimens was 40.46 g, and the ratio of the tumor specimen weight to breast volume was 0.12 g/mL in the patients who underwent glandular tissue reshaping (n=59. The corresponding values were 101.47 g and 0.14 g/mL, respectively, in the patients who underwent reduction oncoplasty (n=17, and 82.54 g and 0.20 g/mL, respectively, in those treated with an LD flap (n=32. Glandular tissue reshaping was mostly performed in the upper outer quadrant, and LD flap transposition was mostly performed in the lower inner quadrant. No major complications were noted. Most patients were satisfied with the aesthetic results. Conclusions We report satisfactory outcomes of oncoplastic surgical procedures in Korean patients. The results regarding specimen weight and the tumor-to-breast ratio of Asian patients will be a helpful reference point for determining the most appropriate oncoplastic surgical technique.

  1. Patient Selection in Plastic Surgery: Recognizing Body Dysmorphic Disorder

    Directory of Open Access Journals (Sweden)

    Cihan Sahin

    2013-04-01

    Full Text Available Plastic surgery is a branch of medicine that provides significant improvements to the people with positive changes. But first of all, this branch has a characteristic which requires analysing patients' psychological situation very carefully. Plastic surgeons are often confronted by patients with mental disorders seeking aesthetic surgery. It is imperative for surgeons to recognize possible underlying psychiatric illnesses. Common psychiatric conditions seen in cosmetic surgery patients include body dysmorphic disorder (BDD, narcissistic personality disorder and histrionic personality disorders. BDD is of particular importance to plastic surgeons. Because outrageous dissatisfaction with one's appearance may conceal psychopathologic traits that are not always easily recognizable, and which, if neglected, may result in serious iatrogenic and medicolegal consequences, we hope that this paper will help plastic surgeons in ultimately preventing patient and surgeon dissatisfaction within the population of patients with psychiatric disorders, and should recognize the diagnostic features of body dysmorphic disorder and screen psychologically unstable patients who may never be satisfied with surgery. [Arch Clin Exp Surg 2013; 2(2.000: 109-115

  2. An enhanced PSO-DEFS based feature selection with biometric authentication for identification of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Umarani Balakrishnan

    2016-11-01

    Full Text Available Recently, automatic diagnosis of diabetic retinopathy (DR from the retinal image is the most significant research topic in the medical applications. Diabetic macular edema (DME is the major reason for the loss of vision in patients suffering from DR. Early identification of the DR enables to prevent the vision loss and encourage diabetic control activities. Many techniques are developed to diagnose the DR. The major drawbacks of the existing techniques are low accuracy and high time complexity. To overcome these issues, this paper proposes an enhanced particle swarm optimization-differential evolution feature selection (PSO-DEFS based feature selection approach with biometric authentication for the identification of DR. Initially, a hybrid median filter (HMF is used for pre-processing the input images. Then, the pre-processed images are embedded with each other by using least significant bit (LSB for authentication purpose. Simultaneously, the image features are extracted using convoluted local tetra pattern (CLTrP and Tamura features. Feature selection is performed using PSO-DEFS and PSO-gravitational search algorithm (PSO-GSA to reduce time complexity. Based on some performance metrics, the PSO-DEFS is chosen as a better choice for feature selection. The feature selection is performed based on the fitness value. A multi-relevance vector machine (M-RVM is introduced to classify the 13 normal and 62 abnormal images among 75 images from 60 patients. Finally, the DR patients are further classified by M-RVM. The experimental results exhibit that the proposed approach achieves better accuracy, sensitivity, and specificity than the existing techniques.

  3. Making evidence-based selections of influenza vaccines.

    Science.gov (United States)

    Childress, Billy-Clyde; Montney, Joshua D; Albro, Elise A

    2014-01-01

    Years ago, intramuscular influenza vaccines were the only option for those who wanted to arm themselves against the flu. Today there are alternatives, including intradermal injections and intranasal sprays. In order to select the right influenza vaccine for their patients, pharmacists, and other healthcare professionals must have a basic understanding of the immune system. Influenza vaccines elicit different levels of immune response involving innate and adaptive immunity, which are critical to fighting infection. For the 2013-2014 flu season, there were 13 different formulations of influenza vaccines on the market with vast differences in indications, contraindications, and effectiveness. The CDC does not recommend one vaccine over another, but recommends that all patients be vaccinated against the flu. Preventing the spread of influenza is no simple task; however, the most recent evidence on influenza vaccines and sufficient knowledge of the immune system will allow pharmacists and other healthcare providers to better advocate for vaccines, determine which are most appropriate, and ensure their proper administration.

  4. A Selected Reaction Monitoring (SRM)-Based Method for Absolute Quantification of Aβ38, Aβ40, and Aβ42 in Cerebrospinal Fluid of Alzheimer's Disease Patients and Healthy Controls

    DEFF Research Database (Denmark)

    Pannee, Josef; Portelius, Erik; Oppermann, Madalina

    2013-01-01

    with mild to moderate dementia. Analytical characteristics of the method include a lower limit of quantification of 62.5 pg/mL for Aβ42 and coefficients of variations below 10%. In a pilot study on AD patients and controls, we verified disease-association with decreased levels of Aβ42 similar......). Samples were prepared by solid-phase extraction and quantification was performed using stable-isotope labeled Aβ peptides as internal standards. The diagnostic performance of the method was evaluated on two independent clinical materials with research volunteers who were cognitively normal and AD patients...

  5. Selecting relevant and feasible measurement instruments for the revised Dutch clinical practice guideline for physical therapy in patients after stroke

    NARCIS (Netherlands)

    Otterman, Nicoline; Veerbeek, Janne; Schiemanck, Sven; van der Wees, Philip; Nollet, Frans; Kwakkel, Gert

    2017-01-01

    Purpose: To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. Methods: In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability

  6. Selecting relevant and feasible measurement instruments for the revised Dutch clinical practice guideline for physical therapy in patients after stroke

    NARCIS (Netherlands)

    Otterman, N.; Veerbeek, J.; Schiemanck, S.; Wees, P.J. van der; Nollet, F.; Kwakkel, G.

    2017-01-01

    PURPOSE: To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. METHODS: In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability

  7. Selective Sequential Zero-Base Budgeting Procedures Based on Total Factor Productivity Indicators

    OpenAIRE

    A. Ishikawa; E. F. Sudit

    1981-01-01

    The authors' purpose in this paper is to develop productivity-based sequential budgeting procedures designed to expedite identification of major problem areas in bugetary performance, as well as to reduce the costs associated with comprehensive zero-base analyses. The concept of total factor productivity is reviewed and its relations to ordinary and zero-based budgeting are discussed in detail. An outline for a selective sequential analysis based on monitoring of three key indicators of (a) i...

  8. Successful selective arterial thrombolysis in patient with acute abdominal thromboembolism

    Directory of Open Access Journals (Sweden)

    Christo Tsekov

    2016-06-01

    Full Text Available The paper reports successful thrombolysis conducted in 64 years old woman admitted to the clinic with clinical and angiographic data for acute surgical abdomen caused by acute tromboembolia of arteria mesenterica superior (AMS. The therapeutic approach required to undertake lifesaving decision on i.e. surgical vs. invasive treatment in conditions of emergency. Finally, it was decided to undertake invasive treatment with successful restoration of blood flow in the related artery. The patient was discharged from the clinic with considerable clinical improvement on the fifth day of her stay. The case report includes discussion on issues relating the consequence of the diagnostic and interventional procedures in such patients, opportunities for conducting emergency thrombolysis in acute embolia of AMS and preventive measures in patients with high tromboembolic risk. Keywords: Mesenterial circulation, Abdominal thromboembolism, Arterial thrombolysis

  9. Patient and personnel dose measurements at selective coronarangiography

    International Nuclear Information System (INIS)

    Maripuu, E.

    1977-01-01

    During 1975 dose measurements were performed on patients and doctors at the thoraxradiologic department of the Caroline Hospital in Stockholm, Sweden. The doses were measured during angiography. Skin doses are listed in tables. Also the doses to the bone marrow was estimated. LiF-dosemeters were used for the measurements. Calibration of the dosemeters and errors in the measurements are discussed

  10. Deep brain stimulation for dystonia: patient selection and outcomes

    NARCIS (Netherlands)

    Speelman, J. D.; Contarino, M. F.; Schuurman, P. R.; Tijssen, M. A. J.; de Bie, R. M. A.

    2010-01-01

    In a literature survey, 341 patients with primary and 109 with secondary dystonias treated with deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi) were identified. In general, the outcomes for primary dystonias were more favourable compared to the secondary forms. For

  11. Deep brain stimulation for dystonia : Patient selection and outcomes

    NARCIS (Netherlands)

    Speelman, J. D.; Contarino, M. F.; Schuurman, P. R.; Tijssen, M. A. J.; de Bie, R. M. A.

    In a literature survey, 341 patients with primary and 109 with secondary dystonias treated with deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi) were identified. In general, the outcomes for primary dystonias were more favourable compared to the secondary forms. For

  12. Selective use of diagnostic laparoscopy in patients with suspected appendicitis

    NARCIS (Netherlands)

    van den Broek, W. T.; Bijnen, A. B.; van Eerten, P. V.; de Ruiter, P.; Gouma, D. J.

    2000-01-01

    BACKGROUND: Diagnostic laparoscopy has been introduced as a new diagnostic tool for patients with acute appendicitis. We performed diagnostic laparoscopy when the clinical diagnosis of appendicitis was in doubt. The aims of this study were to evaluate this strategy and to analyze the efficacy of

  13. Selective carbon monoxide oxidation over Ag-based composite oxides

    Energy Technology Data Exchange (ETDEWEB)

    Guldur, C. [Gazi University, Ankara (Turkey). Chemical Engineering Department; Balikci, F. [Gazi University, Ankara (Turkey). Institute of Science and Technology, Environmental Science Department

    2002-02-01

    We report our results of the synthesis of 1 : 1 molar ratio of the silver cobalt and silver manganese composite oxide catalysts to remove carbon monoxide from hydrogen-rich fuels by the catalytic oxidation reaction. Catalysts were synthesized by the co-precipitation method. XRD, BET, TGA, catalytic activity and catalyst deactivation studies were used to identify active catalysts. Both CO oxidation and selective CO oxidation were carried out in a microreactor using a reaction gas mixture of 1 vol% CO in air and another gas mixture was prepared by mixing 1 vol% CO, 2 vol% O{sub 2}, 84 vol% H{sub 2}, the balance being He. 15 vol% CO{sub 2} was added to the reactant gas mixture in order to determine the effect of CO{sub 2}, reaction gases were passed through the humidifier to determine the effect of the water vapor on the oxidation reaction. It was demonstrated that metal oxide base was decomposed to the metallic phase and surface areas of the catalysts were decreased when the calcination temperature increased from 200{sup o}C to 500{sup o}C. Ag/Co composite oxide catalyst calcined at 200{sup o}C gave good activity at low temperatures and 90% of CO conversion at 180{sup o}C was obtained for the selective CO oxidation reaction. The addition of the impurities (CO{sub 2} or H{sub 2}O) decreased the activity of catalyst for selective CO oxidation in order to get highly rich hydrogen fuels. (author)

  14. A prototype of behavior selection mechanism based on emotion

    Science.gov (United States)

    Zhang, Guofeng; Li, Zushu

    2007-12-01

    In bionic methodology rather than in design methodology more familiar with, summarizing the psychological researches of emotion, we propose the biologic mechanism of emotion, emotion selection role in creature evolution and a anima framework including emotion similar to the classical control structure; and consulting Prospect Theory, build an Emotion Characteristic Functions(ECF) that computer emotion; two more emotion theories are added to them that higher emotion is preferred and middle emotion makes brain run more efficiently, emotional behavior mechanism comes into being. A simulation of proposed mechanism are designed and carried out on Alife Swarm software platform. In this simulation, a virtual grassland ecosystem is achieved where there are two kinds of artificial animals: herbivore and preyer. These artificial animals execute four types of behavior: wandering, escaping, finding food, finding sex partner in their lives. According the theories of animal ethnology, escaping from preyer is prior to other behaviors for its existence, finding food is secondly important behavior, rating is third one and wandering is last behavior. In keeping this behavior order, based on our behavior characteristic function theory, the specific functions of emotion computing are built of artificial autonomous animals. The result of simulation confirms the behavior selection mechanism.

  15. The future of cytotoxic therapy: selective cytotoxicity based on biology is the key

    International Nuclear Information System (INIS)

    Bono, Johann S de; Tolcher, Anthony W; Rowinsky, Eric K

    2003-01-01

    Although mortality from breast cancer is decreasing, 15% or more of all patients ultimately develop incurable metastatic disease. It is hoped that new classes of target-based cytotoxic therapeutics will significantly improve the outcome for these patients. Many of these novel agents have displayed cytotoxic activity in preclinical and clinical evaluations, with little toxicity. Such preferential cytotoxicity against malignant tissues will remain tantamount to the Holy Grail in oncologic therapeutics because this portends improved patient tolerance and overall quality of life, and the capacity to deliver combination therapy. Combinations of such rationally designed target-based therapies are likely to be increasingly important in treating patients with breast carcinoma. The anticancer efficacy of these agents will, however, remain dependent on the involvement of the targets of these agents in the biology of the individual patient's disease. Results of DNA microarray analyses have raised high hopes that the analyses of RNA expression levels can successfully predict patient prognosis, and indicate that the ability to rapidly 'fingerprint' the oncogenic profile of a patient's tumor is now possible. It is hoped that these studies will support the identification of the molecules driving a tumor's growth, and the selection of the appropriate combination of targeted agents in the near future

  16. Do Culture-based Segments Predict Selection of Market Strategy?

    Directory of Open Access Journals (Sweden)

    Veronika Jadczaková

    2015-01-01

    Full Text Available Academists and practitioners have already acknowledged the importance of unobservable segmentation bases (such as psychographics yet still focusing on how well these bases are capable of describing relevant segments (the identifiability criterion rather than on how precisely these segments can predict (the predictability criterion. Therefore, this paper intends to add a debate to this topic by exploring whether culture-based segments do account for a selection of market strategy. To do so, a set of market strategy variables over a sample of 251 manufacturing firms was first regressed on a set of 19 cultural variables using canonical correlation analysis. Having found significant relationship in the first canonical function, it was further examined by means of correspondence analysis which cultural segments – if any – are linked to which market strategies. However, as correspondence analysis failed to find a significant relationship, it may be concluded that business culture might relate to the adoption of market strategy but not to the cultural groupings presented in the paper.

  17. Feature selection gait-based gender classification under different circumstances

    Science.gov (United States)

    Sabir, Azhin; Al-Jawad, Naseer; Jassim, Sabah

    2014-05-01

    This paper proposes a gender classification based on human gait features and investigates the problem of two variations: clothing (wearing coats) and carrying bag condition as addition to the normal gait sequence. The feature vectors in the proposed system are constructed after applying wavelet transform. Three different sets of feature are proposed in this method. First, Spatio-temporal distance that is dealing with the distance of different parts of the human body (like feet, knees, hand, Human Height and shoulder) during one gait cycle. The second and third feature sets are constructed from approximation and non-approximation coefficient of human body respectively. To extract these two sets of feature we divided the human body into two parts, upper and lower body part, based on the golden ratio proportion. In this paper, we have adopted a statistical method for constructing the feature vector from the above sets. The dimension of the constructed feature vector is reduced based on the Fisher score as a feature selection method to optimize their discriminating significance. Finally k-Nearest Neighbor is applied as a classification method. Experimental results demonstrate that our approach is providing more realistic scenario and relatively better performance compared with the existing approaches.

  18. Selective Osmotic Shock (SOS)-Based Islet Isolation for Microencapsulation.

    Science.gov (United States)

    Enck, Kevin; McQuilling, John Patrick; Orlando, Giuseppe; Tamburrini, Riccardo; Sivanandane, Sittadjody; Opara, Emmanuel C

    2017-01-01

    Islet transplantation (IT) has recently been shown to be a promising alternative to pancreas transplantation for reversing diabetes. IT requires the isolation of the islets from the pancreas, and these islets can be used to fabricate a bio-artificial pancreas. Enzymatic digestion is the current gold standard procedure for islet isolation but has lingering concerns. One such concern is that it has been shown to damage the islets due to nonselective tissue digestion. This chapter provides a detailed description of a nonenzymatic method that we are exploring in our lab as an alternative to current enzymatic digestion procedures for islet isolation from human and nonhuman pancreatic tissues. This method is based on selective destruction and protection of specific cell types and has been shown to leave the extracellular matrix (ECM) of islets intact, which may thus enhance islet viability and functionality. We also show that these SOS-isolated islets can be microencapsulated for transplantation.

  19. Analysis of Trust-Based Approaches for Web Service Selection

    DEFF Research Database (Denmark)

    Dragoni, Nicola; Miotto, Nicola

    2011-01-01

    The basic tenet of Service-Oriented Computing (SOC) is the possibility of building distributed applications on the Web by using Web services as fundamental building blocks. The proliferation of such services is considered the second wave of evolution in the Internet age, moving the Web from...... a collection of pages to a collections of services. Consensus is growing that this Web service revolution wont eventuate until we resolve trust-related issues. Indeed, the intrinsic openness of the SOC vision makes crucial to locate useful services and recognize them as trustworthy. In this paper we review...... the field of trust-based Web service selection, providing a structured classification of current approaches and highlighting the main limitations of each class and of the overall field....

  20. Wave impedance selection for passivity-based bilateral teleoperation

    Science.gov (United States)

    D'Amore, Nicholas John

    When a task must be executed in a remote or dangerous environment, teleoperation systems may be employed to extend the influence of the human operator. In the case of manipulation tasks, haptic feedback of the forces experienced by the remote (slave) system is often highly useful in improving an operator's ability to perform effectively. In many of these cases (especially teleoperation over the internet and ground-to-space teleoperation), substantial communication latency exists in the control loop and has the strong tendency to cause instability of the system. The first viable solution to this problem in the literature was based on a scattering/wave transformation from transmission line theory. This wave transformation requires the designer to select a wave impedance parameter appropriate to the teleoperation system. It is widely recognized that a small value of wave impedance is well suited to free motion and a large value is preferable for contact tasks. Beyond this basic observation, however, very little guidance exists in the literature regarding the selection of an appropriate value. Moreover, prior research on impedance selection generally fails to account for the fact that in any realistic contact task there will simultaneously exist contact considerations (perpendicular to the surface of contact) and quasi-free-motion considerations (parallel to the surface of contact). The primary contribution of the present work is to introduce an approximate linearized optimum for the choice of wave impedance and to apply this quasi-optimal choice to the Cartesian reality of such a contact task, in which it cannot be expected that a given joint will be either perfectly normal to or perfectly parallel to the motion constraint. The proposed scheme selects a wave impedance matrix that is appropriate to the conditions encountered by the manipulator. This choice may be implemented as a static wave impedance value or as a time-varying choice updated according to the

  1. SELECTIVE INTESTINAL DECONTAMINATION FOR PREVENTION OF WOUND COLONIZATION IN SEVERELY BURNED PATIENTS - A RETROSPECTIVE ANALYSIS

    NARCIS (Netherlands)

    MANSON, WL; KLASEN, HJ; SAUER, EW; OLIEMAN, A

    In this study the effect of selective intestinal decontamination of the digestive tract (SDD) on wound colonization was investigated. Ninety-one patients with at least 25 per cent total burned surface area (TBSA) were included in this study. All patients received oral polymyxin. In 63 patients oral

  2. Electromyographic control of functional electrical stimulation in selected patients.

    Science.gov (United States)

    Graupe, D; Kohn, K H; Basseas, S; Naccarato, E

    1984-07-01

    The paper describes initial results of above-lesion electromyographic (EMG) controlled functional electrical stimulation (FES) of paraplegics. Such controlled stimulation is to provide upper-motor-neuron paraplegics (T5 to T12) with self-controlled standing and some walking without braces and with only the help of walkers or crutches. The above-lesion EMG signal employed serves to map the posture of the patient's upper trunk via a computerized mapping of the temporal patterns of that EMG. Such control also has an inherent safety feature in that it prevents the patient from performing a lower-limb movement via FES unless his trunk posture is adequate. Copyright 2013, SLACK Incorporated.

  3. Mitral valve prolapse and hyperthyroidism: effect of patient selection.

    Science.gov (United States)

    Zullo, M A; Devereux, R B; Kramer-Fox, R; Lutas, E M; Brown, W T

    1985-11-01

    Patients with mitral valve prolapse and hyperthyroidism have common symptoms; the most outstanding symptom is palpitation. To determine whether or not common symptoms contributed to the reported association of these conditions, we evaluated 220 patients with symptomatic mitral valve prolapse and 216 first-degree relatives in 72 families; 65 relatives with mitral valve prolapse and 151 relatives without mitral valve prolapse, all greater than or equal to 16 years of age. Thirty subjects, aged 49 +/- 13 years (p less than 0.025 vs entire study group), had thyroid disease (23 subjects had definite thyroid disease, seven subjects had probable); 27 of 30 subjects with thyroid disease (90%) were female (p less than 0.005). The age- and sex-adjusted prevalence of hyperthyroidism was significantly higher in probands with mitral valve prolapse than in family members without mitral valve prolapse (3.5% vs 0%, p = 0.03), while an intermediate prevalence of hyperthyroidism (2.2%) was observed in family members with mitral valve prolapse. Thus, the prevalence of hyperthyroidism is increased among symptomatic patients with mitral valve prolapse as compared to family members without mitral valve prolapse, but the prevalence of thyroid conditions is similar among family members with or without this condition. These findings are explained by the effect of common symptoms on clinical detection of both mitral valve prolapse and hyperthyroidism.

  4. Multi-atlas pancreas segmentation: Atlas selection based on vessel structure.

    Science.gov (United States)

    Karasawa, Ken'ichi; Oda, Masahiro; Kitasaka, Takayuki; Misawa, Kazunari; Fujiwara, Michitaka; Chu, Chengwen; Zheng, Guoyan; Rueckert, Daniel; Mori, Kensaku

    2017-07-01

    Automated organ segmentation from medical images is an indispensable component for clinical applications such as computer-aided diagnosis (CAD) and computer-assisted surgery (CAS). We utilize a multi-atlas segmentation scheme, which has recently been used in different approaches in the literature to achieve more accurate and robust segmentation of anatomical structures in computed tomography (CT) volume data. Among abdominal organs, the pancreas has large inter-patient variability in its position, size and shape. Moreover, the CT intensity of the pancreas closely resembles adjacent tissues, rendering its segmentation a challenging task. Due to this, conventional intensity-based atlas selection for pancreas segmentation often fails to select atlases that are similar in pancreas position and shape to those of the unlabeled target volume. In this paper, we propose a new atlas selection strategy based on vessel structure around the pancreatic tissue and demonstrate its application to a multi-atlas pancreas segmentation. Our method utilizes vessel structure around the pancreas to select atlases with high pancreatic resemblance to the unlabeled volume. Also, we investigate two types of applications of the vessel structure information to the atlas selection. Our segmentations were evaluated on 150 abdominal contrast-enhanced CT volumes. The experimental results showed that our approach can segment the pancreas with an average Jaccard index of 66.3% and an average Dice overlap coefficient of 78.5%. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Characterization of Cardiac Patients Based on the Synergy Model

    Directory of Open Access Journals (Sweden)

    Tavangar

    2014-10-01

    Full Text Available Background Cardiac patients need comprehensive support due to the adverse effects of this disease on different aspects of their lives. Synergy intervention is a model that focuses on patients' requirements. Objectives This study aimed to determine the eightfold characteristic of cardiac patients based on the synergy model that represent their clinical requirements. Materials and Methods In this descriptive cross-sectional study, 40 cardiac patients hospitalized at the cardiac care unit (CCU of Yazd Afshar Hospital were randomly selected. The data were collected by using a two-part check-list including demographic characteristics and also by studying eight characteristics of patients through interviewing and reviewing their records. The results were analyzed using descriptive statistics such as frequency (percentage and analytical statistics such as Spearman and Mann-Whitney test with the SPSS software, version 18. Results The results showed that among patients' internal characteristics, reversibility (70.6%, vulnerability (68.6%, and predictability (80.4% at level 1 (the minimum score had the highest frequency and stability (49% and complexity (54.9% were at level 3 (average score. Among external characteristics participation in decision-making (80.4% at level 1 had the highest frequency while care (62.7% and recourses (98% were at level 3. Conclusions Ignoring any of the eightfold characteristics based on the synergy model interferes with comprehensive support of cardiac patients. Therefore, it is necessary for professional health practitioners, especially nurses, to consider patients' eightfold characteristics in order to provide quality care.

  6. Covariance-Based Measurement Selection Criterion for Gaussian-Based Algorithms

    Directory of Open Access Journals (Sweden)

    Fernando A. Auat Cheein

    2013-01-01

    Full Text Available Process modeling by means of Gaussian-based algorithms often suffers from redundant information which usually increases the estimation computational complexity without significantly improving the estimation performance. In this article, a non-arbitrary measurement selection criterion for Gaussian-based algorithms is proposed. The measurement selection criterion is based on the determination of the most significant measurement from both an estimation convergence perspective and the covariance matrix associated with the measurement. The selection criterion is independent from the nature of the measured variable. This criterion is used in conjunction with three Gaussian-based algorithms: the EIF (Extended Information Filter, the EKF (Extended Kalman Filter and the UKF (Unscented Kalman Filter. Nevertheless, the measurement selection criterion shown herein can also be applied to other Gaussian-based algorithms. Although this work is focused on environment modeling, the results shown herein can be applied to other Gaussian-based algorithm implementations. Mathematical descriptions and implementation results that validate the proposal are also included in this work.

  7. Selective mutism: a consensus based care pathway of good practice.

    Science.gov (United States)

    Keen, D V; Fonseca, S; Wintgens, A

    2008-10-01

    Selective mutism (SM) now acknowledged as an anxiety condition, tends to be a poorly understood, highly complex and vastly under-recognised clinical entity. Children with SM are a vulnerable group as the condition is not the remit of any one professional group. This inevitably leads to delay in formal diagnosis and management. There is a lack of systematic research on which to base guidelines for management. To develop, agree and validate key principles underlying the management of SM through a consensus process involving international experts, in order to create a local care pathway. A local multi-agency consultation process developed 11 statements, which were felt to be the key principles underpinning a potential care pathway for managing SM. Thirteen recognised experts from North America, Europe and Australia participated in a modified Delphi process involving two rounds using a Likert-scale and free commentary. Both quantitative and qualitative analyses were used in the validation or revision of the statements at each stage. Response rates were 100% for Round 1 and 84.6% for Round 2. Despite the differing professional backgrounds and service contexts, by successive revision and/or revalidation of statements, it was possible to arrive at a consensus about key principles relating to early recognition, assessment and intervention. The agreed key principles are presented together with the resulting local care pathway. Through a Delphi process, agreement was reached by a multidisciplinary group of professionals, on key principles that underpin the timely identification, assessment and management of children with SM. These include the potential for staff in school/preschool settings to identify SM and that intervention programmes should generally be based in these settings. Children with SM should receive assessment for possible coexisting disorders, whether developmental, emotional or behavioural and additional specific intervention given for these. Agreement was

  8. Selective contracting and channelling patients to preferred providers.

    NARCIS (Netherlands)

    Bes, R.; Curfs, E.; Groenewegen, P.; Jong, J. de

    2014-01-01

    Background: In 2006, the Dutch health care system changed from a supplyoriented system to a demand-oriented system based on managed competition. In a system of managed competition, health insurers (HIs) are supposed to be prudent purchasers of health care on behalf of their enrolees. In order for

  9. Supra-annular structure assessment for self-expanding transcatheter heart valve size selection in patients with bicuspid aortic valve.

    Science.gov (United States)

    Liu, Xianbao; He, Yuxin; Zhu, Qifeng; Gao, Feng; He, Wei; Yu, Lei; Zhou, Qijing; Kong, Minjian; Wang, Jian'an

    2018-04-01

    To explore assessment of supra-annular structure for self-expanding transcatheter heart valve (THV) size selection in patients with bicuspid aortic stenosis (AS). Annulus-based device selection from CT measurement is the standard sizing strategy for tricuspid aortic valve before transcatheter aortic valve replacement (TAVR). Because of supra-annular deformity, device selection for bicuspid AS has not been systemically studied. Twelve patients with bicuspid AS who underwent TAVR with self-expanding THVs were included in this study. To assess supra-annular structure, sequential balloon aortic valvuloplasty was performed in every 2 mm increments until waist sign occurred with less than mild regurgitation. Procedural results and 30 day follow-up outcomes were analyzed. Seven patients (58.3%) with 18 mm; three patients (25%) with sequential 18 mm, 20 mm; and only two patients (16.7%) with sequential 18 mm, 20 mm, and 22 mm balloon sizing were performed, respectively. According to the results of supra-annular assessment, a smaller device size (91.7%) was selected in all but one patient compared with annulus based sizing strategy, and the outcomes were satisfactory with 100% procedural success. No mortality and 1 minor stroke were observed at 30 d follow-up. The percentage of NYHA III/IV decreased from 83.3% (9/12) to 16.7% (2/12). No new permanent pacemaker implantation and no moderate or severe paravalvular leakage were found. A supra-annular structure based sizing strategy is feasible for TAVR in patients with bicuspid AS. © 2018 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

  10. Bacterial clonal diagnostics as a tool for evidence-based empiric antibiotic selection.

    Directory of Open Access Journals (Sweden)

    Veronika Tchesnokova

    Full Text Available Despite the known clonal distribution of antibiotic resistance in many bacteria, empiric (pre-culture antibiotic selection still relies heavily on species-level cumulative antibiograms, resulting in overuse of broad-spectrum agents and excessive antibiotic/pathogen mismatch. Urinary tract infections (UTIs, which account for a large share of antibiotic use, are caused predominantly by Escherichia coli, a highly clonal pathogen. In an observational clinical cohort study of urgent care patients with suspected UTI, we assessed the potential for E. coli clonal-level antibiograms to improve empiric antibiotic selection. A novel PCR-based clonotyping assay was applied to fresh urine samples to rapidly detect E. coli and the urine strain's clonotype. Based on a database of clonotype-specific antibiograms, the acceptability of various antibiotics for empiric therapy was inferred using a 20%, 10%, and 30% allowed resistance threshold. The test's performance characteristics and possible effects on prescribing were assessed. The rapid test identified E. coli clonotypes directly in patients' urine within 25-35 minutes, with high specificity and sensitivity compared to culture. Antibiotic selection based on a clonotype-specific antibiogram could reduce the relative likelihood of antibiotic/pathogen mismatch by ≥ 60%. Compared to observed prescribing patterns, clonal diagnostics-guided antibiotic selection could safely double the use of trimethoprim/sulfamethoxazole and minimize fluoroquinolone use. In summary, a rapid clonotyping test showed promise for improving empiric antibiotic prescribing for E. coli UTI, including reversing preferential use of fluoroquinolones over trimethoprim/sulfamethoxazole. The clonal diagnostics approach merges epidemiologic surveillance, antimicrobial stewardship, and molecular diagnostics to bring evidence-based medicine directly to the point of care.

  11. Bacterial clonal diagnostics as a tool for evidence-based empiric antibiotic selection.

    Science.gov (United States)

    Tchesnokova, Veronika; Avagyan, Hovhannes; Rechkina, Elena; Chan, Diana; Muradova, Mariya; Haile, Helen Ghirmai; Radey, Matthew; Weissman, Scott; Riddell, Kim; Scholes, Delia; Johnson, James R; Sokurenko, Evgeni V

    2017-01-01

    Despite the known clonal distribution of antibiotic resistance in many bacteria, empiric (pre-culture) antibiotic selection still relies heavily on species-level cumulative antibiograms, resulting in overuse of broad-spectrum agents and excessive antibiotic/pathogen mismatch. Urinary tract infections (UTIs), which account for a large share of antibiotic use, are caused predominantly by Escherichia coli, a highly clonal pathogen. In an observational clinical cohort study of urgent care patients with suspected UTI, we assessed the potential for E. coli clonal-level antibiograms to improve empiric antibiotic selection. A novel PCR-based clonotyping assay was applied to fresh urine samples to rapidly detect E. coli and the urine strain's clonotype. Based on a database of clonotype-specific antibiograms, the acceptability of various antibiotics for empiric therapy was inferred using a 20%, 10%, and 30% allowed resistance threshold. The test's performance characteristics and possible effects on prescribing were assessed. The rapid test identified E. coli clonotypes directly in patients' urine within 25-35 minutes, with high specificity and sensitivity compared to culture. Antibiotic selection based on a clonotype-specific antibiogram could reduce the relative likelihood of antibiotic/pathogen mismatch by ≥ 60%. Compared to observed prescribing patterns, clonal diagnostics-guided antibiotic selection could safely double the use of trimethoprim/sulfamethoxazole and minimize fluoroquinolone use. In summary, a rapid clonotyping test showed promise for improving empiric antibiotic prescribing for E. coli UTI, including reversing preferential use of fluoroquinolones over trimethoprim/sulfamethoxazole. The clonal diagnostics approach merges epidemiologic surveillance, antimicrobial stewardship, and molecular diagnostics to bring evidence-based medicine directly to the point of care.

  12. Selective digestive tract decontamination and selective oropharyngeal decontamination and antibiotic resistance in patients in intensive-care units: an open-label, clustered group-randomised, crossover study

    NARCIS (Netherlands)

    Smet, A.M. de; Kluytmans, J.A.; Blok, H.E.; Mascini, E.M.; Benus, R.F.; Bernards, A.T.; Kuijper, E.J.; Leverstein-van Hall, M.A.; Jansz, A.R.; Jongh, B.M. de; Asselt, G.J. van; Frenay, I.H.; Thijsen, S.F.; Conijn, S.N.; Kaan, J.A.; Arends, J.P.; Sturm, P.D.J.; Bootsma, M.C.; Bonten, M.J.

    2011-01-01

    BACKGROUND: Previously, we assessed selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) on survival and prevention of bacteraemia in patients in intensive-care units. In this analysis, we aimed to assess effectiveness of these interventions for

  13. Selective digestive tract decontamination and selective oropharyngeal decontamination and antibiotic resistance in patients in intensive-care units : an open-label, clustered group-randomised, crossover study

    NARCIS (Netherlands)

    de Smet, Anne Marie G. A.; Kluytmans, Jan A. J. W.; Blok, Hetty E. M.; Mascini, Ellen M.; Benus, Robin F. J.; Bernards, Alexandra T.; Kuijper, Ed J.; Leverstein-van Hall, Maurine A.; Jansz, Arjan R.; de Jongh, Bartelt M.; van Asselt, Gerard J.; Frenay, Ine H. M. E.; Thijsen, Steven F. T.; Conijn, Simon N. M.; Kaan, Jan A.; Arends, Jan P.; Sturm, Patrick D. J.; Bootsma, Martin C. J.; Bonten, Marc J. M.

    Background Previously, we assessed selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) on survival and prevention of bacteraemia in patients in intensive-care units. In this analysis, we aimed to assess effectiveness of these interventions for prevention

  14. Solving a More Flexible Home Health Care Scheduling and Routing Problem with Joint Patient and Nursing Staff Selection

    Directory of Open Access Journals (Sweden)

    Jamal Abdul Nasir

    2018-01-01

    Full Text Available Development of an efficient and effective home health care (HHC service system is a quite recent and challenging task for the HHC firms. This paper aims to develop an HHC service system in the perspective of long-term economic sustainability as well as operational efficiency. A more flexible mixed-integer linear programming (MILP model is formulated by incorporating the dynamic arrival and departure of patients along with the selection of new patients and nursing staff. An integrated model is proposed that jointly addresses: (i patient selection; (ii nurse hiring; (iii nurse to patient assignment; and (iv scheduling and routing decisions in a daily HHC planning problem. The proposed model extends the HHC problem from conventional scheduling and routing issues to demand and capacity management aspects. It enables an HHC firm to solve the daily scheduling and routing problem considering existing patients and nursing staff in combination with the simultaneous selection of new patients and nurses, and optimizing the existing routes by including new patients and nurses. The model considers planning issues related to compatibility, time restrictions, contract durations, idle time and workload balance. Two heuristic methods are proposed to solve the model by exploiting the variable neighborhood search (VNS approach. Results obtained from the heuristic methods are compared with a CPLEX based solution. Numerical experiments performed on different data sets, show the efficiency and effectiveness of the solution methods to handle the considered problem.

  15. Reducing wrong patient selection errors: exploring the design space of user interface techniques.

    Science.gov (United States)

    Sopan, Awalin; Plaisant, Catherine; Powsner, Seth; Shneiderman, Ben

    2014-01-01

    Wrong patient selection errors are a major issue for patient safety; from ordering medication to performing surgery, the stakes are high. Widespread adoption of Electronic Health Record (EHR) and Computerized Provider Order Entry (CPOE) systems makes patient selection using a computer screen a frequent task for clinicians. Careful design of the user interface can help mitigate the problem by helping providers recall their patients' identities, accurately select their names, and spot errors before orders are submitted. We propose a catalog of twenty seven distinct user interface techniques, organized according to a task analysis. An associated video demonstrates eighteen of those techniques. EHR designers who consider a wider range of human-computer interaction techniques could reduce selection errors, but verification of efficacy is still needed.

  16. Psychosocial and Patient Education Needs of Prostate Cancers Selecting Watchful Waiting

    National Research Council Canada - National Science Library

    Knight, Sara J; Latini, David M

    2006-01-01

    ... of this approach to disease management. We propose to gather data from prostate cancer patients selecting watchful waiting in lieu of an active treatment for their cancer in order to understand the psychosocial and symptom management...

  17. Cost effectiveness of selective decontamination of the digestive tract in liver transplant patients

    NARCIS (Netherlands)

    van Enckevort, PJ; Zwaveling, JH; Bottema, JT; Maring, JK; Klompmaker, IJ; Slooff, MJH; TenVergert, EM

    2001-01-01

    Objective: To assess the cost effectiveness of selective decontamination of the digestive tract (SDD) in liver transplant patients. Design: Randomised, placebo-controlled, double-blind trial with an integrated economic evaluation. Setting: Two university hospitals in The Netherlands. Cost

  18. Exploring Visual Selective Attention towards Novel Stimuli in Alzheimer's Disease Patients

    OpenAIRE

    Sarah A. Chau; Nathan Herrmann; Moshe Eizenman; Jonathan Chung; Krista L. Lanctôt

    2015-01-01

    Background: Alzheimer's disease (AD) is associated with selective attention impairments, which could contribute to cognitive and functional deficits. Selective attention can be explored through examination of novelty preference. Aims: In this study, we quantified novelty preference in AD patients by measuring visual scanning behaviour using an eye tracking paradigm. Methods: Mild-to-moderate AD patients and elderly controls viewed slides containing novel and repeated images simultaneously. Th...

  19. Selection for Surgical Training: An Evidence-Based Review.

    Science.gov (United States)

    Schaverien, Mark V

    2016-01-01

    The predictive relationship between candidate selection criteria for surgical training programs and future performance during and at the completion of training has been investigated for several surgical specialties, however there is no interspecialty agreement regarding which selection criteria should be used. Better understanding the predictive reliability between factors at selection and future performance may help to optimize the process and lead to greater standardization of the surgical selection process. PubMed and Ovid MEDLINE databases were searched. Over 560 potentially relevant publications were identified using the search strategy and screened using the Cochrane Collaboration Data Extraction and Assessment Template. 57 studies met the inclusion criteria. Several selection criteria used in the traditional selection demonstrated inconsistent correlation with subsequent performance during and at the end of surgical training. The following selection criteria, however, demonstrated good predictive relationships with subsequent resident performance: USMLE examination scores, Letters of Recommendation (LOR) including the Medical Student Performance Evaluation (MSPE), academic performance during clinical clerkships, the interview process, displaying excellence in extracurricular activities, and the use of unadjusted rank lists. This systematic review supports that the current selection process needs to be further evaluated and improved. Multicenter studies using standardized outcome measures of success are now required to improve the reliability of the selection process to select the best trainees. Published by Elsevier Inc.

  20. Non-selective beta-blockers decrease thrombotic events in patients with heart failure

    NARCIS (Netherlands)

    De Peuter, Olav R.; Souverein, Patrick C.; Klungel, Olaf H.; Lip, Gregory Y.; Buller, Harry R.; De Boer, Anthonius; Kamphuisen, Pieter W.

    2010-01-01

    Background: Beta-blockers are often prescribed to patients with heart failure (HF) without distinctions between types of beta-blockers. The 2002 COMET study showed superiority of carvedilol (a non-selective beta-blocker) over metoprolol (selective beta-blocker) on mortality and cardiovascular events

  1. Sol-gel based sensor for selective formaldehyde determination

    Energy Technology Data Exchange (ETDEWEB)

    Bunkoed, Opas [Trace Analysis and Biosensor Research Center, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand); Department of Chemistry and Center for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand); Davis, Frank [Cranfield Health, Cranfield University, Bedford MK43 0AL (United Kingdom); Kanatharana, Proespichaya, E-mail: proespichaya.K@psu.ac.th [Trace Analysis and Biosensor Research Center, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand); Department of Chemistry and Center for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand); Thavarungkul, Panote [Trace Analysis and Biosensor Research Center, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand); Department of Physics, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand); Higson, Seamus P.J., E-mail: s.p.j.higson@cranfield.ac.uk [Cranfield Health, Cranfield University, Bedford MK43 0AL (United Kingdom)

    2010-02-05

    We report the development of transparent sol-gels with entrapped sensitive and selective reagents for the detection of formaldehyde. The sampling method is based on the adsorption of formaldehyde from the air and reaction with {beta}-diketones (for example acetylacetone) in a sol-gel matrix to produce a yellow product, lutidine, which was detected directly. The proposed method does not require preparation of samples prior to analysis and allows both screening by visual detection and quantitative measurement by simple spectrophotometry. The detection limit of 0.03 ppmv formaldehyde is reported which is lower than the maximum exposure concentrations recommended by both the World Health Organisation (WHO) and the Occupational Safety and Health Administration (OSHA). This sampling method was found to give good reproducibility, the relative standard deviation at 0.2 and 1 ppmv being 6.3% and 4.6%, respectively. Other carbonyl compounds i.e. acetaldehyde, benzaldehyde, acetone and butanone do not interfere with this analytical approach. Results are provided for the determination of formaldehyde in indoor air.

  2. Sol-gel based sensor for selective formaldehyde determination

    International Nuclear Information System (INIS)

    Bunkoed, Opas; Davis, Frank; Kanatharana, Proespichaya; Thavarungkul, Panote; Higson, Seamus P.J.

    2010-01-01

    We report the development of transparent sol-gels with entrapped sensitive and selective reagents for the detection of formaldehyde. The sampling method is based on the adsorption of formaldehyde from the air and reaction with β-diketones (for example acetylacetone) in a sol-gel matrix to produce a yellow product, lutidine, which was detected directly. The proposed method does not require preparation of samples prior to analysis and allows both screening by visual detection and quantitative measurement by simple spectrophotometry. The detection limit of 0.03 ppmv formaldehyde is reported which is lower than the maximum exposure concentrations recommended by both the World Health Organisation (WHO) and the Occupational Safety and Health Administration (OSHA). This sampling method was found to give good reproducibility, the relative standard deviation at 0.2 and 1 ppmv being 6.3% and 4.6%, respectively. Other carbonyl compounds i.e. acetaldehyde, benzaldehyde, acetone and butanone do not interfere with this analytical approach. Results are provided for the determination of formaldehyde in indoor air.

  3. A Lightweight Structure Redesign Method Based on Selective Laser Melting

    Directory of Open Access Journals (Sweden)

    Li Tang

    2016-11-01

    Full Text Available The purpose of this paper is to present a new design method of lightweight parts fabricated by selective laser melting (SLM based on the “Skin-Frame” and to explore the influence of fabrication defects on SLM parts with different sizes. Some standard lattice parts were designed according to the Chinese GB/T 1452-2005 standard and manufactured by SLM. Then these samples were tested in an MTS Insight 30 compression testing machine to study the trends of the yield process with different structure sizes. A set of standard cylinder samples were also designed according to the Chinese GB/T 228-2010 standard. These samples, which were made of iron-nickel alloy (IN718, were also processed by SLM, and then tested in the universal material testing machine INSTRON 1346 to obtain their tensile strength. Furthermore, a lightweight redesigned method was researched. Then some common parts such as a stopper and connecting plate were redesigned using this method. These redesigned parts were fabricated and some application tests have already been performed. The compression testing results show that when the minimum structure size is larger than 1.5 mm, the mechanical characteristics will hardly be affected by process defects. The cylinder parts were fractured by the universal material testing machine at about 1069.6 MPa. These redesigned parts worked well in application tests, with both the weight and fabrication time of these parts reduced more than 20%.

  4. Moldless PEGDA-Based Optoelectrofluidic Platform for Microparticle Selection

    Directory of Open Access Journals (Sweden)

    Shih-Mo Yang

    2011-01-01

    Full Text Available This paper reports on an optoelectrofluidic platform which consists of the organic photoconductive material, titanium oxide phthalocyanine (TiOPc, and the photocrosslinkable polymer, poly (ethylene glycol diacrylate (PEGDA. TiOPc simplifies the fabrication process of the optoelectronic chip due to requiring only a single spin-coating step. PEGDA is applied to embed the moldless PEGDA-based microchannel between the top ITO glass and the bottom TiOPc substrate. A real-time control interface via a touch panel screen is utilized to select the target 15 μm polystyrene particles. When the microparticles flow to an illuminating light bar, which is oblique to the microfluidic flow path, the lateral driving force diverts the microparticles. Two light patterns, the switching oblique light bar and the optoelectronic ladder phenomenon, are designed to demonstrate the features. This work integrating the new material design, TiOPc and PEGDA, and the ability of mobile microparticle manipulation demonstrates the potential of optoelectronic approach.

  5. Towards Identify Selective Antibacterial Peptides Based on Abstracts Meaning

    Directory of Open Access Journals (Sweden)

    Liliana I. Barbosa-Santillán

    2016-01-01

    Full Text Available We present an Identify Selective Antibacterial Peptides (ISAP approach based on abstracts meaning. Laboratories and researchers have significantly increased the report of their discoveries related to antibacterial peptides in primary publications. It is important to find antibacterial peptides that have been reported in primary publications because they can produce antibiotics of different generations that attack and destroy the bacteria. Unfortunately, researchers used heterogeneous forms of natural language to describe their discoveries (sometimes without the sequence of the peptides. Thus, we propose that learning the words meaning instead of the antibacterial peptides sequence is possible to identify and predict antibacterial peptides reported in the PubMed engine. The ISAP approach consists of two stages: training and discovering. ISAP founds that the 35% of the abstracts sample had antibacterial peptides and we tested in the updated Antimicrobial Peptide Database 2 (APD2. ISAP predicted that 45% of the abstracts had antibacterial peptides. That is, ISAP found that 810 antibacterial peptides were not classified like that, so they are not reported in APD2. As a result, this new search tool would complement the APD2 with a set of peptides that are candidates to be antibacterial. Finally, 20% of the abstracts were not semantic related to APD2.

  6. Route Selection with Unspecified Sites Using Knowledge Based Genetic Algorithm

    Science.gov (United States)

    Kanoh, Hitoshi; Nakamura, Nobuaki; Nakamura, Tomohiro

    This paper addresses the problem of selecting a route to a given destination that traverses several non-specific sites (e.g. a bank, a gas station) as requested by a driver. The proposed solution uses a genetic algorithm that includes viral infection. The method is to generate two populations of viruses as domain specific knowledge in addition to a population of routes. A part of an arterial road is regarded as a main virus, and a road that includes a site is regarded as a site virus. An infection occurs between two points common to a candidate route and the virus, and involves the substitution of the intersections carried by the virus for those on the existing candidate route. Crossover and infection determine the easiest-to-drive and quasi-shortest route through the objective landmarks. Experiments using actual road maps show that this infection-based mechanism is an effective way of solving the problem. Our strategy is general, and can be effectively used in other optimization problems.

  7. New Criteria of Indication and Selection of Patients to Cochlear Implant

    Directory of Open Access Journals (Sweden)

    André L. L. Sampaio

    2011-01-01

    Full Text Available Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant.

  8. Assessment of different quit smoking methods selected by patients in tobacco cessation centers in Iran

    Directory of Open Access Journals (Sweden)

    Gholamreza Heydari

    2015-01-01

    Full Text Available Background: Health systems play key roles in identifying tobacco users and providing evidence-based care to help them quit. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess different quit smoking methods selected by patients in tobacco cessation centers in Iran in order to identify those that are most appropriate for the country health system. Methods: In this cross-sectional and descriptive study, a random sample of all quit centers at the country level was used to obtain a representative sample. Patients completed the self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: A total of 1063 smokers returned completed survey questionnaires. The most frequently used methods were Nicotine Replacement Therapy (NRT and combination therapy (NRT and Counseling with 228 and 163 individuals reporting these respectively. The least used methods were hypnotism (n = 8 and the quit and win (n = 17. The methods which gained the maximum scores were respectively the combined method, personal and Champix with means of 21.4, 20.4 and 18.4. The minimum scores were for e-cigarettes, hypnotism and education with means of 12.8, 11 and 10.8, respectively. There were significant differences in mean scores based on different cities and different methods. Conclusions: According to smokers′ selection the combined therapy, personal methods and Champix are the most effective methods for quit smoking and these methods could be much more considered in the country health system.

  9. Change-based test selection : An empirical evaluation

    NARCIS (Netherlands)

    Soetens, Quinten; Demeyer, Serge; Zaidman, A.E.; Perez, Javier

    2015-01-01

    Regression test selection (i.e., selecting a subset of a given regression test suite) is a problem that has been studied intensely over the last decade. However, with the increasing popularity of developer tests as the driver of the test process, more fine-grained solutions that work well within the

  10. Selecting a Good Conference Location Based on Participants' Interests

    Science.gov (United States)

    Miah, Muhammed

    2011-01-01

    Selecting a good conference location within budget constraints to attract paper authors and participants is a very difficult job for the conference organizers. A conference location is also very important along with other issues such as ranking of the conference. Selecting a bad conference location may reduce the number of paper submissions and…

  11. The impact of exercise myocardial perfusion SPECT imaging on the selection of patients for coronary angiography

    International Nuclear Information System (INIS)

    Song Liping; He Zuoxiang; Liu Xiujie; Shi Rongfang; Liu Yunzhong; Tian Yueqin; Zhang Xiaoli; Qin Xuewen; Chen Jilin; Gao Runlin

    2001-01-01

    Objective: Exercise 99 Tc m -MIBI myocardial perfusion SPECT is accurate for the diagnosis of coronary artery disease (CAD). This study assessed the impact of exercise myocardial perfusion imaging on the selection of patients for coronary angiography. Methods: 2188 consecutive patients who underwent exercise myocardial perfusion SPECT in authors' department in 1999 were retrospectively analyzed. Among them, 1807 were men, 381 women (average age: 53.5 +- 7.2 years). Overall, exercise myocardial SPECT was normal in 1731 patients, abnormal in 359 cases, and equivocal in 98 patients. There were 141 patients who underwent CAG within 60 days after myocardial SPECT. Results: Overall, 12% of the patients with abnormal SPECT imaging underwent coronary angiography, but only 5% of the patients with a normal SPECT imaging did (P < 0.001). Among these 141 patients who underwent coronary angiography, significant coronary stenosis was present in 91% of the patients who had had an abnormal SPECT imaging, but only 8% of those who had had a normal SPECT imaging (P < 0.001). In those patients who underwent coronary angiography, revascularization rate was 25% for the patients with abnormal SPECT imaging, but only 1% for the patients with a normal SPECT imaging. Conclusion: The results of exercise myocardial perfusion SPECT have a significant impact on the selection of patients for coronary angiography and revascularization

  12. Performance Measurement Model for the Supplier Selection Based on AHP

    Directory of Open Access Journals (Sweden)

    Fabio De Felice

    2015-10-01

    Full Text Available The performance of the supplier is a crucial factor for the success or failure of any company. Rational and effective decision making in terms of the supplier selection process can help the organization to optimize cost and quality functions. The nature of supplier selection processes is generally complex, especially when the company has a large variety of products and vendors. Over the years, several solutions and methods have emerged for addressing the supplier selection problem (SSP. Experience and studies have shown that there is no best way for evaluating and selecting a specific supplier process, but that it varies from one organization to another. The aim of this research is to demonstrate how a multiple attribute decision making approach can be effectively applied for the supplier selection process.

  13. Evaluation of a selective management strategy of patients with primary cystic neoplasms of the pancreas

    NARCIS (Netherlands)

    de Castro, S. M. M.; Houwert, J. T.; van der Gaag, N. A.; Busch, O. R. C.; van Gulik, T. M.; Gouma, D. J.

    2011-01-01

    Recent studies have shown that a selective group of patients with primary cystic neoplasms of the pancreas can be managed conservatively by radiological follow-up. The aim of this study was to analyze if such a strategy is efficient and safe. A retrospective analyses was performed of patients who

  14. Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients

    Directory of Open Access Journals (Sweden)

    Han-Song Sheng

    2017-08-01

    Conclusion: Our results suggest that trephination mini-craniectomy is a safe surgical technique for selected PFEDH patients with moderate hematoma volume and stabilized neurological functions. However, standard craniectomy is recommend when there are rapid deteriorations in patients' neurological functions or the hematomas are large and exerted severe mass effects.

  15. IMRT QA: Selecting gamma criteria based on error detection sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Steers, Jennifer M. [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California 90048 and Physics and Biology in Medicine IDP, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095 (United States); Fraass, Benedick A., E-mail: benedick.fraass@cshs.org [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California 90048 (United States)

    2016-04-15

    Purpose: The gamma comparison is widely used to evaluate the agreement between measurements and treatment planning system calculations in patient-specific intensity modulated radiation therapy (IMRT) quality assurance (QA). However, recent publications have raised concerns about the lack of sensitivity when employing commonly used gamma criteria. Understanding the actual sensitivity of a wide range of different gamma criteria may allow the definition of more meaningful gamma criteria and tolerance limits in IMRT QA. We present a method that allows the quantitative determination of gamma criteria sensitivity to induced errors which can be applied to any unique combination of device, delivery technique, and software utilized in a specific clinic. Methods: A total of 21 DMLC IMRT QA measurements (ArcCHECK®, Sun Nuclear) were compared to QA plan calculations with induced errors. Three scenarios were studied: MU errors, multi-leaf collimator (MLC) errors, and the sensitivity of the gamma comparison to changes in penumbra width. Gamma comparisons were performed between measurements and error-induced calculations using a wide range of gamma criteria, resulting in a total of over 20 000 gamma comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using 36 different gamma criteria. Results: This study demonstrates that systematic errors and case-specific errors can be detected by the error curve analysis. Depending on the location of the error curve peak (e.g., not centered about zero), 3%/3 mm threshold = 10% at 90% pixels passing may miss errors as large as 15% MU errors and ±1 cm random MLC errors for some cases. As the dose threshold parameter was increased for a given %Diff/distance-to-agreement (DTA) setting, error sensitivity was increased by up to a factor of two for select cases. This increased sensitivity with increasing dose

  16. Generalized Selectivity Description for Polymeric Ion-Selective Electrodes Based on the Phase Boundary Potential Model.

    Science.gov (United States)

    Bakker, Eric

    2010-02-15

    A generalized description of the response behavior of potentiometric polymer membrane ion-selective electrodes is presented on the basis of ion-exchange equilibrium considerations at the sample-membrane interface. This paper includes and extends on previously reported theoretical advances in a more compact yet more comprehensive form. Specifically, the phase boundary potential model is used to derive the origin of the Nernstian response behavior in a single expression, which is valid for a membrane containing any charge type and complex stoichiometry of ionophore and ion-exchanger. This forms the basis for a generalized expression of the selectivity coefficient, which may be used for the selectivity optimization of ion-selective membranes containing electrically charged and neutral ionophores of any desired stoichiometry. It is shown to reduce to expressions published previously for specialized cases, and may be effectively applied to problems relevant in modern potentiometry. The treatment is extended to mixed ion solutions, offering a comprehensive yet formally compact derivation of the response behavior of ion-selective electrodes to a mixture of ions of any desired charge. It is compared to predictions by the less accurate Nicolsky-Eisenman equation. The influence of ion fluxes or any form of electrochemical excitation is not considered here, but may be readily incorporated if an ion-exchange equilibrium at the interface may be assumed in these cases.

  17. OBSERVATIONAL SELECTION EFFECTS WITH GROUND-BASED GRAVITATIONAL WAVE DETECTORS

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Hsin-Yu; Holz, Daniel E. [University of Chicago, Chicago, Illinois 60637 (United States); Essick, Reed; Vitale, Salvatore; Katsavounidis, Erik [LIGO, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States)

    2017-01-20

    Ground-based interferometers are not perfect all-sky instruments, and it is important to account for their behavior when considering the distribution of detected events. In particular, the LIGO detectors are most sensitive to sources above North America and the Indian Ocean, and as the Earth rotates, the sensitive regions are swept across the sky. However, because the detectors do not acquire data uniformly over time, there is a net bias on detectable sources’ right ascensions. Both LIGO detectors preferentially collect data during their local night; it is more than twice as likely to be local midnight than noon when both detectors are operating. We discuss these selection effects and how they impact LIGO’s observations and electromagnetic (EM) follow-up. Beyond galactic foregrounds associated with seasonal variations, we find that equatorial observatories can access over 80% of the localization probability, while mid-latitudes will access closer to 70%. Facilities located near the two LIGO sites can observe sources closer to their zenith than their analogs in the south, but the average observation will still be no closer than 44° from zenith. We also find that observatories in Africa or the South Atlantic will wait systematically longer before they can begin observing compared to the rest of the world; though, there is a preference for longitudes near the LIGOs. These effects, along with knowledge of the LIGO antenna pattern, can inform EM follow-up activities and optimization, including the possibility of directing observations even before gravitational-wave events occur.

  18. OBSERVATIONAL SELECTION EFFECTS WITH GROUND-BASED GRAVITATIONAL WAVE DETECTORS

    International Nuclear Information System (INIS)

    Chen, Hsin-Yu; Holz, Daniel E.; Essick, Reed; Vitale, Salvatore; Katsavounidis, Erik

    2017-01-01

    Ground-based interferometers are not perfect all-sky instruments, and it is important to account for their behavior when considering the distribution of detected events. In particular, the LIGO detectors are most sensitive to sources above North America and the Indian Ocean, and as the Earth rotates, the sensitive regions are swept across the sky. However, because the detectors do not acquire data uniformly over time, there is a net bias on detectable sources’ right ascensions. Both LIGO detectors preferentially collect data during their local night; it is more than twice as likely to be local midnight than noon when both detectors are operating. We discuss these selection effects and how they impact LIGO’s observations and electromagnetic (EM) follow-up. Beyond galactic foregrounds associated with seasonal variations, we find that equatorial observatories can access over 80% of the localization probability, while mid-latitudes will access closer to 70%. Facilities located near the two LIGO sites can observe sources closer to their zenith than their analogs in the south, but the average observation will still be no closer than 44° from zenith. We also find that observatories in Africa or the South Atlantic will wait systematically longer before they can begin observing compared to the rest of the world; though, there is a preference for longitudes near the LIGOs. These effects, along with knowledge of the LIGO antenna pattern, can inform EM follow-up activities and optimization, including the possibility of directing observations even before gravitational-wave events occur.

  19. FPGA-based RF spectrum merging and adaptive hopset selection

    Science.gov (United States)

    McLean, R. K.; Flatley, B. N.; Silvius, M. D.; Hopkinson, K. M.

    The radio frequency (RF) spectrum is a limited resource. Spectrum allotment disputes stem from this scarcity as many radio devices are confined to a fixed frequency or frequency sequence. One alternative is to incorporate cognition within a reconfigurable radio platform, therefore enabling the radio to adapt to dynamic RF spectrum environments. In this way, the radio is able to actively sense the RF spectrum, decide, and act accordingly, thereby sharing the spectrum and operating in more flexible manner. In this paper, we present a novel solution for merging many distributed RF spectrum maps into one map and for subsequently creating an adaptive hopset. We also provide an example of our system in operation, the result of which is a pseudorandom adaptive hopset. The paper then presents a novel hardware design for the frequency merger and adaptive hopset selector, both of which are written in VHDL and implemented as a custom IP core on an FPGA-based embedded system using the Xilinx Embedded Development Kit (EDK) software tool. The design of the custom IP core is optimized for area, and it can process a high-volume digital input via a low-latency circuit architecture. The complete embedded system includes the Xilinx PowerPC microprocessor, UART serial connection, and compact flash memory card IP cores, and our custom map merging/hopset selection IP core, all of which are targeted to the Virtex IV FPGA. This system is then incorporated into a cognitive radio prototype on a Rice University Wireless Open Access Research Platform (WARP) reconfigurable radio.

  20. Global stocks of selected mineral-based commodities

    Science.gov (United States)

    Wilburn, David R.; Bleiwas, Donald I.; Karl, Nick A.

    2016-12-05

    IntroductionThe U.S. Geological Survey, National Minerals Information Center, analyzes mineral and metal supply chains by identifying and describing major components of mineral and material flows from ore extraction, through intermediate forms, to a final product. This report focuses on an important component of the world’s supply chain: the amounts and global distribution of major consumer, producer, and exchange stocks of selected mineral commodities. In this report, the term “stock” is used instead of “inventory” and refers to accumulations of mined ore, intermediate products, and refined mineral-based commodities that are in a form that meets the agreed-upon specifications of a buyer or processor of intermediate products. These may include certain ores such as bauxite, concentrates, smelter products, and refined metals. Materials sometimes referred to as inventory for accounting purposes, such as ore contained in a deposit or in a leach pile, or materials that need to be further processed before they can be shipped to a consumer, are not considered. Stocks may be held (owned) by consumers, governments, investors, producers, and traders. They may serve as (1) a means to achieve economic, social, and strategic goals through government policies; (2) a secure source of supply to meet demand and to mitigate potential shortages in the supply chain; (3) a hedge to mitigate price volatility; and (4) vehicles for speculative investment.The paucity and uneven reliability of data for stocks of ores and concentrates and for material held by producers, consumers, and merchants hinder the accurate estimating of the size and distribution of this portion of the supply chain for certain commodities. This paper reviews the more visible stocks held in commodity exchange warehouses distributed throughout the world.

  1. Recurrence predictive models for patients with hepatocellular carcinoma after radiofrequency ablation using support vector machines with feature selection methods.

    Science.gov (United States)

    Liang, Ja-Der; Ping, Xiao-Ou; Tseng, Yi-Ju; Huang, Guan-Tarn; Lai, Feipei; Yang, Pei-Ming

    2014-12-01

    Recurrence of hepatocellular carcinoma (HCC) is an important issue despite effective treatments with tumor eradication. Identification of patients who are at high risk for recurrence may provide more efficacious screening and detection of tumor recurrence. The aim of this study was to develop recurrence predictive models for HCC patients who received radiofrequency ablation (RFA) treatment. From January 2007 to December 2009, 83 newly diagnosed HCC patients receiving RFA as their first treatment were enrolled. Five feature selection methods including genetic algorithm (GA), simulated annealing (SA) algorithm, random forests (RF) and hybrid methods (GA+RF and SA+RF) were utilized for selecting an important subset of features from a total of 16 clinical features. These feature selection methods were combined with support vector machine (SVM) for developing predictive models with better performance. Five-fold cross-validation was used to train and test SVM models. The developed SVM-based predictive models with hybrid feature selection methods and 5-fold cross-validation had averages of the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the ROC curve as 67%, 86%, 82%, 69%, 90%, and 0.69, respectively. The SVM derived predictive model can provide suggestive high-risk recurrent patients, who should be closely followed up after complete RFA treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun [AMC, Seoul (Korea, Republic of); Kim, Seung Kook [Kwang-Ju Health College, Kwang-Ju (Korea, Republic of)

    2001-06-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously.

  3. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    International Nuclear Information System (INIS)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun; Kim, Seung Kook

    2001-01-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously

  4. Evaluation of the effects of patient-selected music therapy on the sleep quality and pain intensity of burn patients

    Directory of Open Access Journals (Sweden)

    Fatemeh Muhaddith Ardabili

    2016-02-01

    Full Text Available Background: Sleep disturbances and pain are some of the most common problems among burn patients, which have adverse effects on recovery process and patient comfort. Given the use of music as a non-pharmacological approach to alleviate pain and provide comfort, this study aimed to evaluate the effect of patient-selected music on sleep quality and pain intensity in burn patients. Methods: This clinical trial was conducted on burn patients hospitalized in one of the hospitals of Tehran, Iran in 2015. In total, 50 patients were selected using randomized convenience sampling and divided into two intervention (n=25 and control (n=25 groups. Intervention was carried out for the intervention group through playing instrumental music, selected by the patients, in three consecutive 45-minute sessions before sleep. Severity of pain in the participants was evaluated for three nights (before and five minutes after the intervention using visual analog scale (VAS. In addition, sleep quality of the samples was assessed three days before the intervention using Pittsburgh sleep quality index (PSQI and during the post-intervention days through interviews. The mentioned scales were applied for the control group as well. Data analysis was performed in SPSS version 18 using Chi-square, as well as paired and independent t-tests. Results: In this study, a significant improvement was observed in sleep quality (P<0.001 and pain intensity (P=0.012 in the participants of intervention group after listening to music. Moreover, a significant difference was observed between the study groups after the intervention in terms of mean sleep quality score (P<0.001 and pain intensity (P=0.046. Conclusion: According to the results of this study, application of patient-selected music therapy could be associated with a significant improve in sleep quality and decrease in pain intensity in burn patients. Therefore, it is recommended that this intervention approach be applied by

  5. Evaluation of the effect of patient-selected music on sleep quality and pain intensity in burn patients

    Directory of Open Access Journals (Sweden)

    Mohaddes Ardabili Fatemeh

    2016-08-01

    Full Text Available Background and Objective: Sleep disturbances and pain are some of the most common problems among burn patients, which have adverse effects on recovery process and patient comfort. Given the use of music as a non-pharmacological approach to alleviate pain and provide comfort, this study aimed to evaluate the effect of patient-selected music on sleep quality and pain intensity in burn patients. Materials and Method: This clinical trial was conducted on burn patients hospitalized in one of the hospitals of Tehran, Iran in 2015. In total, 50 patients were selected using randomized convenience sampling and divided into two intervention (n=25 and control (n=25 groups. Intervention was carried out for the intervention group through playing instrumental music, selected by the patients, in three consecutive 45-minute sessions before sleep. Severity of pain in the participants was evaluated for three nights (before and five minutes after the intervention using visual analog scale (VAS. In addition, sleep quality of the samples was assessed three days before the intervention using Pittsburgh sleep quality index (PSQI and during the post-intervention days through interviews. The mentioned scales were applied for the control group as well. Data analysis was performed in SPSS version 18 using Chi-square, as well as paired and independent t-tests. Results: In this study, a significant improvement was observed in sleep quality (P<0.001  and pain intensity (P=0.012 in the participants of intervention group after listening to music. Moreover, a significant difference was observed between the study groups after the intervention in terms of mean sleep quality score (P<0.001 and pain intensity (P=0.046. Conclusion: According to the results of this study, application of patient-selected music therapy could be associated with a significant improve in sleep quality and decrease in pain intensity in burn patients. Therefore, it is recommended that this intervention

  6. Selective extraction and detection of noble metal based on ionic ...

    Indian Academy of Sciences (India)

    ClPrNTf2) was developed for selective detection of gold(III) by use of inductively coupled ... The importance to develop pre- ... attention. Ionic liquids (ILs) immobilized onto SG have been successfully applied as solid phase adsorbents for.

  7. Fluorescent naphthalene-based benzene tripod for selective ...

    Indian Academy of Sciences (India)

    The sensing property was extended for practical utility to sense fluoride in tap water, pond water and river water. Keywords. ... Development of selective optical signalling systems for ... contaminant level defined by the US Environmental.

  8. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study

    Science.gov (United States)

    de Abajo, Francisco José; Rodríguez, Luis Alberto García; Montero, Dolores

    1999-01-01

    Objective To examine the association between selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding. Design Population based case-control study. Setting General practices included in the UK general practice research database. Subjects 1651 incident cases of upper gastrointestinal bleeding and 248 cases of ulcer perforation among patients aged 40 to 79 years between April 1993 and September 1997, and 10 000 controls matched for age, sex, and year that the case was identified. Interventions Review of computer profiles for all potential cases, and an internal validation study to confirm the accuracy of the diagnosis on the basis of the computerised information. Main outcome measures Current use of selective serotonin reuptake inhibitors or other antidepressants within 30 days before the index date. Results Current exposure to selective serotonin reuptake inhibitors was identified in 3.1% (52 of 1651) of patients with upper gastrointestinal bleeding but only 1.0% (95 of 10 000) of controls, giving an adjusted rate ratio of 3.0 (95% confidence interval 2.1 to 4.4). This effect measure was not modified by sex, age, dose, or treatment duration. A crude incidence of 1 case per 8000 prescriptions was estimated. A small association was found with non-selective serotonin reuptake inhibitors (relative risk 1.4, 1.1 to 1.9) but not with antidepressants lacking this inhibitory effect. None of the groups of antidepressants was associated with ulcer perforation. The concurrent use of selective serotonin reuptake inhibitors with non-steroidal anti-inflammatory drugs increased the risk of upper gastrointestinal bleeding beyond the sum of their independent effects (15.6, 6.6 to 36.6). A smaller interaction was also found between selective serotonin reuptake inhibitors and low dose aspirin (7.2, 3.1 to 17.1). Conclusions Selective serotonin reuptake inhibitors increase the risk of upper gastrointestinal bleeding. The absolute effect is, however

  9. Innovation in values based public health nursing student selection: A qualitative evaluation of candidate and selection panel member perspectives.

    Science.gov (United States)

    McGraw, Caroline; Abbott, Stephen; Brook, Judy

    2018-02-19

    Values based recruitment emerges from the premise that a high degree of value congruence, or the extent to which an individual's values are similar to those of the health organization in which they work, leads to organizational effectiveness. The aim of this evaluation was to explore how candidates and selection panel members experienced and perceived innovative methods of values based public health nursing student selection. The evaluation was framed by a qualitative exploratory design involving semi-structured interviews and a group exercise. Data were thematically analyzed. Eight semi-structured interviews were conducted with selection panel members. Twenty-two successful candidates took part in a group exercise. The use of photo elicitation interviews and situational judgment questions in the context of selection to a university-run public health nursing educational program was explored. While candidates were ambivalent about the use of photo elicitation interviews, with some misunderstanding the task, selection panel members saw the benefits for improving candidate expression and reducing gaming and deception. Situational interview questions were endorsed by candidates and selection panel members due to their fidelity to real-life problems and the ability of panel members to discern value congruence from candidates' responses. Both techniques offered innovative solutions to candidate selection for entry to the public health nursing education program. © 2018 Wiley Periodicals, Inc.

  10. Theory of mind selectively predicts preschoolers’ knowledge-based selective word learning

    Science.gov (United States)

    Brosseau-Liard, Patricia; Penney, Danielle; Poulin-Dubois, Diane

    2015-01-01

    Children can selectively attend to various attributes of a model, such as past accuracy or physical strength, to guide their social learning. There is a debate regarding whether a relation exists between theory-of-mind skills and selective learning. We hypothesized that high performance on theory-of-mind tasks would predict preference for learning new words from accurate informants (an epistemic attribute), but not from physically strong informants (a non-epistemic attribute). Three- and 4-year-olds (N = 65) completed two selective learning tasks, and their theory of mind abilities were assessed. As expected, performance on a theory-of-mind battery predicted children’s preference to learn from more accurate informants but not from physically stronger informants. Results thus suggest that preschoolers with more advanced theory of mind have a better understanding of knowledge and apply that understanding to guide their selection of informants. This work has important implications for research on children’s developing social cognition and early learning. PMID:26211504

  11. Theory of mind selectively predicts preschoolers' knowledge-based selective word learning.

    Science.gov (United States)

    Brosseau-Liard, Patricia; Penney, Danielle; Poulin-Dubois, Diane

    2015-11-01

    Children can selectively attend to various attributes of a model, such as past accuracy or physical strength, to guide their social learning. There is a debate regarding whether a relation exists between theory-of-mind skills and selective learning. We hypothesized that high performance on theory-of-mind tasks would predict preference for learning new words from accurate informants (an epistemic attribute), but not from physically strong informants (a non-epistemic attribute). Three- and 4-year-olds (N = 65) completed two selective learning tasks, and their theory-of-mind abilities were assessed. As expected, performance on a theory-of-mind battery predicted children's preference to learn from more accurate informants but not from physically stronger informants. Results thus suggest that preschoolers with more advanced theory of mind have a better understanding of knowledge and apply that understanding to guide their selection of informants. This work has important implications for research on children's developing social cognition and early learning. © 2015 The British Psychological Society.

  12. Selective oropharyngeal decontamination versus selective digestive decontamination in critically ill patients: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Zhao D

    2015-07-01

    Full Text Available Di Zhao,1,* Jian Song,2,* Xuan Gao,3 Fei Gao,4 Yupeng Wu,2 Yingying Lu,5 Kai Hou1 1Department of Neurosurgery, The First Hospital of Hebei Medical University, 2Department of Neurosurgery, 3Department of Neurology, The Second Hospital of Hebei Medical University, 4Hebei Provincial Procurement Centers for Medical Drugs and Devices, 5Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang People’s Republic of China *These authors contributed equally to this work Background: Selective digestive decontamination (SDD and selective oropharyngeal decontamination (SOD are associated with reduced mortality and infection rates among patients in intensive care units (ICUs; however, whether SOD has a superior effect than SDD remains uncertain. Hence, we conducted a meta-analysis of randomized controlled trials (RCTs to compare SOD with SDD in terms of clinical outcomes and antimicrobial resistance rates in patients who were critically ill. Methods: RCTs published in PubMed, Embase, and Web of Science were systematically reviewed to compare the effects of SOD and SDD in patients who were critically ill. Outcomes included day-28 mortality, length of ICU stay, length of hospital stay, duration of mechanical ventilation, ICU-acquired bacteremia, and prevalence of antibiotic-resistant Gram-negative bacteria. Results were expressed as risk ratio (RR with 95% confidence intervals (CIs, and weighted mean differences (WMDs with 95% CIs. Pooled estimates were performed using a fixed-effects model or random-effects model, depending on the heterogeneity among studies. Results: A total of four RCTs involving 23,822 patients met the inclusion criteria and were included in this meta-analysis. Among patients whose admitting specialty was surgery, cardiothoracic surgery (57.3% and neurosurgery (29.7% were the two main types of surgery being performed. Pooled results showed that SOD had similar effects as SDD in day-28 mortality (RR =1

  13. Patient's decision making in selecting a hospital for elective orthopaedic surgery.

    Science.gov (United States)

    Moser, Albine; Korstjens, Irene; van der Weijden, Trudy; Tange, Huibert

    2010-12-01

    The admission to a hospital for elective surgery, like arthroplasty, can be planned ahead. The elective nature of arthroplasty and the increasing stimulus of the public to critically select a hospital raise the issue of how patients actually take such decisions. The aim of this paper is to describe the decision-making process of selecting a hospital as experienced by people who underwent elective joint arthroplasty and to understand what factors influenced the decision-making process. Qualitative descriptive study with 18 participants who had a hip or knee replacement within the last 5 years. Data were gathered from eight individual interviews and four focus group interviews and analysed by content analysis. Three categories that influenced the selection of a hospital were revealed: information sources, criteria in decision making and decision-making styles within the GP- patient relationship. Various contextual aspects influenced the decision-making process. Most participants gave higher priority to the selection of a medical specialist than to the selection of a hospital. Selecting a hospital for arthroplasty is extremely complex. The decision-making process is a highly individualized process because patients have to consider and assimilate a diversity of aspects, which are relevant to their specific situation. Our findings support the model of shared decision making, which indicates that general practitioners should be attuned to the distinct needs of each patient at various moments during the decision making, taking into account personal, medical and contextual factors. © 2010 Blackwell Publishing Ltd.

  14. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium.

    Science.gov (United States)

    Gribble, Phillip A; Delahunt, Eamonn; Bleakley, Chris; Caulfield, Brian; Docherty, Carrie; Fourchet, François; Fong, Daniel Tik-Pui; Hertel, Jay; Hiller, Claire; Kaminski, Thomas; McKeon, Patrick; Refshauge, Kathryn; van der Wees, Philip; Vincenzino, Bill; Wikstrom, Erik

    2014-07-01

    While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant/patient selection criteria across studies presents a potential obstacle to addressing the problem properly. This major gap within the literature limits the ability to generalise this evidence to the target patient population. Therefore, there is a need to provide standards for patient/participant selection criteria in research focused on CAI with justifications using the best available evidence. The International Ankle Consortium provides this position paper to present and discuss an endorsed set of selection criteria for patients with CAI based on the best available evidence to be used in future research and study designs. These recommendations will enhance the validity of research conducted in this clinical population with the end goal of bringing the research evidence to the clinician and patient. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. A Simple K-Map Based Variable Selection Scheme in the Direct ...

    African Journals Online (AJOL)

    A multiplexer with (n-l) data select inputs can realise directly a function of n variables. In this paper, a simple k-map based variable selection scheme is proposed such that an n variable logic function can be synthesised using a multiplexer with (n-q) data input variables and q data select variables. The procedure is based on ...

  16. Impact of Menu Sequencing on Internet-Based Educational Module Selection

    Science.gov (United States)

    Bensley, Robert; Brusk, John J.; Rivas, Jason; Anderson, Judith V.

    2006-01-01

    Patterns of Internet-based menu item selection can occur for a number of reasons, many of which may not be based on interest in topic. It then becomes important to ensure menu order is devised in a way that ensures the greatest accuracy in matching user need with selection. This study examined the impact of menu rotation on the selection of…

  17. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)

    International Nuclear Information System (INIS)

    Polgar, Csaba; Limbergen, Erik Van; Poetter, Richard; Kovacs, Gyoergy; Polo, Alfredo; Lyczek, Jaroslaw; Hildebrandt, Guido; Niehoff, Peter; Guinot, Jose Luis; Guedea, Ferran; Johansson, Bengt; Ott, Oliver J.; Major, Tibor; Strnad, Vratislav

    2010-01-01

    Purpose: To give recommendations on patient selection criteria for the use of accelerated partial-breast irradiation (APBI) based on available clinical evidence complemented by expert opinion. Methods and materials: Overall, 340 articles were identified by a systematic search of the PubMed database using the keywords 'partial-breast irradiation' and 'APBI'. This search was complemented by searches of reference lists of articles and handsearching of relevant conference abstracts and book chapters. Of these, 3 randomized and 19 prospective non-randomized studies with a minimum median follow-up time of 4 years were identified. The authors reviewed the published clinical evidence on APBI, complemented by relevant clinical and pathological studies of standard breast-conserving therapy and, through a series of personal communications, formulated the recommendations presented in this article. Results: The GEC-ESTRO Breast Cancer Working Group recommends three categories guiding patient selection for APBI: (1) a low-risk group for whom APBI outside the context of a clinical trial is an acceptable treatment option; including patients ageing at least 50 years with unicentric, unifocal, pT1-2 (≤30 mm) pN0, non-lobular invasive breast cancer without the presence of an extensive intraductal component (EIC) and lympho-vascular invasion (LVI) and with negative surgical margins of at least 2 mm, (2) a high-risk group, for whom APBI is considered contraindicated; including patients ageing ≤40 years; having positive margins, and/or multicentric or large (>30 mm) tumours, and/or EIC positive or LVI positive tumours, and/or 4 or more positive lymph nodes or unknown axillary status (pNx), and (3) an intermediate-risk group, for whom APBI is considered acceptable only in the context of prospective clinical trials. Conclusions: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized

  18. Selective Distance-Based K+ Quantification on Paper-Based Microfluidics.

    Science.gov (United States)

    Gerold, Chase T; Bakker, Eric; Henry, Charles S

    2018-04-03

    In this study, paper-based microfluidic devices (μPADs) capable of K + quantification in aqueous samples, as well as in human serum, using both colorimetric and distance-based methods are described. A lipophilic phase containing potassium ionophore I (valinomycin) was utilized to achieve highly selective quantification of K + in the presence of Na + , Li + , and Mg 2+ ions. Successful addition of a suspended lipophilic phase to a wax printed paper-based device is described and offers a solution to current approaches that rely on organic solvents, which damage wax barriers. The approach provides an avenue for future alkali/alkaline quantification utilizing μPADs. Colorimetric spot tests allowed for K + quantification from 0.1-5.0 mM using only 3.00 μL of sample solution. Selective distance-based quantification required small sample volumes (6.00 μL) and gave responses sensitive enough to distinguish between 1.0 and 2.5 mM of sample K + . μPADs using distance-based methods were also capable of differentiating between 4.3 and 6.9 mM K + in human serum samples. Distance-based methods required no digital analysis, electronic hardware, or pumps; any steps required for quantification could be carried out using the naked eye.

  19. Process observation in fiber laser-based selective laser melting

    Science.gov (United States)

    Thombansen, Ulrich; Gatej, Alexander; Pereira, Milton

    2015-01-01

    The process observation in selective laser melting (SLM) focuses on observing the interaction point where the powder is processed. To provide process relevant information, signals have to be acquired that are resolved in both time and space. Especially in high-power SLM, where more than 1 kW of laser power is used, processing speeds of several meters per second are required for a high-quality processing results. Therefore, an implementation of a suitable process observation system has to acquire a large amount of spatially resolved data at low sampling speeds or it has to restrict the acquisition to a predefined area at a high sampling speed. In any case, it is vitally important to synchronously record the laser beam position and the acquired signal. This is a prerequisite that allows the recorded data become information. Today, most SLM systems employ f-theta lenses to focus the processing laser beam onto the powder bed. This report describes the drawbacks that result for process observation and suggests a variable retro-focus system which solves these issues. The beam quality of fiber lasers delivers the processing laser beam to the powder bed at relevant focus diameters, which is a key prerequisite for this solution to be viable. The optical train we present here couples the processing laser beam and the process observation coaxially, ensuring consistent alignment of interaction zone and observed area. With respect to signal processing, we have developed a solution that synchronously acquires signals from a pyrometer and the position of the laser beam by sampling the data with a field programmable gate array. The relevance of the acquired signals has been validated by the scanning of a sample filament. Experiments with grooved samples show a correlation between different powder thicknesses and the acquired signals at relevant processing parameters. This basic work takes a first step toward self-optimization of the manufacturing process in SLM. It enables the

  20. Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Yiotakis Ioannis E

    2009-08-01

    Full Text Available Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23% and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.

  1. Selection and ranking of patient video cases in paediatric neurology in relation to learner levels.

    Science.gov (United States)

    Balslev, Thomas; Muijtjens, Arno M M; Maarbjerg, Sabine Frølich; de Grave, Willem

    2018-05-01

    Teaching and learning with patient video cases may add authenticity, enhance diagnostic accuracy and improve chances of early diagnosis. The aim of this study is firstly to identify selection criteria for key Patient video cases (PVCs), secondly to identify trends in relevance of PVCs for learner levels and thirdly, to rank PVCs for learner levels. Based on a literature review, we identified criteria for key PVCs for use in paediatric neurology. We then performed a multi-round Delphi analysis to obtain agreement between 28 expert clinician teachers concerning key PVCs for four learner levels. We identified two major criteria: key PVCs should demonstrate key movements, and these movements should be subtle and/or difficult to note. The expert clinician teachers subsequently assessed a list of 14 topics for key PVCs. We found a clear, increasing trend in relevance scores, from medical students to young residents to experienced residents and specialists. For medical students and residents, epileptic spasms, Down syndrome, developmental delay, cerebral palsy and absence epilepsy were highly ranked. For specialists, conditions like chorea, focal seizures or eye movement disorders topped the ranking list, although ranking was less clear for this group of advanced learners. Key PVCs should demonstrate movements that are difficult to note for learners. Ranked lists of key PVCs for teaching and learning at different learner levels are now available and may help institutions build validated local libraries of PVCs. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  2. The brain's silent messenger: using selective attention to decode human thought for brain-based communication.

    Science.gov (United States)

    Naci, Lorina; Cusack, Rhodri; Jia, Vivian Z; Owen, Adrian M

    2013-05-29

    The interpretation of human thought from brain activity, without recourse to speech or action, is one of the most provoking and challenging frontiers of modern neuroscience. In particular, patients who are fully conscious and awake, yet, due to brain damage, are unable to show any behavioral responsivity, expose the limits of the neuromuscular system and the necessity for alternate forms of communication. Although it is well established that selective attention can significantly enhance the neural representation of attended sounds, it remains, thus far, untested as a response modality for brain-based communication. We asked whether its effect could be reliably used to decode answers to binary (yes/no) questions. Fifteen healthy volunteers answered questions (e.g., "Do you have brothers or sisters?") in the fMRI scanner, by selectively attending to the appropriate word ("yes" or "no"). Ninety percent of the answers were decoded correctly based on activity changes within the attention network. The majority of volunteers conveyed their answers with less than 3 min of scanning, suggesting that this technique is suited for communication in a reasonable amount of time. Formal comparison with the current best-established fMRI technique for binary communication revealed improved individual success rates and scanning times required to detect responses. This novel fMRI technique is intuitive, easy to use in untrained participants, and reliably robust within brief scanning times. Possible applications include communication with behaviorally nonresponsive patients.

  3. GoDisco: Selective Gossip Based Dissemination of Information in Social Community Based Overlays

    Science.gov (United States)

    Datta, Anwitaman; Sharma, Rajesh

    We propose and investigate a gossip based, social principles and behavior inspired decentralized mechanism (GoDisco) to disseminate information in online social community networks, using exclusively social links and exploiting semantic context to keep the dissemination process selective to relevant nodes. Such a designed dissemination scheme using gossiping over a egocentric social network is unique and is arguably a concept whose time has arrived, emulating word of mouth behavior and can have interesting applications like probabilistic publish/subscribe, decentralized recommendation and contextual advertisement systems, to name a few. Simulation based experiments show that despite using only local knowledge and contacts, the system has good global coverage and behavior.

  4. Metasurface-based angle-selective multichannel acoustic refractor

    Science.gov (United States)

    Liu, Bingyi; Jiang, Yongyuan

    2018-05-01

    We theoretically study the angle-selective refractions of an impedance-matched acoustic gradient-index metasurface, which is integrated with a rigid bar array of a deep subwavelength period. An interesting refraction order appears under the all-angle incidence despite the existence of a critical angle, and notably, the odevity of the phase-discretization level apparently selects the transmitted diffraction orders. We utilize the strategy of multilayered media design to realize a three-channel acoustic refractor, which shows good promise for constructing multifunctional diffractive acoustic elements for acoustic communication.

  5. Directory of selected forestry-related bibliographic data bases

    Science.gov (United States)

    Peter A. Evans

    1979-01-01

    This compilation lists 117 bibliographic data bases maintained by scientists of the Forest Service, U.S. Department of Agriculture. For each data base, the following information is provided; name of the data base; originator; date started; coverage by subject; geographic area, and size of collection; base format; retrieval format; ways to query; who to query; and...

  6. Verbal learning and memory outcome in selective amygdalohippocampectomy versus temporal lobe resection in patients with hippocampal sclerosis.

    Science.gov (United States)

    Foged, Mette Thrane; Vinter, Kirsten; Stauning, Louise; Kjær, Troels W; Ozenne, Brice; Beniczky, Sándor; Paulson, Olaf B; Madsen, Flemming Find; Pinborg, Lars H

    2018-02-01

    With the advent of new very selective techniques like thermal laser ablation to treat drug-resistant focal epilepsy, the controversy of resection size in relation to seizure outcome versus cognitive deficits has gained new relevance. The purpose of this study was to test the influence of the selective amygdalohippocampectomy (SAH) versus nonselective temporal lobe resection (TLR) on seizure outcome and cognition in patients with mesial temporal lobe epilepsy (MTLE) and histopathological verified hippocampal sclerosis (HS). We identified 108 adults (>16years) with HS, operated between 1995 and 2009 in Denmark. Exclusion criteria are the following: Intelligence below normal range, right hemisphere dominance, other native languages than Danish, dual pathology, and missing follow-up data. Thus, 56 patients were analyzed. The patients were allocated to SAH (n=22) or TLR (n=34) based on intraoperative electrocorticography. Verbal learning and verbal memory were tested pre- and postsurgery. Seizure outcome did not differ between patients operated using the SAH versus the TLR at 1year (p=0.951) nor at 7years (p=0.177). Verbal learning was more affected in patients resected in the left hemisphere than in the right (p=0.002). In patients with left-sided TLR, a worsening in verbal memory performance was found (p=0.011). Altogether, 73% were seizure-free for 1year and 64% for 7years after surgery. In patients with drug-resistant focal MTLE, HS and no magnetic resonance imaging (MRI) signs of dual pathology, selective amygdalohippocampectomy results in sustained seizure freedom and better memory function compared with patients operated with nonselective temporal lobe resection. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Dasatinib for the treatment of chronic myeloid leukemia: patient selection and special considerations.

    Science.gov (United States)

    Keskin, Dilek; Sadri, Sevil; Eskazan, Ahmet Emre

    2016-01-01

    Dasatinib is one of the second-generation tyrosine kinase inhibitors used in imatinib resistance and/or intolerance, as well as in the frontline setting in patients with chronic myeloid leukemia-chronic phase, and also in patients with advanced disease. It is also utilized in Philadelphia chromosome-positive acute lymphocytic leukemia. While choosing the appropriate tyrosine kinase inhibitor (ie, dasatinib) for each individual patient, comorbidities and BCR-ABL1 kinase domain mutations should always be taken into consideration, among other things. This review mainly focuses on patient selection prior to dasatinib administration in the treatment of chronic myeloid leukemia.

  8. Selecting a risk-based tool to aid in decision making

    Energy Technology Data Exchange (ETDEWEB)

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  9. Development and selection of Asian-specific humeral implants based on statistical atlas: toward planning minimally invasive surgery.

    Science.gov (United States)

    Wu, K; Daruwalla, Z J; Wong, K L; Murphy, D; Ren, H

    2015-08-01

    The commercial humeral implants based on the Western population are currently not entirely compatible with Asian patients, due to differences in bone size, shape and structure. Surgeons may have to compromise or use different implants that are less conforming, which may cause complications of as well as inconvenience to the implant position. The construction of Asian humerus atlases of different clusters has therefore been proposed to eradicate this problem and to facilitate planning minimally invasive surgical procedures [6,31]. According to the features of the atlases, new implants could be designed specifically for different patients. Furthermore, an automatic implant selection algorithm has been proposed as well in order to reduce the complications caused by implant and bone mismatch. Prior to the design of the implant, data clustering and extraction of the relevant features were carried out on the datasets of each gender. The fuzzy C-means clustering method is explored in this paper. Besides, two new schemes of implant selection procedures, namely the Procrustes analysis-based scheme and the group average distance-based scheme, were proposed to better search for the matching implants for new coming patients from the database. Both these two algorithms have not been used in this area, while they turn out to have excellent performance in implant selection. Additionally, algorithms to calculate the matching scores between various implants and the patient data are proposed in this paper to assist the implant selection procedure. The results obtained have indicated the feasibility of the proposed development and selection scheme. The 16 sets of male data were divided into two clusters with 8 and 8 subjects, respectively, and the 11 female datasets were also divided into two clusters with 5 and 6 subjects, respectively. Based on the features of each cluster, the implants designed by the proposed algorithm fit very well on their reference humeri and the proposed

  10. Moment Conditions Selection Based on Adaptive Penalized Empirical Likelihood

    Directory of Open Access Journals (Sweden)

    Yunquan Song

    2014-01-01

    Full Text Available Empirical likelihood is a very popular method and has been widely used in the fields of artificial intelligence (AI and data mining as tablets and mobile application and social media dominate the technology landscape. This paper proposes an empirical likelihood shrinkage method to efficiently estimate unknown parameters and select correct moment conditions simultaneously, when the model is defined by moment restrictions in which some are possibly misspecified. We show that our method enjoys oracle-like properties; that is, it consistently selects the correct moment conditions and at the same time its estimator is as efficient as the empirical likelihood estimator obtained by all correct moment conditions. Moreover, unlike the GMM, our proposed method allows us to carry out confidence regions for the parameters included in the model without estimating the covariances of the estimators. For empirical implementation, we provide some data-driven procedures for selecting the tuning parameter of the penalty function. The simulation results show that the method works remarkably well in terms of correct moment selection and the finite sample properties of the estimators. Also, a real-life example is carried out to illustrate the new methodology.

  11. Emotion of Physiological Signals Classification Based on TS Feature Selection

    Institute of Scientific and Technical Information of China (English)

    Wang Yujing; Mo Jianlin

    2015-01-01

    This paper propose a method of TS-MLP about emotion recognition of physiological signal.It can recognize emotion successfully by Tabu search which selects features of emotion’s physiological signals and multilayer perceptron that is used to classify emotion.Simulation shows that it has achieved good emotion classification performance.

  12. Functional Assessment-Based Intervention for Selective Mutism

    Science.gov (United States)

    Kern, Lee; Starosta, Kristin M.; Bambara, Linda M.; Cook, Clayton R.; Gresham, Frank R.

    2007-01-01

    The process of functional assessment has emerged as an essential component for intervention development. Applications across divergent types of problem behavior, however, remain limited. This study evaluated the applicability of this promising approach to students with selective mutism. Two middle school students served as participants. The…

  13. based 2D dynamic metal-organic framework showing selective

    Indian Academy of Sciences (India)

    materials have been extensively studied for storage, separation, magnetism, sensing, biomedical and very recently for ion conduction applications.14–21 Hydrogen ... thesis of dynamic MOF with high affinity for water becomes handy in separation applications. Also, for a material to be smart sorbent, in addition to selective ...

  14. A CORPUS-BASED STYLISTIC ANALYSIS OF SELECTED RADIO ...

    African Journals Online (AJOL)

    NGOZI

    from Pendants of Rhythm: A Selection of Radio Nigeria Network News ... social roles we have to fill in everyday life and where the meaning processes, or discourses .... Antonymy: Some words opposite in meaning are juxtaposed to underscore .... Hyperbole: The ignorant man is greedy and stuffs his mouth with food until his ...

  15. Graph-based unsupervised feature selection and multiview ...

    Indian Academy of Sciences (India)

    2015-09-28

    Sep 28, 2015 ... is presented by Yu et al. (2010) to retrieve biomedical ... dimensional microarray data, still require further research to be done in this topic .... relatively aggressive and require therapy soon after diagnosis or else patient dies ...

  16. Symptoms and Character Traits in Patients Selected for Long-term Psychodynamic Psychotherapy

    Science.gov (United States)

    Wilczek, Alexander; Weinryb, Robert M.; Gustavsson, Petter J.; Barber, Jacques P.; Schubert, Johan; ÅSBERG, Marie

    1998-01-01

    In this naturalistic study of 55 outpatients selected for long-term psychodynamic psychotherapy, two Swedish assessment instruments are presented (the Karolinska Psychodynamic Profile and the Karolinska Scales of Personality), and the significance of psychodynamic criteria for the selection of patients is discussed. Thirty patients (55%) fulfilled criteria for a DSM-III-R diagnosis. The most prominent psychodynamically defined character pathology was found in the areas of coping with aggressive affects; dependency and separation; frustration tolerance; and impulse control. Some psychodynamically defined character traits, particularly poor frustration tolerance, were related to symptomatic suffering. PMID:9407473

  17. ANALYSIS OF THE SECONDARY CURVES IN PATIENTS UNDERGOING SELECTIVE ARTHRODESIS LENKE I

    Directory of Open Access Journals (Sweden)

    TADEU GERVAZONI DEBOM

    2015-12-01

    Full Text Available Objective : To radiographically evaluate the behavior of the secondary curves in the coronal and sagittal planes in patients with AIS classified as Lenke I, who underwent surgical treatment of selective arthrodesis by posterior approach. Methods : Retrospective study which analyzed 40 patients with AIS, being 33 female. The measurement of the radiographic parameters used followed the recommendations by Cobb. Results : The average correction of the thoracic proximal, primary and lumbar curves was 34.73%, 75.06% and 64.64%, respectively. Conclusion : Surgical treatment by selective arthrodesis in cases of AIS Lenke type I provide correction of compensatory curves in the coronal and maintenance in the sagittal plane.

  18. Computational intelligence-based polymerase chain reaction primer selection based on a novel teaching-learning-based optimisation.

    Science.gov (United States)

    Cheng, Yu-Huei

    2014-12-01

    Specific primers play an important role in polymerase chain reaction (PCR) experiments, and therefore it is essential to find specific primers of outstanding quality. Unfortunately, many PCR constraints must be simultaneously inspected which makes specific primer selection difficult and time-consuming. This paper introduces a novel computational intelligence-based method, Teaching-Learning-Based Optimisation, to select the specific and feasible primers. The specified PCR product lengths of 150-300 bp and 500-800 bp with three melting temperature formulae of Wallace's formula, Bolton and McCarthy's formula and SantaLucia's formula were performed. The authors calculate optimal frequency to estimate the quality of primer selection based on a total of 500 runs for 50 random nucleotide sequences of 'Homo species' retrieved from the National Center for Biotechnology Information. The method was then fairly compared with the genetic algorithm (GA) and memetic algorithm (MA) for primer selection in the literature. The results show that the method easily found suitable primers corresponding with the setting primer constraints and had preferable performance than the GA and the MA. Furthermore, the method was also compared with the common method Primer3 according to their method type, primers presentation, parameters setting, speed and memory usage. In conclusion, it is an interesting primer selection method and a valuable tool for automatic high-throughput analysis. In the future, the usage of the primers in the wet lab needs to be validated carefully to increase the reliability of the method.

  19. Prediction of hepatocellular carcinoma biological behavior in patient selection for liver transplantation

    Science.gov (United States)

    Cillo, Umberto; Giuliani, Tommaso; Polacco, Marina; Herrero Manley, Luz Maria; Crivellari, Gino; Vitale, Alessandro

    2016-01-01

    Morphological criteria have always been considered the benchmark for selecting hepatocellular carcinoma (HCC) patients for liver transplantation (LT). These criteria, which are often inappropriate to express the tumor’s biological behavior and aggressiveness, offer only a static view of the disease burden and are frequently unable to correctly stratify the tumor recurrence risk after LT. Alpha-fetoprotein (AFP) and its progression as well as AFP-mRNA, AFP-L3%, des-γ-carboxyprothrombin, inflammatory markers and other serological tests appear to be correlated with post-transplant outcomes. Several other markers for patient selection including functional imaging studies such as 18F-FDG-PET imaging, histological evaluation of tumor grade, tissue-specific biomarkers, and molecular signatures have been outlined in the literature. HCC growth rate and response to pre-transplant therapies can further contribute to the transplant evaluation process of HCC patients. While AFP, its progression, and HCC response to pre-transplant therapy have already been used as a part of an integrated prognostic model for selecting patients, the utility of other markers in the transplant setting is still under investigation. This article intends to review the data in the literature concerning predictors that could be included in an integrated LT selection model and to evaluate the importance of biological aggressiveness in the evaluation process of these patients. PMID:26755873

  20. Home noninvasive ventilatory support for patients with chronic obstructive pulmonary disease : patient selection and perspectives

    NARCIS (Netherlands)

    Storre, Jan Hendrik; Callegari, Jens; Magnet, Friederike Sophie; Schwarz, Sarah Bettina; Duiverman, Marieke Leontine; Wijkstra, Peter Jan; Windisch, Wolfram

    2018-01-01

    Long-term or home mechanical noninvasive ventilation (Home-NIV) has become a well-established form of therapy over the last few decades for chronic hypercapnic COPD patients in European countries. However, meta-analyses and clinical guidelines do not recommend Home-NIV for COPD patients on a routine

  1. Comparative studies of praseodymium(III) selective sensors based on newly synthesized Schiff's bases

    International Nuclear Information System (INIS)

    Gupta, Vinod K.; Goyal, Rajendra N.; Pal, Manoj K.; Sharma, Ram A.

    2009-01-01

    Praseodymium ion selective polyvinyl chloride (PVC) membrane sensors, based on two new Schiff's bases 1,3-diphenylpropane-1,3-diylidenebis(azan-1-ylidene)diphenol (M 1 ) and N,N'-bis(pyridoxylideneiminato) ethylene (M 2 ) have been developed and studied. The sensor having membrane composition of PVC: o-NPOE: ionophore (M 1 ): NaTPB (w/w; mg) of 150: 300: 8: 5 showed best performances in comparison to M 2 based membranes. The sensor based on (M 1 ) exhibits the working concentration range 1.0 x 10 -8 to 1.0 x 10 -2 M with a detection limit of 5.0 x 10 -9 M and a Nernstian slope 20.0 ± 0.3 mV decade -1 of activity. It exhibited a quick response time as <8 s and its potential responses were pH independent across the range of 3.5-8.5.The influence of the membrane composition and possible interfering ions have also been investigated on the response properties of the electrode. The sensor has been found to work satisfactorily in partially non-aqueous media up to 15% (v/v) content of methanol, ethanol or acetonitrile and could be used for a period of 3 months. The selectivity coefficients determined by using fixed interference method (FIM) indicate high selectivity for praseodymium(III) ions over wide variety of other cations. To asses its analytical applicability the prepared sensor was successfully applied for determination of praseodymium(III) in spiked water samples.

  2. Studying the Factors for Selecting Public or Private Hospitals by Non Emergent Patients of Ardabil District in 2012

    Directory of Open Access Journals (Sweden)

    Saadat Jalili

    2014-12-01

    Full Text Available Background & objectives: At the present time, health care services have been increasingly transformed to a competitive issue and many factors influence usage of hospital services and selection of a hospital by the patients. This study has been performed for surveying effective factors on selecting a public or private hospital among non-emergent patients of Ardabil hospitals in 2012.   Method: This research was a cross-sectional descriptive-correlational study and the statistical population was non emergent patients of four public and two private hospitals of Ardabil in 2012. The samples (598 patients were collected by stratified random sampling method. Data-gathering tool was a researcher-made questionnaire and data were analyzed by descriptive statistics, frequency [distribution] tables, and logistic regression analysis.   Results: The results depicted a direct interdependence between selecting a hospital (public or private and the three factors of social elements, hospital services, and hospital facilities with a confidence coefficient of 92%. Based on logistic regression analysis and Exp(B coefficient, the patients’ priorities for hospital choosing were hospital services, social elements, and hospital facilities with Exp(B of 1.932, 1.332, and 0.338, respectively.   Conclusion: The most important factor for choosing public hospitals was lower cost of services and for private hospitals was physician’s recommendation. The strong effects of these two factors have overshadowed other variables.

  3. BIM-Based Decision Support System for Material Selection Based on Supplier Rating

    Directory of Open Access Journals (Sweden)

    Abiola Akanmu

    2015-12-01

    Full Text Available Material selection is a delicate process, typically hinged on a number of factors which can be either cost or environmental related. This process becomes more complicated when designers are faced with several material options of building elements and each option can be supplied by different suppliers whose selection criteria may affect the budgetary and environmental requirements of the project. This paper presents the development of a decision support system based on the integration of building information models, a modified harmony search algorithm and supplier performance rating. The system is capable of producing the cost and environmental implications of different material combinations or building designs. A case study is presented to illustrate the functionality of the developed system.

  4. Neural bases of selective attention in action video game players

    OpenAIRE

    Bavelier, D; Achtman, RL; Mani, M; Föcker, J

    2011-01-01

    Over the past few years, the very act of playing action video games has been shown to enhance several different aspects of visual selective attention. Yet little is known about the neural mechanisms that mediate such attentional benefits. A review of the aspects of attention enhanced in action game players suggests there are changes in the mechanisms that control attention allocation and its efficiency (Hubert-Wallander et al., 2010). The present study used brain imaging to test this hypothes...

  5. Selective recognition of Pr3+ based on fluorescence enhancement sensor

    International Nuclear Information System (INIS)

    Ganjali, M.R.; Hosseini, M.; Ghafarloo, A.; Khoobi, M.; Faridbod, F.; Shafiee, A.; Norouzi, P.

    2013-01-01

    (E)-2-(1-(4-hydroxy-2-oxo-2H-chromen-3-yl)ethylidene) hydrazinecarbothioamide (L) has been used to detect trace amounts of praseodymium ion in acetonitrile–water solution (MeCN/H 2 O) by fluorescence spectroscopy. The fluorescent probe undergoes fluorescent emission intensity enhancement upon binding to Pr 3+ ions in MeCN/H 2 O (9/1:v/v) solution. The fluorescence enhancement of L is attributed to a 1:1 complex formation between L and Pr 3+ , which has been utilized as the basis for selective detection of Pr 3+ . The sensor can be applied to the quantification of praseodymium ion with a linear range of 1.6 × 10 −7 to 1.0 × 10 −5 M. The limit of detection was 8.3 × 10 −8 M. The sensor exhibits high selectivity toward praseodymium ions in comparison with common metal ions. The proposed fluorescent sensor was successfully used for determination of Pr 3+ in water samples. - Highlights: • A new fluorescent sensor is introduced as a selective probe for Pr 3+ detection. • Fluorescent intensity of the chemical probe enhances upon binding to Pr 3+ ion. • The sensor can be used for Pr 3+ determination in the range of 1.6 × 10 −7 –1.0 × 10 −5 M

  6. Rank-based model selection for multiple ions quantum tomography

    International Nuclear Information System (INIS)

    Guţă, Mădălin; Kypraios, Theodore; Dryden, Ian

    2012-01-01

    The statistical analysis of measurement data has become a key component of many quantum engineering experiments. As standard full state tomography becomes unfeasible for large dimensional quantum systems, one needs to exploit prior information and the ‘sparsity’ properties of the experimental state in order to reduce the dimensionality of the estimation problem. In this paper we propose model selection as a general principle for finding the simplest, or most parsimonious explanation of the data, by fitting different models and choosing the estimator with the best trade-off between likelihood fit and model complexity. We apply two well established model selection methods—the Akaike information criterion (AIC) and the Bayesian information criterion (BIC)—two models consisting of states of fixed rank and datasets such as are currently produced in multiple ions experiments. We test the performance of AIC and BIC on randomly chosen low rank states of four ions, and study the dependence of the selected rank with the number of measurement repetitions for one ion states. We then apply the methods to real data from a four ions experiment aimed at creating a Smolin state of rank 4. By applying the two methods together with the Pearson χ 2 test we conclude that the data can be suitably described with a model whose rank is between 7 and 9. Additionally we find that the mean square error of the maximum likelihood estimator for pure states is close to that of the optimal over all possible measurements. (paper)

  7. Multilevel selection in a resource-based model

    Science.gov (United States)

    Ferreira, Fernando Fagundes; Campos, Paulo R. A.

    2013-07-01

    In the present work we investigate the emergence of cooperation in a multilevel selection model that assumes limiting resources. Following the work by R. J. Requejo and J. Camacho [Phys. Rev. Lett.0031-900710.1103/PhysRevLett.108.038701 108, 038701 (2012)], the interaction among individuals is initially ruled by a prisoner's dilemma (PD) game. The payoff matrix may change, influenced by the resource availability, and hence may also evolve to a non-PD game. Furthermore, one assumes that the population is divided into groups, whose local dynamics is driven by the payoff matrix, whereas an intergroup competition results from the nonuniformity of the growth rate of groups. We study the probability that a single cooperator can invade and establish in a population initially dominated by defectors. Cooperation is strongly favored when group sizes are small. We observe the existence of a critical group size beyond which cooperation becomes counterselected. Although the critical size depends on the parameters of the model, it is seen that a saturation value for the critical group size is achieved. The results conform to the thought that the evolutionary history of life repeatedly involved transitions from smaller selective units to larger selective units.

  8. Treatment of Prolapsing Hemorrhoids in HIV-Infected Patients with Tissue-Selecting Technique

    Directory of Open Access Journals (Sweden)

    Zhe Fan

    2017-01-01

    Full Text Available The aim of this retrospective study was to evaluate the outcome of a tissue-selecting therapy stapler (TST for prolapsing hemorrhoids in HIV-infected patients. Sixty-two patients with stage III-IV hemorrhoidal prolapse were treated with TST by a single surgeon between June and November 2014. The TST group comprised 32 patients (4 females, and the TST + HIV group comprised 30 HIV-infected patients (3 females. Age, gender, and preoperative examination as well as intraoperative and postoperative features were assessed. There was no marked difference in hemorrhoidal prolapse between the TST and HIV + TST groups, except for patient satisfaction at 12 months. TST is an effective and safe technique for treatment of prolapsing hemorrhoids in HIV-infected patients.

  9. Conditional Mutual Information Based Feature Selection for Classification Task

    Czech Academy of Sciences Publication Activity Database

    Novovičová, Jana; Somol, Petr; Haindl, Michal; Pudil, Pavel

    2007-01-01

    Roč. 45, č. 4756 (2007), s. 417-426 ISSN 0302-9743 R&D Projects: GA MŠk 1M0572; GA AV ČR IAA2075302 EU Projects: European Commission(XE) 507752 - MUSCLE Grant - others:GA MŠk(CZ) 2C06019 Institutional research plan: CEZ:AV0Z10750506 Keywords : Pattern classification * feature selection * conditional mutual information * text categorization Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.402, year: 2005

  10. Fuzzy Investment Portfolio Selection Models Based on Interval Analysis Approach

    Directory of Open Access Journals (Sweden)

    Haifeng Guo

    2012-01-01

    Full Text Available This paper employs fuzzy set theory to solve the unintuitive problem of the Markowitz mean-variance (MV portfolio model and extend it to a fuzzy investment portfolio selection model. Our model establishes intervals for expected returns and risk preference, which can take into account investors' different investment appetite and thus can find the optimal resolution for each interval. In the empirical part, we test this model in Chinese stocks investment and find that this model can fulfill different kinds of investors’ objectives. Finally, investment risk can be decreased when we add investment limit to each stock in the portfolio, which indicates our model is useful in practice.

  11. Portfolio Selection Based on Distance between Fuzzy Variables

    Directory of Open Access Journals (Sweden)

    Weiyi Qian

    2014-01-01

    Full Text Available This paper researches portfolio selection problem in fuzzy environment. We introduce a new simple method in which the distance between fuzzy variables is used to measure the divergence of fuzzy investment return from a prior one. Firstly, two new mathematical models are proposed by expressing divergence as distance, investment return as expected value, and risk as variance and semivariance, respectively. Secondly, the crisp forms of the new models are also provided for different types of fuzzy variables. Finally, several numerical examples are given to illustrate the effectiveness of the proposed approach.

  12. LOPES: Selective control of gait functions during the gait rehabilitation of CVA patients

    NARCIS (Netherlands)

    Ekkelenkamp, R.; Veneman, J.F.; van der Kooij, Herman

    2005-01-01

    LOPES aims for an active role of the patient by selective and partial support of gait functions during robotic treadmill training sessions. Virtual model control (VMC) was applied to the robot as an intuitive method for translating current treadmill gait rehabilitation therapy programs into robotic

  13. Selective digestive decontamination in patients in intensive care. The Dutch Working Group on Antibiotic Policy

    NARCIS (Netherlands)

    Bonten, M. J.; Kullberg, B. J.; van Dalen, R.; Girbes, A. R.; Hoepelman, I. M.; Hustinx, W.; van der Meer, J. W.; Speelman, P.; Stobberingh, E. E.; Verbrugh, H. A.; Verhoef, J.; Zwaveling, J. H.

    2000-01-01

    Selective digestive decontamination (SDD) is the most extensively studied method for the prevention of infection in patients in intensive care units (ICUs). Despite 27 prospective randomized studies and six meta-analyses, routine use of SDD is still controversial. In this review, we summarize the

  14. GSK2586184, a JAK1 selective inhibitor, in two patients with ulcerative colitis

    NARCIS (Netherlands)

    de Vries, Leonie C. S.; Ludbrook, Valerie J.; Hicks, Kirsty J.; D'Haens, Geert R.

    2017-01-01

    Tofacitinib, a non-selective Janus kinase (JAK) inhibitor, is effective in inducing clinical and endoscopic remission in patients with active ulcerative colitis (UC). Tofacitinib inhibits cytokine signalling through blockade of JAK1, JAK2, JAK3 and tyrosine kinase 2 (TYK2). Adverse events including

  15. Dynamic Educational e-Content Selection Using Multiple Criteria in Web-Based Personalized Learning Environments.

    Science.gov (United States)

    Manouselis, Nikos; Sampson, Demetrios

    This paper focuses on the way a multi-criteria decision making methodology is applied in the case of agent-based selection of offered learning objects. The problem of selection is modeled as a decision making one, with the decision variables being the learner model and the learning objects' educational description. In this way, selection of…

  16. Supplier selection based on improved MOGA and its application in nuclear power equipment procurement

    International Nuclear Information System (INIS)

    Yan Zhaojun; Wang Dezhong; Zhou Lei

    2007-01-01

    Considering the fact that there are few objective and available methods supporting the supplier selection in nuclear power equipment purchasing process, a supplier selection method based on improved multi-objective genetic algorithm (MOGA) is proposed. The simulation results demonstrate the effectiveness and efficiency of this method for the supplier selection in nuclear power equipment procurement process. (authors)

  17. Understanding Patient Experience Using Internet-based Email Surveys: A Feasibility Study at Mount Sinai Hospital.

    Science.gov (United States)

    Morgan, Matthew; Lau, Davina; Jivraj, Tanaz; Principi, Tania; Dietrich, Sandra; Bell, Chaim M

    2015-01-01

    Email is becoming a widely accepted communication tool in healthcare settings. This study sought to test the feasibility of Internet-based email surveys of patient experience in the ambulatory setting. We conducted a study of email Internet-based surveys sent to patients in selected ambulatory clinics at Mount Sinai Hospital in Toronto, Canada. Our findings suggest that email links to Internet surveys are a feasible, timely and efficient method to solicit patient feedback about their experience. Further research is required to optimally leverage Internet-based email surveys as a tool to better understand the patient experience.

  18. Problem based review: The patient taking methadone.

    Science.gov (United States)

    Arora, Alok; Williams, Karen

    2013-01-01

    Methadone maintenance treatment (MMT) is an effective therapy for opioid-dependence; its use is based on a harm reduction philosophy and represents one of a range of treatment approaches for opioid-dependent individuals. The medical literature supports MMT as a well established and cost-effective treatment for opioid-dependence that allows a return-to-normal physiological, psychological and societal functioning. The effectiveness of MMT is enhanced by psycho-social interventions such as contingency management and addressing other co-existing health and social needs. MMT saves lives and reduces violent and non-violent crime, drug use and the transmission of HIV, hepatitis C and other communicable diseases. For some people, MMT may continue for life, while others may eventually be able to discontinue and remain abstinent. Methadone interacts with numerous drugs and prolongs the corrected QT interval (QTc) with risk of sudden cardiac death. It has a prolonged half-life and premature discharge of patients after methadone overdose may be fatal. Each patient must be assessed, treated and monitored on an individual basis. Successful outcomes through MMT require knowledge, experience, vigilance, and diligence on the part of the physician, the patient and all of those involved in treatment.

  19. Defining new criteria for selection of cell-based intestinal models using publicly available databases

    Directory of Open Access Journals (Sweden)

    Christensen Jon

    2012-06-01

    Full Text Available Abstract Background The criteria for choosing relevant cell lines among a vast panel of available intestinal-derived lines exhibiting a wide range of functional properties are still ill-defined. The objective of this study was, therefore, to establish objective criteria for choosing relevant cell lines to assess their appropriateness as tumor models as well as for drug absorption studies. Results We made use of publicly available expression signatures and cell based functional assays to delineate differences between various intestinal colon carcinoma cell lines and normal intestinal epithelium. We have compared a panel of intestinal cell lines with patient-derived normal and tumor epithelium and classified them according to traits relating to oncogenic pathway activity, epithelial-mesenchymal transition (EMT and stemness, migratory properties, proliferative activity, transporter expression profiles and chemosensitivity. For example, SW480 represent an EMT-high, migratory phenotype and scored highest in terms of signatures associated to worse overall survival and higher risk of recurrence based on patient derived databases. On the other hand, differentiated HT29 and T84 cells showed gene expression patterns closest to tumor bulk derived cells. Regarding drug absorption, we confirmed that differentiated Caco-2 cells are the model of choice for active uptake studies in the small intestine. Regarding chemosensitivity we were unable to confirm a recently proposed association of chemo-resistance with EMT traits. However, a novel signature was identified through mining of NCI60 GI50 values that allowed to rank the panel of intestinal cell lines according to their drug responsiveness to commonly used chemotherapeutics. Conclusions This study presents a straightforward strategy to exploit publicly available gene expression data to guide the choice of cell-based models. While this approach does not overcome the major limitations of such models

  20. Samarium (III Selective Membrane Sensor Based on Tin (IV Boratophosphate

    Directory of Open Access Journals (Sweden)

    Ashok S. K. Kumar

    2004-08-01

    Full Text Available Abstract: A number of Sm (III selective membranes of varying compositions using tin (IV boratophosphate as electroactive material were prepared. Polyvinyl chloride, polystyrene and epoxy resin were used as binding materials. Membrane having composition of 40% exchanger and 60% epoxy resin exhibited best performance. This membrane worked well over a wide concentration range of 1x10-5M to 1x10-1 M of samarium ions with a Super-Nernstian slope of 40 mV/decade. It has a fast response time of less than 10 seconds and can be used for at least six months without any considerable divergence in potentials. The proposed sensor revealed good selectivities with respect to alkali, alkaline earth, some transition and rare earth metal ions and can be used in the pH range of 4.0-10.0. It was used as an indicator electrode in the potentiometric titration of Sm (III ions against EDTA. Effect of internal solution was studied and the electrode was successfully used in non-aqueous media, too.

  1. Selective decontamination of the gastrointestinal tract in patients undergoing esophageal resection

    Directory of Open Access Journals (Sweden)

    Lange Jochen

    2010-12-01

    Full Text Available Abstract Background Selective decontamination of the digestive tract (SDD to eliminate gram-negative bacteria is still not widely accepted, although it reduces the incidence of nosocomial infections. In a previous retrospective study, a clear benefit to perioperative morbidity, and a reduction in nosocomial infections were found in patients who underwent an esophageal anastomosis. Thus, SDD was applied routinely for esophageal anastomoses. We report the outcome of a cohort of 81 patients who underwent this treatment. Methods From 2002, patients who underwent an esophageal anastomosis (esophagojejunostomy were prospectively recorded. Perioperatively, patients received polymyxin, tobramycin, vancomycin and nystatin by mouth four times a day. Outcome was compared to a control group that was treated before 2002 (68 patients without SDD and 53 patients with SDD. Postoperative morbidity and mortality were assessed. Results Between 2002 and 2007, 81 patients who underwent an esophageal anastomosis received SDD. Compared to a retrospective control group, patients with SDD had significantly less pneumonia (OR 0.06 (0.01-0.46, p Conclusions SDD significantly reduces perioperative morbidity and mortality in patients who undergo a distal esophageal anastomosis compared to a historical control group. In patients with an anastomotic leakage, there was a strong tendency of SDD to reduce postoperative mortality.

  2. Total pancreatectomy for recurrent acute and chronic pancreatitis: a critical review of patient selection criteria

    Science.gov (United States)

    Faghih, Mahya; Gonzalez, Francisco Garcia; Makary, Martin A.; Singh, Vikesh K.

    2018-01-01

    Purpose of review Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. Recent findings The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition. Abdominal pain is not specific for chronic pancreatitis and is more likely to be encountered in patients with functional gastrointestinal disorders based on the high incidence of these conditions. The duration of pain and opioid analgesic use results in central sensitization that adversely affects pain outcomes after total pancreatectomy. An alcoholic cause is associated with poorer pain outcomes after total pancreatectomy. Summary The lack of a gold standard for noncalcific chronic pancreatitis limits the diagnostic accuracy of imaging and laboratory tests. The pain of chronic pancreatitis is nonspecific and is affected by duration, preoperative opioid use, and cause. These factors will need to be considered in the development of future selection criteria for this morbid surgery. PMID:28700371

  3. Annotation-Based Whole Genomic Prediction and Selection

    DEFF Research Database (Denmark)

    Kadarmideen, Haja; Do, Duy Ngoc; Janss, Luc

    Genomic selection is widely used in both animal and plant species, however, it is performed with no input from known genomic or biological role of genetic variants and therefore is a black box approach in a genomic era. This study investigated the role of different genomic regions and detected QTLs...... in their contribution to estimated genomic variances and in prediction of genomic breeding values by applying SNP annotation approaches to feed efficiency. Ensembl Variant Predictor (EVP) and Pig QTL database were used as the source of genomic annotation for 60K chip. Genomic prediction was performed using the Bayes...... classes. Predictive accuracy was 0.531, 0.532, 0.302, and 0.344 for DFI, RFI, ADG and BF, respectively. The contribution per SNP to total genomic variance was similar among annotated classes across different traits. Predictive performance of SNP classes did not significantly differ from randomized SNP...

  4. Chaotic Dynamical State Variables Selection Procedure Based Image Encryption Scheme

    Directory of Open Access Journals (Sweden)

    Zia Bashir

    2017-12-01

    Full Text Available Nowadays, in the modern digital era, the use of computer technologies such as smartphones, tablets and the Internet, as well as the enormous quantity of confidential information being converted into digital form have resulted in raised security issues. This, in turn, has led to rapid developments in cryptography, due to the imminent need for system security. Low-dimensional chaotic systems have low complexity and key space, yet they achieve high encryption speed. An image encryption scheme is proposed that, without compromising the security, uses reasonable resources. We introduced a chaotic dynamic state variables selection procedure (CDSVSP to use all state variables of a hyper-chaotic four-dimensional dynamical system. As a result, less iterations of the dynamical system are required, and resources are saved, thus making the algorithm fast and suitable for practical use. The simulation results of security and other miscellaneous tests demonstrate that the suggested algorithm excels at robustness, security and high speed encryption.

  5. Risk-based selection of SSCs at Peach Bottom

    International Nuclear Information System (INIS)

    Krueger, G.A.; Marie, A.J.

    1993-01-01

    The purpose of identifying risk significant systems, structures, and components (SSCS) that are within the scope of the maintenance rule is to bring a higher level of attention to a subset of those SSCS. These risk-significant SSCs will have specific performance criteria established for them, and failure to meet this performance criteria will result in establishing goals to ensure the necessary improvement in performance. The Peach Bottom individual plant examination (IPE) results were used to provide insights for the verification of proposed probabilistic risk assessment (PRA) methods set forth in the Industry Maintenance Guidelines for Implementation of the Maintenance Rule. The objective of reviewing the methods for selection of SSCs that are considered risk significant was to ensure the methods used are logical, reproducible, and can be consistently applied

  6. Materials selection for oxide-based resistive random access memories

    International Nuclear Information System (INIS)

    Guo, Yuzheng; Robertson, John

    2014-01-01

    The energies of atomic processes in resistive random access memories (RRAMs) are calculated for four typical oxides, HfO 2 , TiO 2 , Ta 2 O 5 , and Al 2 O 3 , to define a materials selection process. O vacancies have the lowest defect formation energy in the O-poor limit and dominate the processes. A band diagram defines the operating Fermi energy and O chemical potential range. It is shown how the scavenger metal can be used to vary the O vacancy formation energy, via controlling the O chemical potential, and the mean Fermi energy. The high endurance of Ta 2 O 5 RRAM is related to its more stable amorphous phase and the adaptive lattice rearrangements of its O vacancy

  7. Nanoparticle array based optical frequency selective surfaces: theory and design.

    Science.gov (United States)

    Saeidi, Chiya; van der Weide, Daniel

    2013-07-01

    We demonstrate a synthesis procedure for designing a bandstop optical frequency selective surface (FSS) composed of nanoparticle (NP) elements. The proposed FSS uses two-dimensional (2-D) periodic arrays of NPs with subwavelength unit-cell dimensions. We derive equivalent circuit for a nanoparticle array (NPA) using the closed-form solution for a 2-D NPA excited by a plane wave in the limit of the dipole approximation, which includes contribution from both individual and collective plasmon modes. Using the extracted equivalent circuit, we demonstrate synthesis of an optical FSS using cascaded NPA layers as coupled resonators, which we validate with both circuit model and full-wave simulation for a third-order Butterworth bandstop prototype.

  8. Supplier Selection based on the Performance by using PROMETHEE Method

    Science.gov (United States)

    Sinaga, T. S.; Siregar, K.

    2017-03-01

    Generally, companies faced problem to identify vendors that can provide excellent service in availability raw material and on time delivery. The performance of suppliers in a company have to be monitored to ensure the availability to fulfill the company needs. This research is intended to explain how to assess suppliers to improve manufacturing performance. The criteria that considered in evaluating suppliers is criteria of Dickson. There are four main criteria which further split into seven sub-criteria, namely compliance with accuracy, consistency, on-time delivery, right quantity order, flexibility and negotiation, timely of order confirmation, and responsiveness. This research uses PROMETHEE methodology in assessing the supplier performances and obtaining a selected supplier as the best one that shown from the degree of alternative comparison preference between suppliers.

  9. Materials selection for oxide-based resistive random access memories

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Yuzheng; Robertson, John [Engineering Department, Cambridge University, Cambridge CB2 1PZ (United Kingdom)

    2014-12-01

    The energies of atomic processes in resistive random access memories (RRAMs) are calculated for four typical oxides, HfO{sub 2}, TiO{sub 2}, Ta{sub 2}O{sub 5}, and Al{sub 2}O{sub 3}, to define a materials selection process. O vacancies have the lowest defect formation energy in the O-poor limit and dominate the processes. A band diagram defines the operating Fermi energy and O chemical potential range. It is shown how the scavenger metal can be used to vary the O vacancy formation energy, via controlling the O chemical potential, and the mean Fermi energy. The high endurance of Ta{sub 2}O{sub 5} RRAM is related to its more stable amorphous phase and the adaptive lattice rearrangements of its O vacancy.

  10. Expected utility violations evolve under status-based selection mechanisms.

    Science.gov (United States)

    Dickson, Eric S

    2008-10-07

    The expected utility theory of decision making under uncertainty, a cornerstone of modern economics, assumes that humans linearly weight "utilities" for different possible outcomes by the probabilities with which these outcomes occur. Despite the theory's intuitive appeal, both from normative and from evolutionary perspectives, many experiments demonstrate systematic, though poorly understood, patterns of deviation from EU predictions. This paper offers a novel theoretical account of such patterns of deviation by demonstrating that EU violations can emerge from evolutionary selection when individual "status" affects inclusive fitness. In humans, battles for resources and social standing involve high-stakes decision making, and assortative mating ensures that status matters for fitness outcomes. The paper therefore proposes grounding the study of decision making under uncertainty in an evolutionary game-theoretic framework.

  11. Isoniazid release from suppositories compounded with selected bases.

    Science.gov (United States)

    Hudson, Kristofer C; Asbill, C Scott; Webster, Andrew A

    2007-01-01

    There is an increasing need for an alternative route of isoniazid adminstration for prophylaxis and treatment of tuberculosis in children. The purpose of this study is to evaluate the in vitro release of isoniazid from extemporaneously compounded isoniazid suppositories with a goal of optimizing the suppository dosage form for this indication. Suppositories were compounded using three different base formulations (cocoa butter, Witepsol H15 Base F, and a combination of polyethylene glycols 3350, 1000, and 400). The release profiles of six compounded suppositories with isoniazid (100 mg) were tested with a United States Pharmacopeial Convention-approved dissolution apparatus. Isoniazid concentrations at predetermined time points were determined using high-performance liquid chromatographic analysis. The results show that drug release from the water-solutble base (mixed polyethylene glycols) was significantly greater than that from the lipophilic bases (cocoa butter and Witepsol H15). The percentage of isoniazid release form the polyethylene glycol suppository formulation (70 +/- 1.4 mg/mL) was greater than that from the cocoa butter (55 +/- 1.1 mg/mL) and Witepsol H15 Base F (18 +/- 0.36 mg/mL) suppository formulations.

  12. Performance Analysis of a Threshold-Based Parallel Multiple Beam Selection Scheme for WDM FSO Systems

    KAUST Repository

    Nam, Sung Sik; Alouini, Mohamed-Slim; Ko, Young-Chai

    2018-01-01

    In this paper, we statistically analyze the performance of a threshold-based parallel multiple beam selection scheme for a free-space optical (FSO) based system with wavelength division multiplexing (WDM) in cases where a pointing error has occurred

  13. Selection of Shared and Neoantigen-Reactive T Cells for Adoptive Cell Therapy Based on CD137 Separation

    Directory of Open Access Journals (Sweden)

    Sivan Seliktar-Ofir

    2017-10-01

    Full Text Available Adoptive cell therapy (ACT of autologous tumor infiltrating lymphocytes (TIL is an effective immunotherapy for patients with solid tumors, yielding objective response rates of around 40% in refractory patients with metastatic melanoma. Most clinical centers utilize bulk, randomly isolated TIL from the tumor tissue for ex vivo expansion and infusion. Only a minor fraction of the administered T cells recognizes tumor antigens, such as shared and mutation-derived neoantigens, and consequently eliminates the tumor. Thus, there are many ongoing effects to identify and select tumor-specific TIL for therapy; however, those approaches are very costly and require months, which is unreasonable for most metastatic patients. CD137 (4-1BB has been identified as a co-stimulatory marker, which is induced upon the specific interaction of T cells with their target cell. Therefore, CD137 can be a useful biomarker and an important tool for the selection of tumor-reactive T cells. Here, we developed and validated a simple and time efficient method for the selection of CD137-expressing T cells for therapy based on magnetic bead separation. CD137 selection was performed with clinical grade compliant reagents, and TIL were expanded in a large-scale manner to meet cell numbers required for the patient setting in a GMP facility. For the first time, the methodology was designed to comply with both clinical needs and limitations, and its feasibility was assessed. CD137-selected TIL demonstrated significantly increased antitumor reactivity and were enriched for T cells recognizing neoantigens as well as shared tumor antigens. CD137-based selection enabled the enrichment of tumor-reactive T cells without the necessity of knowing the epitope specificity or the antigen type. The direct implementation of the CD137 separation method to the cell production of TIL may provide a simple way to improve the clinical efficiency of TIL ACT.

  14. Natural ingredients based cosmetics. Content of selected fragrance sensitizers

    DEFF Research Database (Denmark)

    Rastogi, Suresh Chandra; Johansen, J D; Menné, T

    1996-01-01

    In the present study, we have investigated 42 cosmetic products based on natural ingredients for content of 11 fragrance substances: geraniol, hydroxycitronellal, eugenol, isoeugenol, cinnamic aldehyde, cinnamic alcohol, alpha-amylcinnamic aldehyde, citral, coumarin, dihydrocoumarin and alpha......-hexylcinnamic aldehyde. The study revealed that the 91% (20/22) of the natural ingredients based perfumes contained 0.027%-7.706% of 1 to 7 of the target fragrances. Between 1 and 5 of the chemically defined synthetic constituents of fragrance mix were found in 82% (18/22) of the perfumes. 35% (7/20) of the other...... of hydroxycitronellal and alpha-hexylcinnamic aldehyde in some of the products demonstrates that artificial fragrances, i.e., compounds not yet regarded as natural substances, may be present in products claimed to be based on natural ingredients....

  15. A phantom based method for deriving typical patient doses from measurements of dose-area product on populations of patients

    International Nuclear Information System (INIS)

    Chapple, C.-L.; Broadhead, D.A.

    1995-01-01

    One of the chief sources of uncertainty in the comparison of patient dosimetry data is the influence of patient size on dose. Dose has been shown to relate closely to the equivalent diameter of the patient. This concept has been used to derive a prospective, phantom based method for determining size correction factors for measurements of dose-area product. The derivation of the size correction factor has been demonstrated mathematically, and the appropriate factor determined for a number of different X-ray sets. The use of phantom measurements enables the effect of patient size to be isolated from other factors influencing patient dose. The derived factors agree well with those determined retrospectively from patient dose survey data. Size correction factors have been applied to the results of a large scale patient dose survey, and this approach has been compared with the method of selecting patients according to their weight. For large samples of data, mean dose-area product values are independent of the analysis method used. The chief advantage of using size correction factors is that it allows all patient data to be included in a survey, whereas patient selection has been shown to exclude approximately half of all patients. (author)

  16. Multi-spectral band selection for satellite-based systems

    International Nuclear Information System (INIS)

    Clodius, W.B.; Weber, P.G.; Borel, C.C.; Smith, B.W.

    1998-01-01

    The design of satellite based multispectral imaging systems requires the consideration of a number of tradeoffs between cost and performance. The authors have recently been involved in the design and evaluation of a satellite based multispectral sensor operating from the visible through the long wavelength IR. The criteria that led to some of the proposed designs and the modeling used to evaluate and fine tune the designs will both be discussed. These criteria emphasized the use of bands for surface temperature retrieval and the correction of atmospheric effects. The impact of cost estimate changes on the final design will also be discussed

  17. Optimised Selection of Stroke Biomarker Based on Svm and Information Theory

    Directory of Open Access Journals (Sweden)

    Wang Xiang

    2017-01-01

    Full Text Available With the development of molecular biology and gene-engineering technology, gene diagnosis has been an emerging approach for modern life sciences. Biological marker, recognized as the hot topic in the molecular and gene fields, has important values in early diagnosis, malignant tumor stage, treatment and therapeutic efficacy evaluation. So far, the researcher has not found any effective way to predict and distinguish different type of stroke. In this paper, we aim to optimize stroke biomarker and figure out effective stroke detection index based on SVM (support vector machine and information theory. Through mutual information analysis and principal component analysis to complete the selection of biomarkers and then we use SVM to verify our model. According to the testing data of patients provided by Xuanwu Hospital, we explore the significant markers of the stroke through data analysis. Our model can predict stroke well. Then discuss the effects of each biomarker on the incidence of stroke.

  18. Risk-based audit selection of dairy farms

    NARCIS (Netherlands)

    Asseldonk, van M.A.P.M.; Velthuis, A.G.J.

    2014-01-01

    Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process

  19. Gear-based species selectivity and potential interactions between ...

    African Journals Online (AJOL)

    ... and competition between different co-occurring fisheries is therefore important for the implementation of ecosystem based fisheries management interventions. In this study, we used multivariate and ecological approaches to evaluate gear competition and interactions between artisanal and aquarium fishers using a case ...

  20. DFT-based inhibitor and promoter selection criteria for pentagonal ...

    Indian Academy of Sciences (India)

    Methane hydrate formation inhibition by methanol and ethylene glycol as well as methane hydrate stabilization by cyclopentane and tetrahydrofuran are critically analysed based on the interaction energy, free energy change, dipole moment and infrared frequency calculation. Calculation of free energy change for formation ...

  1. Influence of selected biotopes on chironomid-based bioassessment ...

    African Journals Online (AJOL)

    ... three distinct biotopes, i.e., stones, vegetation and sediments. In this study, the influence of reducing the numbers of biotopes on chironomid-based bioassessment of pollution in the Swartkops River was investigated. This paper addresses the following questions: (i) can the chironomid species assemblage from any single ...

  2. Evaluation Of Selected Commercial Banks Financing Of Agro Based ...

    African Journals Online (AJOL)

    The result showed that the agro-based enterprises are faced with the problems of insufficient collateral, high interest rate and poor documentation while the banks are faced with the problems of loan diversion, irregular loan repayment and none presentation of perfectible collaterals by loan beneficiaries. Commercial banks ...

  3. Evaluation and Selection of Gel Base for the Formulation of ...

    African Journals Online (AJOL)

    Purpose: To formulate dexpanthenol gels with enhanced in vivo absorption properties via skin. Methods: Carboxyvinyl derivatives (Carbopol 980 and Ultrez 10) and poloxamer (Lutrol F 127) were used as the hydrogel base in the formulations. Changes in rheological properties (apparent viscosity and penetration values) ...

  4. Real-time 3D echo in patient selection for cardiac resynchronization therapy.

    Science.gov (United States)

    Kapetanakis, Stamatis; Bhan, Amit; Murgatroyd, Francis; Kearney, Mark T; Gall, Nicholas; Zhang, Qing; Yu, Cheuk-Man; Monaghan, Mark J

    2011-01-01

    this study investigated the use of 3-dimensional (3D) echo in quantifying left ventricular mechanical dyssynchrony (LVMD), its interhospital agreement, and potential impact on patient selection. assessment of LVMD has been proposed as an improvement on conventional criteria in selecting patients for cardiac resynchronization therapy (CRT). Three-dimensional echo offers a reproducible assessment of left ventricular (LV) structure, function, and LVMD and may be useful in selecting patients for this intervention. we studied 187 patients at 2 institutions. Three-dimensional data from baseline and longest follow-up were quantified for volume, left ventricular ejection fraction (LVEF), and systolic dyssynchrony index (SDI). New York Heart Association (NYHA) functional class was assessed independently. Several outcomes from CRT were considered: 1) reduction in NYHA functional class; 2) 20% relative increase in LVEF; and 3) 15% reduction in LV end-systolic volume. Sixty-two cases were shared between institutions to analyze interhospital agreement. there was excellent interhospital agreement for 3D-derived LV end-diastolic and end- systolic volumes, EF, and SDI (variability: 2.9%, 1%, 7.1%, and 7.6%, respectively). Reduction in NYHA functional class was found in 78.9% of patients. Relative improvement in LVEF of 20% was found in 68% of patients, but significant reduction in LV end-systolic volume was found in only 41.5%. The QRS duration was not predictive of any of the measures of outcome (area under the curve [AUC]: 0.52, 0.58, and 0.57 for NYHA functional class, LVEF, and LV end-systolic volume), whereas SDI was highly predictive of improvement in these parameters (AUC: 0.79, 0.86, and 0.66, respectively). For patients not fulfilling traditional selection criteria (atrial fibrillation, QRS duration <120 ms, or undergoing device upgrade), SDI had similar predictive value. A cutoff of 10.4% for SDI was found to have the highest accuracy for predicting improvement following

  5. GAIN RATIO BASED FEATURE SELECTION METHOD FOR PRIVACY PRESERVATION

    Directory of Open Access Journals (Sweden)

    R. Praveena Priyadarsini

    2011-04-01

    Full Text Available Privacy-preservation is a step in data mining that tries to safeguard sensitive information from unsanctioned disclosure and hence protecting individual data records and their privacy. There are various privacy preservation techniques like k-anonymity, l-diversity and t-closeness and data perturbation. In this paper k-anonymity privacy protection technique is applied to high dimensional datasets like adult and census. since, both the data sets are high dimensional, feature subset selection method like Gain Ratio is applied and the attributes of the datasets are ranked and low ranking attributes are filtered to form new reduced data subsets. K-anonymization privacy preservation technique is then applied on reduced datasets. The accuracy of the privacy preserved reduced datasets and the original datasets are compared for their accuracy on the two functionalities of data mining namely classification and clustering using naïve Bayesian and k-means algorithm respectively. Experimental results show that classification and clustering accuracy are comparatively the same for reduced k-anonym zed datasets and the original data sets.

  6. Alkali resistivity of Cu based selective catalytic reduction catalysts

    DEFF Research Database (Denmark)

    Putluru, Siva Sankar Reddy; Jensen, Anker Degn; Riisager, Anders

    2012-01-01

    The deactivation of V2O5–WO3–TiO2, Cu–HZSM5 and Cu–HMOR plate type monolithic catalysts was investigated when exposed to KCl aerosols in a bench-scale reactor. Fresh and exposed catalysts were characterized by selective catalytic reduction (SCR) activity measurements, scanning electron microscope......–energy dispersive X-ray spectroscopy (SEM–EDX) and NH3-temperature programmed desorption (NH3-TPD). 95% deactivation was observed for the V2O5–WO3–TiO2 catalyst, while the Cu–HZSM5 and Cu–HMOR catalysts deactivated only 58% and 48%, respectively, after 1200 h KCl exposure. SEM analysis of the KCl aerosol exposed...... catalysts revealed that the potassium salt not only deposited on the catalyst surface, but also penetrated into the catalyst wall. Thus, the K/M ratio (M = V or Cu) was high on V2O5–WO3–TiO2 catalyst and comparatively less on Cu–HZSM5 and Cu–HMOR catalysts. NH3-TPD revealed that the KCl exposed Cu–HZSM5...

  7. Neural bases of selective attention in action video game players.

    Science.gov (United States)

    Bavelier, D; Achtman, R L; Mani, M; Föcker, J

    2012-05-15

    Over the past few years, the very act of playing action video games has been shown to enhance several different aspects of visual selective attention, yet little is known about the neural mechanisms that mediate such attentional benefits. A review of the aspects of attention enhanced in action game players suggests there are changes in the mechanisms that control attention allocation and its efficiency (Hubert-Wallander, Green, & Bavelier, 2010). The present study used brain imaging to test this hypothesis by comparing attentional network recruitment and distractor processing in action gamers versus non-gamers as attentional demands increased. Moving distractors were found to elicit lesser activation of the visual motion-sensitive area (MT/MST) in gamers as compared to non-gamers, suggestive of a better early filtering of irrelevant information in gamers. As expected, a fronto-parietal network of areas showed greater recruitment as attentional demands increased in non-gamers. In contrast, gamers barely engaged this network as attentional demands increased. This reduced activity in the fronto-parietal network that is hypothesized to control the flexible allocation of top-down attention is compatible with the proposal that action game players may allocate attentional resources more automatically, possibly allowing more efficient early filtering of irrelevant information. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Gorleben. Waste management site based on an appropriate selection procedure

    International Nuclear Information System (INIS)

    Tiggemann, Anselm

    2010-01-01

    On February 22, 1977, the Lower Saxony state government decided in favor of Gorleben as a ''preliminary'' site of a ''potential'' facility for managing the back end of the fuel cycle of the nuclear power plants in the Federal Republic of Germany. The Lower Saxony files, closed until recently, now allow both the factual basis and the political background to be reconstructed comprehensively. The first selection procedure, financed by the federal government, for the site of a ''nuclear waste management center,'' which had been conducted by Kernbrennstoff-Wiederaufarbeitungsgesellschaft (KEWA) in 1974, had not considered Gorleben in any detail. As early as in the winter of 1975/76, Gorleben and a number of other potential sites were indicated to KEWA by the Lower Saxony State Ministry of Economics. The new finding is KEWA's conclusion of 1976 that Gorleben surpassed all potential sites examined so far in terms of suitability. As a consequence, Gorleben was regarded as an alternative alongside the 3 sites favored before, i.e. Wahn, Lutterloh, and Lichtenhorst, when the 3 Federal Ministers, Hans Matthoefer (SPD), Werner Maihofer (F.D.P.), and Hans Friderichs (F.D.P.), discussed the nuclear waste management project with Minister President Albrecht (CDU) in November 1976. The Lower Saxony State Cabinet commissioned an interministerial working party (IMAK) to find other potential sites besides Wahn, Lutterloh, Lichtenhorst, and Gorleben. IMAK proposed Gorleben, Lichtenhorst, Mariaglueck, and Wahn for further examination. IMAK recommended to the State Cabinet in another proposal to earmark either Gorleben or Lichtenhorst. (orig.)

  9. Strategy selection in cue-based decision making.

    Science.gov (United States)

    Bryant, David J

    2014-06-01

    People can make use of a range of heuristic and rational, compensatory strategies to perform a multiple-cue judgment task. It has been proposed that people are sensitive to the amount of cognitive effort required to employ decision strategies. Experiment 1 employed a dual-task methodology to investigate whether participants' preference for heuristic versus compensatory decision strategies can be altered by increasing the cognitive demands of the task. As indicated by participants' decision times, a secondary task interfered more with the performance of a heuristic than compensatory decision strategy but did not affect the proportions of participants using either type of strategy. A stimulus set effect suggested that the conjunction of cue salience and cue validity might play a determining role in strategy selection. The results of Experiment 2 indicated that when a perceptually salient cue was also the most valid, the majority of participants preferred a single-cue heuristic strategy. Overall, the results contradict the view that heuristics are more likely to be adopted when a task is made more cognitively demanding. It is argued that people employ 2 learning processes during training, one an associative learning process in which cue-outcome associations are developed by sampling multiple cues, and another that involves the sequential examination of single cues to serve as a basis for a single-cue heuristic.

  10. Addressing the selective role of distinct prefrontal areas in response suppression: A study with brain tumor patients.

    Science.gov (United States)

    Arbula, Sandra; Pacella, Valentina; De Pellegrin, Serena; Rossetto, Marta; Denaro, Luca; D'Avella, Domenico; Della Puppa, Alessandro; Vallesi, Antonino

    2017-06-01

    The diverging evidence for functional localization of response inhibition within the prefrontal cortex might be justified by the still unclear involvement of other intrinsically related cognitive processes like response selection and sustained attention. In this study, the main aim was to understand whether inhibitory impairments, previously found in patients with both left and right frontal lesions, could be better accounted for by assessing these potentially related cognitive processes. We tested 37 brain tumor patients with left prefrontal, right prefrontal and non-prefrontal lesions and a healthy control group on Go/No-Go and Foreperiod tasks. In both types of tasks inhibitory impairments are likely to cause false alarms, although additionally the former task requires response selection and the latter target detection abilities. Irrespective of the task context, patients with right prefrontal damage showed frequent Go and target omissions, probably due to sustained attention lapses. Left prefrontal patients, on the other hand, showed both Go and target omissions and high false alarm rates to No-Go and warning stimuli, suggesting a decisional rather than an inhibitory impairment. An exploratory whole-brain voxel-based lesion-symptom mapping analysis confirmed the association of left ventrolateral and dorsolateral prefrontal lesions with target discrimination failure, and right ventrolateral and medial prefrontal lesions with target detection failure. Results from this study show how left and right prefrontal areas, which previous research has linked to response inhibition, underlie broader cognitive control processes, particularly involved in response selection and target detection. Based on these findings, we suggest that successful inhibitory control relies on more than one functionally distinct process which, if assessed appropriately, might help us to better understand inhibitory impairments across different pathologies. Copyright © 2017 The Authors

  11. Selective interface transparency in graphene nanoribbon based molecular junctions.

    Science.gov (United States)

    Dou, K P; Kaun, C C; Zhang, R Q

    2018-03-08

    A clear understanding of electrode-molecule interfaces is a prerequisite for the rational engineering of future generations of nanodevices that will rely on single-molecule coupling between components. With a model system, we reveal a peculiar dependence on interfaces in all graphene nanoribbon-based carbon molecular junctions. The effect can be classified into two types depending on the intrinsic feature of the embedded core graphene nanoflake (GNF). For metallic GNFs with |N A - N B | = 1, good/poor contact transparency occurs when the core device aligns with the center/edge of the electrode. The situation is reversed when a semiconducting GNF is the device, where N A = N B . These results may shed light on the design of real connecting components in graphene-based nanocircuits.

  12. Photochemical selectivity in guanine-cytosine base-pair structures

    Czech Academy of Sciences Publication Activity Database

    Abo-Riziq, A.; Grace, L.; Nir, E.; Kabeláč, Martin; Hobza, Pavel; Vries de, M. S.

    2005-01-01

    Roč. 102, č. 1 (2005), s. 20-23 ISSN 0027-8424 R&D Projects: GA ČR(CZ) GA203/05/0009 Grant - others:NSF(US) CHE-0244341 Institutional research plan: CEZ:AV0Z40550506 Keywords : DNA base pairs * IR-UV spectroscopy * phytochemistry Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 10.231, year: 2005

  13. Automated Threshold Selection for Template-Based Sonar Target Detection

    Science.gov (United States)

    2017-08-01

    features,” OCEANS 2014 - TAIPEI. 4. Groen, J.; Coiras, E .; Del Rio, J.; Evans, Vera B., “Model-based sea mine classification with synthetic aperture...2) 3$*(6 D1$0(2)5(63216,%/(3(5621 D5(3257 E $%675$&7 F7+,63$*( /,0,7$7,212) $%675$&7 6WDQGDUG)RUP 5HY...3UHVFULEHG E \\$16,6WG= 7KHSXEOLFUHSRUWLQJEXUGHQIRUWKLVFROOHFWLRQRI LQIRUPDWLRQLVHVWLPDWHGWRDYHUDJHKRXUSHUUHVSRQVH

  14. A Cancer Gene Selection Algorithm Based on the K-S Test and CFS

    Directory of Open Access Journals (Sweden)

    Qiang Su

    2017-01-01

    Full Text Available Background. To address the challenging problem of selecting distinguished genes from cancer gene expression datasets, this paper presents a gene subset selection algorithm based on the Kolmogorov-Smirnov (K-S test and correlation-based feature selection (CFS principles. The algorithm selects distinguished genes first using the K-S test, and then, it uses CFS to select genes from those selected by the K-S test. Results. We adopted support vector machines (SVM as the classification tool and used the criteria of accuracy to evaluate the performance of the classifiers on the selected gene subsets. This approach compared the proposed gene subset selection algorithm with the K-S test, CFS, minimum-redundancy maximum-relevancy (mRMR, and ReliefF algorithms. The average experimental results of the aforementioned gene selection algorithms for 5 gene expression datasets demonstrate that, based on accuracy, the performance of the new K-S and CFS-based algorithm is better than those of the K-S test, CFS, mRMR, and ReliefF algorithms. Conclusions. The experimental results show that the K-S test-CFS gene selection algorithm is a very effective and promising approach compared to the K-S test, CFS, mRMR, and ReliefF algorithms.

  15. Tuning Selectivity of Fluorescent Carbon Nanotube-Based Neurotransmitter Sensors.

    Science.gov (United States)

    Mann, Florian A; Herrmann, Niklas; Meyer, Daniel; Kruss, Sebastian

    2017-06-28

    Detection of neurotransmitters is an analytical challenge and essential to understand neuronal networks in the brain and associated diseases. However, most methods do not provide sufficient spatial, temporal, or chemical resolution. Near-infrared (NIR) fluorescent single-walled carbon nanotubes (SWCNTs) have been used as building blocks for sensors/probes that detect catecholamine neurotransmitters, including dopamine. This approach provides a high spatial and temporal resolution, but it is not understood if these sensors are able to distinguish dopamine from similar catecholamine neurotransmitters, such as epinephrine or norepinephrine. In this work, the organic phase (DNA sequence) around SWCNTs was varied to create sensors with different selectivity and sensitivity for catecholamine neurotransmitters. Most DNA-functionalized SWCNTs responded to catecholamine neurotransmitters, but both dissociation constants ( K d ) and limits of detection were highly dependent on functionalization (sequence). K d values span a range of 2.3 nM (SWCNT-(GC) 15 + norepinephrine) to 9.4 μM (SWCNT-(AT) 15 + dopamine) and limits of detection are mostly in the single-digit nM regime. Additionally, sensors of different SWCNT chirality show different fluorescence increases. Moreover, certain sensors (e.g., SWCNT-(GT) 10 ) distinguish between different catecholamines, such as dopamine and norepinephrine at low concentrations (50 nM). These results show that SWCNTs functionalized with certain DNA sequences are able to discriminate between catecholamine neurotransmitters or to detect them in the presence of interfering substances of similar structure. Such sensors will be useful to measure and study neurotransmitter signaling in complex biological settings.

  16. Practical considerations and patient selection for intrathecal drug delivery in the management of chronic pain

    Directory of Open Access Journals (Sweden)

    Saulino M

    2014-11-01

    Full Text Available Michael Saulino,1,2 Philip S Kim,3,4 Erik Shaw5 1MossRehab, Elkins Park, PA, USA; 2Department of Rehabilitation Medicine, Jefferson Medical College, Philadelphia, PA, USA; 3Helen F Graham Cancer Center, Christiana Care Health System, Newark, DE, USA; 4Center for Interventional Pain Spine, LLC., Bryn Mawr, PA, USA; 5Shepherd Pain Institute, Shepherd Center, Atlanta, GA, USA Abstract: Chronic pain continues to pose substantial and growing challenges for patients, caregivers, health care professionals, and health care systems. By the time a patient with severe refractory pain sees a pain specialist for evaluation and management, that patient has likely tried and failed several nonpharmacologic and pharmacologic approaches to pain treatment. Although relegated to one of the interventions of “last resort”, intrathecal drug delivery can be useful for improving pain control, optimizing patient functionality, and minimizing the use of systemic pain medications in appropriately selected patients. Due to its clinical and logistical requirements, however, intrathecal drug delivery may fit poorly into the classic pain clinic/interventional model and may be perceived as a "critical mass" intervention that is feasible only for large practices that have specialized staff and appropriate office resources. Potentially, intrathecal drug delivery may be more readily adopted into larger practices that can commit the necessary staff and resources to support patients' needs through the trialing, initiation, monitoring, maintenance, and troubleshooting phases of this therapy. Currently, two agents – morphine and ziconotide – are approved by the United States Food and Drug Administration for long-term intrathecal delivery. The efficacy and safety profiles of morphine have been assessed in long-term, open-label, and retrospective studies of >400 patients with chronic cancer and noncancer pain types. The efficacy and safety profiles of ziconotide have been

  17. Eleven-Year Retrospective Report of Super-Selective Venous Sampling for the Evaluation of Recurrent or Persistent Hyperparathyroidism in 32 Patients.

    Science.gov (United States)

    Habibollahi, Peiman; Shin, Benjamin; Shamchi, Sara P; Wachtel, Heather; Fraker, Douglas L; Trerotola, Scott O

    2018-01-01

    Parathyroid venous sampling (PAVS) is usually reserved for patients with persistent or recurrent hyperparathyroidism after parathyroidectomy with inconclusive noninvasive imaging studies. A retrospective study was performed to evaluate the diagnostic efficacy of super-selective PAVS (SSVS) in patients needing revision neck surgery with inconclusive imaging. Patients undergoing PAVS between 2005 and 2016 due to persistent or recurrent hyperparathyroidism following surgery were reviewed. PAVS was performed in all patients using super-selective technique. Single-value measurements within central neck veins performed as part of super-selective PAVS were used to simulate selective venous sampling (SVS) and allow for comparison to data, which might be obtained in a non-super-selective approach. 32 patients (mean age 51 ± 15 years; 8 men and 24 women) met inclusion and exclusion criteria. The sensitivity and positive predictive value (PPV) of SSVS for localizing the source of elevated PTH to a limited area in the neck or chest was 96 and 84%, respectively. Simulated SVS, on the other hand, had a sensitivity of 28% and a PPV of 89% based on the predefined gold standard. SSVS had a significantly higher sensitivity compared to simulated SVS (p localizing the source of hyperparathyroidism in patients undergoing revision surgery for hyperparathyroidism in whom noninvasive imaging studies are inconclusive. SSVS data had also markedly higher sensitivity for localizing disease in these patients compared to simulated SVS.

  18. Different cortical mechanisms for spatial vs. feature-based attentional selection in visual working memory

    Directory of Open Access Journals (Sweden)

    Anna Heuer

    2016-08-01

    Full Text Available The limited capacity of visual working memory necessitates attentional mechanisms that selectively update and maintain only the most task-relevant content. Psychophysical experiments have shown that the retroactive selection of memory content can be based on visual properties such as location or shape, but the neural basis for such differential selection is unknown. For example, it is not known if there are different cortical modules specialized for spatial versus feature-based mnemonic attention, in the same way that has been demonstrated for attention to perceptual input. Here, we used transcranial magnetic stimulation (TMS to identify areas in human parietal and occipital cortex involved in the selection of objects from memory based on cues to their location (spatial information or their shape (featural information. We found that TMS over the supramarginal gyrus (SMG selectively facilitated spatial selection, whereas TMS over the lateral occipital cortex selectively enhanced feature-based selection for remembered objects in the contralateral visual field. Thus, different cortical regions are responsible for spatial vs. feature-based selection of working memory representations. Since the same regions are involved in attention to external events, these new findings indicate overlapping mechanisms for attentional control over perceptual input and mnemonic representations.

  19. Mutual information based feature selection for medical image retrieval

    Science.gov (United States)

    Zhi, Lijia; Zhang, Shaomin; Li, Yan

    2018-04-01

    In this paper, authors propose a mutual information based method for lung CT image retrieval. This method is designed to adapt to different datasets and different retrieval task. For practical applying consideration, this method avoids using a large amount of training data. Instead, with a well-designed training process and robust fundamental features and measurements, the method in this paper can get promising performance and maintain economic training computation. Experimental results show that the method has potential practical values for clinical routine application.

  20. Non-invasive examinations successfully select patients with medial temporal lobe epilepsy for anterior temporal lobectomy

    Energy Technology Data Exchange (ETDEWEB)

    Morioka, Takato; Nishio, Shunji; Kawamura, Tadao; Fukui, Kimiko; Sasaki, Masayuki; Fukui, Masashi [Kyushu Univ., Fukuoka (Japan). Graduate School of Medical Sciences

    2001-06-01

    We retrospectively analyzed 8 patients with intractable medial temporal lobe epilepsy (MTLE) who underwent the anterior temporal lobectomy with hippocampectomy (ATL) without invasive examinations such as chronic subdural electrode recording. Five patients had a history of febrile convulsion. While all 8 patients had oral automatism, automatism of ipsilateral limbs with dystonic posture of contralateral limbs was demonstrated in 2 patients. Bilateral temporal paroxysmal activities on interictal EEG was observed in 4 patients and all patients had clear ictal onset zone on unilateral anterior temporal region. MRI demonstrated unilateral hippocampal sclerosis in 5 cases. Interictal FDG-PET depicted hypometabolism of the unilateral temporal lobe in all cases, however, ECD-SPECT failed to reveal the hypoperfusion of the unilateral temporal lobe in a case. Postoperatively, 7 cases became seizure free, and one had rare seizure. Non-invasive examinations, especially ictal EEG and concordant FDG-PET findings, in patients with oral automatism in seizure semiology, successfully select patients with MTLE for ATL. (author)

  1. Non-invasive examinations successfully select patients with medial temporal lobe epilepsy for anterior temporal lobectomy

    International Nuclear Information System (INIS)

    Morioka, Takato; Nishio, Shunji; Kawamura, Tadao; Fukui, Kimiko; Sasaki, Masayuki; Fukui, Masashi

    2001-01-01

    We retrospectively analyzed 8 patients with intractable medial temporal lobe epilepsy (MTLE) who underwent the anterior temporal lobectomy with hippocampectomy (ATL) without invasive examinations such as chronic subdural electrode recording. Five patients had a history of febrile convulsion. While all 8 patients had oral automatism, automatism of ipsilateral limbs with dystonic posture of contralateral limbs was demonstrated in 2 patients. Bilateral temporal paroxysmal activities on interictal EEG was observed in 4 patients and all patients had clear ictal onset zone on unilateral anterior temporal region. MRI demonstrated unilateral hippocampal sclerosis in 5 cases. Interictal FDG-PET depicted hypometabolism of the unilateral temporal lobe in all cases, however, ECD-SPECT failed to reveal the hypoperfusion of the unilateral temporal lobe in a case. Postoperatively, 7 cases became seizure free, and one had rare seizure. Non-invasive examinations, especially ictal EEG and concordant FDG-PET findings, in patients with oral automatism in seizure semiology, successfully select patients with MTLE for ATL. (author)

  2. Plasma cytokine profiles in depressed patients who fail to respond to selective serotonin reuptake inhibitor therapy.

    LENUS (Irish Health Repository)

    O'Brien, Sinead M

    2012-02-03

    OBJECTIVE: Approximately 30% of patients with depression fail to respond to a selective serotonin reuptake inhibitor (SSRI). Few studies have attempted to define these patients from a biological perspective. Studies suggest that overall patients with depression show increased production of proinflammatory cytokines. We examined pro- and anti-inflammatory cytokine levels in patients who were SSRI resistant. METHODS: Plasma concentrations of IL-6, IL-8, IL-10, TNF-alpha and sIL-6R were measured with enzyme linked immunosorbent assays (ELISA) in DSM-1V major depressives who were SSRI resistant, in formerly SSRI resistant patients currently euthymic and in healthy controls. RESULTS: Patients with SSRI-resistant depression had significantly higher production of the pro-inflammatory cytokines IL-6 (p=0.01) and TNF-alpha (p=0.004) compared to normal controls. Euthymic patients who were formerly SSRI resistant had proinflammatory cytokine levels which were similar to the healthy subject group. Anti-inflammatory cytokine levels did not differ across the 3 groups. CONCLUSION: Suppression of proinflammatory cytokines does not occur in depressed patients who fail to respond to SSRIs and is necessary for clinical recovery.

  3. A bioinformatics approach for precision medicine off-label drug drug selection among triple negative breast cancer patients.

    Science.gov (United States)

    Cheng, Lijun; Schneider, Bryan P; Li, Lang

    2016-07-01

    Cancer has been extensively characterized on the basis of genomics. The integration of genetic information about cancers with data on how the cancers respond to target based therapy to help to optimum cancer treatment. The increasing usage of sequencing technology in cancer research and clinical practice has enormously advanced our understanding of cancer mechanisms. The cancer precision medicine is becoming a reality. Although off-label drug usage is a common practice in treating cancer, it suffers from the lack of knowledge base for proper cancer drug selections. This eminent need has become even more apparent considering the upcoming genomics data. In this paper, a personalized medicine knowledge base is constructed by integrating various cancer drugs, drug-target database, and knowledge sources for the proper cancer drugs and their target selections. Based on the knowledge base, a bioinformatics approach for cancer drugs selection in precision medicine is developed. It integrates personal molecular profile data, including copy number variation, mutation, and gene expression. By analyzing the 85 triple negative breast cancer (TNBC) patient data in the Cancer Genome Altar, we have shown that 71.7% of the TNBC patients have FDA approved drug targets, and 51.7% of the patients have more than one drug target. Sixty-five drug targets are identified as TNBC treatment targets and 85 candidate drugs are recommended. Many existing TNBC candidate targets, such as Poly (ADP-Ribose) Polymerase 1 (PARP1), Cell division protein kinase 6 (CDK6), epidermal growth factor receptor, etc., were identified. On the other hand, we found some additional targets that are not yet fully investigated in the TNBC, such as Gamma-Glutamyl Hydrolase (GGH), Thymidylate Synthetase (TYMS), Protein Tyrosine Kinase 6 (PTK6), Topoisomerase (DNA) I, Mitochondrial (TOP1MT), Smoothened, Frizzled Class Receptor (SMO), etc. Our additional analysis of target and drug selection strategy is also fully

  4. Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

    Science.gov (United States)

    Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

    2014-12-01

    Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

  5. Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances

    Directory of Open Access Journals (Sweden)

    A. Boudewyns

    2007-12-01

    Full Text Available Although continuous positive airway pressure (CPAP is considered to represent the standard treatment for patients with moderate-to-severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS, poor treatment compliance and/or refusal is an issue in 20–30% of these patients. As an alternative to life-long CPAP treatment, conservative procedures exist with dental appliances for mandibular advancement, as well as curative surgical techniques. Surgical treatment of OSAHS can be divided into the following two main groups: 1 upper airway surgery by soft tissue resection (uvulopalatopharyngoplasty, etc., and 2 skeletal procedures, such as maxillo-mandibular advancement. Proper selection of patients for the different treatment modalities is the key for full treatment success. Patient-related factors, such as the site of upper airway collapse, craniofacial characteristics, dental health, obesity, age, profession and positional dependence, as well as treatment-related factors, should be evaluated before a final proposal for these treatment alternatives is formulated.

  6. Structure-Based Prediction of Subtype Selectivity of Histamine H3 Receptor Selective Antagonists in Clinical Trials

    DEFF Research Database (Denmark)

    Kim, Soo-Kyung; Fristrup, Peter; Abrol, Ravinder

    2011-01-01

    applications, including treatment of Alzheimer’s disease, attention deficit hyperactivity disorder (ADHD), epilepsy, and obesity.(1) However, many of these drug candidates cause undesired side effects through the cross-reactivity with other histamine receptor subtypes. In order to develop improved selectivity...... and antagonists. We find that E2065.46 contributes most in binding H3 selective agonists (5, 6, 7) in agreement with experimental mutation studies. We also find that conserved E5.46/S5.43 in both of hH3HR and hH4HR are involved in H3/ H4 subtype selectivity. In addition, we find that M3786.55 in hH3HR provides...... additional hydrophobic interactions different from hH4HR (the corresponding amino acid of T3236.55 in hH4HR) to provide additional subtype bias. From these studies, we developed a pharmacophore model based on our predictions for known hH3HR selective antagonists in clinical study [ABT-239 1, GSK-189,254 2...

  7. Tripartite Evolutionary Game Analysis on Selection Behavior of Trans-Regional Hospitals and Patients in Telemedicine System

    Directory of Open Access Journals (Sweden)

    Yuxuan Gao

    2017-01-01

    Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.

  8. Opportunities for inhaler device selection in elderly patients with asthma or COPD

    Directory of Open Access Journals (Sweden)

    Barrons R

    2015-12-01

    Full Text Available Robert Barrons,1 James Wheeler,2 J Andrew Woods1 1Wingate University School of Pharmacy, Wingate, NC, USA; 2University of Tennessee Health Science Center, Nashville, TN, USA Abstract: An anticipated surge in the elderly population will be accompanied by a rise in aging patients with asthma or COPD. Clinician selection of inhalers needs to address the unique challenges to elderly patients. These challenges to the use of inhalers include diminished physical and cognitive abilities, as well as cost reimbursement issues associated with polypharmacy and the Medicare gap. Clinicians should consider patient preferences for an inhaler device that provides ease of administration, and addresses conveniences such as portability, visual, and auditory indicators of dosing completion. The addition of spacer devices resolves hand-breath coordination difficulty with pressurized metered dose inhalers, but reduces overall inhaler convenience. Soft mist inhalers (Respimat® improve ease of administration, but use may be limited by cost and formulary availability. Multiple dose dry powder inhalers provide convenience and simplified use by requiring only one to two steps prior to administration, but concerns of peak inspiratory flow requirements remain among patients with advanced age and severity of COPD. If unaddressed, these challenges to inhaler selection contribute to inappropriate use of inhalers in 41% to 69% of patients, accompanied by at least 51% non-adherence to treatment. Clinicians must first avail themselves of reputable educational resources regarding new inhaler developments and administration, for competent patient instruction. Patient education should include a checklist of inhaler technique, with physical demonstration of each device by the patient and provider. Device demonstration significantly improves inhaler technique and identifies the need for nebulization therapy. Clinician and patient knowledge of available inhalers and their

  9. Interferon and ribavarin associated depression in hcv patients and role of selective serotonin reuptake inhibitors

    International Nuclear Information System (INIS)

    Bashir, K.; Hussain, C.A.; Amer, K.

    2013-01-01

    Objective: To determine the frequency and severity of depression associated with antiviral therapy of Hepatitis C Virus (HCV) infection and effect of selective serotonin reuptake Inhibitors (SSRIs) to treat these depressive symptoms. Type of Study: Observational Analytical study. Place of Study and Duration: The study was conducted at Psychiatry, Medicine and Pathology department of Combined Military Hospital Sialkot Pakistan from February 2009 to July 2010. Subjects and Methods: All the patients in this study were suffering from HCV infection and were managed with Interferon (3 m.i.u. s/c thrice weekly) and Cap Ribavirin (400 mg bid) for six months. Patients were assessed by Hospital Anxiety and Depression Scale (HADS) - Urdu Version and Beck's Depressive Inventory (BDI) Scores after twelve weeks of antiviral therapy. Depressed patients were managed with selective serotonin reuptake inhibitors (SSRIs) for six weeks and again evaluated on HADS and BDI Scores. Response to SSRIs was defined as complete response, partial response and no response. Results: A total of 105 patients were studied out of which 75 were male and 30 were female with mean age 29.4 years. Out of these 54 (51.43%) patients developed depression and this tendency to develop depression was not related with the age and sex of the patients. The mean HADS and BDI scores before and after treatments with SSRIs were compared for significance and it was quite significant. There was not a single patient who did not show response to SSRIs. Conclusion: Depression is frequently associated with antiviral therapy of HCV RNA viraemia with interferon and SSRIs have proved an effective and safe remedy in these patients. (author)

  10. Patients with chronic insomnia have selective impairments in memory that are modulated by cortisol.

    Science.gov (United States)

    Chen, Gui-Hai; Xia, Lan; Wang, Fang; Li, Xue-Wei; Jiao, Chuan-An

    2016-10-01

    Memory impairment is a frequent complaint in insomniacs; however, it is not consistently demonstrated. It is unknown whether memory impairment in insomniacs involves neuroendocrine dysfunction. The participants in this study were selected from the clinical setting and included 21 patients with chronic insomnia disorder (CID), 25 patients with insomnia and comorbid depressive disorder (CDD), and 20 control participants without insomnia. We evaluated spatial working and reference memory, object working and reference memory, and object recognition memory using the Nine Box Maze Test. We also evaluated serum neuroendocrine hormone levels. Compared to the controls, the CID patients made significantly more errors in spatial working and object recognition memory (p memory types (p memory (r = .534, p = .033) and negatively correlated with the errors in object recognition memory (r = -.659, p = .006) in the CID patients. The results suggest that the CID patients had selective memory impairment, which may be mediated by increased cortisol levels. © 2016 Society for Psychophysiological Research.

  11. Selected problems associated with the treatment and care for patients with colostomy – part 2

    Science.gov (United States)

    Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care. PMID:24596509

  12. Selected problems associated with the treatment and care for patients with colostomy - part 2.

    Science.gov (United States)

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care.

  13. Gastric emptying for solids in patients with duodenal ulcer before and after highly selective vagotomy

    Energy Technology Data Exchange (ETDEWEB)

    Mistiaen, W.; Van Hee, R.; Blockx, P.; Hubens, A. (Univ. of Antwerp (Belgium))

    1990-03-01

    In a series of 31 duodenal ulcer patients (23 males and 8 females), who underwent a highly selective vagotomy, gastric emptying characteristics of a solid meal, labeled with (99mTc)stannous colloid, were assessed before, two weeks and six months after operation. The clinical diagnosis was confirmed by endoscopy and x-ray; failure of treatment with H2 antagonists or antacids during 1-18 (mean 5) years was the direct indication for operative treatment. A temporary delay in gastric emptying is noted two weeks after operation (T1/2: 124 vs 57 min). After six months, gastric emptying time has practically normalized. It appears that this is the result of the preservation of the antropyloric vagal nerve supply. In these patients, a 10% recurrence rate is noted, comparable to the results in the literature. Highly selective vagotomy proves to be a safe and effective procedure with few side effects. It does not impair gastric motility.

  14. Clonal Selection Based Artificial Immune System for Generalized Pattern Recognition

    Science.gov (United States)

    Huntsberger, Terry

    2011-01-01

    The last two decades has seen a rapid increase in the application of AIS (Artificial Immune Systems) modeled after the human immune system to a wide range of areas including network intrusion detection, job shop scheduling, classification, pattern recognition, and robot control. JPL (Jet Propulsion Laboratory) has developed an integrated pattern recognition/classification system called AISLE (Artificial Immune System for Learning and Exploration) based on biologically inspired models of B-cell dynamics in the immune system. When used for unsupervised or supervised classification, the method scales linearly with the number of dimensions, has performance that is relatively independent of the total size of the dataset, and has been shown to perform as well as traditional clustering methods. When used for pattern recognition, the method efficiently isolates the appropriate matches in the data set. The paper presents the underlying structure of AISLE and the results from a number of experimental studies.

  15. Selected aspects of nursing care for an elderly patient with chronic obstructive pulmonary disease

    OpenAIRE

    Budnik, Marta; Galikowska, Anna; Marzec, Izabela; Balcerak, Dominika; Kobus, Edyta; Posieczek, Zuzanna

    2017-01-01

    Budnik Marta, Galikowska Anna, Marzec Izabela, Balcerak Dominika, Kobus Edyta, Posieczek Zuzanna. Selected aspects of nursing care for an elderly patient with chronic obstructive pulmonary disease. Journal of Education, Health and Sport. 2017;7(6):34-44. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.802926 http://ojs.ukw.edu.pl/index.php/johs/article/view/4501 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation...

  16. Selected problems associated with the treatment and care for patients with colostomy – part 2

    OpenAIRE

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and maste...

  17. Selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty with duplex scanning

    International Nuclear Information System (INIS)

    Bostroem Ardin, A.; Hellberg, A.; Ljungman, C.; Logason, K.; Karacagil, S.; Loefberg, A.M.; Andren, B.

    2002-01-01

    Aim: To evaluate the role of duplex scanning in the selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty (PTA). Material and Methods: From January 1995 through May 2000, 702 patients (952 limbs), with chronic lower extremity ischemia due to infrainguinal atherosclerotic disease diagnosed by duplex scanning, were retrospectively studied. Diagnostic angiography (130 limbs) or infrainguinal PTA (108 limbs) was performed in 238 limbs. Two investigators retrospectively analyzed the duplex examinations and angiographies in a blinded manner and used similar criteria for the interpretation of lesions suitable or not suitable for PTA. Results: The superficial femoral, popliteal and crural artery lesions were correctly selected for PTA in 85%, 66% and 32%, respectively. The accuracy, sensitivity, specificity, negative predictive value and positive predictive value of duplex scanning to appropriately categorize femoropopliteal lesions as suitable or unsuitable for PTA were 89%, 83%, 92%, 94% and 78%, respectively. The accuracy of duplex scanning for predicting the performance of infrainguinal PTA was 83%. Conclusion: Duplex scanning has an important impact on the selection of treatment modalities in limbs with infrainguinal arterial occlusive disease. Femoropopliteal lesions can be reliably selected to PTA according to duplex scan findings

  18. Selection of ultimately ill cancer patients able to fulfill a questionnaire: Identification of inherent biases.

    Science.gov (United States)

    Fournier, Emmanuelle; Fournier, Charles; Christophe, Véronique; Reich, Michel; Villet, Stéphanie; Gamblin, Vincent; Ryckewaert, Thomas; Rodrigues, Isabelle; Amela, Eric Yaovi; Lefebvre, Gautier; Clisant, Stéphanie; Antoine, Pascal; Penel, Nicolas

    2015-09-01

    Physical or psychological well-being is an essential component of quality care assessment in palliative unit. This assessment is mainly based on self-assessment (questionnaires or interviews). The aim of this study is to compare the clinical characteristics of patients able to fulfill a questionnaire and those not able to do that. The clinical characteristics of 166 cancer patients admitted in palliative care unit from December 2006 to February 2008 have been collected. Characteristics of patients able to fulfill a questionnaire (80, 48.2%) have been compared to other patients (86, 51.8%). Moreover, functional independence measure (FIM) had been evaluated by nurses. Median age (60 versus 62) and sex ratio (40/40 versus 42/44) are similar in both groups. Lung primaries are significantly less frequent in patients able to fulfill the questionnaire (4% versus 17%, P=0.005). Patients able to fulfill the questionnaire had had better performance status (Karnofsky Index≤30%: 54% versus 21%, Ppatients non able to fulfill the questionnaire. Patients able to fulfill a questionnaire represent only 48.2% of all consecutive admitted patients. These patients are not representative of all patients since they had better performance status, they are less dependent and they display significant better survival. We have to think about new methods to avoid the biases generated by the use of patient-reported outcomes. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  19. Determination of Selected Amino Acids in Serum of Patients with Liver Disease.

    Science.gov (United States)

    Kanďár, Roman; Drábková, Petra; Toiflová, Tereza; Čegan, Alexander

    2016-01-01

    The determination of amino acids can be a reliable approach for extended diagnosis of liver diseases. This is because liver disease can be a cause of impaired amino acid metabolism. Therefore, a method for the determination of serum amino acids, applicable for clinical purposes, is necessary. The aim of this study was to find differences in the levels of selected amino acids between patients with liver disease and a control group. Samples of peripheral venous blood were obtained from a group of patients with liver disease (n = 131, 59 women at an average age of 60 years and 72 men at an average age of 52 years) and a control group (n = 105, 47 women at an average age of 62 years and 58 men at an average age of 58 years). Before the separation, the amino acids were derivatized with naphthalene-2,3-dicarboxaldehyde. For the separation, reverse phase column was used. The effluent was monitored with a fluorescence detector. There were significant differences in the concentrations of some amino acids between the patients and the control group, but also between women and men. Correlations between some amino acids and markers of liver blood tests and lipid metabolism were observed. A simple, relatively rapid and selective HPLC method with fluorescence detection for the determination of selected amino acids in serum has been developed.

  20. Student Entrepreneurship in Hungary: Selected Results Based on GUESSS Survey

    Directory of Open Access Journals (Sweden)

    Andrea S. Gubik

    2016-12-01

    Full Text Available Objective: This study investigates students’ entrepreneurial activities and aims to answer questions regarding to what extent do students utilize the knowledge gained during their studies and the personal connections acquired at universities, as well as what role a family business background plays in the development of students’ business start-ups. Research Design & Methods: This paper is based on the database of the GUESSS project investigates 658 student entrepreneurs (so-called ‘active entrepreneurs’ who have already established businesses of their own. Findings: The rate of self-employment among Hungarian students who study in tertiary education and consider themselves to be entrepreneurs is high. Motivations and entrepreneurial efforts differ from those who owns a larger company, they do not necessarily intend to make an entrepreneurial path a career option in the long run. A family business background and family support play a determining role in entrepreneurship and business start-ups, while entrepreneurial training and courses offered at higher institutions are not reflected in students’ entrepreneurial activities. Implications & Recommendations: Universities should offer not only conventional business courses (for example, business planning, but also new forms of education so that students meet various entrepreneurial tasks and problems, make decisions in different situations, explore and acquaint themselves with entrepreneurship. Contribution & Value Added: The study provides literature overview of youth entrepreneurship, describes the main characteristics of students’ enterprises and contributes to understanding the factors of youth entrepreneurship.

  1. Route Selection Problem Based on Hopfield Neural Network

    Directory of Open Access Journals (Sweden)

    N. Kojic

    2013-12-01

    Full Text Available Transport network is a key factor of economic, social and every other form of development in the region and the state itself. One of the main conditions for transport network development is the construction of new routes. Often, the construction of regional roads is dominant, since the design and construction in urban areas is quite limited. The process of analysis and planning the new roads is a complex process that depends on many factors (the physical characteristics of the terrain, the economic situation, political decisions, environmental impact, etc. and can take several months. These factors directly or indirectly affect the final solution, and in combination with project limitations and requirements, sometimes can be mutually opposed. In this paper, we present one software solution that aims to find Pareto optimal path for preliminary design of the new roadway. The proposed algorithm is based on many different factors (physical and social with the ability of their increase. This solution is implemented using Hopfield's neural network, as a kind of artificial intelligence, which has shown very good results for solving complex optimization problems.

  2. Update on prescription extended-release opioids and appropriate patient selection

    Directory of Open Access Journals (Sweden)

    Brennan MJ

    2013-07-01

    Full Text Available Michael J Brennan The Pain Center of Fairfield, Fairfield, CT, USA Abstract: Chronic pain is largely underdiagnosed, often undertreated, and expected to increase as the American population ages. Many patients with chronic pain require long-term treatment with analgesic medications, and pain management may involve use of prescription opioids for patients whose pain is inadequately controlled through other therapies. Yet because of the potential for abuse and addiction, many clinicians hesitate to treat their patients with pain with potentially beneficial agents. Finding the right opioid for the right patient is the first – often complicated – step. Ensuring that patients continue to properly use the medication while achieving therapeutic analgesic effects is the long-term goal. Combined with careful patient selection and ongoing monitoring, new formulations using extended-release technologies incorporating tamper-resistant features may help combat the growing risk of abuse or misuse, which will hopefully reduce individual suffering and the societal burden of chronic pain. The objective of this manuscript is to provide an update on extended-release opioids and to provide clinicians with a greater understanding of which patients might benefit from these new opioid formulations and how to integrate the recommended monitoring for abuse potential into clinical practice. Keywords: chronic pain, opioid analgesics, extended release, abuse prevention

  3. Multi-Objective Particle Swarm Optimization Approach for Cost-Based Feature Selection in Classification.

    Science.gov (United States)

    Zhang, Yong; Gong, Dun-Wei; Cheng, Jian

    2017-01-01

    Feature selection is an important data-preprocessing technique in classification problems such as bioinformatics and signal processing. Generally, there are some situations where a user is interested in not only maximizing the classification performance but also minimizing the cost that may be associated with features. This kind of problem is called cost-based feature selection. However, most existing feature selection approaches treat this task as a single-objective optimization problem. This paper presents the first study of multi-objective particle swarm optimization (PSO) for cost-based feature selection problems. The task of this paper is to generate a Pareto front of nondominated solutions, that is, feature subsets, to meet different requirements of decision-makers in real-world applications. In order to enhance the search capability of the proposed algorithm, a probability-based encoding technology and an effective hybrid operator, together with the ideas of the crowding distance, the external archive, and the Pareto domination relationship, are applied to PSO. The proposed PSO-based multi-objective feature selection algorithm is compared with several multi-objective feature selection algorithms on five benchmark datasets. Experimental results show that the proposed algorithm can automatically evolve a set of nondominated solutions, and it is a highly competitive feature selection method for solving cost-based feature selection problems.

  4. Exploring Visual Selective Attention towards Novel Stimuli in Alzheimer's Disease Patients

    Directory of Open Access Journals (Sweden)

    Sarah A. Chau

    2015-12-01

    Full Text Available Background: Alzheimer's disease (AD is associated with selective attention impairments, which could contribute to cognitive and functional deficits. Selective attention can be explored through examination of novelty preference. Aims: In this study, we quantified novelty preference in AD patients by measuring visual scanning behaviour using an eye tracking paradigm. Methods: Mild-to-moderate AD patients and elderly controls viewed slides containing novel and repeated images simultaneously. The outcome measure was time spent on specific images, with novelty preference defined by greater relative fixation time (RFT on novel versus repeated images. Cognitive status (Standardized Mini-Mental State Examination, SMMSE and attention (Digit Span, DS were also measured. Results: AD patients (age 79.2 ± 6.7 years, SMMSE 22.2 ± 4.0, n = 41 and controls (age 76.2 ± 6.4 years, SMMSE 28.1 ± 2.0, n = 24 were similar in age, education and sex. Compared with controls, AD patients had lower RFT on novel than on repeated images (F1,63 = 11.18, p = 0.001. Further, reduced RFT was associated with lower scores on SMMSE (r63 = 0.288, p = 0.020 and DS (r63 = 0.269, p = 0.030. Within individuals, novelty preference was detected in 92.3% of patients and in 100% of controls. Conclusion: These findings suggest that novelty preference, measured by visual scanning behaviour, can differentiate cognitively healthy and impaired people and may offer a nonverbal, less cognitively demanding method of assessing selective attention.

  5. Exploring Visual Selective Attention towards Novel Stimuli in Alzheimer's Disease Patients.

    Science.gov (United States)

    Chau, Sarah A; Herrmann, Nathan; Eizenman, Moshe; Chung, Jonathan; Lanctôt, Krista L

    2015-01-01

    Alzheimer's disease (AD) is associated with selective attention impairments, which could contribute to cognitive and functional deficits. Selective attention can be explored through examination of novelty preference. In this study, we quantified novelty preference in AD patients by measuring visual scanning behaviour using an eye tracking paradigm. Mild-to-moderate AD patients and elderly controls viewed slides containing novel and repeated images simultaneously. The outcome measure was time spent on specific images, with novelty preference defined by greater relative fixation time (RFT) on novel versus repeated images. Cognitive status (Standardized Mini-Mental State Examination, SMMSE) and attention (Digit Span, DS) were also measured. AD patients (age 79.2 ± 6.7 years, SMMSE 22.2 ± 4.0, n = 41) and controls (age 76.2 ± 6.4 years, SMMSE 28.1 ± 2.0, n = 24) were similar in age, education and sex. Compared with controls, AD patients had lower RFT on novel than on repeated images (F1,63 = 11.18, p = 0.001). Further, reduced RFT was associated with lower scores on SMMSE (r63 = 0.288, p = 0.020) and DS (r63 = 0.269, p = 0.030). Within individuals, novelty preference was detected in 92.3% of patients and in 100% of controls. These findings suggest that novelty preference, measured by visual scanning behaviour, can differentiate cognitively healthy and impaired people and may offer a nonverbal, less cognitively demanding method of assessing selective attention.

  6. Collagenase Clostridium histolyticum in the treatment of Peyronie’s disease: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Kuhlmann PK

    2017-03-01

    Full Text Available Paige K Kuhlmann,1 Kenneth J DeLay,2 James Anaissie,2 Wayne JG Hellstrom,2 Faysal A Yafi3 1University of Missouri-Columbia School of Medicine, Columbia, MO, 2Department of Urology, Tulane University School of Medicine, New Orleans, LA, 3Department of Urology, University of California Irvine, Orange, CA, USA Abstract: The safety and efficacy of the use of collagenase Clostridium histolyticum (CCH for the treatment of Peyronie’s disease has been confirmed over the past several years. However, identification of the ideal patient population for use of this treatment is not well established. Multiple studies have attempted to delineate various patient-specific factors that may predict response to treatment with CCH, with the intent of enhancing patient selection. To date, these include baseline curvature severity, duration of disease, disease phase at presentation, plaque calcification, baseline erectile function, plaque size, age, comorbid diabetes, previous penile trauma, responsiveness to first treatment cycle, baseline penile shortening or pain, prior treatment with intralesional injection, compliance with plaque modeling, and atypical curvature. In addition, other studies have sought to explore various aspects of treatment with CCH that may affect patient perspective of treatment. They have focused on patient-reported outcomes, female partner considerations, cost of treatment, and potential confounders of patient satisfaction. This review provides a summary and analysis of currently available literature on topics of patient selection and perspectives in regard to treatment of Peyronie’s disease with CCH. Keywords: Peyronie’s disease, collagenase Clostridium histolyticum, Peyronie’s disease questionnaire, curvature deformity, intralesional injection, erectile function

  7. Sequence-based classification using discriminatory motif feature selection.

    Directory of Open Access Journals (Sweden)

    Hao Xiong

    Full Text Available Most existing methods for sequence-based classification use exhaustive feature generation, employing, for example, all k-mer patterns. The motivation behind such (enumerative approaches is to minimize the potential for overlooking important features. However, there are shortcomings to this strategy. First, practical constraints limit the scope of exhaustive feature generation to patterns of length ≤ k, such that potentially important, longer (> k predictors are not considered. Second, features so generated exhibit strong dependencies, which can complicate understanding of derived classification rules. Third, and most importantly, numerous irrelevant features are created. These concerns can compromise prediction and interpretation. While remedies have been proposed, they tend to be problem-specific and not broadly applicable. Here, we develop a generally applicable methodology, and an attendant software pipeline, that is predicated on discriminatory motif finding. In addition to the traditional training and validation partitions, our framework entails a third level of data partitioning, a discovery partition. A discriminatory motif finder is used on sequences and associated class labels in the discovery partition to yield a (small set of features. These features are then used as inputs to a classifier in the training partition. Finally, performance assessment occurs on the validation partition. Important attributes of our approach are its modularity (any discriminatory motif finder and any classifier can be deployed and its universality (all data, including sequences that are unaligned and/or of unequal length, can be accommodated. We illustrate our approach on two nucleosome occupancy datasets and a protein solubility dataset, previously analyzed using enumerative feature generation. Our method achieves excellent performance results, with and without optimization of classifier tuning parameters. A Python pipeline implementing the approach is

  8. Clinical characteristics of patient selection and imaging predictors of outcome in solid tumors treated with checkpoint-inhibitors

    International Nuclear Information System (INIS)

    Rossi, Sabrina; Toschi, Luca; Castello, Angelo; Grizzi, Fabio; Mansi, Luigi; Lopci, Egesta

    2017-01-01

    The rapidly evolving knowledge on tumor immunology and the continuous implementation of immunotherapy in cancer have recently led to the FDA and EMA approval of several checkpoint inhibitors as immunotherapic agents in clinical practice. Anti-CTLA-4, anti-PD-1, and anti-PDL-1 antibodies are becoming standard of care in advanced melanoma, as well as in relapsed or metastatic lung and kidney cancer, demonstrating higher and longer response compared to standard chemotherapy. These encouraging results have fostered the evaluation of these antibodies either alone or in combination with other therapies in several dozen clinical trials for the treatment of multiple tumor types. However, not all patients respond to immune checkpoint inhibitors, hence, specific biomarkers are necessary to guide and monitor therapy. The utility of PD-L1 expression as a biomarker has varied in different clinical trials, but, to date, no consensus has been reached on whether PD-L1 expression is an ideal marker for response and patient selection; approximately 20-25% of patients will respond to immunotherapy with checkpoint inhibitors despite a negative PD-L1 staining. On the other hand, major issues concern the evaluation of objective response in patients treated with immunotherapy. Pure morphological criteria as commonly used in solid tumors (i.e. RECIST) are not sufficient because change in size is not an early and reliable marker of tumor response to biological therapies. Thus, the scientific community has required a continuous adaptation of immune-related response criteria (irRC) to overcome the problem. In this context, metabolic information and antibody-based imaging with positron emission tomography (PET) have been investigated, providing a powerful approach for an optimal stratification of patients at staging and during the evaluation of the response to therapy. In the present review we provide an overview on the clinical characteristics of patient selection when using imaging

  9. Clinical characteristics of patient selection and imaging predictors of outcome in solid tumors treated with checkpoint-inhibitors

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Sabrina; Toschi, Luca [Humanitas Clinical and Research Hospital, Medical Oncology, Rozzano (Italy); Castello, Angelo [Humanitas Clinical and Research Hospital, Nuclear Medicine, Rozzano (Italy); Grizzi, Fabio [Humanitas Clinical and Research Hospital, Immunology and Inflammation, Rozzano (Italy); Mansi, Luigi [Seconda Universita di Napoli, Nuclear Medicine, Naples (Italy); Lopci, Egesta [Humanitas Clinical and Research Hospital, Nuclear Medicine, Rozzano (Italy); Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Nuclear Medicine, Rozzano, MI (Italy)

    2017-12-15

    The rapidly evolving knowledge on tumor immunology and the continuous implementation of immunotherapy in cancer have recently led to the FDA and EMA approval of several checkpoint inhibitors as immunotherapic agents in clinical practice. Anti-CTLA-4, anti-PD-1, and anti-PDL-1 antibodies are becoming standard of care in advanced melanoma, as well as in relapsed or metastatic lung and kidney cancer, demonstrating higher and longer response compared to standard chemotherapy. These encouraging results have fostered the evaluation of these antibodies either alone or in combination with other therapies in several dozen clinical trials for the treatment of multiple tumor types. However, not all patients respond to immune checkpoint inhibitors, hence, specific biomarkers are necessary to guide and monitor therapy. The utility of PD-L1 expression as a biomarker has varied in different clinical trials, but, to date, no consensus has been reached on whether PD-L1 expression is an ideal marker for response and patient selection; approximately 20-25% of patients will respond to immunotherapy with checkpoint inhibitors despite a negative PD-L1 staining. On the other hand, major issues concern the evaluation of objective response in patients treated with immunotherapy. Pure morphological criteria as commonly used in solid tumors (i.e. RECIST) are not sufficient because change in size is not an early and reliable marker of tumor response to biological therapies. Thus, the scientific community has required a continuous adaptation of immune-related response criteria (irRC) to overcome the problem. In this context, metabolic information and antibody-based imaging with positron emission tomography (PET) have been investigated, providing a powerful approach for an optimal stratification of patients at staging and during the evaluation of the response to therapy. In the present review we provide an overview on the clinical characteristics of patient selection when using imaging

  10. Optimizing radiology peer review: a mathematical model for selecting future cases based on prior errors.

    Science.gov (United States)

    Sheu, Yun Robert; Feder, Elie; Balsim, Igor; Levin, Victor F; Bleicher, Andrew G; Branstetter, Barton F

    2010-06-01

    Peer review is an essential process for physicians because it facilitates improved quality of patient care and continuing physician learning and improvement. However, peer review often is not well received by radiologists who note that it is time intensive, is subjective, and lacks a demonstrable impact on patient care. Current advances in peer review include the RADPEER() system, with its standardization of discrepancies and incorporation of the peer-review process into the PACS itself. The purpose of this study was to build on RADPEER and similar systems by using a mathematical model to optimally select the types of cases to be reviewed, for each radiologist undergoing review, on the basis of the past frequency of interpretive error, the likelihood of morbidity from an error, the financial cost of an error, and the time required for the reviewing radiologist to interpret the study. The investigators compiled 612,890 preliminary radiology reports authored by residents and attending radiologists at a large tertiary care medical center from 1999 to 2004. Discrepancies between preliminary and final interpretations were classified by severity and validated by repeat review of major discrepancies. A mathematical model was then used to calculate, for each author of a preliminary report, the combined morbidity and financial costs of expected errors across 3 modalities (MRI, CT, and conventional radiography) and 4 departmental divisions (neuroradiology, abdominal imaging, musculoskeletal imaging, and thoracic imaging). A customized report was generated for each on-call radiologist that determined the category (modality and body part) with the highest total cost function. A universal total cost based on probability data from all radiologists was also compiled. The use of mathematical models to guide case selection could optimize the efficiency and effectiveness of physician time spent on peer review and produce more concrete and meaningful feedback to radiologists

  11. Patient Selection for Drip and Ship Thrombolysis in Acute Ischemic Stroke.

    Science.gov (United States)

    Lyerly, Michael J; Albright, Karen C; Boehme, Amelia K; Shahripour, Reza Bavarsad; Donnelly, John P; Houston, James T; Rawal, Pawan V; Kapoor, Niren; Alvi, Muhammad; Sisson, April; Alexandrov, Anne W; Alexandrov, Andrei V

    2015-07-01

    The drip and ship model is a method used to deliver thrombolysis to acute stroke patients in facilities lacking onsite neurology coverage. We sought to determine whether our drip and ship population differs from patients treated directly at our stroke center (direct presenters). We retrospectively reviewed consecutive patients who received thrombolysis at an outside facility with subsequent transfer to our center between 2009 and 2011. Patients received thrombolysis after telephone consultation with a stroke specialist. We examined demographics, vascular risk factors, laboratory values, and stroke severity in drip and ship patients compared with direct presenters. Ninety-six patients were identified who received thrombolysis by drip and ship compared with 212 direct presenters. The two groups did not differ with respect to sex, ethnicity, vascular risk factors, or admission glucose. The odds ratio (OR) of arriving at our hospital as a drip and ship for someone 80 years or older was 0.31 (95% confidence interval [CI] 0.15-0.61, P < 0.001). Only 21% of drip and ship patients were black versus 38% of direct presenters (OR 0.434, 95% CI 0.25-0.76, P = 0.004). Even after stratifying by age (<80 vs ≥80), a smaller proportion of drip and ship patients were black (OR 0.44, 95% CI 0.24-0.81, P = 0.008). Furthermore, we found that fewer black patients with severe strokes arrived by drip and ship (OR 0.33, 95% CI 0.11-0.98, P = 0.0028). Our study showed that a smaller proportion of blacks and older adults arrived at our center by the drip and ship model. This may reflect differences in how patients are selected for thrombolysis and transfer to a higher level of care.

  12. The transverse musculocutaneous gracilis flap for breast reconstruction: guidelines for flap and patient selection.

    Science.gov (United States)

    Schoeller, Thomas; Huemer, Georg M; Wechselberger, Gottfried

    2008-07-01

    The transverse musculocutaneous gracilis (TMG) flap has received little attention in the literature as a valuable alternative source of donor tissue in the setting of breast reconstruction. The authors give an in-depth review of their experience with breast reconstruction using the TMG flap. A retrospective review of 111 patients treated with a TMG flap for breast reconstruction in an immediate or a delayed setting between August of 2002 and July of 2007 was undertaken. Of these, 26 patients underwent bilateral reconstruction and 68 underwent unilateral reconstruction, and 17 patients underwent reconstruction unilaterally with a double TMG flap. Patient age ranged between 24 and 65 years (mean, 37 years). Twelve patients had to be taken back to the operating room because of flap-related problems and nine patients underwent successful revision microsurgically, resulting in three complete flap losses in a series of 111 patients with 154 transplanted TMG flaps. Partial flap loss was encountered in two patients, whereas fat tissue necrosis was managed conservatively in six patients. Donor-site morbidity was an advantage of this flap, with a concealed scar and minimal contour irregularities of the thigh, even in unilateral harvest. Complications included delayed wound healing (n = 10), hematoma (n = 5), and transient sensory deficit over the posterior thigh (n = 49). The TMG flap is more than an alternative to the deep inferior epigastric perforator (DIEP) flap in microsurgical breast reconstruction in selected patients. In certain indications, such as bilateral reconstructions, it possibly surpasses the DIEP flap because of a better concealed donor scar and easier harvest.

  13. On the benefits of location-based relay selection in mobile wireless networks

    DEFF Research Database (Denmark)

    Nielsen, Jimmy Jessen; Madsen, Tatiana Kozlova; Schwefel, Hans-Peter

    2016-01-01

    We consider infrastructure-based mobile networks that are assisted by a single relay transmission where both the downstream destination and relay nodes are mobile. Selecting the optimal transmission path for a destination node requires up-to-date link quality estimates of all relevant links....... If the relay selection is based on link quality measurements, the number of links to update grows quadratically with the number of nodes, and measurements need to be updated frequently when nodes are mobile. In this paper, we consider a location-based relay selection scheme where link qualities are estimated...... from node positions; in the scenario of a node-based location system such as GPS, the location-based approach reduces signaling overhead, which in this case only grows linearly with the number of nodes. This paper studies these two relay selection approaches and investigates how they are affected...

  14. A Reinforcement Learning Approach to Improve the Argument Selection Effectiveness in Argumentation-based Negotiation

    OpenAIRE

    Amandi, Analia Adriana; Monteserin, Ariel José

    2016-01-01

    Argument selection is considered the essence of the strategy in argumentation-based negotiation. An agent, which is arguing during a negotiation, must decide what arguments are the best to persuade the opponent. In fact, in each negotiation step, the agent must select an argument from a set of candidate arguments by applying some selection policy. Following this policy, the agent observes some factors of the negotiation context, for instance: trust in the opponent and expected utility of the...

  15. Flexible guideline-based patient careflow systems.

    Science.gov (United States)

    Quaglini, S; Stefanelli, M; Lanzola, G; Caporusso, V; Panzarasa, S

    2001-04-01

    Workflow Management Systems integrate domain and organisational knowledge to support business processes. When applied to the medical environment, they can be termed "Careflow Management Systems", and may be used to manage care delivery by enhancing co-operation among healthcare professionals. This paper focuses on care delivery based on clinical practice guidelines. Healthcare organisations are very different from industrial or commercial companies: their main goal is not profit, but maintaining and improving the health of the public. Therefore, outcomes are difficult to measure. Firstly, physicians, while playing a variety of roles, are quite independent decision-makers; secondly, the object of the process, i.e. the patient, may be involved in choosing treatment options, and may be treated by different institutions. For these reasons, the standard functionality of typical Workflow Management Systems must be strongly enhanced in order to cope with healthcare delivery needs. A major issue is accounting for exceptions. In most non-clinical settings this is not a problem because processes are very well defined and can often be easily controlled by some higher authority. As explained above, this does not happen in healthcare organisations. Responsibilities are widely shared, and health care professionals may be non-compliant with guidelines for a variety of reasons. The paper presents a classification of possible exceptions, and shows how the sequence of tasks described by a guideline may be altered, at the implementation level, in order to meet actual user needs, while maintaining guideline intentions as much as possible. A terminology server is also exploited towards this end. This work illustrates a prototype of a Careflow Management System based on an international guideline for ischemic stroke treatment, developed by the American Heart Association.

  16. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists.

    Science.gov (United States)

    Hifinger, M; Hiligsmann, M; Ramiro, S; Watson, V; Severens, J L; Fautrel, B; Uhlig, T; van Vollenhoven, R; Jacques, P; Detert, J; Canas da Silva, J; Scirè, C A; Berghea, F; Carmona, L; Péntek, M; Keat, A; Boonen, A

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety (probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  17. Motor-evacuatory gastric function in patients with duodenal cancer after selective proximal vagotomy

    Energy Technology Data Exchange (ETDEWEB)

    Aliev, M A; Kabdrakhmanov, T K; Kashkin, K A; Darmenov, O K; Kuspangaljeva, Sh U [Kazakhskij Inst. Klinicheskoj i Ehksperimental' noj Khirurgii Minzdrava Kazakhskoj SSR, Alma-Ata

    1983-06-01

    Motor-evacuatory stomach function by using continuous radiogastrography was studied in patients with duodenal ulcers. Radiogastrograms were analyzed before operation, on the 7th-15th day after selective proximal vagotomy performed either independently or in combination with draining operations. A faster evacuation of food from the stomach prevailed in an uncomplicated form of duodenal ulcer and compensated stenosis of the pyloroduodenal zone, evacuatory stomach function was retarded or absent in subcompensated and decompensated stenosis. Discoordinated gastric peristalsis and a reverse food input were noted in patients with subcompensated stenosis. At early time after operations temporary inhibition of evacuatory stomach function occurred in 94.2% of the patients; it could be corrected with conservative therapeutic measures.

  18. Motor-evacuatory gastric function in patients with duodenal cancer after selective proximal vagotomy

    International Nuclear Information System (INIS)

    Aliev, M.A.; Kabdrakhmanov, T.K.; Kashkin, K.A.; Darmenov, O.K.; Kuspangaljeva, Sh.U.

    1983-01-01

    Motor-evacuatory stomach function by using continuous radiogastrography was studied in patients with duodenal ulcers. Radiogastrograms were analyzed before operation, on the 7th-15th day after selective proximal vagotomy performed either independently or in combination with draining operations. A faster evacuation of food from the stomach prevailed in an uncomplicated form of duodenal ulcer and compensated stenosis of the pyloroduodenal zone, evacuatory stomach function was retarded or absent in subcompensated and decompensated stenosis. Discoordinated gastric peristalsis and a reverse food input were noted in patients with subcompensated stenosis. At early time after operations temporary inhibition of evacuatory stomach function occurred in 94.2% of the patients; it could be corrected with conservative therapeutic measures

  19. Disturbed prepulse inhibition in patients with schizophrenia is consequential to dysfunction of selective attention.

    Science.gov (United States)

    Scholes, Kirsty E; Martin-Iverson, Mathew T

    2010-03-01

    Controversy exists as to the cause of disturbed prepulse inhibition (PPI) in patients with schizophrenia. This study aimed to clarify the nature of PPI in schizophrenia using improved methodology. Startle and PPI were measured in 44 patients with schizophrenia and 32 controls across a range of startling stimulus intensities under two conditions, one while participants were attending to the auditory stimuli (ATTEND condition) and one while participants completed a visual task in order to ensure they were ignoring the auditory stimuli (IGNORE condition). Patients showed reduced PPI of R(MAX) (reflex capacity) and increased PPI of Hillslope (reflex efficacy) only under the INGORE condition, and failed to show the same pattern of attentional modulation of the reflex parameters as controls. In conclusion, disturbed PPI in schizophrenia appears to result from deficits in selective attention, rather than from preattentive dysfunction.

  20. Design Guidelines for a Content-Based Image Retrieval Color-Selection Interface

    NARCIS (Netherlands)

    Eggen, Berry; van den Broek, Egon; van der Veer, Gerrit C.; Kisters, Peter M.F.; Willems, Rob; Vuurpijl, Louis G.

    2004-01-01

    In Content-Based Image Retrieval (CBIR) two query-methods exist: query-by-example and query-by-memory. The user either selects an example image or selects image features retrieved from memory (such as color, texture, spatial attributes, and shape) to define his query. Hitherto, research on CBIR

  1. Entrainer selection for the synthesis of fatty acid esters by entrainer-based reactive distillation

    NARCIS (Netherlands)

    Jong, de M.C.; Zondervan, E.; Dimian, A.C.; Haan, de A.B.

    2010-01-01

    In this research it is demonstrated that, due to the similarities between Entrainer-based Reactive Distillation and azeotropic distillation, the same selection rules can be applied to select a suitable entrainer. From a list of suitable entrainers for the azeotropic distillation of isopropanol and

  2. Systematic differences in the response of genetic variation to pedigree and genome-based selection methods

    NARCIS (Netherlands)

    Heidaritabar, M.; Vereijken, A.; Muir, W.M.; Meuwissen, T.H.E.; Cheng, H.; Megens, H.J.W.C.; Groenen, M.; Bastiaansen, J.W.M.

    2014-01-01

    Genomic selection (GS) is a DNA-based method of selecting for quantitative traits in animal and plant breeding, and offers a potentially superior alternative to traditional breeding methods that rely on pedigree and phenotype information. Using a 60¿K SNP chip with markers spaced throughout the

  3. Development of a disposable mercury ion-selective optode based on tritylpicolinamide as ionophore

    NARCIS (Netherlands)

    Kuswandi, Bambang; Nuriman, [Unknown; Dam, H.H.; Reinhoudt, David; Verboom, Willem

    2007-01-01

    A disposable ion-selective optode for mercury based on trityl-picolinamide (T-Pico) as neutral ionophore was developed. The sensing layer consist of plasticised PVC incorporating T-Pico as a selective ionophore for Hg2+, ETH 5418 as a chromoionophore, and potassium

  4. Usefulness of oral loading of oxcarbazepine suspension in selected patients with epilepsy.

    Science.gov (United States)

    Kim, Dong Wook; Gu, Namyi; Lee, Howard; Jang, In-Jin; Chu, Kon; Yu, Kyung-Sang; Cho, Joo-Youn; Yoon, Seo Hyun; Na, Hyun Jeong; Lee, Sang Kun

    2013-10-01

    Oral loading of oxcarbazepine tablet is effective and well tolerated to adequately achieve the therapeutic levels of its active metabolite, 10,11-dihydro-10-hydroxy-carbazepine (monohydroxy derivative, MHD) in epilepsy patients. The present study was performed to investigate the safety, tolerability, and pharmacokinetic profiles of oral loading of oxcarbazepine suspension in epilepsy patients with a high risk of recurrent seizures. Oxcarbazepine suspension was administered orally at a single loading dose of 30 mg/kg to 38 adult patients with recurrent seizures, who required rapid seizure control or temporarily discontinued antiepileptic drugs for diagnostic or pre-surgical evaluation. Plasma concentrations of oxcarbazepine and MHD were determined, and adverse events were assessed at 2, 4, 6, 8, 10, 12, 14, 16, and 24 hours after oral loading of oxcarbazepine suspension. 30 patients experienced ≥ 1 adverse event during the first 24 hours after oral loading of oxcarbazepine (e.g., dizziness, transient diplopia, nausea or vomiting), most of which occurred within 4 hours after loading, suggesting no temporal association with MHD plasma levels. 35 (92.1%) patients were still compliant with a maintenance dose of oxcarbazepine after discharge from hospital. 34 (89.4%) patients reached the lower therapeutic level of MHD (12 mg/l) at 4 hours after oral loading of oxcarbazepine suspension, which lasted up to 24 hours in most patients. No patient reached the supratherapeutic levels of MHD (> 35 mg/l) during the study. The mean plasma concentration-time curves and pharmacokinetic profiles of oral loading of oxcarbazepine suspension were similar to those of oral loading of oxcarbazepine tablet. Oral loading of oxcarbazepine suspension followed by maintenance dosing is well tolerated and effective in steadily achieving the therapeutic level of MHD in selected patients with epilepsy.

  5. Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients: a cost-effectiveness analysis

    NARCIS (Netherlands)

    Oostdijk, E.A.; Wit, G.A. de; Bakker, M; Smet, A.M. de; Bonten, M.J.; Hoeven, J.G. van der; Pickkers, P.; Sturm, P.D.J.; Voss, A.; et al.,

    2013-01-01

    OBJECTIVE: To determine costs and effects of selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) as compared with standard care (ie, no SDD/SOD (SC)) from a healthcare perspective in Dutch Intensive Care Units (ICUs). DESIGN: A post hoc analysis of a

  6. Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients : a cost-effectiveness analysis

    NARCIS (Netherlands)

    Oostdijk, Evelien A. N.; de Wit, G. A.; Bakker, Marina; de Smet, Anne-Marie; Bonten, M. J. M.

    2013-01-01

    Objective: To determine costs and effects of selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) as compared with standard care (ie, no SDD/SOD (SC)) from a healthcare perspective in Dutch Intensive Care Units (ICUs). Design: A post hoc analysis of a

  7. EVALUATION OF N-RATIO IN SELECTING PATIENTS FOR ADJUVANT CHEMORADIOTHERAPY AFTER D2-GASTRECTOMY

    Directory of Open Access Journals (Sweden)

    Wilson Luiz da COSTA JUNIOR

    2013-12-01

    Full Text Available Context Whether adjuvant chemoradiotherapy may contribute to improve survival outcomes after D2-gastrectomy remains controvertial. Objective To explore the clinical utility of N-Ratio in selecting gastric cancer patients for adjuvant chemoradiotherapy after D2-gastrectomy. Methods A retrospective cohort study was carried out on gastric cancer patients who underwent D2-gastrectomy alone or D2-gastrectomy plus adjuvant chemoradiotherapy (INT-0116 protocol at the Hospital A. C. Camargo from September 1998 to December 2008. Statistical analysis were performed using multiple conventional methods, such as c-statistic, adjusted Cox's regression and stratified survival analysis. Results Our analysis involved 128 patients. According to c-statistic, the N-Ratio (i.e., as a continuous variable presented “area under ROC curve” (AUC of 0.713, while the number of metastatic nodes presented AUC of 0.705. After categorization, the cut-offs provide by Marchet et al. displayed the highest discriminating power – AUC value of 0.702. This N-Ratio categorization was confirmed as an independent predictor of survival using multivariate analyses. There also was a trend of better survival by adding of adjuvant chemoradiotherapy only for patients with milder degrees of lymphatic spread – 5-year survival of 23.1% vs 66.9%, respectively (HR = 0.426, 95% CI 0.150–1.202; P = 0.092. Conclusions This study confirms the N-Ratio as a tool to improve the lymph node metastasis staging in gastric cancer and suggests the cut-offs provided by Marchet et al. as the best way for its categorization after a D2-gastrectomy. In these settings, the N-Ratio appears a useful tool to select patients for adjuvant chemoradiotherapy, and the benefit of adding this type of adjuvancy to D2-gastrectomy is suggested to be limited to patients with milder degrees of lymphatic spread (i.e., NR2, 10%–25%.

  8. Home blood pressure monitoring and self-titration of antihypertensive medications: Proposed patient selection criteria.

    Science.gov (United States)

    Hill, James R

    2016-05-01

    Recent studies have demonstrated that home blood pressure monitoring (HBPM), coupled with self-titration of medications is a viable intervention to control hypertension. There are currently no established criteria to evaluate patients for inclusion in such a program. The purpose of this discussion is to propose criteria for determining if a patient is appropriate to participate in a program of HBPM and self-titration. Inclusion criteria for two self-titration trials were examined, and additional factors in clinical practice were identified and discussed. Additional selection criteria were proposed to support the decision to enroll a patient in an antihypertensive self-titration program. Inclusion criteria from self-titration trials provide a reasonable starting point for choosing appropriate patients in clinical practice, but additional research is necessary. Adaptation of these criteria and consideration of the identified factors can be used to develop decision support instruments. Such instruments should be evaluated for effectiveness and reliability prior to use in clinical practice. HBPM combined with self-titration is an effective patient-centered approach for hypertension management. Decision support instruments to determine appropriate patients are necessary for safe and effective use in clinical practice. ©2015 American Association of Nurse Practitioners.

  9. Structure-based prediction of subtype selectivity of histamine H3 receptor selective antagonists in clinical trials.

    Science.gov (United States)

    Kim, Soo-Kyung; Fristrup, Peter; Abrol, Ravinder; Goddard, William A

    2011-12-27

    Histamine receptors (HRs) are excellent drug targets for the treatment of diseases, such as schizophrenia, psychosis, depression, migraine, allergies, asthma, ulcers, and hypertension. Among them, the human H(3) histamine receptor (hH(3)HR) antagonists have been proposed for specific therapeutic applications, including treatment of Alzheimer's disease, attention deficit hyperactivity disorder (ADHD), epilepsy, and obesity. However, many of these drug candidates cause undesired side effects through the cross-reactivity with other histamine receptor subtypes. In order to develop improved selectivity and activity for such treatments, it would be useful to have the three-dimensional structures for all four HRs. We report here the predicted structures of four HR subtypes (H(1), H(2), H(3), and H(4)) using the GEnSeMBLE (GPCR ensemble of structures in membrane bilayer environment) Monte Carlo protocol, sampling ∼35 million combinations of helix packings to predict the 10 most stable packings for each of the four subtypes. Then we used these 10 best protein structures with the DarwinDock Monte Carlo protocol to sample ∼50 000 × 10(20) poses to predict the optimum ligand-protein structures for various agonists and antagonists. We find that E206(5.46) contributes most in binding H(3) selective agonists (5, 6, 7) in agreement with experimental mutation studies. We also find that conserved E5.46/S5.43 in both of hH(3)HR and hH(4)HR are involved in H(3)/ H(4) subtype selectivity. In addition, we find that M378(6.55) in hH(3)HR provides additional hydrophobic interactions different from hH(4)HR (the corresponding amino acid of T323(6.55) in hH(4)HR) to provide additional subtype bias. From these studies, we developed a pharmacophore model based on our predictions for known hH(3)HR selective antagonists in clinical study [ABT-239 1, GSK-189,254 2, PF-3654746 3, and BF2.649 (tiprolisant) 4] that suggests critical selectivity directing elements are: the basic proton

  10. Selecting a summation base in diffraction transformation of seismic recordings (in an example of Northern Sakhalin)

    Energy Technology Data Exchange (ETDEWEB)

    Bulatov, M.G.; Telegin, A.N.

    1984-01-01

    The effect of the dimensions of a processing base on the results of diffraction transformation of seismic recordings is examined. A formula is cited for rating the optimal summation base on the basis of a proposed range of slant angles of the reflecting boundaries. The recommendations for selecting a processing base are confirmed by factual material.

  11. Base Stabilization Guidance and Additive Selection for Pavement Design and Rehabilitation

    Science.gov (United States)

    2017-12-01

    Significant improvements have been made in base stabilization practice that include design specifications and methodology, experience with the selection of stabilizing additives, and equipment for distribution and uniform blending of additives. For t...

  12. Improved Frame Mode Selection for AMR-WB+ Based on Decision Tree

    Science.gov (United States)

    Kim, Jong Kyu; Kim, Nam Soo

    In this letter, we propose a coding mode selection method for the AMR-WB+ audio coder based on a decision tree. In order to reduce computation while maintaining good performance, decision tree classifier is adopted with the closed loop mode selection results as the target classification labels. The size of the decision tree is controlled by pruning, so the proposed method does not increase the memory requirement significantly. Through an evaluation test on a database covering both speech and music materials, the proposed method is found to achieve a much better mode selection accuracy compared with the open loop mode selection module in the AMR-WB+.

  13. Hematopoietic stem cell transplantation in sickle cell disease: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Bhatia M

    2015-07-01

    be donors. Matched siblings should be referred to an experienced transplant center for evaluation and counseling. In this review, we will discuss the rationale for these opinions and make recommendations for patient selection.Keywords: sickle cell disease, morbidity, stem cell transplantation, patient selection, matched sibling donor

  14. Mobile phone based imaging system for selected tele-healthcare applications

    OpenAIRE

    Condominas Guàrdia, Jordi

    2013-01-01

    A mobile phone based telemedicine study is developed to see how feasible phone usage is in selected health care applications. The research is divided into three different objectives. The first objective is to compile the technical characteristics of selected mobile phones from telemedicine perspective. The second objective is to develop techniques to acquire quality images of skin with mobile phones. Finally a smartphone based telemedicine application will be developed to asses...

  15. Should breast density influence patient selection for breast-conserving surgery?

    Science.gov (United States)

    Kapoor, Nimmi S; Eaton, Anne; King, Tari A; Patil, Sujata; Stempel, Michelle; Morris, Elizabeth; Brogi, Edi; Morrow, Monica

    2013-02-01

    In a previous study of the relationship between breast density and primary tumor features, we observed a higher mastectomy rate in patients with extremely dense breasts. Here we examine possible reasons for this finding. Data were obtained from a prospectively maintained database of 1,056 invasive breast cancer patients from January 2005 to June 2007. Mammographic density was assigned by Breast Imaging-Reporting and Data System (BI-RADS) classification. Initial and final surgical procedures, and patient and tumor variables were recorded. Breast-conserving surgery (BCS) was attempted in 758 patients (72 %), 385 (51 %) of whom had preoperative magnetic resonance imaging (MRI). Initial BCS was less common among patients with the highest (BI-RADS 4) breast density compared to patients with less-dense breasts (52 vs. 74 %; p mastectomy compared to patients with less-dense breasts. After initial BCS, 387 patients (51 %) had positive shaved margins, 96 (25 %) of whom converted to mastectomy. MRI did not correlate with the rate of positive margins overall or among those with dense breasts. Adjusting for clinical and pathologic variables, density did not predict margin status or conversion to mastectomy. In a multivariate model, age, histologic grade, extensive intraductal component, and multicentricity/multifocality were independently associated with conversion to mastectomy. Density alone seems to influence the decision to proceed with initial mastectomy. When BCS was attempted, breast density was not associated with positive margins or conversion to mastectomy. A benefit of MRI in decreasing positive margins was not observed. These data do not support the use of breast density as a selection criterion for BCS.

  16. Selection and application of familiar and novel tools in patients with left and right hemispheric stroke: Psychometrics and normative data.

    Science.gov (United States)

    Buchmann, Ilka; Randerath, Jennifer

    2017-09-01

    Frequently left brain damage (LBD) leads to limb apraxia, a disorder that can affect tool-use. Despite its impact on daily life, classical tests examining the pantomime of tool-use and imitation of gestures are seldom applied in clinical practice. The study's aim was to present a diagnostic approach which appears more strongly related to actions in daily life in order to sensitize applicants and patients about the relevance of the disorder before patients are discharged. Two tests were introduced that evaluate actual tool selection and tool-object-application: the Novel Tools (NTT) and the Familiar Tools (FTT) Test (parts of the DILA-S: Diagnostic Instrument for Limb Apraxia - Short Version). Normative data in healthy subjects (N = 82) was collected. Then the tests were applied in stroke patients with unilateral left brain damage (LBD: N = 33), a control right brain damage group (RBD: N = 20) as well as healthy age and gender matched controls (CL: N = 28, and CR, N = 18). The tests showed appropriate interrater-reliability and internal consistency as well as concurrent and divergent validity. To examine criterion validity based on the well-known left lateralization of limb apraxia, group comparisons were run. As expected, the LBD group demonstrated a high prevalence of tool-use apraxia (NTT: 36.4%, FTT: 48.5%) ranging from mild to severe impairment and scored worse than their control group (CL). A few RBD patients did demonstrate impairments in tool-use (NTT: 15%, FTT: 15%). On a group level they did not differ from their healthy controls (CR). Further, it was demonstrated that the selection and application of familiar and novel tools can be impaired selectively. Our study results suggest that real tool-use tests evaluating tool selection and tool application should be considered for standard diagnosis of limb apraxia in left as well as right brain damaged patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Wavenumber selection based analysis in Raman spectroscopy improves skin cancer diagnostic specificity at high sensitivity levels (Conference Presentation)

    Science.gov (United States)

    Zhao, Jianhua; Zeng, Haishan; Kalia, Sunil; Lui, Harvey

    2017-02-01

    Background: Raman spectroscopy is a non-invasive optical technique which can measure molecular vibrational modes within tissue. A large-scale clinical study (n = 518) has demonstrated that real-time Raman spectroscopy could distinguish malignant from benign skin lesions with good diagnostic accuracy; this was validated by a follow-up independent study (n = 127). Objective: Most of the previous diagnostic algorithms have typically been based on analyzing the full band of the Raman spectra, either in the fingerprint or high wavenumber regions. Our objective in this presentation is to explore wavenumber selection based analysis in Raman spectroscopy for skin cancer diagnosis. Methods: A wavenumber selection algorithm was implemented using variably-sized wavenumber windows, which were determined by the correlation coefficient between wavenumbers. Wavenumber windows were chosen based on accumulated frequency from leave-one-out cross-validated stepwise regression or least and shrinkage selection operator (LASSO). The diagnostic algorithms were then generated from the selected wavenumber windows using multivariate statistical analyses, including principal component and general discriminant analysis (PC-GDA) and partial least squares (PLS). A total cohort of 645 confirmed lesions from 573 patients encompassing skin cancers, precancers and benign skin lesions were included. Lesion measurements were divided into training cohort (n = 518) and testing cohort (n = 127) according to the measurement time. Result: The area under the receiver operating characteristic curve (ROC) improved from 0.861-0.891 to 0.891-0.911 and the diagnostic specificity for sensitivity levels of 0.99-0.90 increased respectively from 0.17-0.65 to 0.20-0.75 by selecting specific wavenumber windows for analysis. Conclusion: Wavenumber selection based analysis in Raman spectroscopy improves skin cancer diagnostic specificity at high sensitivity levels.

  18. A Consumer Health Information System to Assist Patients Select Quality Home Health Services

    Directory of Open Access Journals (Sweden)

    Dimitrios Zikos

    2017-11-01

    Full Text Available Patients evaluate the quality of home health agencies (HHAs using the Health Consumer Assessment of Healthcare Providers and Systems (HCAHPS survey. This paper describes a prototype community health information system to help patients select appropriate and quality HHAs, according to the location, proprietary status, type of service, and year of HHA establishment. Five HCAHPS indicators were selected: “summary rating”, “quality of care”, “professional care”, “communication”, and “recommend agency”. Independent t-test analysis showed that agencies offering Speech Pathology, Medical-Social, or Home Health Aide services, receive significantly worse HCAHPS ratings, while mean ratings vary significantly across different US states. Multiple comparisons with post hoc ANOVA revealed differences between and within HHAs of different proprietary status (p < 0.001: governmental HHAs receiving higher ratings than private HHAs. Finally, there was observed a relationship between all five quality rating variables and the HHA year of establishment (Pearson, p < 0.001. The older the agency is, the better the HCAPS summary ratings. Findings provided the knowledge to design of a consumer health information system, to provide rankings filtered according to user criteria, comparing the quality rankings of eligible HHAs. Users can also see how a specific agency is ranked against eligible HHAs. Ultimately, the system aims to support the patient community with contextually realistic comparisons in an effort to choose optimal HH service.

  19. A Feature Selection Method for Large-Scale Network Traffic Classification Based on Spark

    Directory of Open Access Journals (Sweden)

    Yong Wang

    2016-02-01

    Full Text Available Currently, with the rapid increasing of data scales in network traffic classifications, how to select traffic features efficiently is becoming a big challenge. Although a number of traditional feature selection methods using the Hadoop-MapReduce framework have been proposed, the execution time was still unsatisfactory with numeral iterative computations during the processing. To address this issue, an efficient feature selection method for network traffic based on a new parallel computing framework called Spark is proposed in this paper. In our approach, the complete feature set is firstly preprocessed based on Fisher score, and a sequential forward search strategy is employed for subsets. The optimal feature subset is then selected using the continuous iterations of the Spark computing framework. The implementation demonstrates that, on the precondition of keeping the classification accuracy, our method reduces the time cost of modeling and classification, and improves the execution efficiency of feature selection significantly.

  20. Attribute Based Selection of Thermoplastic Resin for Vacuum Infusion Process: A Decision Making Methodology

    DEFF Research Database (Denmark)

    Raghavalu Thirumalai, Durai Prabhakaran; Lystrup, Aage; Løgstrup Andersen, Tom

    2012-01-01

    The composite industry looks toward a new material system (resins) based on thermoplastic polymers for the vacuum infusion process, similar to the infusion process using thermosetting polymers. A large number of thermoplastics are available in the market with a variety of properties suitable...... be beneficial. In this paper, the authors introduce a new decision making tool for resin selection based on significant attributes. This article provides a broad overview of suitable thermoplastic material systems for vacuum infusion process available in today’s market. An illustrative example—resin selection...... for vacuum infused of a wind turbine blade—is shown to demonstrate the intricacies involved in the proposed methodology for resin selection....

  1. Using Variable Dwell Time to Accelerate Gaze-based Web Browsing with Two-step Selection

    OpenAIRE

    Chen, Zhaokang; Shi, Bertram E.

    2017-01-01

    In order to avoid the "Midas Touch" problem, gaze-based interfaces for selection often introduce a dwell time: a fixed amount of time the user must fixate upon an object before it is selected. Past interfaces have used a uniform dwell time across all objects. Here, we propose an algorithm for adjusting the dwell times of different objects based on the inferred probability that the user intends to select them. In particular, we introduce a probabilistic model of natural gaze behavior while sur...

  2. Introduction of helical computed tomography affects patient selection for V/Q lung scan

    International Nuclear Information System (INIS)

    Zettinig, G.; Baudrexel, S.; Leitha, Th.

    2002-01-01

    Aim: Retrospective analysis for determination of the effect of helical computed tomography (HCT) on utilization of V/Q lung scanning to diagnose pulmonary embolism (PE) in a large general hospital. Methods: A total number of 2676 V/Q scans of in- and out-patients referred to our department between March 1992 and December 1998 and between April 1997 and December 1998 were analyzed by an identical group of nuclear physicians. Results: Neither the total number of annually performed V/Q scans (446 ± 135) nor the mean age of patients (56 years ± 17) changed significantly since the introduction of HCT. However, the referral pattern was different. The percentage of patients with high and intermediate probability for PE decreased significantly from 15.2% to 9.4% (p <0.01) and from 10.2% to 7.3% (p <0.05), respectively. Low probability scans significantly increased from 37.8% to 42.7% (p <0.05). The percentage of normal scans did not change significantly, however, there was a highly significant increase summarizing patients with normal and low probability scans (74.6% to 83.3%; p <0.01). Conclusion: The introduction of HCT affected the selection of patients referred for V/Q lung scanning since V/Q scanning was primarily used to exclude rather to confirm PE. (orig.)

  3. Frequency of gastric varices in patients with portal hypertension based on endoscopic findings

    International Nuclear Information System (INIS)

    Mir, A.W.; Chaudry, A.A.; Mir, S.; Ahmed, N.; Khan, A.A.; Shahzadi, M.

    2017-01-01

    To find out the frequency of gastric varices in patients with portal hypertension based on endoscopic findings. Study Design: Descriptive Study. Place and Duration of Study: Department of Gastroenterology, Military Hospital, Rawalpindi from Jan to Jun 2011. Material and Methods: All patients fulfilling the inclusion criteria were selected through consecutive sampling. The patients presenting with hematemesis, melena or ascites with portal hypertension on ultrasound abdomen were admitted in the hospital. The patients were first stabilized hemodynamically and then kept empty stomach for at least four hours before endoscopy. The patients were sedated with intravenous midazolam and endoscopic findings obtained were entered on the patient proforma. Results: The overall frequency of gastric varices was 11 percent, whereas 89 percent had no gastric varices. Conclusion: A large number of patients with portal hypertension have gastric varices. It is recommended that endoscopy be carried out in all patients with identified portal hypertension. (author)

  4. Bet hedging based cooperation can limit kin selection and form a basis for mutualism.

    Science.gov (United States)

    Uitdehaag, Joost C M

    2011-07-07

    Mutualism is a mechanism of cooperation in which partners that differ help each other. As such, mutualism opposes mechanisms of kin selection and tag-based selection (for example the green beard mechanism), which are based on giving exclusive help to partners that are related or carry the same tag. In contrast to kin selection, which is a basis for parochialism and intergroup warfare, mutualism can therefore be regarded as a mechanism that drives peaceful coexistence between different groups and individuals. Here the competition between mutualism and kin (tag) selection is studied. In a model where kin selection and tag-based selection are dominant, mutualism is promoted by introducing environmental fluctuations. These fluctuations cause reduction in reproductive success by the mechanism of variance discount. The best strategy to counter variance discount is to share with agents who experience the most anticorrelated fluctuations, a strategy called bet hedging. In this way, bet hedging stimulates cooperation with the most unrelated partners, which is a basis for mutualism. Analytic results and simulations reveal that, if this effect is large enough, mutualistic strategies can dominate kin selective strategies. In addition, mutants of these mutualistic strategies that experience fluctuations that are more anticorrelated to their partner, can outcompete wild type, which can lead to the evolution of specialization. In this way, the evolutionary success of mutualistic strategies can be explained by bet hedging-based cooperation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. [Selected aspects of quality of life of patients treated for neoplasms of oral cavity].

    Science.gov (United States)

    Fraczak, Piotr

    2008-01-01

    Neoplasms of oral cavity make up 2.4% of all neoplasms in male and 1.1% in female population of Poland. Treatment of neoplasms in this area is mainly surgical and leads to a smaller or larger disability with a disorder of basic physiological functions such as breathing, swallowing and speech. It leads as well to the creation of psychological symptoms such as anxiety, depression. Lack of available data in Polish literature as well as in foreign literature on the subject of psychological state and quality of life of those patients, convinced me to start research in this area. The research was conducted on a group of 131 patients aged 44-82 years. The patients were divided into three groups: group I consisted of patients after surgical procedures in the face area, group II of patients with serious prognosis (leukaemia) and group III of healthy patients. All patients were subject to survey, which consisted of 2 parts. First part contained 7 questions and related to patient's knowledge as to prognosis for further life (this part pertained patients from group I and II). Second part of the questionnaire was a shortened version of a depression scale based on 15 traits and short version based on 4 traits. It was adopted, that this is a good research tool in case of depression, since it is directed exclusively on diagnosis of depression symptoms. Short research technique facilitates the patient to answer questions asked. The results were interpreted according to depression rating scale. The research indicated that amongst patients after surgical procedures; over 50% of women and almost 40% of man showed intensified growth of depression. This percentage was significantly lower in the group of patients with serious prognosis. In the healthy group, all of the women and over 80% of men had no depression. Education statistically had no significant influence on the depression level. It can be ascertained that surgical procedures in the facial area and oral cavity have influence

  6. Alemtuzumab in the treatment of multiple sclerosis: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Dörr J

    2016-10-01

    the other are not yet available. Thus, the overall success of alemtuzumab treatment critically depends on the patient selection. The aim of this article is therefore, to characterize the significance of alemtuzumab in the treatment of MS with a focus on the selection of the optimal patient. Keywords: multiple sclerosis, treatment, safety, efficacy, selection, benefit risk relation

  7. Pembrolizumab in the treatment of metastatic non-small-cell lung cancer: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Somasundaram A

    2017-01-01

    Full Text Available Ashwin Somasundaram, Timothy F Burns Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA Abstract: Lung cancer is the leading killer of both men and women in the US, and the 5-year survival remains poor. However, the approval of checkpoint blockade immunotherapy has shifted the treatment paradigm and provides hope for improved survival. The ability of non-small-cell lung cancer (NSCLC to evade the host immune system can be overcome by agents such as pembrolizumab (MK-3475/lambrolizumab, which is a monoclonal antibody targeting the programmed death 1 (PD-1 receptor. In early studies, treatment with pembrolizumab led to dramatic and durable responses in select patients (PD-L1+ tumors. This remarkable efficacy lead to approval of pembrolizumab in the second-line setting as response rates were almost doubled compared to standard of care (SOC chemotherapy. Most recently, data in the first-line setting from the KEYNOTE-024 study have redefined the SOC therapy for a selected subset of patients. In patients with ≥50% PD-L1+ tumors, pembrolizumab had a clear progression-free survival and overall survival benefit. Toxicity was mostly immune related and similar to checkpoint blockade toxicities observed in previous studies. The initial approval and subsequent studies of pembrolizumab required and utilized a companion diagnostic test, Dako’s IHC 22C3, to assess PD-L1 status of patients. The evaluation and scoring system of this assay has been used by other companies as a reference to develop their own assays, which may complicate selection of patients. Finally, the impact of pembrolizumab in NSCLC is growing as evidenced by the numerous, ongoing trials open for combinations with chemotherapy, chemoradiation, other immunotherapeutics, immunomodulators, tyrosine kinase inhibitors, PI3K inhibitors, MEK inhibitors, hypomethylating agents, and histone deacetylase inhibitors. Further studies

  8. An ontological knowledge based system for selection of process monitoring and analysis tools

    DEFF Research Database (Denmark)

    Singh, Ravendra; Gernaey, Krist; Gani, Rafiqul

    2010-01-01

    monitoring and analysis tools for a wide range of operations has made their selection a difficult, time consuming and challenging task. Therefore, an efficient and systematic knowledge base coupled with an inference system is necessary to support the optimal selection of process monitoring and analysis tools......, satisfying the process and user constraints. A knowledge base consisting of the process knowledge as well as knowledge on measurement methods and tools has been developed. An ontology has been designed for knowledge representation and management. The developed knowledge base has a dual feature. On the one...... procedures has been developed to retrieve the data/information stored in the knowledge base....

  9. FiGS: a filter-based gene selection workbench for microarray data

    Directory of Open Access Journals (Sweden)

    Yun Taegyun

    2010-01-01

    Full Text Available Abstract Background The selection of genes that discriminate disease classes from microarray data is widely used for the identification of diagnostic biomarkers. Although various gene selection methods are currently available and some of them have shown excellent performance, no single method can retain the best performance for all types of microarray datasets. It is desirable to use a comparative approach to find the best gene selection result after rigorous test of different methodological strategies for a given microarray dataset. Results FiGS is a web-based workbench that automatically compares various gene selection procedures and provides the optimal gene selection result for an input microarray dataset. FiGS builds up diverse gene selection procedures by aligning different feature selection techniques and classifiers. In addition to the highly reputed techniques, FiGS diversifies the gene selection procedures by incorporating gene clustering options in the feature selection step and different data pre-processing options in classifier training step. All candidate gene selection procedures are evaluated by the .632+ bootstrap errors and listed with their classification accuracies and selected gene sets. FiGS runs on parallelized computing nodes that capacitate heavy computations. FiGS is freely accessible at http://gexp.kaist.ac.kr/figs. Conclusion FiGS is an web-based application that automates an extensive search for the optimized gene selection analysis for a microarray dataset in a parallel computing environment. FiGS will provide both an efficient and comprehensive means of acquiring optimal gene sets that discriminate disease states from microarray datasets.

  10. Single-donor islet transplantation and long-term insulin independence in select patients with type 1 diabetes mellitus.

    Science.gov (United States)

    Al-Adra, David P; Gill, Richdeep S; Imes, Sharleen; O'Gorman, Doug; Kin, Tatsuya; Axford, Sara J; Shi, Xinzhe; Senior, Peter A; Shapiro, A M James

    2014-11-15

    Islet transplantation is a recognized treatment option for select patients with type I diabetes mellitus. However, islet infusions from multiple donors are often required to achieve insulin independence. Ideally, insulin independence would be achieved routinely with only a single donor. Identification of factors associated with insulin independence after single-donor islet transplantation may help to select recipient-donor combinations with the highest probability of success. Subjects undergoing islet transplantation at a single center (Edmonton, Canada) between March 1999 and August 2013 were included. Recipient, donor, and transplant characteristics were collected and compared between recipients who became insulin independent after one islet transplantation and those who did not. Thirty-one patients achieved insulin independence after a single-donor islet transplantation, and 149 did not. Long-term insulin-free survival was not different between the groups. Factors significantly associated with single-donor success included recipient age, insulin requirement at baseline, donor weight, donor body mass index, islet transplant mass, and peritransplant heparin and insulin administration. On multivariate analysis, pretransplantation daily insulin requirements, the use of peritransplantation heparin and insulin infusions, and islet transplant mass remained significant. We have identified clinically relevant differences defining the achievement of insulin independence after single-donor transplantation. Based on these differences, a preoperative insulin requirement of less than 0.6 U/kg per day and receiving more than 5,646 islet equivalents (IEQ)/kg have a sensitivity of 84% and 71% and specificity of 50% and 50%, respectively, for insulin independence after single-donor islet transplantation. With ideal patient selection, this finding could potentially increase single-donor transplantation success and may be especially relevant for presensitized subjects or those who

  11. Selected Factors Determining a Way of Coping with Stress in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Anna Beata Sobol-Pacyniak

    2014-01-01

    Full Text Available Objectives. The aim of the study was to examine factors which determine stress coping styles in type 2 diabetic (T2D patients, with regard to selected demographic variables, clinical diabetes-related variables and selected psychical variables (anxiety level and assessment of depressive disorders. Methods. 50 T2D patients, aged 59.9 ± 10.2 years were assessed by Coping Inventory for Stressful Situations (CISS, Spielberger State-Trait Anxiety Inventory (STAI, and Beck Depression Inventory (BDI. In the statistical analysis simple and multivariable logistic regression models were used. Results. Variables significantly increasing the selection risk of stress coping style different from preferred task-oriented strategy in a simple logistic regression model are: hypoglycemia within three months prior to the research: odds ratio (OR = 6.86 (95% confidence interval (CI 1.25–37.61, taking antidepressants or neuroleptics: OR =15.42 (95% CI 2.42–98.33, severe depression in Beck’s scale: OR = 84.00 (95% CI 6.51–1083.65, high state-anxiety level: OR = 9.60 (95% CI 1.08–85.16, and high trait-anxiety level: OR = 18.40 (95%CI 2.96–114.31, but in a multivariable model, diagnosed depression is the strongest factor: OR = 32.38 (95% CI 4.94–212.13. Conclusions. In T2D patients, the strategy to cope with stress appears to be mostly influenced by psychical predisposition.

  12. [General principles of effective communication between physician and patient with selected mental disorders].

    Science.gov (United States)

    Błaszczyk, Justyna; Bobińska, Kinga; Filip, Maria; Gałecki, Piotr

    2015-04-01

    Faced with the growing frequency of mental disorders occurrence and considering the necessity of improving the patient care, it is particularly important that physicians of different specialties knew the general principles of effective communication with patients who are mentally ill. Equally important is to spread the knowledge of the symptomatology of various mental illnesses. Studies published by the Institute of Psychiatry and Neurology involving persons between 18 and 64 years old, show that 8 millions Poles suffers or suffered from mental disorders. This represents almost 25% of Polish society. The above data confirm, that basic knowledge of criteria for diagnosing mental disorders and their treatment by primary care physicians, determines the success of the entire health care system. It must be taken into consideration that frequently patients seeing general practitioner (GP) are suffering from more than one mental illness or it is accompanied by somatic disease. Adequate communication determines effective treatment. Simple yet exact message, ability to adapt it to patient and problems reported by him, is a valuable means in daily medical practice. It reduces the risk of iatrogenic disorder, encourages the efficiency of the entire therapeutic process. Good cooperation with the patient is also determined by patience, empathy, understanding, and competence. The aim of this study is to present the principles of effective communication between doctor and patient suffering from selected mental disorders. The article defines the concept of communication. It shows symptomatology of primary psychiatric disorders. Moreover, the most common difficulties in relationship between the doctor and the patient had been pointed. © 2015 MEDPRESS.

  13. A threshold-based multiple optical signal selection scheme for WDM FSO systems

    KAUST Repository

    Nam, Sung Sik

    2017-07-20

    In this paper, we propose a threshold-based-multiple optical signal selection scheme (TMOS) for free-space optical systems based on wavelength division multiplexing. With the proposed TMOS, we can obtain higher spectral efficiency while reducing the potential increase in complexity of implementation caused by applying a selection-based beam selection scheme without a considerable performance loss. Here, to accurately characterize the performance of the proposed TMOS, we statistically analyze the characteristics with heterodyne detection technique over independent and identically distributed Log-normal turbulence conditions taking into considerations the impact of pointing error. Specifically, we derive exact closed-form expressions for the average bit error rate, and the average spectral efficiency by adopting an adaptive modulation. Some selected results shows that the average spectral efficiency can be increased with TMOS while the system requirement is satisfied.

  14. A threshold-based multiple optical signal selection scheme for WDM FSO systems

    KAUST Repository

    Nam, Sung Sik; Alouini, Mohamed-Slim; Ko, Young-Chai; Cho, Sung Ho

    2017-01-01

    In this paper, we propose a threshold-based-multiple optical signal selection scheme (TMOS) for free-space optical systems based on wavelength division multiplexing. With the proposed TMOS, we can obtain higher spectral efficiency while reducing the potential increase in complexity of implementation caused by applying a selection-based beam selection scheme without a considerable performance loss. Here, to accurately characterize the performance of the proposed TMOS, we statistically analyze the characteristics with heterodyne detection technique over independent and identically distributed Log-normal turbulence conditions taking into considerations the impact of pointing error. Specifically, we derive exact closed-form expressions for the average bit error rate, and the average spectral efficiency by adopting an adaptive modulation. Some selected results shows that the average spectral efficiency can be increased with TMOS while the system requirement is satisfied.

  15. Does a selective 5-hydroxytryptamine antagonist (ICI 169, 369) lower blood pressure in hypertensive patients?

    OpenAIRE

    Scott, A K; Roy-Chaudhury, P; Webster, J; Petrie, J C

    1989-01-01

    1. The effect of single doses (10, 30 and 50 mg) of a selective 5-HT2 receptor antagonist, ICI 169, 369, on blood pressure, heart rate and the electrocardiogram was studied using a double-blind, placebo-controlled, within subject design in hypertensive patients. 2. ICI 169, 369 did not reduce blood pressure or increase QT interval as has been reported with ketanserin. This suggests that it is the other properties of ketanserin which are responsible for its antihypertensive effect. 3. Plasma c...

  16. A Site Selection Model for a Straw-Based Power Generation Plant with CO2 Emissions

    Directory of Open Access Journals (Sweden)

    Hao Lv

    2014-10-01

    Full Text Available The decision on the location of a straw-based power generation plant has a great influence on the plant’s operation and performance. This study explores traditional theories for site selection. Using integer programming, the study optimizes the economic and carbon emission outcomes of straw-based power generation as two objectives, with the supply and demand of straw as constraints. It provides a multi-objective mixed-integer programming model to solve the site selection problem for a straw-based power generation plant. It then provides a case study to demonstrate the application of the model in the decision on the site selection for a straw-based power generation plant with a Chinese region. Finally, the paper discusses the result of the model in the context of the wider aspect of straw-based power generation.

  17. Performance Analysis of a Threshold-Based Parallel Multiple Beam Selection Scheme for WDM FSO Systems

    KAUST Repository

    Nam, Sung Sik

    2018-04-09

    In this paper, we statistically analyze the performance of a threshold-based parallel multiple beam selection scheme for a free-space optical (FSO) based system with wavelength division multiplexing (WDM) in cases where a pointing error has occurred under independent identically distributed Gamma-Gamma fading conditions. To simplify the mathematical analysis, we additionally consider Gamma turbulence conditions, which are a good approximation of Gamma-Gamma distribution. Specifically, we statistically analyze the characteristics in operation under conventional detection schemes (i.e., heterodyne detection (HD) and intensity modulation/direct detection (IM/DD) techniques) for both adaptive modulation (AM) case in addition to non-AM case (i.e., coherent/non-coherent binary modulation). Then, based on the statistically derived results, we evaluate the outage probability of a selected beam, the average spectral efficiency (ASE), the average number of selected beams (ANSB) and the average bit error rate (BER). Selected results show that we can obtain higher spectral efficiency and simultaneously reduce the potential for increasing the complexity of implementation caused by applying the selection-based beam selection scheme without considerable performance loss. Especially for the AM case, the ASE can be increased further compared to the non- AM cases. Our derived results based on the Gamma distribution as an approximation of the Gamma-Gamma distribution can be used as approximated performance measure bounds, especially, they may lead to lower bounds on the approximated considered performance measures.

  18. Size- and charge selectivity of glomerular filtration in Type 1 (insulin-dependent) diabetic patients with and without albuminuria

    DEFF Research Database (Denmark)

    Deckert, T; Kofoed-Enevoldsen, A; Vidal, P

    1993-01-01

    Albuminuria is the first clinical event in the development of diabetic nephropathy. We assessed glomerular charge- and size selectivity in 51 patients with Type 1 (insulin-dependent) diabetes mellitus of juvenile onset and 11 healthy individuals. Patients were allocated to five groups. The urinary...... techniques and tubular protein reabsorption by excretion of beta 2-microglobulin. Charge selectivity was estimated from the IgG/IgG4 selectivity index. Size selectivity was measured by dextran clearance. Dextran was measured by refractive index detection after fractionation (2 A fractions in the range 26...... macromolecular pathways in the development of diabetic nephropathy....

  19. [Problem list in computer-based patient records].

    Science.gov (United States)

    Ludwig, C A

    1997-01-14

    Computer-based clinical information systems are capable of effectively processing even large amounts of patient-related data. However, physicians depend on rapid access to summarized, clearly laid out data on the computer screen to inform themselves about a patient's current clinical situation. In introducing a clinical workplace system, we therefore transformed the problem list-which for decades has been successfully used in clinical information management-into an electronic equivalent and integrated it into the medical record. The table contains a concise overview of diagnoses and problems as well as related findings. Graphical information can also be integrated into the table, and an additional space is provided for a summary of planned examinations or interventions. The digital form of the problem list makes it possible to use the entire list or selected text elements for generating medical documents. Diagnostic terms for medical reports are transferred automatically to corresponding documents. Computer technology has an immense potential for the further development of problem list concepts. With multimedia applications sound and images will be included in the problem list. For hyperlink purpose the problem list could become a central information board and table of contents of the medical record, thus serving as the starting point for database searches and supporting the user in navigating through the medical record.

  20. Patient Similarity in Prediction Models Based on Health Data: A Scoping Review

    Science.gov (United States)

    Sharafoddini, Anis; Dubin, Joel A

    2017-01-01

    Background Physicians and health policy makers are required to make predictions during their decision making in various medical problems. Many advances have been made in predictive modeling toward outcome prediction, but these innovations target an average patient and are insufficiently adjustable for individual patients. One developing idea in this field is individualized predictive analytics based on patient similarity. The goal of this approach is to identify patients who are similar to an index patient and derive insights from the records of similar patients to provide personalized predictions.. Objective The aim is to summarize and review published studies describing computer-based approaches for predicting patients’ future health status based on health data and patient similarity, identify gaps, and provide a starting point for related future research. Methods The method involved (1) conducting the review by performing automated searches in Scopus, PubMed, and ISI Web of Science, selecting relevant studies by first screening titles and abstracts then analyzing full-texts, and (2) documenting by extracting publication details and information on context, predictors, missing data, modeling algorithm, outcome, and evaluation methods into a matrix table, synthesizing data, and reporting results. Results After duplicate removal, 1339 articles were screened in abstracts and titles and 67 were selected for full-text review. In total, 22 articles met the inclusion criteria. Within included articles, hospitals were the main source of data (n=10). Cardiovascular disease (n=7) and diabetes (n=4) were the dominant patient diseases. Most studies (n=18) used neighborhood-based approaches in devising prediction models. Two studies showed that patient similarity-based modeling outperformed population-based predictive methods. Conclusions Interest in patient similarity-based predictive modeling for diagnosis and prognosis has been growing. In addition to raw/coded health

  1. Can non-selective beta-blockers prevent hepatocellular carcinoma in patients with cirrhosis?

    DEFF Research Database (Denmark)

    Thiele, Maja; Wiest, Reiner; Gluud, Lise Lotte

    2013-01-01

    Hepatocellular carcinoma is the main liver-related cause of death in patients with compensated cirrhosis. The early phases are asymptomatic and the prognosis is poor, which makes prevention essential. We propose that non-selective beta-blockers decrease the incidence and growth of hepatocellular...... and growth of hepatocellular carcinoma. Rodent and in vitro studies support the hypothesis, but clinical verification is needed. Different study designs may be considered. The feasibility of a randomized controlled trial is limited due to the necessary large number of patients and long follow......-up. Observational studies carry a high risk of bias. The meta-analytic approach may be used if the incidence and mortality of hepatocellular carcinoma can be extracted from trials on variceal bleeding and if the combined sample size and follow up is sufficient....

  2. Health of women: associations among life events, social support, and personality for selected patient groups.

    Science.gov (United States)

    Norlander, T; Dahlin, A; Archer, T

    2000-02-01

    This study examined the effects of life events, social support, personality traits, and siblings' birth-order on the health of women. 199 middle-class participants were included. 95 women, randomly assigned from four different patient groups, were compared with a control group of 96 randomly selected women without any special health problems. They completed a questionnaire which included questions regarding family background, health, different life events, social support, and signs of disease and a projective test, the Sivik Psychosomatism Test. Analysis indicated that report of negative life events was associated with more physical symptoms than positive life events and that the patient groups reported more negative life events and less social support than the control group.

  3. Selection of high risk groups among prognostically favorable patients with breast cancer.

    Science.gov (United States)

    Andersen, J A; Fischermann, K; Hou-Jensen, K; Henriksen, E; Andersen, K W; Johansen, H; Brincker, H; Mouridsen, H T; Castberg, T; Rossing, N; Rørth, M

    1981-01-01

    In a prospective, nationwide, decentralized breast cancer project conducted by The Danish Breast Cancer Cooperative Group (DBCG) the recurrence rate within the first year after surgery was analysed in relation to tumor anaplasia. One thousand forty-eight patients met the requirements of eligibility, i.e. tumor size less than or equal to 5 cm with negative axillary nodes, and no skin or deep invasion. The recurrence rates in tumors with anaplasia Grades I, II, and III were 4, 9, and 14%, respectively (p = 0.001). Therefore, it seems possible, prospectively, among otherwise prognostically favorable patients, to select a group with high risk of recurrence which might benefit from adjuvant systemic therapy. PMID:7247527

  4. The Selective Impairment of the Phonological Output Buffer: Evidence From a Chinese Patient

    Directory of Open Access Journals (Sweden)

    Hua Shu

    2005-01-01

    Full Text Available We present a Chinese-speaking patient, SJ, who makes phonological errors across all tasks involving oral production. Detailed analyses of the errors across different tasks reveal that the patterns are very similar for reading, oral picture naming, and repetition tasks, which are also comparable to the error patterns of the phonological buffer deficit cases reported in the literature. The nature of the errors invites us to conclude that the patient's phonological output buffer is selectively impaired. Different from previously reported cases, SJ's deficits in oral production tasks are not accompanied by a similar impairment of writing performance. We argue that this dissociation is evidence that the phonological output buffer is not involved in writing Chinese words. Furthermore, the majority of SJ's errors occur at the onset of a syllable, indicating that the buffer has a structure that makes the onset more prone to impairment.

  5. Different effects of color-based and location-based selection on visual working memory.

    Science.gov (United States)

    Li, Qi; Saiki, Jun

    2015-02-01

    In the present study, we investigated how feature- and location-based selection influences visual working memory (VWM) encoding and maintenance. In Experiment 1, cue type (color, location) and cue timing (precue, retro-cue) were manipulated in a change detection task. The stimuli were color-location conjunction objects, and binding memory was tested. We found a significantly greater effect for color precues than for either color retro-cues or location precues, but no difference between location pre- and retro-cues, consistent with previous studies (e.g., Griffin & Nobre in Journal of Cognitive Neuroscience, 15, 1176-1194, 2003). We also found no difference between location and color retro-cues. Experiment 2 replicated the color precue advantage with more complex color-shape-location conjunction objects. Only one retro-cue effect was different from that in Experiment 1: Color retro-cues were significantly less effective than location retro-cues in Experiment 2, which may relate to a structural property of multidimensional VWM representations. In Experiment 3, a visual search task was used, and the result of a greater location than color precue effect suggests that the color precue advantage in a memory task is related to the modulation of VWM encoding rather than of sensation and perception. Experiment 4, using a task that required only memory for individual features but not for feature bindings, further confirmed that the color precue advantage is specific to binding memory. Together, these findings reveal new aspects of the interaction between attention and VWM and provide potentially important implications for the structural properties of VWM representations.

  6. Awake Craniotomy in Arteriovenous Malformation Surgery: The Usefulness of Cortical and Subcortical Mapping of Language Function in Selected Patients.

    Science.gov (United States)

    Gamble, Alexander J; Schaffer, Sarah G; Nardi, Dominic J; Chalif, David J; Katz, Jeffery; Dehdashti, Amir R

    2015-11-01

    Awake craniotomy for removal of intra-axial lesions is a well-established procedure. Few studies, however, have investigated the usefulness of this approach for resection of arteriovenous malformations adjacent to eloquent language areas. We demonstrate our experience by using cortical stimulation mapping and report for the first time on the usefulness of subcortical stimulation with interrogation of language function during resection of arteriovenous malformations (AVMs) located near language zones. Patients undergoing awake craniotomy for AVMs located in language zones and at least 5 mm away from the closest functional magnetic resonance imaging activation were analyzed. During surgery, cortical bipolar stimulation at 50 Hz, with an intensity of 2 mA, increased to a maximum of 10 mA was performed in the region around the AVM before claiming it negative for language function. In positive language site, the area was restimulated 3 times to confirm the functional deficit. The AVM resection was started based on cortical mapping findings. Further subcortical stimulation performed in concert with speech interrogation by the neuropsychologist continued at key points throughout the resection as feasible. The usefulness of cortical and subcortical stimulation in addition to patient outcomes was analyzed. Between March 2009 and September 2014, 42 brain AVM resections were performed. Four patients with left-sided language zone AVMs underwent awake craniotomy. The AVM locations were fronto-opercular in 2 patients and posterior temporal in 2. The AVM Spetzler-Martin grades were II (2 patients) and III (2 patients). In 1 patient, complete speech arrest was noticed during mapping of the peri-malformation zone, which was not breached during resection. In a second patient who initially demonstrated negative cortical mapping, a speech deficit was noticed during resection and subcortical stimulation. This guided the approach to protect and avoid the sensitive zone. This patient

  7. Criteria for the selective use of chest computed tomography in blunt trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Brink, Monique; Dekker, Helena M.; Kool, Digna R.; Blickman, Johan G. [Radboud University Nijmegen, Medical Centre, Department of Radiology, Nijmegen (Netherlands); Deunk, Jaap; Edwards, Michael J.R. [Radboud University Nijmegen, Medical Centre, Department of Surgery, Nijmegen (Netherlands); Vugt, Arie B. van [Radboud University Nijmegen, Medical Centre Nijmegen, Department of Emergency Medicine, Nijmegen (Netherlands); Kuijk, Cornelis van [VU (Vrije Universiteit) University, Medical Center Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2010-04-15

    The purpose of this study was to derive parameters that predict which high-energy blunt trauma patients should undergo computed tomography (CT) for detection of chest injury. This observational study prospectively included consecutive patients ({>=}16 years old) who underwent multidetector CT of the chest after a high-energy mechanism of blunt trauma in one trauma centre. We included 1,047 patients (median age, 37; 70% male), of whom 508 had chest injuries identified by CT. Using logistic regression, we identified nine predictors of chest injury presence on CT (age {>=}55 years, abnormal chest physical examination, altered sensorium, abnormal thoracic spine physical examination, abnormal chest conventional radiography (CR), abnormal thoracic spine CR, abnormal pelvic CR or abdominal ultrasound, base excess <-3 mmol/l and haemoglobin <6 mmol/l). Of 855 patients with {>=}1 positive predictors, 484 had injury on CT (95% of all 508 patients with injury). Of all 192 patients with no positive predictor, 24 (13%) had chest injury, of whom 4 (2%) had injuries that were considered clinically relevant. Omission of CT in patients without any positive predictor could reduce imaging frequency by 18%, while most clinically relevant chest injuries remain adequately detected. (orig.)

  8. Criteria for the selective use of chest computed tomography in blunt trauma patients

    International Nuclear Information System (INIS)

    Brink, Monique; Dekker, Helena M.; Kool, Digna R.; Blickman, Johan G.; Deunk, Jaap; Edwards, Michael J.R.; Vugt, Arie B. van; Kuijk, Cornelis van

    2010-01-01

    The purpose of this study was to derive parameters that predict which high-energy blunt trauma patients should undergo computed tomography (CT) for detection of chest injury. This observational study prospectively included consecutive patients (≥16 years old) who underwent multidetector CT of the chest after a high-energy mechanism of blunt trauma in one trauma centre. We included 1,047 patients (median age, 37; 70% male), of whom 508 had chest injuries identified by CT. Using logistic regression, we identified nine predictors of chest injury presence on CT (age ≥55 years, abnormal chest physical examination, altered sensorium, abnormal thoracic spine physical examination, abnormal chest conventional radiography (CR), abnormal thoracic spine CR, abnormal pelvic CR or abdominal ultrasound, base excess <-3 mmol/l and haemoglobin <6 mmol/l). Of 855 patients with ≥1 positive predictors, 484 had injury on CT (95% of all 508 patients with injury). Of all 192 patients with no positive predictor, 24 (13%) had chest injury, of whom 4 (2%) had injuries that were considered clinically relevant. Omission of CT in patients without any positive predictor could reduce imaging frequency by 18%, while most clinically relevant chest injuries remain adequately detected. (orig.)

  9. Minimally cultured or selected autologous tumor-infiltrating lymphocytes after a lympho-depleting chemotherapy regimen in metastatic melanoma patients.

    Science.gov (United States)

    Besser, Michal J; Shapira-Frommer, Ronnie; Treves, Avraham J; Zippel, Dov; Itzhaki, Orit; Schallmach, Ester; Kubi, Adva; Shalmon, Bruria; Hardan, Izhar; Catane, Raphael; Segal, Eran; Markel, Gal; Apter, Sara; Nun, Alon Ben; Kuchuk, Iryna; Shimoni, Avichai; Nagler, Arnon; Schachter, Jacob

    2009-05-01

    Adoptive cell therapy with autologous tumor-infiltrating lymphocytes (TIL) and high-dose interleukin-2 (IL-2), after nonmyeloablative chemotherapy, has been shown to result in tumor regression in half of refractory metastatic melanoma patients. In the present study, we describe 2 separate clinical protocols. Twelve patients were treated with "Selected"-TIL, as previously reported and 8 patients with the modified version of "Young"-TIL. Selected-TIL protocol required the establishment of multiple T-cell cultures from 1 patient and in vitro selection of cultures secreting interferon-gamma upon antigenic stimulation. In contrast, Young-TIL are minimally cultured T cells with superior in vitro features that do not require further selection. Two of 12 Selected-TIL patients experienced objective clinical responses (1 complete response, 1 partial response). Out of 8 treated Young-TIL patients, 1 experienced complete response, 2 partial response, and 4 patients had disease stabilization. Twenty-one of 33 enrolled Selected-TIL patients were excluded from the protocol, mainly as cultures failed the interferon-gamma selection criteria or due to clinical deterioration, compared with only 3 Young-TIL patients. Expected bone marrow suppression and high-dose IL-2 toxicity were transient. There was no treatment-related mortality. This study vindicates the feasibility and effectiveness of TIL technology and calls for further efforts to implement and enhance this modality. The use of minimally cultured, unselected Young-TIL enables the treatment of most enrolled patients. Although the cohort of Young-TIL patients treated so far is rather small and the follow-up short, the response rate is encouraging.

  10. Selective, sustained, and shift in attention in patients with diagnoses of schizophrenia.

    Science.gov (United States)

    Hagh-Shenas, H; Toobai, S; Makaremi, A

    2002-12-01

    Attentional deficits are a prominent aspect of cognitive dysfunction in schizophrenia. The present study was designed to investigate attention deficit in a group of patients with diagnosis of schizophrenia. According to the segmental set theory suggested by Hogarty and Flesher, three aspects of attention problems, selective, sustained, and shift in attention, were studied. The 30 patients hospitalized on three psychiatric wards at Shiraz and Isfahan and 30 normal healthy subjects matched for age, sex, and years of education were administered a computerized Continuous Performance Test, Stroop Color-word Test, and Wisconsin Card Sorting test. Analysis showed patients performed more poorly than control subjects on measured aspects of attention. The acute/chronic classification did not predict differences in attention scores between subtypes of schizophrenia, while the positive/negative classification did. Paranoid, undifferentiated, and residual groups by subtypes of schizophrenia showed similar performance on the Continuous Performance Test, but were significantly different on errors on the Wisconsin Card Sorting test and on reaction time to Stroop stimuli in the incongruent color-word condition. Patients with paranoid diagnosis performed better than other subtypes on these tasks. Present results suggest that the Continuous Performance Test is valuable for differentiating of schizophrenia spectrum disorder, while scores on Stroop and Wisconsin card sorting may have better diagnostic value for differentiating subtypes of the disorder.

  11. Ranking and selection of commercial off-the-shelf using fuzzy distance based approach

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2015-06-01

    Full Text Available There is a tremendous growth of the use of the component based software engineering (CBSE approach for the development of software systems. The selection of the best suited COTS components which fulfils the necessary requirement for the development of software(s has become a major challenge for the software developers. The complexity of the optimal selection problem increases with an increase in alternative potential COTS components and the corresponding selection criteria. In this research paper, the problem of ranking and selection of Data Base Management Systems (DBMS components is modeled as a multi-criteria decision making problem. A ‘Fuzzy Distance Based Approach (FDBA’ method is proposed for the optimal ranking and selection of DBMS COTS components of an e-payment system based on 14 selection criteria grouped under three major categories i.e. ‘Vendor Capabilities’, ‘Business Issues’ and ‘Cost’. The results of this method are compared with other Analytical Hierarchy Process (AHP which is termed as a typical multi-criteria decision making approach. The proposed methodology is explained with an illustrated example.

  12. Case Study: Evidence-Based Interventions Enhancing Diabetic Foot Care Behaviors among Hospitalized DM Patients

    Directory of Open Access Journals (Sweden)

    Titis Kurniawan

    2011-01-01

    Full Text Available Background: Improving diabetic patients’ foot care behaviors is one of the most effective strategies in minimizing diabetic foot ulceration and its further negative impacts, either in diabetic hospitalized patients or outpatients.Purpose: To describe foot care knowledge and behaviors among hospitalized diabetic patients, to apply selected foot care knowledge and behaviors improvement evidence, and to evaluate its effectiveness.Method: Four diabetic patients who were under our care for at least three days and could communicate in Thai language were selected from a surgical ward in a university hospital. The authors applied educational program based on patients’ learning needs, provided diabetic foot care leaflet, and assisted patients to set their goal and action plans. In the third day of treatment, we evaluated patients’ foot care knowledge and their goal and action plan statements in improving foot care behaviors.Result: Based on the data collected among four hospitalized diabetic patients, it was shown that all patients needed foot care behaviors improvement and the educational program improved hospitalized patients’ foot care knowledge and their perceived foot care behaviors. The educational program that combined with goal setting and action plans method was easy, safe, and seemed feasibly applicable for diabetic hospitalized patients.Conclusion: The results of this study provide valuable information for improvement of hospitalized diabetic patients’ foot care knowledge and behaviors. The authors recommend nurses to use this evidence-based practice to contribute in improving the quality of diabetic care.Keywords: Intervention, diabetic foot care, hospitalized diabetic patients

  13. Data Visualization and Feature Selection Methods in Gel-based Proteomics

    DEFF Research Database (Denmark)

    Silva, Tomé Santos; Richard, Nadege; Dias, Jorge P.

    2014-01-01

    -based proteomics, summarizing the current state of research within this field. Particular focus is given on discussing the usefulness of available multivariate analysis tools both for data visualization and feature selection purposes. Visual examples are given using a real gel-based proteomic dataset as basis....

  14. Mode-Selective Wavelength Conversion Based on Four-Wave Mixing in a Multimode Silicon Waveguide

    DEFF Research Database (Denmark)

    Ding, Yunhong; Xu, Jing; Ou, Haiyan

    2013-01-01

    We report all-optical mode-selective wavelength conversion based on four-wave mixing in a multimode Si waveguide. A two-mode division multiplexing circuit using tapered directional coupler based (de)multiplexers is used for the application. Experimental results show clear eye-diagrams and moderate...

  15. Health selection into neighborhoods among patients enrolled in a clinical trial

    Directory of Open Access Journals (Sweden)

    Mariana C. Arcaya

    2017-12-01

    Full Text Available Health selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS to explore whether random assignment to intensive blood-glucose control therapy, which improved long-term health outcomes after median 10 years follow-up, subsequently affected what neighborhoods patients lived in. We extracted postcode-level deprivation indices for the 2710 surviving participants of UKPDS living in England at study end in 1996/1997. We observed small neighborhood advantages in the intensive versus conventional therapy group, although these differences were not statistically significant. This analysis failed to show conclusive evidence of health selection into neighborhoods, but data suggest the hypothesis may be worthy of exploration in other clinical trials or in a meta-analysis. Keywords: Neighborhoods, Self-selection, Health, Equity, Socioeconomic status

  16. Space-based visual attention: a marker of immature selective attention in toddlers?

    Science.gov (United States)

    Rivière, James; Brisson, Julie

    2014-11-01

    Various studies suggested that attentional difficulties cause toddlers' failure in some spatial search tasks. However, attention is not a unitary construct and this study investigated two attentional mechanisms: location selection (space-based attention) and object selection (object-based attention). We investigated how toddlers' attention is distributed in the visual field during a manual search task for objects moving out of sight, namely the moving boxes task. Results show that 2.5-year-olds who failed this task allocated more attention to the location of the relevant object than to the object itself. These findings suggest that in some manual search tasks the primacy of space-based attention over object-based attention could be a marker of immature selective attention in toddlers. © 2014 Wiley Periodicals, Inc.

  17. Patient-Centered Goal Setting in a Hospital-Based Outpatient Stroke Rehabilitation Center.

    Science.gov (United States)

    Rice, Danielle B; McIntyre, Amanda; Mirkowski, Magdalena; Janzen, Shannon; Viana, Ricardo; Britt, Eileen; Teasell, Robert

    2017-09-01

    Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. Retrospective chart review. Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. Goal satisfaction scores. A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P rehabilitation program (P stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients

  18. Effects of tryptophan depletion on selective serotonin reuptake inhibitor-remitted patients with obsessive compulsive disorder.

    Science.gov (United States)

    Hood, Sean D; Broyd, Annabel; Robinson, Hayley; Lee, Jessica; Hudaib, Abdul-Rahman; Hince, Dana A

    2017-12-01

    Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan

  19. Greater fruit selection following an appearance-based compared with a health-based health promotion poster

    Science.gov (United States)

    2016-01-01

    Abstract Background This study investigated the impact of an appearance-based compared with a traditional health-based public health message for healthy eating. Methods A total of 166 British University students (41 males; aged 20.6 ± 1.9 years) were randomized to view either an appearance-based (n = 82) or a health-based (n = 84) fruit promotion poster. Intentions to consume fruit and immediate fruit selection (laboratory observation) were assessed immediately after poster viewing, and subsequent self-report fruit consumption was assessed 3 days later. Results Intentions to consume fruit were not predicted by poster type (largest β = 0.03, P = 0.68) but were associated with fruit-based liking, past consumption, attitudes and social norms (smallest β = 0.16, P = 0.04). Immediate fruit selection was greater following the appearance-based compared with the health-based poster (β = −0.24, P poster (β = −0.22, P = 0.03), but this effect became non-significant on consideration of participant characteristics (β = −0.15, P = 0.13), and was instead associated with fruit-based liking and past consumption (smallest β = 0.24, P = 0.03). Conclusions These findings demonstrate the clear value of an appearance-based compared with a health-based health promotion poster for increasing fruit selection. A distinction between outcome measures and the value of a behavioural measure is also demonstrated. PMID:28158693

  20. Can non-selective beta-blockers prevent hepatocellular carcinoma in patients with cirrhosis?

    Science.gov (United States)

    Thiele, Maja; Wiest, Reiner; Gluud, Lise Lotte; Albillos, Agustín; Krag, Aleksander

    2013-11-01

    Hepatocellular carcinoma is the main liver-related cause of death in patients with compensated cirrhosis. The early phases are asymptomatic and the prognosis is poor, which makes prevention essential. We propose that non-selective beta-blockers decrease the incidence and growth of hepatocellular carcinoma via a reduction of the inflammatory load from the gut to the liver and inhibition of angiogenesis. Due to their effect on the portal pressure, non-selective beta-blockers are used for prevention of esophageal variceal bleeding. Recently, non-hemodynamic effects of beta-blockers have received increasing attention. Blockage of β-adrenoceptors in the intestinal mucosa and gut lymphatic tissue together with changes in type and virulence of the intestinal microbiota lead to reduced bacterial translocation and a subsequent decrease in the portal load of pathogen-associated molecular patterns. This may reduce hepatic inflammation. Blockage of β-adrenoceptors also decrease angiogenesis by inhibition of vascular endothelial growth factors. Because gut-derived inflammation and neo-angiogenesis are important in hepatic carcinogenesis, non-selective beta-blockers can potentially reduce the development and growth of hepatocellular carcinoma. Rodent and in vitro studies support the hypothesis, but clinical verification is needed. Different study designs may be considered. The feasibility of a randomized controlled trial is limited due to the necessary large number of patients and long follow-up. Observational studies carry a high risk of bias. The meta-analytic approach may be used if the incidence and mortality of hepatocellular carcinoma can be extracted from trials on variceal bleeding and if the combined sample size and follow up is sufficient. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Hoffman DA

    2012-06-01

    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  2. A Robust Service Selection Method Based on Uncertain QoS

    Directory of Open Access Journals (Sweden)

    Yanping Chen

    2016-01-01

    Full Text Available Nowadays, the number of Web services on the Internet is quickly increasing. Meanwhile, different service providers offer numerous services with the similar functions. Quality of Service (QoS has become an important factor used to select the most appropriate service for users. The most prominent QoS-based service selection models only take the certain attributes into account, which is an ideal assumption. In the real world, there are a large number of uncertain factors. In particular, at the runtime, QoS may become very poor or unacceptable. In order to solve the problem, a global service selection model based on uncertain QoS was proposed, including the corresponding normalization and aggregation functions, and then a robust optimization model adopted to transform the model. Experiment results show that the proposed method can effectively select services with high robustness and optimality.

  3. Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS.

    Science.gov (United States)

    Zaidan, A A; Zaidan, B B; Al-Haiqi, Ahmed; Kiah, M L M; Hussain, Muzammil; Abdulnabi, Mohamed

    2015-02-01

    Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Maximum relevance, minimum redundancy band selection based on neighborhood rough set for hyperspectral data classification

    International Nuclear Information System (INIS)

    Liu, Yao; Chen, Yuehua; Tan, Kezhu; Xie, Hong; Wang, Liguo; Xie, Wu; Yan, Xiaozhen; Xu, Zhen

    2016-01-01

    Band selection is considered to be an important processing step in handling hyperspectral data. In this work, we selected informative bands according to the maximal relevance minimal redundancy (MRMR) criterion based on neighborhood mutual information. Two measures MRMR difference and MRMR quotient were defined and a forward greedy search for band selection was constructed. The performance of the proposed algorithm, along with a comparison with other methods (neighborhood dependency measure based algorithm, genetic algorithm and uninformative variable elimination algorithm), was studied using the classification accuracy of extreme learning machine (ELM) and random forests (RF) classifiers on soybeans’ hyperspectral datasets. The results show that the proposed MRMR algorithm leads to promising improvement in band selection and classification accuracy. (paper)

  5. Salicylimine-Based Colorimetric and Fluorescent Chemosensor for Selective Detection of Cyanide in Aqueous Buffer

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Jin Young; Hwang, In Hong; Kim, Hyun; Song, Eun Joo; Kim, Kyung Beom; Kim, Cheal [Seoul National Univ., Seoul (Korea, Republic of)

    2013-07-15

    A simple colorimetric and fluorescent anion sensor 1 based on salicylimine showed a high selectivity and sensitivity for detection of cyanide in aqueous solution. The receptor 1 showed high selectivity toward CN{sup -} ions in a 1:1 stoichiometric manner, which induces a fast color change from colorless to orange and a dramatic enhancement in fluorescence intensity selectively for cyanide anions over other anions. Such selectivity resulted from the nucleophilic addition of CN{sup -} to the carbon atom of an electron-deficient imine group. The sensitivity of the fluorescence-based assay (0.06 μM) is below the 1.9 μM suggested by the World Health Organization (WHO) as the maximum allowable cyanide concentration in drinking water, capable of being a practical system for the monitoring of CN. concentrations in aqueous samples.

  6. An Entropy-based gene selection method for cancer classification using microarray data

    Directory of Open Access Journals (Sweden)

    Krishnan Arun

    2005-03-01

    Full Text Available Abstract Background Accurate diagnosis of cancer subtypes remains a challenging problem. Building classifiers based on gene expression data is a promising approach; yet the selection of non-redundant but relevant genes is difficult. The selected gene set should be small enough to allow diagnosis even in regular clinical laboratories and ideally identify genes involved in cancer-specific regulatory pathways. Here an entropy-based method is proposed that selects genes related to the different cancer classes while at the same time reducing the redundancy among the genes. Results The present study identifies a subset of features by maximizing the relevance and minimizing the redundancy of the selected genes. A merit called normalized mutual information is employed to measure the relevance and the redundancy of the genes. In order to find a more representative subset of features, an iterative procedure is adopted that incorporates an initial clustering followed by data partitioning and the application of the algorithm to each of the partitions. A leave-one-out approach then selects the most commonly selected genes across all the different runs and the gene selection algorithm is applied again to pare down the list of selected genes until a minimal subset is obtained that gives a satisfactory accuracy of classification. The algorithm was applied to three different data sets and the results obtained were compared to work done by others using the same data sets Conclusion This study presents an entropy-based iterative algorithm for selecting genes from microarray data that are able to classify various cancer sub-types with high accuracy. In addition, the feature set obtained is very compact, that is, the redundancy between genes is reduced to a large extent. This implies that classifiers can be built with a smaller subset of genes.

  7. Empower the patients with a dialogue-based web application

    DEFF Research Database (Denmark)

    Bjørnes, Charlotte D.; Cummings, Elizabeth; Nøhr, Christian

    2012-01-01

    -based web application was designed and implemented to accommodate patients' information and communication needs in short stay hospital settings. To ensure the system meet the patients' needs, both patients and healthcare professionals were involved in the design process by applying various participatory...

  8. Systemic tobramycin concentrations during selective decontamination of the digestive tract in intensive care unit patients on continuous venovenous hemofiltration

    NARCIS (Netherlands)

    Mol, Meriel; van Kan, H. J. M.; Schultz, Marcus J.; de Jonge, Evert

    2008-01-01

    OBJECTIVE: To study whether selective decontamination of the digestive tract (SDD) results in detectable serum tobramycin concentrations in intensive care unit (ICU) patients with acute renal failure treated with continuous venovenous hemofiltration (CVVH). DESIGN AND SETTING: Prospective,

  9. SUSTAINABILITY LOGISTICS BASING SCIENCE AND TECHNOLOGY OBJECTIVE DEMONSTRATION; SELECTED TECHNOLOGY ASSESSMENT

    Science.gov (United States)

    2018-03-22

    BASING SCIENCE AND TECHNOLOGY OBJECTIVE – DEMONSTRATION; SELECTED TECHNOLOGY ASSESSMENT by Gregg J. Gildea Paul D. Carpenter Benjamin J...Campbell William F. Harris* Michael A. McCluskey** and José A. Miletti*** *General Dynamics Information Technology Fairfax, VA 22030 **Maneuver...SCIENCE AND TECHNOLOGY OBJECTIVE – DEMONSTRATION; SELECTED TECHNOLOGY ASSESSMENT 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

  10. Traditional and robust vector selection methods for use with similarity based models

    International Nuclear Information System (INIS)

    Hines, J. W.; Garvey, D. R.

    2006-01-01

    Vector selection, or instance selection as it is often called in the data mining literature, performs a critical task in the development of nonparametric, similarity based models. Nonparametric, similarity based modeling (SBM) is a form of 'lazy learning' which constructs a local model 'on the fly' by comparing a query vector to historical, training vectors. For large training sets the creation of local models may become cumbersome, since each training vector must be compared to the query vector. To alleviate this computational burden, varying forms of training vector sampling may be employed with the goal of selecting a subset of the training data such that the samples are representative of the underlying process. This paper describes one such SBM, namely auto-associative kernel regression (AAKR), and presents five traditional vector selection methods and one robust vector selection method that may be used to select prototype vectors from a larger data set in model training. The five traditional vector selection methods considered are min-max, vector ordering, combination min-max and vector ordering, fuzzy c-means clustering, and Adeli-Hung clustering. Each method is described in detail and compared using artificially generated data and data collected from the steam system of an operating nuclear power plant. (authors)

  11. Rational Selection and Use of Antimicrobials in Patients with Burn Injuries.

    Science.gov (United States)

    Hill, David M; Sinclair, Scott E; Hickerson, William L

    2017-07-01

    Caring for patients with burn injuries is challenging secondary to the acute disease process, chronic comorbidities, and underrepresentation in evidence-based literature. Much current practice relies on extrapolation of guidance from different patient populations and wide variations in universal practices. Identifying infections or sepsis in this hypermetabolic population is imperfect and often leads to overprescribing of antimicrobials, suboptimal dosing, and multidrug resistance. An understanding of pharmacokinetics and pharmacodynamics may aid optimization of dosing regimens to better attain treatment targets. This article provides an overview of the current status of burn infection and attempts recommendations for consideration to improve universally accepted care. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Prototype selection based on FCM and its application in discrimination between nuclear explosion and earthquake

    International Nuclear Information System (INIS)

    Han Shaoqing; Li Xihai; Song Zibiao; Liu Daizhi

    2007-01-01

    The synergetic pattern recognition is a new way of pattern recognition with many excellent features such as noise resistance and deformity resistance. But when it is used in the discrimination between nuclear explosion and earthquake using existing methods of prototype selection, the results are not satisfying. A new method of prototype selection based on FCM is proposed in this paper. First, each group of training samples is clustered into c groups using FCM; then c barycenters or centers are chosen as prototypes. Experiment results show that compared with existing methods of prototype selection this new method is effective and it increases the recognition ratio greatly. (authors)

  13. Flexible selection process based on skills applied to the communication manager position

    Directory of Open Access Journals (Sweden)

    Rita Jácome López

    2016-03-01

    Full Text Available The Communication Manager position is relevant to the reputation of an organization, because it influences through its own personal image and reputation; therefore, the selection of this manager has to be painstaking. In this paper we propose a flexible selection process based on fuzzy logic, to fit the skills of candidates for the job and to support decision making. We present two techniques:one that selects the best applicant and another one that compares candidates with an ideal constructed with information provided by Spanish managers.

  14. On the Feature Selection and Classification Based on Information Gain for Document Sentiment Analysis

    Directory of Open Access Journals (Sweden)

    Asriyanti Indah Pratiwi

    2018-01-01

    Full Text Available Sentiment analysis in a movie review is the needs of today lifestyle. Unfortunately, enormous features make the sentiment of analysis slow and less sensitive. Finding the optimum feature selection and classification is still a challenge. In order to handle an enormous number of features and provide better sentiment classification, an information-based feature selection and classification are proposed. The proposed method reduces more than 90% unnecessary features while the proposed classification scheme achieves 96% accuracy of sentiment classification. From the experimental results, it can be concluded that the combination of proposed feature selection and classification achieves the best performance so far.

  15. Selection for biopsy of kidney transplant patients by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Steiger, Philipp; Barbieri, Sebastiano; Ith, Michael; Thoeny, Harriet C. [Inselspital, Bern University Hospital, University of Bern, Inselspital, Department of Radiology, Neuroradiology, and Nuclear Medicine, Institute of Diagnostic, Pediatric, and Interventional Radiology, Bern (Switzerland); Kruse, Anja [Inselspital, Bern University Hospital, University of Bern, Inselspital, Department of Nephrology and Hypertension, Bern (Switzerland)

    2017-10-15

    To assess retrospectively whether diffusion-weighted magnetic resonance imaging (DW-MRI) allows physicians to determine the severity of histopathologic findings in biopsies of renal allograft patients with deteriorating renal function. Forty consecutive kidney transplant patients underwent DW-MRI and biopsy. Patients were assigned to one group with severe and to another group with normal or mild histopathologic findings. These two groups were compared based on a qualitative DW-MRI assessment (homo-/heterogeneity) and the combination of qualitative and quantitative DW-MRI parameters (ADC, and intravoxel incoherent motion, IVIM, parameters: D, f, D*). Sensitivity, specificity, and accuracy were determined for each parameter. Biopsy findings were severe in 25 patients and normal or mild in 15 patients. Qualitative DW-MRI led to a sensitivity of 44.0% and a specificity of 93.3%. Combined qualitative and quantitative DW-MRI led to an accuracy of 80% for both the minimal ADC (ADCmin) and the minimal perfusion fraction (fmin) with a sensitivity of 84.0% and 92.0% and a specificity of 73.3% and 60.0%, respectively. Combined qualitative and quantitative DW-MRI might allow physicians to determine the severity of histopathologic findings in biopsies of a high number of kidney transplant patients. (orig.)

  16. Comparing Non-Medical Sex Selection and Saviour Sibling Selection in the Case of JS and LS v Patient Review Panel: Beyond the Welfare of the Child?

    Science.gov (United States)

    Smith, Malcolm K; Taylor-Sands, Michelle

    2018-03-01

    The national ethical guidelines relevant to assisted reproductive technology (ART) have recently been reviewed by the National Health and Medical Research Council (NHMRC). The review process paid particular attention to the issue of non-medical sex selection, although ultimately, the updated ethical guidelines maintain the pre-consultation position of a prohibition on non-medical sex selection. Whilst this recent review process provided a public forum for debate and discussion of this ethically contentious issue, the Victorian case of JS and LS v Patient Review Panel (Health and Privacy) [2011] VCAT 856 provides a rare instance where the prohibition on non-medical sex selection has been explored by a court or tribunal in Australia. This paper analyses the reasoning in that decision, focusing specifically on how the Victorian Civil and Administrative Tribunal applied the statutory framework relevant to ART and its comparison to other uses of embryo selection technologies. The Tribunal relied heavily upon the welfare-of-the-child principle under the Assisted Reproductive Treatment Act 2008 (Vic). The Tribunal also compared non-medical sex selection with saviour sibling selection (that is, where a child is purposely conceived as a matched tissue donor for an existing child of the family). Our analysis leads us to conclude that the Tribunal's reasoning fails to adequately justify the denial of the applicants' request to utilize ART services to select the sex of their prospective child.

  17. Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Tatum JA

    2017-02-01

    Full Text Available Jacob A Tatum,* Max O Meneveau,* Kenneth L Brayman Department of Surgery, Division of Transplantation, The University of Virginia Health System, Charlottesville, VA, USA *These authors contributed equally to this work. Abstract: Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient’s ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes. Given the shortage of transplantable organs, selecting appropriate candidates for whom the procedure will be of greatest benefit is essential. Although many of those who receive islets do not retain insulin independence, grafts do play a significant role in preventing hypoglycemic episodes that can be quite detrimental to quality of life and potentially fatal. Additionally, islet transplant requires lifelong immunosuppression. Antibodies, both preformed and following islet infusion, may play important roles in graft outcomes. Finally, no procedure is without inherent risk and islet transfusions can have serious consequences for recipients’ livers in the form of both vascular and metabolic complications. Therefore, patient-specific factors that should be taken into account before islet transplantation include aims of therapy, sensitization, and potential increased risk for hepatic and portal-venous sequelae. Keywords: islet transplantation, diabetes mellitus type 1, brittle diabetes, single donor, patient

  18. Selection and Characterization of Palmitic Acid Responsive Patients with an OXPHOS Complex I Defect

    Directory of Open Access Journals (Sweden)

    Tom E. J. Theunissen

    2017-10-01

    a clinical and biochemical level that a high fat diet can be beneficial for complex I patients and that our cell line assay will be an easy tool for the selection of patients, who might potentially benefit from this therapeutic diet.

  19. Goal selection versus process control in a brain-computer interface based on sensorimotor rhythms.

    Science.gov (United States)

    Royer, Audrey S; He, Bin

    2009-02-01

    In a brain-computer interface (BCI) utilizing a process control strategy, the signal from the cortex is used to control the fine motor details normally handled by other parts of the brain. In a BCI utilizing a goal selection strategy, the signal from the cortex is used to determine the overall end goal of the user, and the BCI controls the fine motor details. A BCI based on goal selection may be an easier and more natural system than one based on process control. Although goal selection in theory may surpass process control, the two have never been directly compared, as we are reporting here. Eight young healthy human subjects participated in the present study, three trained and five naïve in BCI usage. Scalp-recorded electroencephalograms (EEG) were used to control a computer cursor during five different paradigms. The paradigms were similar in their underlying signal processing and used the same control signal. However, three were based on goal selection, and two on process control. For both the trained and naïve populations, goal selection had more hits per run, was faster, more accurate (for seven out of eight subjects) and had a higher information transfer rate than process control. Goal selection outperformed process control in every measure studied in the present investigation.

  20. [Shared decision-making based on equal information. Patient guidelines as a tool for patient counseling].

    Science.gov (United States)

    Sänger, Sylvia; Kopp, Ina; Englert, Gerhard; Brunsmann, Frank; Quadder, Bernd; Ollenschläger, Günter

    2007-06-15

    In discussions on the quality of cross-sectorial health-care services high importance is attributed to patient education and patient counseling, with guideline-based patient information being considered a crucial tool. Guideline-based patient information is supposed to serve patients as a decision-making basis and, in addition, to also support the implementation of the guidelines themselves. The article highlights how patient guidelines for National Disease Management Guidelines in Germany--within the scope of patient education and patient counseling--may provide a uniform information platform for physicians and patients aiming to promote shared decision-making. The authors will also address the issue which contents should be included in patient guidelines in order to meet these requirements and which measures are required to review their quality. The present paper continues the series of articles on the Program for German National Disease Management Guidelines.

  1. The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants

    International Nuclear Information System (INIS)

    Clarke, Daniel H.; Banks, Stephen J.; Wiederhorn, A. Roger; Klousia, John W.; Lissy, Jeanne M.; Miller, Michelle; Able, Arnold M.; Artiles, Carlos; Hindle, William V.; Blair, Deborah N.; Houk, Russell R.; Sheridan, Michael J.

    2002-01-01

    Purpose: To assess the role of endorectal coil magnetic resonance imaging (MRI) staging for patients undergoing seed implantation (SI) with or without external beam radiotherapy (EBRT). Methods and Materials: Between October 1994 and December 1998, 390 patients underwent prostate SI (98% Pd-103, 2% I-125). Seventy-six percent of patients had a prostate serum antigen (PSA) 20. Ten percent of patients had a Gleason score (GS) of 4-5, 54% had GS 6, 29% had GS 7, and 7% had GS ≥ 8. Monotherapy was employed in 46% of patients, and the remaining 54% received combined EBRT and SI. Three hundred twenty-seven were staged by high-resolution phased array pelvic coil, or in most cases, an endorectal coil MRI. The MRI findings were used to guide stage-appropriate treatment recommendations, and to assist in the preplanning and optimization of seed distributions. The criteria utilized to determine MRI-based stage were founded on the reported literature from the University of Pennsylvania. All MRI studies were reviewed by C.A., D.B., or W.H., who were unaware of clinical stage at the time of their review. The biopsy report was available to them as the only clinical correlate. Results: Of the 327 patients staged by MRI, 70% were upstaged from the digital rectal examination-based clinical stage; 26% of T 1 , T 2 patients were upstaged to T 3 . Perineural invasion and the percentage of positive cores predicted for T 3 MRI stage (p 3 intermediate-risk group patients treated by combined therapy with a previous study of T 3 intermediate-risk group treated by radical prostatectomy (RP) at the University of Pennsylvania. Our 36-month PSA FFP was 94% compared with 21% for the previous study's RP patients. Conclusion: MRI is a valuable staging procedure for prostate cancer patients treated by SI. PSA FFP results appear to be improved by MRI staging. MRI T 3 disease can be treated more effectively by SI + EBRT than by RP

  2. Patient Posture Monitoring System Based on Flexible Sensors

    Directory of Open Access Journals (Sweden)

    Youngsu Cha

    2017-03-01

    Full Text Available Monitoring patients using vision cameras can cause privacy intrusion problems. In this paper, we propose a patient position monitoring system based on a patient cloth with unobtrusive sensors. We use flexible sensors based on polyvinylidene fluoride, which is a flexible piezoelectric material. Theflexiblesensorsareinsertedintopartsclosetothekneeandhipoftheloosepatientcloth. We measure electrical signals from the sensors caused by the piezoelectric effect when the knee and hip in the cloth are bent. The measured sensor outputs are transferred to a computer via Bluetooth. We use a custom-made program to detect the position of the patient through a rule-based algorithm and the sensor outputs. The detectable postures are based on six human motions in and around a bed. The proposed system can detect the patient positions with a success rate over 88 percent for three patients.

  3. Beta-1-Selective Beta-Blockers and Cognitive Functions in Patients With Coronary Artery Disease: A Cross-Sectional Study.

    Science.gov (United States)

    Burkauskas, Julius; Noreikaite, Aurelija; Bunevicius, Adomas; Brozaitiene, Julija; Neverauskas, Julius; Mickuviene, Narseta; Bunevicius, Robertas

    2016-01-01

    The association between current beta-1-selective beta-blocker use and cognitive function was evaluated in 722 patients with coronary artery disease without dementia. Beta-1-selective beta-blocker use was associated with worse incidental learning independently of sociodemographic characteristics, clinical coronary artery disease severity, and depression/anxiety.

  4. A trait-based approach reveals the feeding selectivity of a small endangered Mediterranean fish

    OpenAIRE

    Rodriguez-Lozano, Pablo; Verkaik, Iraima; Maceda Veiga, Alberto; Monroy, Mario; de Sostoa, Adolf; Rieradevall, Maria; Prat, Narcis

    2016-01-01

    Abstract Functional traits are growing in popularity in modern ecology, but feeding studies remain primarily rooted in a taxonomic?based perspective. However, consumers do not have any reason to select their prey using a taxonomic criterion, and prey assemblages are variable in space and time, which makes taxon?based studies assemblage?specific. To illustrate the benefits of the trait?based approach to assessing food choice, we studied the feeding ecology of the endangered freshwater fish Bar...

  5. Web-Based Patient Education in Orthopedics: Systematic Review.

    Science.gov (United States)

    Dekkers, Tessa; Melles, Marijke; Groeneveld, Bob Sander; de Ridder, Huib

    2018-04-23

    Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients' knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients' knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only. ©Tessa Dekkers, Marijke Melles, Bob Sander Groeneveld, Huib de Ridder. Originally published in the Journal of Medical Internet Research (http

  6. General quality of life of patients with acne vulgaris before and after performing selected cosmetological treatments

    Science.gov (United States)

    Chilicka, Karolina; Maj, Joanna; Panaszek, Bernard

    2017-01-01

    Background Achieving a satisfying quality of life for a patient by applying individually matched therapy is, simultaneously, a great challenge and a priority for contemporary medicine. Patients with visible dermatological ailments are particularly susceptible to reduction in the general quality of life. Among the dermatological diseases, acne causes considerable reduction in the quality of life and changes in self-perception that lead to the worsening of a patient’s mental condition, including depression and suicidal thoughts. As a result, difficulties in contact with loved ones, as well as social and professional problems are observed, which show that acne is not a somatic problem alone. To a large extent, it becomes a part of psychodermatology, becoming an important topic of public health in social medicine practice. Pharmacological treatment of acne is a challenge for a dermatologist and often requires the necessity of cooperating with a cosmetologist. Cosmetological treatments are aimed at improving the condition of the skin and reduction or subsiding of acne skin changes. Aim The aim of this study was to assess the influence of selected cosmetological treatments on the general quality of life of patients with acne. Materials and methods The study group consisted of 101 women aged 19–29 years (x¯=22.5 years, SD =2.3 years). All subjects were diagnosed with acne vulgaris of the face. In the study group, the acne changes occurred over the course of 3–15 years (x¯=8.1 years, SD =2.7 years). Selected cosmetological treatments (intensive pulsing light, alpha-hydroxy acids, cavitation peeling, needle-free mesotherapy, diamond microdermabrasion and sonophoresis) were performed in series in the number depending on the particular patient’s chosen treatment, after excluding contraindications. General quality of life of the patients was estimated using the Skindex-29 and Dermatology Life Quality Index (DLQI) questionnaires, before and after the cosmetological

  7. Acid-base disturbance in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Bendtsen, Flemming; Møller, Søren

    2015-01-01

    (r=-0.25, Psodium (r=-0.38, Preduced standard base excess in all patients (P...PURPOSE: Acid-base disturbances were investigated in patients with cirrhosis in relation to hemodynamic derangement to analyze the hyperventilatory effects and the metabolic compensation. METHODS: A total of 66 patients with cirrhosis and 44 controls were investigated during a hemodynamic study......, and effects of unidentified ions (all P

  8. Reoperation for refractory epilepsy in childhood: a second chance for selected patients.

    Science.gov (United States)

    Ramantani, Georgia; Strobl, Karl; Stathi, Angeliki; Brandt, Armin; Schubert-Bast, Susanne; Wiegand, Gert; Korinthenberg, Rudolf; Stephani, Ulrich; van Velthoven, Vera; Zentner, Josef; Schulze-Bonhage, Andreas; Bast, Thomas

    2013-10-01

    Reoperations account for >10% in pediatric epilepsy surgery cohorts, and they are especially relevant in young children with catastrophic epilepsy. To determine surgical outcomes and their predictive factors in reoperations for refractory epilepsy in childhood. We retrospectively analyzed presurgical findings, resections, and outcomes of 23 consecutive children who underwent reoperations from 2000 to 2011. Etiology included cortical dysplasia with/without glioneuronal tumor in 19 patients (83%), sole glioneuronal tumor in 2, and tuberous sclerosis and Rasmussen encephalitis in 1 each. The reasons for the failure of the initial surgery were functional considerations in 8 (35%), incorrect delineation of the epileptogenic zone in 8 (35%), and resection not performed as initially planned in 7 (30%) cases. Final procedures included 8 (35%) intralobar, 8 (35%) multilobar resections, and 7 (30%) hemispherotomies. Following reoperations, 14 (61%) patients were seizure free, 6 (26%) showed significant or worthwhile improvement, and 3 (13%) did not respond to surgery. Six of 8 patients who underwent the first resection before the age of 3 years, 6 of 8 whose first resection was limited by functional considerations, and all 7 with hemispherotomy as the final resection achieved seizure freedom after reoperation. Reoperation is particularly beneficial for selected children with refractory epilepsy associated with cortical dysplasia that did not respond to an initial limited and/or early resection but achieved seizure freedom after extensive procedures. When indicated, reoperation should be performed at the youngest possible age to profit from higher functional plasticity in compensating for neurological deficit.

  9. [The evaluation of selected oxidative stress parameters in patients with hyperthyroidism].

    Science.gov (United States)

    Andryskowski, Grzegorz; Owczarek, Tomasz

    2007-07-01

    Hyperthyroidism induces the acceleration of the basic metabolism and increases cellular oxygen utilization, consequently intensifies reactive oxygen species production and disturbs the oxidant-antioxidant balance. The objective of this study was to evaluate the selected oxidative stress parameters in patients with hyperthyroidism by analysis of the reactive oxygen species neutralizing enzymes activity--superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and catalase (CAT), the estimation of free radical processes intensity--concentration of malondialdehyde (MDA), sulfhydryl groups (SH) in proteins and by quantification of the serum total antioxidant status (TAS). . Twenty-seven patients treated for hyperthyroidism and 12 healthy individuals were enrolled in the study. Enzyme activity (SOD, GSHPx, CAT), MDA and concentration of SH groups were analysed in erythrocytes, while TAS was measured in serum. Patients with hyperthyroidism compared with healthy subjects were characterized by a higher GSHPx activity in erythrocytes, lower serum TAS, the lower content of SH groups in proteins and the lower MDA concentration in erythrocytes. Our results suggest that hyperthyroidism increases oxidative stress and disturbs oxidant-antioxidant balance in the body. Thyreostatic treatment, if not leads to whole metabolic compensation, may only reduce oxidant-antioxidant disorders, however is not able to eliminate them entirely.

  10. [Comparison of the clinical effects of selective laser melting deposition basal crowns and cobalt chromium alloy base crowns].

    Science.gov (United States)

    Li, Jing-min; Wang, Wei-qian; Ma, Jing-yuan

    2014-06-01

    To evaluate the clinical effects of selective laser melting (SLM) deposition basal crowns and cobalt chromium alloy casting base crowns. One hundred and sixty eight patients treated with either SLM deposition basal crowns (110 teeth) or cobalt chromium alloy casting basal crowns (110 teeth) were followed-up for 1 month, 6 months, 12 months and 24 months. The revised standard of American Public Health Association was used to evaluate the clinical effect of restoration, including the color of porcelain crowns, gingival inflammation, gingival margin discoloration, and crack or fracture. Data analysis was conducted with SPSS 20 software package for Student's t test and Chi-square test. Six cases were lost to follow-up. The patients who were treated with SLM deposition basal crowns (104 teeth) and cobalt chromium alloy casting base crowns (101 teeth) completed the study. Patients were more satisfied with SLM deposition cobalt chromium alloy porcelain crowns. There was 1 prosthesis with poor marginal fit after 24 months of restoration in SLM crowns. There were 6 prostheses with edge coloring and 8 with poor marginal fit in cobalt chromium alloy casting base crowns, which was significantly different between the 2 groups(P<0.05). The SLM deposition copings results in smaller edge coloring and better marginal fit than those of cobalt-chrome copings. Patients are pleased with short-term clinical results.

  11. Fine mapping quantitative trait loci under selective phenotyping strategies based on linkage and linkage disequilibrium criteria

    DEFF Research Database (Denmark)

    Ansari-Mahyari, S; Berg, P; Lund, M S

    2009-01-01

    disequilibrium-based sampling criteria (LDC) for selecting individuals to phenotype are compared to random phenotyping in a quantitative trait loci (QTL) verification experiment using stochastic simulation. Several strategies based on LAC and LDC for selecting the most informative 30%, 40% or 50% of individuals...... for phenotyping to extract maximum power and precision in a QTL fine mapping experiment were developed and assessed. Linkage analyses for the mapping was performed for individuals sampled on LAC within families and combined linkage disequilibrium and linkage analyses was performed for individuals sampled across...... the whole population based on LDC. The results showed that selecting individuals with similar haplotypes to the paternal haplotypes (minimum recombination criterion) using LAC compared to random phenotyping gave at least the same power to detect a QTL but decreased the accuracy of the QTL position. However...

  12. Novel Distance Measure in Fuzzy TOPSIS for Supply Chain Strategy Based Supplier Selection

    Directory of Open Access Journals (Sweden)

    B. Pardha Saradhi

    2016-01-01

    Full Text Available In today’s highly competitive environment, organizations need to evaluate and select suppliers based on their manufacturing strategy. Identification of supply chain strategy of the organization, determination of decision criteria, and methods of supplier selection are appearing to be the most important components in research area in the field of supply chain management. In this paper, evaluation of suppliers is done based on the balanced scorecard framework using new distance measure in fuzzy TOPSIS by considering the supply chain strategy of the manufacturing organization. To take care of vagueness in decision making, trapezoidal fuzzy number is assumed for pairwise comparisons to determine relative weights of perspectives and criteria of supplier selection. Also, linguistic variables specified in terms of trapezoidal fuzzy number are considered for the payoff values of criteria of the suppliers. These fuzzy numbers satisfied the Jensen based inequality. A detailed application of the proposed methodology is illustrated.

  13. Selection of patients for heart transplantation in the current era of heart failure therapy.

    Science.gov (United States)

    Butler, Javed; Khadim, Ghazanfar; Paul, Kimberly M; Davis, Stacy F; Kronenberg, Marvin W; Chomsky, Don B; Pierson, Richard N; Wilson, John R

    2004-03-03

    We sought to assess the relationship between survival, peak exercise oxygen consumption (VO(2)), and heart failure survival score (HFSS) in the current era of heart failure (HF) therapy. Based on predicted survival, HF patients with peak VO(2) 14 ml/min/kg (p = 0.04). Of the patients with peak VO(2) of 10 to 14 ml/min/kg, 55% had low-risk HFSS and exhibited 88% one-year event-free survival. One-year survival after transplantation was 88%, which is similar to the 85% rate reported by the United Network for Organ Sharing for 1999 to 2000. Survival for HF patients in the current era has improved significantly, necessitating re-evaluation of the listing criteria for heart transplantation.

  14. Are web-based questionnaires accepted in patients attending rehabilitation?

    Science.gov (United States)

    Engan, Harald K; Hilmarsen, Christina; Sittlinger, Sverre; Sandmæl, Jon Arne; Skanke, Frode; Oldervoll, Line M

    2016-12-01

    The aim of the present paper was to study preferences for web based self-administered questionnaires (web SAQs) vs. paper-based self-administered questionnaires (paper SAQs) and to evaluate the feasibility of using web SAQs in patients referred to cardiac, lung, occupational and cancer rehabilitation programs. The patients were approached by mail and given the choice to answer the compulsory SAQs either on paper or on a web-based platform. Hundred and twenty seven out of 183 eligible patients (69.3%) were willing to participate and 126 completed the study. Web SAQs were preferred by 77.7%, and these patients were significantly younger, more often cohabiting and tended to have higher level of education than paper SAQ users. Mean number of data missing per patient was less among the web SAQ users than the paper SAQ users (0.55 vs. 2.15, p questionnaires on internet platforms when internet access is common and available. Implications for Rehabilitation The high acceptability of web-based self-administered questionnaires among rehabilitation patients suggests that internet platforms are suitable tools to collect patient information for rehabilitation units. Web-based modes of patient data collection demonstrate low number of missing data and can therefore improve the quality of data collection from rehabilitation patients. Use of web-based questionnaires considerably reduces administrative costs of data collection in rehabilitation settings compared to traditional pen and paper methods.

  15. Condition-dependence, pleiotropy and the handicap principle of sexual selection in melanin-based colouration.

    Science.gov (United States)

    Roulin, Alexandre

    2016-05-01

    The signalling function of melanin-based colouration is debated. Sexual selection theory states that ornaments should be costly to produce, maintain, wear or display to signal quality honestly to potential mates or competitors. An increasing number of studies supports the hypothesis that the degree of melanism covaries with aspects of body condition (e.g. body mass or immunity), which has contributed to change the initial perception that melanin-based colour ornaments entail no costs. Indeed, the expression of many (but not all) melanin-based colour traits is weakly sensitive to the environment but strongly heritable suggesting that these colour traits are relatively cheap to produce and maintain, thus raising the question of how such colour traits could signal quality honestly. Here I review the production, maintenance and wearing/displaying costs that can generate a correlation between melanin-based colouration and body condition, and consider other evolutionary mechanisms that can also lead to covariation between colour and body condition. Because genes controlling melanic traits can affect numerous phenotypic traits, pleiotropy could also explain a linkage between body condition and colouration. Pleiotropy may result in differently coloured individuals signalling different aspects of quality that are maintained by frequency-dependent selection or local adaptation. Colouration may therefore not signal absolute quality to potential mates or competitors (e.g. dark males may not achieve a higher fitness than pale males); otherwise genetic variation would be rapidly depleted by directional selection. As a consequence, selection on heritable melanin-based colouration may not always be directional, but mate choice may be conditional to environmental conditions (i.e. context-dependent sexual selection). Despite the interest of evolutionary biologists in the adaptive value of melanin-based colouration, its actual role in sexual selection is still poorly understood.

  16. Selective fluorescence sensors for detection of nitroaniline and metal Ions based on ligand-based luminescent metal-organic frameworks

    International Nuclear Information System (INIS)

    Yu, Zongchao; Wang, Fengqin; Lin, Xiangyi; Wang, Chengmiao; Fu, Yiyuan; Wang, Xiaojun; Zhao, Yongnan; Li, Guodong

    2015-01-01

    Metal-organic frameworks (MOFs) are porous crystalline materials with high potential for applications in fluorescence sensors. In this work, two solvent-induced Zn(II)–based metal-organic frameworks, Zn_3L_3(DMF)_2 (1) and Zn_3L_3(DMA)_2(H_2O)_3 (2) (L=4,4′-stilbenedicarboxylic acid), were investigated as selective sensing materials for detection of nitroaromatic compounds and metal ions. The sensing experiments show that 1 and 2 both exhibit selective fluorescence quenching toward nitroaniline with a low detection limit. In addition, 1 exhibits high selectivity for detection of Fe"3"+ and Al"3"+ by significant fluorescence quenching or enhancement effect. While for 2, it only exhibits significant fluorescence quenching effect for Fe"3"+. The results indicate that 1 and 2 are both promising fluorescence sensors for detecting and recognizing nitroaniline and metal ions with high sensitivity and selectivity. - Graphical abstract: Two MOFs have been selected as the fluorescence sensing materials for selectively sensing mitroaromatic compounds and metal ions. The high selectivity makes them promising fluorescence sensors for detecting and recognizing nitroaniline and Fe"3"+ or Al"3"+.

  17. A Dynamic and Adaptive Selection Radar Tracking Method Based on Information Entropy

    Directory of Open Access Journals (Sweden)

    Ge Jianjun

    2017-12-01

    Full Text Available Nowadays, the battlefield environment has become much more complex and variable. This paper presents a quantitative method and lower bound for the amount of target information acquired from multiple radar observations to adaptively and dynamically organize the detection of battlefield resources based on the principle of information entropy. Furthermore, for minimizing the given information entropy’s lower bound for target measurement at every moment, a method to dynamically and adaptively select radars with a high amount of information for target tracking is proposed. The simulation results indicate that the proposed method has higher tracking accuracy than that of tracking without adaptive radar selection based on entropy.

  18. Performance-Based Technology Selection Filter description report. INEL Buried Waste Integrated Demonstration System Analysis project

    Energy Technology Data Exchange (ETDEWEB)

    O`Brien, M.C.; Morrison, J.L.; Morneau, R.A.; Rudin, M.J.; Richardson, J.G.

    1992-05-01

    A formal methodology has been developed for identifying technology gaps and assessing innovative or postulated technologies for inclusion in proposed Buried Waste Integrated Demonstration (BWID) remediation systems. Called the Performance-Based Technology Selection Filter, the methodology provides a formalized selection process where technologies and systems are rated and assessments made based on performance measures, and regulatory and technical requirements. The results are auditable, and can be validated with field data. This analysis methodology will be applied to the remedial action of transuranic contaminated waste pits and trenches buried at the Idaho National Engineering Laboratory (INEL).

  19. Targeting hunter distribution based on host resource selection and kill sites to manage disease risk.

    Science.gov (United States)

    Dugal, Cherie J; van Beest, Floris M; Vander Wal, Eric; Brook, Ryan K

    2013-10-01

    Endemic and emerging diseases are rarely uniform in their spatial distribution or prevalence among cohorts of wildlife. Spatial models that quantify risk-driven differences in resource selection and hunter mortality of animals at fine spatial scales can assist disease management by identifying high-risk areas and individuals. We used resource selection functions (RSFs) and selection ratios (SRs) to quantify sex- and age-specific resource selection patterns of collared (n = 67) and hunter-killed (n = 796) nonmigratory elk (Cervus canadensis manitobensis) during the hunting season between 2002 and 2012, in southwestern Manitoba, Canada. Distance to protected area was the most important covariate influencing resource selection and hunter-kill sites of elk (AICw = 1.00). Collared adult males (which are most likely to be infected with bovine tuberculosis (Mycobacterium bovis) and chronic wasting disease) rarely selected for sites outside of parks during the hunting season in contrast to adult females and juvenile males. The RSFs showed selection by adult females and juvenile males to be negatively associated with landscape-level forest cover, high road density, and water cover, whereas hunter-kill sites of these cohorts were positively associated with landscape-level forest cover and increasing distance to streams and negatively associated with high road density. Local-level forest was positively associated with collared animal locations and hunter-kill sites; however, selection was stronger for collared juvenile males and hunter-killed adult females. In instances where disease infects a metapopulation and eradication is infeasible, a principle goal of management is to limit the spread of disease among infected animals. We map high-risk areas that are regularly used by potentially infectious hosts but currently underrepresented in the distribution of kill sites. We present a novel application of widely available data to target hunter distribution based on host resource

  20. Identifying patients at risk of intraoperative and postoperative transfusion in isolated CABG: toward selective conservation strategies.

    Science.gov (United States)

    Arora, Rakesh C; Légaré, Jean-Francois; Buth, Karen J; Sullivan, John A; Hirsch, Gregory M

    2004-11-01

    Allogeneic blood product use during cardiac operation is often reported to exceed 40% despite published guidelines and costly blood conservation strategies. We developed a predictive model, based on eight preoperative risk factors, of allogeneic blood product transfusion rates in patients undergoing a cardiac procedure. All 3,046 consecutive, isolated coronary artery bypass graft (CABG) procedures at a university hospital from 1995 to 1998 were included. A logistic regression model was created to identify independent predictors of allogeneic blood product transfusion. This model was validated using a prospective patient sample. Overall use of allogeneic blood products was 23% with a crude operative mortality of 2.1%. In isolated, elective, first-time CABG cases, 16.9% received allogeneic blood products. Independent predictors of blood product usage in CABG patients were preoperative hemoglobin 12.0 or less, emergent operation, renal failure, female sex, age 70 years or older, left ventricular ejection fraction 0.40 or less, redo procedure, and low body surface area. Prospective validation of this model on 2,117 consecutive isolated CABG patients demonstrated an observed-to-expected allogeneic blood product transfusion rate ratio of 1.06. This internally validated logistic regression risk model is a sensitive and specific predictor of allogeneic blood product use in patients undergoing isolated CABG. Utilization of this model allows for preoperative risk stratification and may allow for more rational resource allocation of costly blood conservation strategies and blood bank resources.

  1. Oxytocin administration selectively improves olfactory detection thresholds for lyral in patients with schizophrenia.

    Science.gov (United States)

    Woolley, J D; Lam, O; Chuang, B; Ford, J M; Mathalon, D H; Vinogradov, S

    2015-03-01

    Olfaction plays an important role in mammalian social behavior. Olfactory deficits are common in schizophrenia and correlate with negative symptoms and low social drive. Despite their prominence and possible clinical relevance, little is understood about the pathological mechanisms underlying olfactory deficits in schizophrenia and there are currently no effective treatments for these deficits. The prosocial neuropeptide oxytocin may affect the olfactory system when administered intranasally to humans and there is growing interest in its therapeutic potential in schizophrenia. To examine this model, we administered 40IU of oxytocin and placebo intranasally to 31 patients with a schizophrenia spectrum illness and 34 age-matched healthy control participants in a randomized, double-blind, placebo-controlled, cross-over study. On each test day, participants completed an olfactory detection threshold test for two different odors: (1) lyral, a synthetic fragrance compound for which patients with schizophrenia have specific olfactory detection threshold deficits, possibly related to decreased cyclic adenosine 3',5'-monophosphate (cAMP) signaling; and (2) anise, a compound for which olfactory detection thresholds change with menstrual cycle phase in women. On the placebo test day, patients with schizophrenia did not significantly differ from healthy controls in detection of either odor. We found that oxytocin administration significantly and selectively improved olfactory detection thresholds for lyral but not for anise in patients with schizophrenia. In contrast, oxytocin had no effect on detection of either odor in healthy controls. Our data indicate that oxytocin administration may ameliorate olfactory deficits in schizophrenia and suggest the effects of intranasal oxytocin may extend to influencing the olfactory system. Given that oxytocin has been found to increase cAMP signaling in vitro a possible mechanism for these effects is discussed. Published by Elsevier Ltd.

  2. Investigation of selected trace elements in hair samples of eczema patients

    International Nuclear Information System (INIS)

    Osman, N. O.

    2010-12-01

    The aim of this case-control study was to investigate the relationship between selected trace elements and skin diseases, namely eczema. Fifty five patients affected by the most frequent eczema types were recruited at the onset of disease at the hospital of dermatology in Khartoum together with thirty healthy controls. Fe, Zn, Cu, and Ni were measured in hair samples obtained from both patients and control group using Atomic Absorption Spectrometry (AAS). Data analysis was performed using the T-test. Partial correlation was used to study the relationship between the elemental concentration. Certified reference material (IAEA-85) Hair Powder) produced by the International Atomic Energy Agency (IAEA) was used as a quality control to check the accuracy and precision of the analytical technique, good agreement was achieved for all elements under investigation. Significant variations (p<0.05) in the concentrations of Fe, Zn, Cu, and Ni in the hair of the patients compared to the control group, and this difference was a decrease of iron, zinc and copper, therefore, should be given to the patient doses of these elements, while there was an increase in the nickel. So it is not included in the treatment. These interesting associations between the levels the of trace elements could be used as an indication for the disease as well as to monitor the treatment. Comparisons of the results obtained in the present study with those conducted for other population in the literature showed very close agreement. The levels of the elements under investigation are comparable with the data obtained from the literature for other populations with exception of Fe which was found to be very high in Sudanese population. (Author)

  3. Investigation of selected trace elements in hair samples of eczema patients

    Energy Technology Data Exchange (ETDEWEB)

    Osman, N O [Atomic Energy Council, Sudan Academy of Sciences (SAS), Khartoum (Sudan)

    2010-12-15

    The aim of this case-control study was to investigate the relationship between selected trace elements and skin diseases, namely eczema. Fifty five patients affected by the most frequent eczema types were recruited at the onset of disease at the hospital of dermatology in Khartoum together with thirty healthy controls. Fe, Zn, Cu, and Ni were measured in hair samples obtained from both patients and control group using Atomic Absorption Spectrometry (AAS). Data analysis was performed using the T-test. Partial correlation was used to study the relationship between the elemental concentration. Certified reference material (IAEA-85) Hair Powder) produced by the International Atomic Energy Agency (IAEA) was used as a quality control to check the accuracy and precision of the analytical technique, good agreement was achieved for all elements under investigation. Significant variations (p<0.05) in the concentrations of Fe, Zn, Cu, and Ni in the hair of the patients compared to the control group, and this difference was a decrease of iron, zinc and copper, therefore, should be given to the patient doses of these elements, while there was an increase in the nickel. So it is not included in the treatment. These interesting associations between the levels the of trace elements could be used as an indication for the disease as well as to monitor the treatment. Comparisons of the results obtained in the present study with those conducted for other population in the literature showed very close agreement. The levels of the elements under investigation are comparable with the data obtained from the literature for other populations with exception of Fe which was found to be very high in Sudanese population. (Author)

  4. Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients.

    Science.gov (United States)

    Dienstmann, Rodrigo; Salazar, Ramon; Tabernero, Josep

    2015-06-01

    For more than three decades, postoperative chemotherapy-initially fluoropyrimidines and more recently combinations with oxaliplatin-has reduced the risk of tumor recurrence and improved survival for patients with resected colon cancer. Although universally recommended for patients with stage III disease, there is no consensus about the survival benefit of postoperative chemotherapy in stage II colon cancer. The most recent adjuvant clinical trials have not shown any value for adding targeted agents, namely bevacizumab and cetuximab, to standard chemotherapies in stage III disease, despite improved outcomes in the metastatic setting. However, biomarker analyses of multiple studies strongly support the feasibility of refining risk stratification in colon cancer by factoring in molecular characteristics with pathologic tumor staging. In stage II disease, for example, microsatellite instability supports observation after surgery. Furthermore, the value of BRAF or KRAS mutations as additional risk factors in stage III disease is greater when microsatellite status and tumor location are taken into account. Validated predictive markers of adjuvant chemotherapy benefit for stage II or III colon cancer are lacking, but intensive research is ongoing. Recent advances in understanding the biologic hallmarks and drivers of early-stage disease as well as the micrometastatic environment are expected to translate into therapeutic strategies tailored to select patients. This review focuses on the pathologic, molecular, and gene expression characterizations of early-stage colon cancer; new insights into prognostication; and emerging predictive biomarkers that could ultimately help define the optimal adjuvant treatments for patients in routine clinical practice. © 2015 by American Society of Clinical Oncology.

  5. Progressive sampling-based Bayesian optimization for efficient and automatic machine learning model selection.

    Science.gov (United States)

    Zeng, Xueqiang; Luo, Gang

    2017-12-01

    Machine learning is broadly used for clinical data analysis. Before training a model, a machine learning algorithm must be selected. Also, the values of one or more model parameters termed hyper-parameters must be set. Selecting algorithms and hyper-parameter values requires advanced machine learning knowledge and many labor-intensive manual iterations. To lower the bar to machine learning, miscellaneous automatic selection methods for algorithms and/or hyper-parameter values have been proposed. Existing automatic selection methods are inefficient on large data sets. This poses a challenge for using machine learning in the clinical big data era. To address the challenge, this paper presents progressive sampling-based Bayesian optimization, an efficient and automatic selection method for both algorithms and hyper-parameter values. We report an implementation of the method. We show that compared to a state of the art automatic selection method, our method can significantly reduce search time, classification error rate, and standard deviation of error rate due to randomization. This is major progress towards enabling fast turnaround in identifying high-quality solutions required by many machine learning-based clinical data analysis tasks.

  6. Robust Feature Selection from Microarray Data Based on Cooperative Game Theory and Qualitative Mutual Information

    Directory of Open Access Journals (Sweden)

    Atiyeh Mortazavi

    2016-01-01

    Full Text Available High dimensionality of microarray data sets may lead to low efficiency and overfitting. In this paper, a multiphase cooperative game theoretic feature selection approach is proposed for microarray data classification. In the first phase, due to high dimension of microarray data sets, the features are reduced using one of the two filter-based feature selection methods, namely, mutual information and Fisher ratio. In the second phase, Shapley index is used to evaluate the power of each feature. The main innovation of the proposed approach is to employ Qualitative Mutual Information (QMI for this purpose. The idea of Qualitative Mutual Information causes the selected features to have more stability and this stability helps to deal with the problem of data imbalance and scarcity. In the third phase, a forward selection scheme is applied which uses a scoring function to weight each feature. The performance of the proposed method is compared with other popular feature selection algorithms such as Fisher ratio, minimum redundancy maximum relevance, and previous works on cooperative game based feature selection. The average classification accuracy on eleven microarray data sets shows that the proposed method improves both average accuracy and average stability compared to other approaches.

  7. Continuous ambulatory peritoneal dialysis: perspectives on patient selection in low- to middle-income countries

    Directory of Open Access Journals (Sweden)

    Wearne N

    2017-01-01

    Full Text Available Nicola Wearne,1 Kajiru Kilonzo,2 Emmanuel Effa,3 Bianca Davidson,1 Peter Nourse,4 Udeme Ekrikpo,1,5 Ikechi G Okpechi1 1Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa; 2Department of Medicine, Kilimanjaro Christian Medical College, Moshi, Tanzania; 3Department of Medicine, University of Calabar, Calabar, Nigeria; 4Division of Paediatric Nephrology, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa; 5Department of Internal Medicine, University of Uyo, Uyo, Nigeria Abstract: Chronic kidney disease is a major public health problem that continues to show an unrelenting global increase in prevalence. The prevalence of chronic kidney disease has been predicted to grow the fastest in low- to middle-income countries (LMICs. There is evidence that people living in LMICs have the highest need for renal replacement therapy (RRT despite the lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD does not require advanced technologies, much infrastructure, or need for dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. However, CAPD is scarcely available in many LMICs, and even where available, there are several hurdles to be confronted regarding patient selection for this modality. High cost of CAPD due to unavailability of fluids, low patient education and motivation, low remuneration for nephrologists, lack of expertise/experience for catheter insertion and management of complications, presence of associated comorbid diseases, and various socio-demographic factors contribute significantly toward reduced patient selection for CAPD. Cost of CAPD fluids seems to be a major constraint given that many countries do not have the capacity to manufacture fluids but instead rely heavily on fluids imported from developed countries. There is need to invest in fluid manufacturing (either nationally or

  8. Routine versus selective antifungal administration for control of fungal infections in patients with cancer

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Johansen, Helle Krogh

    2014-01-01

    commonly used antifungal drugs decrease mortality in cancer patients with neutropenia. SEARCH METHODS: We searched PubMed from 1966 to 7 July 2014 and the reference lists of identified articles. SELECTION CRITERIA: Randomised clinical trials of amphotericin B, fluconazole, ketoconazole, miconazole....... Prophylactic or empirical treatment with amphotericin B significantly decreased total mortality (relative risk (RR) 0.69, 95% confidence interval (CI) 0.50 to 0.96), whereas the estimated RRs for fluconazole, ketoconazole, miconazole, and itraconazole were close to 1.00. No eligible trials were found.......73), fluconazole (RR 0.39, 95% CI 0.27 to 0.57) and itraconazole (RR 0.53, 95% CI 0.29 to 0.97), but not with ketoconazole or miconazole. Effect estimates were similar for those 13 trials that had adequate allocation concealment and were blinded. The reporting of harms was far too variable from trial to trial...

  9. Social comparisons in adults with type 2 diabetes: Patients' reasons for target selection.

    Science.gov (United States)

    Arigo, Danielle; Cornell, Max; Smyth, Joshua M

    2018-07-01

    To examine reasons for selecting a social comparison target (i.e. a specific other for relative self-evaluation), and their influence on affect and motivation for self-care, in type 2 diabetes (T2DM). Adults with T2DM (n = 180, M A1c  = 7.6%) chose to read about one of four targets. Participants rated five reasons for their choice (strongly disagree - strongly agree), and rated affect and self-care motivation before and after reading. To boost confidence in my ability to manage diabetes was rated highest overall (ps motivation (p motivation only among those who chose better-off targets (p = 0.01). Patients' reasons for a particular comparison are associated with short-term changes in affect and self-care motivation, and warrant greater empirical and clinical attention.

  10. Disease severity and staging of obesity: a rational approach to patient selection.

    Science.gov (United States)

    Whyte, M B; Velusamy, S; Aylwin, S J B

    2014-11-01

    The increasing prevalence of obesity places ever-increasing cost demands on healthcare systems. One million individuals are eligible for bariatric surgery in the UK, and yet less than 6000 bariatric procedures are performed annually. Bariatric surgery reverses or improves almost all the medical and psychosocial co-morbidities associated with obesity. Although the BMI is a simple method to estimate adiposity at a population level, it is relatively inaccurate within an individual and provides little-to-no indication of overall health status or disease severity. Staging systems overcome the inherent limitations of BMI and allow highly informed decision-making for an individual. At a societal level, this helps to identify those most likely to gain and maximise economic benefit. This review summarises the co-morbidities associated with obesity and the evidence for their improvement following surgery. The rationale for new staging criteria and appropriate patient selection are discussed.

  11. The incidence of parametrial tumor involvement in select patients with early cervix cancer is too low to justify parametrectomy

    NARCIS (Netherlands)

    Stegeman, M.; Louwen, M.; van der Velden, J.; ten Kate, F. J. W.; den Bakker, M. A.; Burger, C. W.; Ansink, A. C.

    2007-01-01

    OBJECTIVE: To determine the incidence of parametrial involvement in a select group of patients with early cervical cancer. METHODS: We retrospectively reviewed the records of patients with cervical cancer and a maximum tumor diameter of 2 cm, infiltration depth <10 mm and negative pelvic lymph nodes

  12. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections

    DEFF Research Database (Denmark)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel

    2016-01-01

    OBJECTIVES: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. METHODS: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) ...

  13. A Study of Power Relations in Doctor-Patient Interactions in Selected Hospitals in Lagos State, Nigeria

    Science.gov (United States)

    Adam, Qasim

    2014-01-01

    This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the…

  14. Sensor selection of helicopter transmission systems based on physical model and sensitivity analysis

    Directory of Open Access Journals (Sweden)

    Lyu Kehong

    2014-06-01

    Full Text Available In the helicopter transmission systems, it is important to monitor and track the tooth damage evolution using lots of sensors and detection methods. This paper develops a novel approach for sensor selection based on physical model and sensitivity analysis. Firstly, a physical model of tooth damage and mesh stiffness is built. Secondly, some effective condition indicators (CIs are presented, and the optimal CIs set is selected by comparing their test statistics according to Mann–Kendall test. Afterwards, the selected CIs are used to generate a health indicator (HI through sen slop estimator. Then, the sensors are selected according to the monotonic relevance and sensitivity to the damage levels. Finally, the proposed method is verified by the simulation and experimental data. The results show that the approach can provide a guide for health monitoring of helicopter transmission systems, and it is effective to reduce the test cost and improve the system’s reliability.

  15. Secure relay selection based on learning with negative externality in wireless networks

    Science.gov (United States)

    Zhao, Caidan; Xiao, Liang; Kang, Shan; Chen, Guiquan; Li, Yunzhou; Huang, Lianfen

    2013-12-01

    In this paper, we formulate relay selection into a Chinese restaurant game. A secure relay selection strategy is proposed for a wireless network, where multiple source nodes send messages to their destination nodes via several relay nodes, which have different processing and transmission capabilities as well as security properties. The relay selection utilizes a learning-based algorithm for the source nodes to reach their best responses in the Chinese restaurant game. In particular, the relay selection takes into account the negative externality of relay sharing among the source nodes, which learn the capabilities and security properties of relay nodes according to the current signals and the signal history. Simulation results show that this strategy improves the user utility and the overall security performance in wireless networks. In addition, the relay strategy is robust against the signal errors and deviations of some user from the desired actions.

  16. Speech Emotion Feature Selection Method Based on Contribution Analysis Algorithm of Neural Network

    International Nuclear Information System (INIS)

    Wang Xiaojia; Mao Qirong; Zhan Yongzhao

    2008-01-01

    There are many emotion features. If all these features are employed to recognize emotions, redundant features may be existed. Furthermore, recognition result is unsatisfying and the cost of feature extraction is high. In this paper, a method to select speech emotion features based on contribution analysis algorithm of NN is presented. The emotion features are selected by using contribution analysis algorithm of NN from the 95 extracted features. Cluster analysis is applied to analyze the effectiveness for the features selected, and the time of feature extraction is evaluated. Finally, 24 emotion features selected are used to recognize six speech emotions. The experiments show that this method can improve the recognition rate and the time of feature extraction

  17. AHP-Based Optimal Selection of Garment Sizes for Online Shopping

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Garment online shopping has been accepted by more and more consumers in recent years. In online shopping, a buyer only chooses the garment size judged by his own experience without trying-on, so the selected garment may not be the fittest one for the buyer due to the variety of body's figures. Thus, we propose a method of optimal selection of garment sizes for online shopping based on Analytic Hierarchy Process (AHP). The hierarchical structure model for optimal selection of garment sizes is structured and the fittest garment for a buyer is found by calculating the matching degrees between individual's measurements and the corresponding key-part values of ready-to-wear clothing sizes. In order to demonstrate its feasibility, we provide an example of selecting the fittest sizes of men's bottom. The result shows that the proposed method is useful in online clothing sales application.

  18. Bolometric-Effect-Based Wavelength-Selective Photodetectors Using Sorted Single Chirality Carbon Nanotubes

    Science.gov (United States)

    Zhang, Suoming; Cai, Le; Wang, Tongyu; Shi, Rongmei; Miao, Jinshui; Wei, Li; Chen, Yuan; Sepúlveda, Nelson; Wang, Chuan

    2015-01-01

    This paper exploits the chirality-dependent optical properties of single-wall carbon nanotubes for applications in wavelength-selective photodetectors. We demonstrate that thin-film transistors made with networks of carbon nanotubes work effectively as light sensors under laser illumination. Such photoresponse was attributed to photothermal effect instead of photogenerated carriers and the conclusion is further supported by temperature measurements. Additionally, by using different types of carbon nanotubes, including a single chirality (9,8) nanotube, the devices exhibit wavelength-selective response, which coincides well with the absorption spectra of the corresponding carbon nanotubes. This is one of the first reports of controllable and wavelength-selective bolometric photoresponse in macroscale assemblies of chirality-sorted carbon nanotubes. The results presented here provide a viable route for achieving bolometric-effect-based photodetectors with programmable response spanning from visible to near-infrared by using carbon nanotubes with pre-selected chiralities. PMID:26643777

  19. [Location selection for Shenyang urban parks based on GIS and multi-objective location allocation model].

    Science.gov (United States)

    Zhou, Yuan; Shi, Tie-Mao; Hu, Yuan-Man; Gao, Chang; Liu, Miao; Song, Lin-Qi

    2011-12-01

    Based on geographic information system (GIS) technology and multi-objective location-allocation (LA) model, and in considering of four relatively independent objective factors (population density level, air pollution level, urban heat island effect level, and urban land use pattern), an optimized location selection for the urban parks within the Third Ring of Shenyang was conducted, and the selection results were compared with the spatial distribution of existing parks, aimed to evaluate the rationality of the spatial distribution of urban green spaces. In the location selection of urban green spaces in the study area, the factor air pollution was most important, and, compared with single objective factor, the weighted analysis results of multi-objective factors could provide optimized spatial location selection of new urban green spaces. The combination of GIS technology with LA model would be a new approach for the spatial optimizing of urban green spaces.

  20. A target recognition method for maritime surveillance radars based on hybrid ensemble selection

    Science.gov (United States)

    Fan, Xueman; Hu, Shengliang; He, Jingbo

    2017-11-01

    In order to improve the generalisation ability of the maritime surveillance radar, a novel ensemble selection technique, termed Optimisation and Dynamic Selection (ODS), is proposed. During the optimisation phase, the non-dominated sorting genetic algorithm II for multi-objective optimisation is used to find the Pareto front, i.e. a set of ensembles of classifiers representing different tradeoffs between the classification error and diversity. During the dynamic selection phase, the meta-learning method is used to predict whether a candidate ensemble is competent enough to classify a query instance based on three different aspects, namely, feature space, decision space and the extent of consensus. The classification performance and time complexity of ODS are compared against nine other ensemble methods using a self-built full polarimetric high resolution range profile data-set. The experimental results clearly show the effectiveness of ODS. In addition, the influence of the selection of diversity measures is studied concurrently.