WorldWideScience

Sample records for patient selection criteria

  1. 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.

  2. 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.

  3. Green Supplier Selection Criteria

    DEFF Research Database (Denmark)

    Nielsen, Izabela Ewa; Banaeian, Narges; Golinska, Paulina

    2014-01-01

    Green supplier selection (GSS) criteria arise from an organization inclination to respond to any existing trends in environmental issues related to business management and processes, so GSS is integrating environmental thinking into conventional supplier selection. This research is designed...... to determine prevalent general and environmental supplier selection criteria and develop a framework which can help decision makers to determine and prioritize suitable green supplier selection criteria (general and environmental). In this research we considered several parameters (evaluation objectives......) to establish suitable criteria for GSS such as their production type, requirements, policy and objectives instead of applying common criteria. At first a comprehensive and deep review on prevalent and green supplier selection literatures performed. Then several evaluation objectives defined to assess the green...

  4. 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.

  5. Attitude of the Korean dentists towards radiation safety and selection criteria

    International Nuclear Information System (INIS)

    Lee, Byung Do; Ludlow, John B.

    2013-01-01

    X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.

  6. Attitude of the Korean dentists towards radiation safety and selection criteria

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Ludlow, John B. [Graduate Program in Oral and Maxillofacial Radiology, School of Dentistry, University of North Carolina, Chapel Hill (United States)

    2013-09-15

    X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.

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

    NARCIS (Netherlands)

    Gribble, P.A.; Delahunt, E.; Bleakley, C.M.; Caulfield, B.; Docherty, C.L.; Fong, D.T.; Fourchet, F.; Hertel, J.; Hiller, C.E.; Kaminski, T.W.; McKeon, P.O.; Refshauge, K.M.; Wees, P.J. van der; Vicenzino, W.; Wikstrom, E.A.

    2014-01-01

    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 or patient selection criteria across studies presents a potential obstacle to addressing the problem

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

    NARCIS (Netherlands)

    Gribble, P.A.; Delahunt, E.; Bleakley, C.; Caulfield, B.; Docherty, C.; Fourchet, F.; Fong, D.T.; Hertel, J.; Hiller, C.; Kaminski, T.; McKeon, P.; Refshauge, K.; Wees, P.J. van der; Vincenzino, B.; Wikstrom, E.

    2014-01-01

    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.

  9. [Influence of distinct criteria for selecting patients for swabbing on estimation of the effectiveness of the influenza vaccine].

    Science.gov (United States)

    Martínez-Baz, Iván; Guevara, Marcela; Elía, Fernando; Ezpeleta, Carmen; Fernández Alonso, Mirian; Castilla, Jesús

    2014-01-01

    To estimate the effectiveness of the influenza vaccine under different criteria for selecting patients for swabbing. A case-control study was performed of laboratory-confirmed cases (n=909) and negative controls for influenza (n=732) in the 2010-2011 to 2012-2013 seasons in Navarre (Spain). The adjusted vaccine effectiveness was estimated by including all swabs from patients with influenza-like-illness and selecting only the first two cases per physician and week. The first two patients per physician and week were less frequently vaccinated against influenza (7.9% vs. 12.5%, p=0.021) and less often received confirmation of influenza (53.6% vs. 66.4%, p <0.001) than subsequent patients. These differences decreased after adjustment for covariates. The effectiveness of the influenza vaccine was 49% (95% CI: 23-66%) when all swabs were included and was 55% (95% CI: 27-72%) when we selected the first two swabs per week and physician. The selection of the first two patients per physician and week may bias assessment of the effectiveness of the influenza vaccine, although this bias was small in the seasons analyzed. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. 7 CFR 1948.80 - Planning grant selection criteria.

    Science.gov (United States)

    2010-01-01

    ... financial resources available for such planning; (d) The planning priorities and recommended funding level... 7 Agriculture 13 2010-01-01 2009-01-01 true Planning grant selection criteria. 1948.80 Section... Development Assistance Program § 1948.80 Planning grant selection criteria. The following criteria will be...

  11. A multi-criteria decision-making approach to rank supplier selection criteria for hospital waste management: A case from Pakistan.

    Science.gov (United States)

    Ishtiaq, Palvisha; Khan, Sharfuddin Ahmed; Haq, Moiz-Ul

    2018-04-01

    To address environmental issues and cost effectiveness, waste management is necessary for healthcare facilities. Most importantly, segregation of hazardous and non-hazardous waste must be done as in many developing countries; disposal of both types of healthcare waste is done together, which is an unsafe practice. Waste generated in hospitals needs proper management to minimise hazards for patient and healthcare workers. At the same time, it is quite difficult for hospitals to find a systematic way to select appropriate suppliers for hospital waste management. Therefore, the purpose of this article is to identify, validate, and rank criteria that are essential for hospital waste management suppliers' selection. The analytical hierarchal process approach has been used and a survey from Pakistan's largest city (Karachi) has been considered to rank the most appropriate criteria that is necessary to select the supplier, especially in a developing country like Pakistan. Results show that waste management cost (45.5%) and suppliers' details (31.5%) are the top two main criteria for supplier selection; and storage cost (15.7%), waste handling cost (14.7%), and qualification of the suppliers (10.9%) are the top three most important overall sub-criteria for supplier selection for hospital waste management.

  12. [Use of Cone Beam Computed Tomography in endodontics: rational case selection criteria].

    Science.gov (United States)

    Rosen, E; Tsesis, I

    2016-01-01

    To present rational case selection criteria for the use of CBCT (Cone Beam Computed Tomography) in endodontics. This article reviews the literature concerning the benefits of CBCT in endodontics, alongside its radiation risks, and present case selection criteria for referral of endodontic patients to CBCT. Up to date, the expected ultimate benefit of CBCT to the endodontic patient is yet uncertain, and the current literature is mainly restricted to its technical efficacy. In addition, the potential radiation risks of CBCT scan are stochastic in nature and uncertain, and are worrying especially in pediatric patients. Both the efficacy of CBCT in supporting the endodontic practitioner decision making and in affecting treatment outcomes, and its long term potential radiation risks are yet uncertain. Therefore, a cautious rational decision making is essential when a CBCT scan is considered in endodontics. Risk-benefit considerations are presented.

  13. Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide poisoning.

    Science.gov (United States)

    Hampson, N B; Dunford, R G; Kramer, C C; Norkool, D M

    1995-01-01

    Medical directors of North American hyperbaric oxygen (HBO) facilities were surveyed to assess selection criteria applied for treatment of acute carbon monoxide (CO) poisoning within the hyperbaric medicine community. Responses were received from 85% of the 208 facilities in the United States and Canada. Among responders, 89 monoplace and 58 multiplace chamber facilities treat acute CO poisoning, managing a total of 2,636 patients in 1992. A significant majority of facilities treat CO-exposed patients with coma (98%), transient loss of consciousness (LOC) (77%), ischemic changes on electrocardiogram (91%), focal neurologic deficits (94%), or abnormal psychometric testing (91%), regardless of carboxyhemoglobin (COHb) level. Although 92% would use HBO for a patient presenting with headache, nausea, and COHb 40%, only 62% of facilities utilize a specified minimum COHb level as the sole criterion for HBO therapy of an asymptomatic patient. When COHb is used as an independent criterion to determine HBO treatment, the level utilized varies widely between institutions. Half of responding facilities place limits on the delay to treatment for patients with only transient LOC. Time limits are applied less often in cases with persistent neurologic deficits. While variability exists, majority opinions can be derived for many patient selection criteria regarding the use of HBO in acute CO poisoning.

  14. 7 CFR 1469.6 - Enrollment criteria and selection process.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Enrollment criteria and selection process. 1469.6... General Provisions § 1469.6 Enrollment criteria and selection process. (a) Selection and funding of... existing natural resource, environmental quality, and agricultural activity data along with other...

  15. Inflammatory markers as selection criteria of hepatocellular carcinoma in living-donor liver transplantation.

    Science.gov (United States)

    Na, Gun Hyung; Kim, Dong Goo; Han, Jae Hyun; Kim, Eun Young; Lee, Soo Ho; Hong, Tae Ho; You, Young Kyoung

    2014-06-07

    To investigate that inflammatory markers can predict accurately the prognosis of hepatocelluar carcinoma (HCC) patients in living-donor liver transplantation (LDLT). From October 2000 to November 2011, 224 patients who underwent living donor liver transplantation for HCC at our institution were enrolled in this study. We analyzed disease-free survival (DFS) and overall survival (OS) after LT in patients with HCC and designed a new score model using pretransplant neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP). The DFS and OS in patients with an NLR level ≥ 6.0 or CRP level ≥ 1.0 were significantly worse than those of patients with an NLR level < 6.0 or CRP level < 1.0 (P = 0.049, P = 0.003 for NLR and P = 0.010, P < 0.001 for CRP, respectively). Using a new score model using the pretransplant NLR and CRP, we can differentiate HCC patients beyond the Milan criteria with a good prognosis from those with a poor prognosis. Combined with the Milan criteria, new score model using NLR and CRP represent new selection criteria for LDLT candidates with HCC, especially beyond the Milan criteria.

  16. Donor selection criteria and procurement

    International Nuclear Information System (INIS)

    Agcaoili, N.R.

    1999-01-01

    Donor selection is one of the most important aspects of tissue banking practice. Without a good donor selection criteria, the results of any effort of trying to preserve tissues will have disastrous outcome for the recipient of these tissues. While with a very good and strict donor selection the Tissue Bank can guarantee safe and effective tissue allografts. There are significant aspects in the history and physical examination of the donor that must be emphasized. A donor exclusion criteria has also been formulated together with a list of all the needed laboratory examinations to eliminate possible diseases that may be transferred from the donor. The methods of procurement of tissue allografts from living and cadaver donors will be described. The limitations and advantages of each will be taken.There are also special restrictions that are important in the practice of removing the tissues from the donors. All the necessary equipment should be ready and the potential risk on the personnel should be known to all doing Tissue Banking

  17. 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

  18. Reliability criteria selection for integrated resource planning

    International Nuclear Information System (INIS)

    Ruiu, D.; Ye, C.; Billinton, R.; Lakhanpal, D.

    1993-01-01

    A study was conducted on the selection of a generating system reliability criterion that ensures a reasonable continuity of supply while minimizing the total costs to utility customers. The study was conducted using the Institute for Electronic and Electrical Engineers (IEEE) reliability test system as the study system. The study inputs and results for conditions and load forecast data, new supply resources data, demand-side management resource data, resource planning criterion, criterion value selection, supply side development, integrated resource development, and best criterion values, are tabulated and discussed. Preliminary conclusions are drawn as follows. In the case of integrated resource planning, the selection of the best value for a given type of reliability criterion can be done using methods similar to those used for supply side planning. The reliability criteria values previously used for supply side planning may not be economically justified when integrated resource planning is used. Utilities may have to revise and adopt new, and perhaps lower supply reliability criteria for integrated resource planning. More complex reliability criteria, such as energy related indices, which take into account the magnitude, frequency and duration of the expected interruptions are better adapted than the simpler capacity-based reliability criteria such as loss of load expectation. 7 refs., 5 figs., 10 tabs

  19. American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis.

    Science.gov (United States)

    Wallace, Carol A; Giannini, Edward H; Huang, Bin; Itert, Lukasz; Ruperto, Nicolino

    2011-07-01

    To prospectively validate the preliminary criteria for clinical inactive disease (CID) in patients with select categories of juvenile idiopathic arthritis (JIA). We used the process for development of classification and response criteria recommended by the American College of Rheumatology Quality of Care Committee. Patient-visit profiles were extracted from the phase III randomized controlled trial of infliximab in polyarticular-course JIA (i.e., patients considered to resemble those with select categories of JIA) and sent to an international group of expert physician raters. Using the physician ratings as the gold standard, the sensitivity and specificity were calculated using the preliminary criteria. Modifications to the criteria were made, and these were sent to a larger group of pediatric rheumatologists to determine quantitative, face, and content validity. Variables weighted heaviest by physicians when making their judgment were the number of joints with active arthritis, erythrocyte sedimentation rate (ESR), physician's global assessment, and duration of morning stiffness. Three modifications were made: the definition of uveitis, the definition of abnormal ESR, and the addition of morning stiffness. These changes did not alter the accuracy of the preliminary set. The modified criteria, termed the "criteria for CID in select categories of JIA," have excellent feasibility and face, content, criterion, and discriminant validity to detect CID in select categories of JIA. The small changes made to the preliminary criteria set did not alter the area under the receiver operating characteristic curve (0.954) or accuracy (91%), but have increased face and content validity. Copyright © 2011 by the American College of Rheumatology.

  20. Identification of multi-criteria for supplier selection in IT project outsourcing

    Science.gov (United States)

    Fusiripong, Prashaya; Baharom, Fauziah; Yusof, Yuhanis

    2017-10-01

    In the increasing global business competitiveness, most organizations have attempted to determine the suitable external parties to support their core and non-core competency, particularly, in IT project outsourcing. The IT supplier selection is required to apply multi-criteria which comprised tangible criteria and intangible criteria in consider optimal IT supplier. Most researches attempted to identify optimal criteria for selecting IT supplier, however, the criteria cannot be the considered common criteria support the variety of IT outsourcing. Therefore, the study aimed to identify a common set of criteria being used in the various types of IT outsourcing. The common criteria are constructed by multi-criteria and success criteria, which were collected by literature review with comprehensive and comparative approach. Consequently, the researchers are able to identify a common set of criteria adopted in the variety of selection problem IT outsourcing supplier.

  1. A Hybrid Multiple Criteria Decision Making Model for Supplier Selection

    Directory of Open Access Journals (Sweden)

    Chung-Min Wu

    2013-01-01

    Full Text Available The sustainable supplier selection would be the vital part in the management of a sustainable supply chain. In this study, a hybrid multiple criteria decision making (MCDM model is applied to select optimal supplier. The fuzzy Delphi method, which can lead to better criteria selection, is used to modify criteria. Considering the interdependence among the selection criteria, analytic network process (ANP is then used to obtain their weights. To avoid calculation and additional pairwise comparisons of ANP, a technique for order preference by similarity to ideal solution (TOPSIS is used to rank the alternatives. The use of a combination of the fuzzy Delphi method, ANP, and TOPSIS, proposing an MCDM model for supplier selection, and applying these to a real case are the unique features of this study.

  2. Selection criteria for internships in clinical neuropsychology.

    Science.gov (United States)

    Ritchie, David; Odland, Anthony P; Ritchie, Abigail S; Mittenberg, Wiley

    2012-01-01

    Criteria used in the evaluation and selection of applicants for clinical neuropsychology internships were identified by a survey of programs that met guidelines for specialty training. The number of internships that offer training with specialization in clinical neuropsychology has more than doubled during the past 10 years. Supervising neuropsychologists from 75 programs replied to the survey, yielding a 72.8% response rate. Clinical experience in neuropsychological assessment, specialization in clinical neuropsychology during graduate education, personal interview, and letters of recommendation were reported to be the most salient selection criteria. Practica that provide experience with flexible or functional systems assessment approaches at university-affiliated or VA (U.S. Department of Veterans Affairs) medical centers and doctoral curricula that follow International Neuropsychological Society/Division 40 course guidelines, with teaching and supervision provided by neuropsychologists, were preferred prerequisites to internship. These results are consistent with selection criteria reported over a decade ago and indicate continued endorsement of the vertically integrated model of education and training outlined by the Houston Conference on Specialty Education and Training in Clinical Neuropsychology.

  3. Multi-Criteria Decision Making For Determining A Simple Model of Supplier Selection

    Science.gov (United States)

    Harwati

    2017-06-01

    Supplier selection is a decision with many criteria. Supplier selection model usually involves more than five main criteria and more than 10 sub-criteria. In fact many model includes more than 20 criteria. Too many criteria involved in supplier selection models sometimes make it difficult to apply in many companies. This research focuses on designing supplier selection that easy and simple to be applied in the company. Analytical Hierarchy Process (AHP) is used to weighting criteria. The analysis results there are four criteria that are easy and simple can be used to select suppliers: Price (weight 0.4) shipment (weight 0.3), quality (weight 0.2) and services (weight 0.1). A real case simulation shows that simple model provides the same decision with a more complex model.

  4. Selection criteria for dental radiography

    International Nuclear Information System (INIS)

    1998-01-01

    The Faculty of General Dental Practitioners (UK) has a declared commitment to 'improving the standards of patient care'. By the provision of standards and guidelines it aims to help the profession to achieve this goal. Standards and guidelines are simply tools a dentist may use to improve treatment planning and care outcomes. The Self-Assessment Manual and Standards, SAMS, first published in 1991, is now well known to the profession and has become a frequently quoted source in clinical audit and quality assurance initiatives. Since its publication the scientific methodology of systematic reviews of the literature has progressed dramatically and this book is based on these developments. Evidence-based care is well established in medicine and dentistry and these selection criteria and guidelines follow these established protocols by basing advice on the available scientific evidence wherever possible. This book's purpose is a practical one, it is not intended to be limiting or restrictive but to be useful in the decision-making process. This is the first in a series of standards documents from the FGDP(UK) which are based on reviews of the scientific literature and employ the Scottish Intercollegiate Guideline Network (SIGN) methodology for guideline production. They are not constraints but an aid to effective treatment planning and patient care

  5. Selecting an E-(Text)Book: Evaluation Criteria

    Science.gov (United States)

    Marczak, Mariusz

    2013-01-01

    This paper aims to propose a repository of pre-use evaluation criteria for language teachers who wish to introduce e-books or e-textbooks to their own teaching practices. By selectively using a set of such criteria, they will be able to evaluate to what extent a given e-book/e-textbook lends itself to utilisation within their own teaching context.…

  6. Credit Card Selection Criteria: Singapore Perspective

    OpenAIRE

    Lydia L. Gan; Ramin Cooper Maysami

    2006-01-01

    This study used factor analysis to examine credit card selection criteria among Singaporeans. The results showed that convenience of use and protection, economics, and flexibility were the main drivers, while the reputation of card was the least important in determining credit card selection in Singapore. Demographic results showed that high-income earners, the better educated, the elderly, married and the professional preferred the convenience-protection factor to the economic-promotional fa...

  7. 77 FR 12234 - Changes in Hydric Soils Database Selection Criteria

    Science.gov (United States)

    2012-02-29

    ... Conservation Service [Docket No. NRCS-2011-0026] Changes in Hydric Soils Database Selection Criteria AGENCY... Changes to the National Soil Information System (NASIS) Database Selection Criteria for Hydric Soils of the United States. SUMMARY: The National Technical Committee for Hydric Soils (NTCHS) has updated the...

  8. Alternative microbial methods: An overview and selection criteria.

    Science.gov (United States)

    Jasson, Vicky; Jacxsens, Liesbeth; Luning, Pieternel; Rajkovic, Andreja; Uyttendaele, Mieke

    2010-09-01

    This study provides an overview and criteria for the selection of a method, other than the reference method, for microbial analysis of foods. In a first part an overview of the general characteristics of rapid methods available, both for enumeration and detection, is given with reference to relevant bibliography. Perspectives on future development and the potential of the rapid method for routine application in food diagnostics are discussed. As various alternative "rapid" methods in different formats are available on the market, it can be very difficult for a food business operator or for a control authority to select the most appropriate method which fits its purpose. Validation of a method by a third party, according to international accepted protocol based upon ISO 16140, may increase the confidence in the performance of a method. A list of at the moment validated methods for enumeration of both utility indicators (aerobic plate count) and hygiene indicators (Enterobacteriaceae, Escherichia coli, coagulase positive Staphylococcus) as well as for detection of the four major pathogens (Salmonella spp., Listeria monocytogenes, E. coli O157 and Campylobacter spp.) is included with reference to relevant websites to check for updates. In a second part of this study, selection criteria are introduced to underpin the choice of the appropriate method(s) for a defined application. The selection criteria link the definition of the context in which the user of the method functions - and thus the prospective use of the microbial test results - with the technical information on the method and its operational requirements and sustainability. The selection criteria can help the end user of the method to obtain a systematic insight into all relevant factors to be taken into account for selection of a method for microbial analysis. Copyright 2010 Elsevier Ltd. All rights reserved.

  9. 49 CFR 268.17 - Project selection criteria.

    Science.gov (United States)

    2010-10-01

    ... criteria will govern FRA's selection of projects to receive funding under the Maglev Deployment Program. (a... are to be expected in the United States. (4) The degree to which the project will augment a Maglev... development status of the Maglev technology selected by the applicant for the project. (c) Benefits for the...

  10. Geomembrane selection criteria for uranium tailings ponds

    International Nuclear Information System (INIS)

    Mitchell, D.H.; Cuello, R.

    1986-09-01

    The selection criteria, particularly those involving chemical compatibility, of geomembranes to be used in ponds at uranium mill operations are discussed. The principal functional criteria which a geomembrane must meet for this application are: (1) a specified service life and (2) low permeability. Chemical compatibility with the waste is essential in meeting these functional criteria. In two different types of aging tests using simulated acidic uranium mill waste, degradation of chemical and physical properties were examined in geomembranes of high-density polyethylene, polyvinyl chloride, and chlorosulfonated polyethylene. Compatibility tests according to the National Sanitation Foundation procedures are recommended to ascertain the stability of certain physical properties of the proposed geomembrane. Actual experience with a specific geomembrane in an identical application is probably the best method to assure compatibility; however, this experience is frequently not available. Experience with a geomembrane in similar applications is valuable in the selection process, however, small differences in either the geomembrane formulation or the waste composition may result in large differences in performance of the geomembrane. It is likely that many geomembranes have acceptable chemical stability for typical uranium mill applications, therefore, additional factors in the selection processes will include seaming characteristics, mechanical properties, site characteristics, and costs

  11. 28 CFR 34.3 - Selection criteria.

    Science.gov (United States)

    2010-07-01

    ... achievement of project objectives; (4) The project management structure is adequate to the successful conduct of the project; (5) Organizational capability is demonstrated at a level sufficient to successfully....3 Selection criteria. (a) All individual project applications will, at a minimum, be subject to...

  12. Which family physician should I choose? The analytic hierarchy process approach for ranking of criteria in the selection of a family physician.

    Science.gov (United States)

    Kuruoglu, Emel; Guldal, Dilek; Mevsim, Vildan; Gunvar, Tolga

    2015-08-05

    Choosing the most appropriate family physician (FP) for the individual, plays a fundamental role in primary care. The aim of this study is to determine the selection criteria for the patients in choosing their family doctors and priority ranking of these criteria by using the multi-criteria decision-making method of the Analytic Hierarchy Process (AHP) model. The study was planned and conducted in two phases. In the first phase, factors affecting the patients' decisions were revealed with a qualitative research. In the next phase, the priorities of FP selection criteria were determined by using AHP model. Criteria were compared in pairs. 96 patient were asked to fill the information forms which contains comparison scores in the Family Health Centres. According to the analysis of focus group discussions FP selection criteria were congregated in to five groups: Individual Characteristics, Patient-Doctor relationship, Professional characteristics, the Setting, and Ethical Characteristics. For each of the 96 participants, comparison matrixes were formed based on the scores of their information forms. Of these, models of only 5 (5.2 %) of the participants were consistent, in other words, they have been able to score consistent ranking. The consistency ratios (CR) were found to be smaller than 0.10. Therefore the comparison matrix of this new model, which was formed based on the medians of scores only given by these 5 participants, was consistent (CR = 0.06 < 0.10). According to comparison results; with a 0.467 value-weight, the most important criterion for choosing a family physician is his/her 'Professional characteristics'. Selection criteria for choosing a FP were put in a priority order by using AHP model. These criteria can be used as measures for selecting alternative FPs in further researches.

  13. The Ideal Criteria of Supplier Selection for SMEs Food Processing Industry

    Directory of Open Access Journals (Sweden)

    Ramlan Rohaizan

    2016-01-01

    Full Text Available Selection of good supplier is important to determine the performance and profitability of SMEs food processing industry. The lack of managerial capability on supplier selection in SMEs food processing industry affects the competitiveness of SMEs food processing industry. This research aims to determine the ideal criteria of supplier for food processing industry using Analytical Hierarchy Process (AHP. The research was carried out in a quantitative method by distributing questionnaires to 50 SMEs food processing industries. The collected data analysed using Expert Choice software to rank the supplier selection criteria. The result shows that criteria for supplier selection are ranked by cost, quality, service, delivery and management and organisation while purchase cost, audit result, defect analysis, transportation cost and fast responsiveness are the first five sub-criteria. The result of this research intends to improve managerial capabilities of SMEs food processing industry in supplier selection.

  14. 48 CFR 536.602-1 - Selection criteria.

    Science.gov (United States)

    2010-10-01

    ... area of the project and knowledge of locality of the project” as one of several selection criteria. (1... services (based on the total contract price) will be accomplished within the geographical boundaries...

  15. Criteria for the selection of ERP software

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available The implementation of an ERP software package is an important investment for an organization, which is characterized also by a high degree of risk. Selecting the most appropriate software is a necessary condition for a successful implementation. This paper is describing the major aspects of software selection in general and the relevant criteria in the case of ERP software.

  16. The Criteria for the Selection of Wells for Hydraulic Fracturing

    Directory of Open Access Journals (Sweden)

    O.V. Salimov

    2017-12-01

    Full Text Available Various methods of selection of wells for hydraulic fracturing are analyzed. It is established that all methods can be divided into three large groups: criteria in the table form of boundary values of parameters, statistical methods of pattern recognition, methods of engineering calculation. The complication or use of additional parameters only leads to a reduction in the number of wells at which hydraulic fracturing is possible. It is shown that the use of reservoir properties of rocks, which are already used by hydraulic fracturing simulators, is not practicable as selection criteria. It is required to include in the selection criteria only those additional factors on which the effectiveness of hydraulic fracturing depends directly.

  17. Considering Interactions among Multiple Criteria for the Server Selection

    Directory of Open Access Journals (Sweden)

    Vesna Čančer

    2010-06-01

    Full Text Available Decision-making about server selection is one of the multi-criteria decision-making (MCDM processes where interactions among criteria should be considered. The paper introduces and develops some solutions for considering interactions among criteria in the MCDM problems. In the frame procedure for MCDM by using the group of methods, based on assigning weights, special attention is given to the synthesis of the local alternatives’ values into the aggregate values where the mutual preferential independence between two criteria is not assumed. Firstly, we delineate how to complete the additive model into the multiplicative one with synergic and redundancy elements in the case that criteria are structured in one level and in two levels. Furthermore, we adapted the concept of the fuzzy Choquet integral to the multi-attribute value theory. Studying and comparing the results of the example case of the server selection obtained by both aggregation approaches, the paper highlights the advantages of the first one since it does not require from decision makers to determine the weights of all possible combinations of the criteria and it enables the further use of the most preferred MCDM methods.

  18. Analysis of Criteria Influencing Contractor Selection Using TOPSIS Method

    Science.gov (United States)

    Alptekin, Orkun; Alptekin, Nesrin

    2017-10-01

    Selection of the most suitable contractor is an important process in public construction projects. This process is a major decision which may influence the progress and success of a construction project. Improper selection of contractors may lead to problems such as bad quality of work and delay in project duration. Especially in the construction projects of public buildings, the proper choice of contractor is beneficial to the public institution. Public procurement processes have different characteristics in respect to dissimilarities in political, social and economic features of every country. In Turkey, Turkish Public Procurement Law PPL 4734 is the main regulatory law for the procurement of the public buildings. According to the PPL 4734, public construction administrators have to contract with the lowest bidder who has the minimum requirements according to the criteria in prequalification process. Public administrators are not sufficient for selection of the proper contractor because of the restrictive provisions of the PPL 4734. The lowest bid method does not enable public construction administrators to select the most qualified contractor and they have realised the fact that the selection of a contractor based on lowest bid alone is inadequate and may lead to the failure of the project in terms of time delay Eand poor quality standards. In order to evaluate the overall efficiency of a project, it is necessary to identify selection criteria. This study aims to focus on identify importance of other criteria besides lowest bid criterion in contractor selection process of PPL 4734. In this study, a survey was conducted to staff of Department of Construction Works of Eskisehir Osmangazi University. According to TOPSIS (Technique for Order Preference by Similarity to the Ideal Solution) for analysis results, termination of construction work in previous tenders is the most important criterion of 12 determined criteria. The lowest bid criterion is ranked in rank 5.

  19. Selection Criteria in Regime Switching Conditional Volatility Models

    Directory of Open Access Journals (Sweden)

    Thomas Chuffart

    2015-05-01

    Full Text Available A large number of nonlinear conditional heteroskedastic models have been proposed in the literature. Model selection is crucial to any statistical data analysis. In this article, we investigate whether the most commonly used selection criteria lead to choice of the right specification in a regime switching framework. We focus on two types of models: the Logistic Smooth Transition GARCH and the Markov-Switching GARCH models. Simulation experiments reveal that information criteria and loss functions can lead to misspecification ; BIC sometimes indicates the wrong regime switching framework. Depending on the Data Generating Process used in the experiments, great care is needed when choosing a criterion.

  20. 34 CFR 607.21 - What are the selection criteria for planning grants?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What are the selection criteria for planning grants... the Secretary Make an Award? § 607.21 What are the selection criteria for planning grants? The Secretary evaluates an application for a planning grant on the basis of the criteria in this section. (a...

  1. 34 CFR 606.21 - What are the selection criteria for planning grants?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What are the selection criteria for planning grants... PROGRAM How Does the Secretary Make an Award? § 606.21 What are the selection criteria for planning grants? The Secretary evaluates an application for a planning grant on the basis of the criteria in this...

  2. An analysis of project selection and assignment criteria of Danish tenders in Europe

    Directory of Open Access Journals (Sweden)

    Jasper Kranker Larsen

    2013-12-01

    Full Text Available Public construction agencies are one of the largest developers within the Danish construction industry, where such agencies own and develop new public construction projects. Most of these projects are put out in European tender. This study analyses the selection and assignment criteria employed by these agencies in different types of public sector projects. Some of the objectives pursued by the study include the determination of 1/ the selection and assignment criteria mostly used in Danish public tenders 2/ how different types of projects use selection and assignment criteria in the bidding process, and 3/ any significant difference between the use of selection and assignment criteria in Danish public construction projects. The study uses a quantitative research approach where 157 Danish public tender cases were selected from the European Tenders Electronic Daily database between the period: January 2010 to March 2013. Fisher's Exact Test was conducted to determine if there was any significant use of some selection and assignment criteria. The findings of the study showed that invited tenders with pre-qualification and lowest price in 69.8% of the tenders are the most used selection and assignment criteria, with little regard to project type.

  3. The Important Selection Criteria in Choosing Islamic Banks: A Survey in Bahrain

    Directory of Open Access Journals (Sweden)

    Abdullah Hamzah Al-Hadrami

    2017-05-01

    Full Text Available Selection criteria of banks in general and Islamic banks in particular have been given high attention by the marketing researchers nowadays. But this kind of research is still insufficient in numbers especially in the developing countries. Therefore, this study aims to identify the important selection criteria that are considered by customers in selecting Islamic banks in the Kingdom of Bahrain. A 5-Likert scale survey questionnaire and ANOVA were used as the research method. The results indicate that the religious factors were ranked as the most important selection criteria for selecting Islamic banks. The study also found service quality factors as the second important selection criteria. This study is expected to provide Islamic banks in Bahrain with some inputs in setting up their marketing strategies in order to attract new customers and retain their existing customers. This study is also expected to add value to the literature by providing the updated empirical study in the area. DOI: 10.15408/aiq9i2.4635

  4. SUPPLIER SELECTION CRITERIA IN A POWER UTILITY IN MALAYSIA: ENGINEERS’ PERCEPTIONS

    Directory of Open Access Journals (Sweden)

    Sivadass Thiruchelvam

    2012-06-01

    Full Text Available Supplier selection of electricity generating, transmitting and distributing systems is part of the problem-solving environment in a power utility because it is a long-term investment for the organisation. Therefore, the decision over supplier selection directly influences the operational and financial position of a power utility. In addition, the supplier selection of a power-related system is a complex multi-criteria decision problem. While some criteria may be common across different industries, there are some criteria unique to the power industry. This research aims to understand what constitutes the suitable supplier selection criteria for a power utility. This study reveals some interesting findings of how engineers perceive the importance of each criterion and suggests strongly that product quality, price and delivery are key determinants in the supplier evaluation process. The eighteen criteria considered for this study were mapped onto their respective cluster, namely: supplier’s organisational system and technology, buyer-supplier relationship and economic value. The findings of this study should assist various groups of stakeholders (e.g., suppliers, buyers and end users to gain a better understanding of social behaviour in making purchase decisions, particularly with regard to power utilities.

  5. Selection criteria for a radiography programme in South Africa ...

    African Journals Online (AJOL)

    Background: Selection criteria used to admit students to a radiography programme at the Central University of Technology (CUT) included academic criteria, as well as the General Scholastic Aptitude Test (GSAT) and Self-directed Search (SDS) Questionnaire. Aims and objectives: The aim of the study was to identify which ...

  6. The selection criteria for Slovenian bibliography: with special emphasis on the articles

    Directory of Open Access Journals (Sweden)

    Marjeta Šušteričič

    2010-01-01

    Full Text Available Selection principles are an important stage in the creation of a national bibliography.The article outlines the selection of the national output to be included in Slovenian bibliography. It also presents theoretical basis for selection in general, with the emphasis on international guidelines and on the development of national principles and professional outlines. Statistical data and examples give more detailed analysis of selection criteria of articles regarding different types of serial publications. Results of the study show that selection criteria for Slovenian bibliography are to be constantly verified due to the dynamics of the national publishing industry. Nevertheless, the main features of selection criteria remain unchanged: lasting value of subject matter with the emphasis on scientific research and expert knowledge.

  7. 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

  8. Selection of Forklift Unit for Warehouse Operation by Applying Multi-Criteria Analysis

    Directory of Open Access Journals (Sweden)

    Predrag Atanasković

    2013-07-01

    Full Text Available This paper presents research related to the choice of the criteria that can be used to perform an optimal selection of the forklift unit for warehouse operation. The analysis has been done with the aim of exploring the requirements and defining relevant criteria that are important when investment decision is made for forklift procurement, and based on the conducted research by applying multi-criteria analysis, to determine the appropriate parameters and their relative weights that form the input data and database for selection of the optimal handling unit. This paper presents an example of choosing the optimal forklift based on the selected criteria for the purpose of making the relevant investment decision.

  9. Selection criteria for water disinfection techniques in agricultural practices.

    Science.gov (United States)

    Haute, Sam van; Sampers, Imca; Jacxsens, Liesbeth; Uyttendaele, Mieke

    2015-01-01

    This paper comprises a selection tool for water disinfection methods for fresh produce pre- and postharvest practices. A variety of water disinfection technologies is available on the market and no single technology is the best choice for all applications. It can be difficult for end users to choose the technology that is best fit for a specific application. Therefore, the different technologies were characterized in order to identify criteria that influence the suitability of a technology for pre- or postharvest applications. Introduced criteria were divided into three principal components: (i) criteria related to the technology and which relate to the disinfection efficiency, (ii) attention points for the management and proper operation, and (iii) necessities in order to sustain the operation with respect to the environment. The selection criteria may help the end user of the water disinfection technology to obtain a systematic insight into all relevant aspects to be considered for preliminary decision making on which technologies should be put to feasibility testing for water disinfection in pre- and postharvest practices of the fresh produce chain.

  10. Criteria for selecting implementation science theories and frameworks: results from an international survey

    Directory of Open Access Journals (Sweden)

    Sarah A. Birken

    2017-10-01

    Full Text Available Abstract Background Theories provide a synthesizing architecture for implementation science. The underuse, superficial use, and misuse of theories pose a substantial scientific challenge for implementation science and may relate to challenges in selecting from the many theories in the field. Implementation scientists may benefit from guidance for selecting a theory for a specific study or project. Understanding how implementation scientists select theories will help inform efforts to develop such guidance. Our objective was to identify which theories implementation scientists use, how they use theories, and the criteria used to select theories. Methods We identified initial lists of uses and criteria for selecting implementation theories based on seminal articles and an iterative consensus process. We incorporated these lists into a self-administered survey for completion by self-identified implementation scientists. We recruited potential respondents at the 8th Annual Conference on the Science of Dissemination and Implementation in Health and via several international email lists. We used frequencies and percentages to report results. Results Two hundred twenty-three implementation scientists from 12 countries responded to the survey. They reported using more than 100 different theories spanning several disciplines. Respondents reported using theories primarily to identify implementation determinants, inform data collection, enhance conceptual clarity, and guide implementation planning. Of the 19 criteria presented in the survey, the criteria used by the most respondents to select theory included analytic level (58%, logical consistency/plausibility (56%, empirical support (53%, and description of a change process (54%. The criteria used by the fewest respondents included fecundity (10%, uniqueness (12%, and falsifiability (15%. Conclusions Implementation scientists use a large number of criteria to select theories, but there is little

  11. Criteria for selecting implementation science theories and frameworks: results from an international survey.

    Science.gov (United States)

    Birken, Sarah A; Powell, Byron J; Shea, Christopher M; Haines, Emily R; Alexis Kirk, M; Leeman, Jennifer; Rohweder, Catherine; Damschroder, Laura; Presseau, Justin

    2017-10-30

    Theories provide a synthesizing architecture for implementation science. The underuse, superficial use, and misuse of theories pose a substantial scientific challenge for implementation science and may relate to challenges in selecting from the many theories in the field. Implementation scientists may benefit from guidance for selecting a theory for a specific study or project. Understanding how implementation scientists select theories will help inform efforts to develop such guidance. Our objective was to identify which theories implementation scientists use, how they use theories, and the criteria used to select theories. We identified initial lists of uses and criteria for selecting implementation theories based on seminal articles and an iterative consensus process. We incorporated these lists into a self-administered survey for completion by self-identified implementation scientists. We recruited potential respondents at the 8th Annual Conference on the Science of Dissemination and Implementation in Health and via several international email lists. We used frequencies and percentages to report results. Two hundred twenty-three implementation scientists from 12 countries responded to the survey. They reported using more than 100 different theories spanning several disciplines. Respondents reported using theories primarily to identify implementation determinants, inform data collection, enhance conceptual clarity, and guide implementation planning. Of the 19 criteria presented in the survey, the criteria used by the most respondents to select theory included analytic level (58%), logical consistency/plausibility (56%), empirical support (53%), and description of a change process (54%). The criteria used by the fewest respondents included fecundity (10%), uniqueness (12%), and falsifiability (15%). Implementation scientists use a large number of criteria to select theories, but there is little consensus on which are most important. Our results suggest that the

  12. Selection criteria of residents for residency programs in Kuwait.

    Science.gov (United States)

    Marwan, Yousef; Ayed, Adel

    2013-01-19

    In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

  13. Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement.

    Science.gov (United States)

    Tavakoli, Reza; Leprince, Pascal; Gassmann, Max; Jamshidi, Peiman; Yamani, Nassrin; Amour, Julien; Lebreton, Guillaume

    2018-03-26

    Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The incidence of the pathology increases with growing age after 65 years. Conventional surgical aortic valve replacement through median sternotomy has been the gold standard of patient care for symptomatic aortic valve stenosis. However, as the risk profile of patients worsens, other therapeutic strategies have been introduced in an attempt to maintain the excellent results obtained by the established surgical treatment. One of these approaches is represented by transcatheter aortic valve implantation. Although the outcomes of high-risk patients undergoing treatment for symptomatic aortic valve stenosis have improved with transcatheter aortic valve replacement, many patients with this condition remain candidates for surgical aortic valve replacement. In order to reduce the surgical trauma in patients who are candidates for surgical aortic valve replacement, minimally invasive approaches have garnered interest during the past decade. Since the introduction of right anterior thoracotomy for aortic valve replacement in 1993, right anterior mini-thoracotomy and upper hemi-sternotomy have become the predominant incisional approaches among cardiac surgeons performing minimal access aortic valve replacement. Beside the location of the incision, the arterial cannulation site represents the second major landmark of minimal access techniques for aortic valve replacement. The two most frequently used arterial cannulation sites include central aortic and peripheral femoral approaches. With the purpose of reducing surgical trauma in these patients, we have opted for a right anterior mini-thoracotomy approach with a central aortic cannulation site. This protocol describes in detail a technique for minimally invasive aortic valve replacement and provides recommendations for patient selection criteria, including cardiac computer

  14. Description of double-shell tank selection criteria for inspection

    International Nuclear Information System (INIS)

    Schwenk, E.B.; Scott, K.V.

    1996-01-01

    Technical criteria for selecting double-shelf tanks's (DST's) for inspection are presented. Inspection of DST's is planned to non-destructively determine the general condition of their inner wall and bottom knuckle. Inspection of representative tanks will provide a basis for evaluating the integrity of all the DST's and provide a basis for estimating remaining life. The selection criteria recommended are tank age based on date-of-first fluid entry, waste temperature, corrosion inhibitor levels, deviations from normal behavior - involving sludge levels, hydrogen release and waste transfers - least waste depth fluctuation, tank steel type, other chemical species that could activate stress-corrosion cracking, and waste types

  15. Quality criteria for phase change materials selection

    International Nuclear Information System (INIS)

    Vitorino, Nuno; Abrantes, João C.C.; Frade, Jorge R.

    2016-01-01

    Highlights: • Selection criteria of phase change materials for representative applications. • Selection criteria based on reliable solutions for latent heat transfer. • Guidelines for the role of geometry and heat transfer mechanisms. • Performance maps based on PCM properties, operating conditions, size and time scales. - Abstract: Selection guidelines are primary criterion for optimization of materials for specific applications in order to meet simultaneous and often conflicting requirements. This is mostly true for technologies and products required to meet the main societal needs, such as energy. In this case, gaps between supply and demand require strategies for energy conversion and storage, including thermal storage mostly based on phase change materials. Latent heat storage is also very versatile for thermal management and thermal control by allowing high storage density within narrow temperature ranges without strict dependence between stored thermal energy and temperature. Thus, this work addressed the main issues of latent heat storage from a materials selection perspective, based on expected requirements of applications in thermal energy storage or thermal regulation. Representative solutions for the kinetics of latent heat charge/discharge were used to derive optimization guidelines for high energy density, high power, response time (from fast response to thermal inertia), etc. The corresponding property relations were presented in graphical forms for a wide variety of prospective phase change materials, and for wide ranges of operating conditions, and accounting for changes in geometry and mechanisms.

  16. 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...

  17. Multi-Criteria Knapsack Problem for Disease Selection in an Observation Ward

    International Nuclear Information System (INIS)

    Lurkittikul, N; Kittithreerapronchai, O

    2014-01-01

    The aging population and the introduction of Thailand universal healthcare have increased inpatients and outpatients to public hospitals, particularly to a hospital that provides special and comprehensive health services. Many inpatient wards have experienced large influx of inpatients as the hospitals have to admit all patients regardless their conditions. These overcrowding wards cause stress to medical staffs, block access between medical departments, hospital-acquired infections, and ineffective uses of resources. One way to manage such inundated inpatient is to select some patients whose conditions require less clinical attention or whose lengths of stay are predictable and short and, then, place them at an observation ward. This intermediate ward increases turnover of beds and reduces unnecessary paperwork as patients are considered to be outpatients. In this article, we studied inpatient data of a tertiary care hospital in which an observation ward was considered to alleviate the overcrowding problem at Internal Medicine Department. The analysis of data showed that the hospital can balance inpatient flow by managing a group of patients who is admitted because of treatments ordered by its special clinics. Having explored several alternatives, we suggested patient selection criteria and proposed a layout at an observation ward. The hospital should increase medical beds in a new building ward because the current observation ward can handle 27.3% of total short stay patients, while the observation ward is projected to handle 80% of total short stay patients

  18. Multi-Criteria Knapsack Problem for Disease Selection in an Observation Ward

    Science.gov (United States)

    Lurkittikul, N.; Kittithreerapronchai, O.

    2014-06-01

    The aging population and the introduction of Thailand universal healthcare have increased inpatients and outpatients to public hospitals, particularly to a hospital that provides special and comprehensive health services. Many inpatient wards have experienced large influx of inpatients as the hospitals have to admit all patients regardless their conditions. These overcrowding wards cause stress to medical staffs, block access between medical departments, hospital-acquired infections, and ineffective uses of resources. One way to manage such inundated inpatient is to select some patients whose conditions require less clinical attention or whose lengths of stay are predictable and short and, then, place them at an observation ward. This intermediate ward increases turnover of beds and reduces unnecessary paperwork as patients are considered to be outpatients. In this article, we studied inpatient data of a tertiary care hospital in which an observation ward was considered to alleviate the overcrowding problem at Internal Medicine Department. The analysis of data showed that the hospital can balance inpatient flow by managing a group of patients who is admitted because of treatments ordered by its special clinics. Having explored several alternatives, we suggested patient selection criteria and proposed a layout at an observation ward. The hospital should increase medical beds in a new building ward because the current observation ward can handle 27.3% of total short stay patients, while the observation ward is projected to handle 80% of total short stay patients.

  19. 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

  20. MULTIPLE CRITERIA DECISION MAKING APPROACH FOR INDUSTRIAL ENGINEER SELECTION USING FUZZY AHP-FUZZY TOPSIS

    OpenAIRE

    Deliktaş, Derya; ÜSTÜN, Özden

    2018-01-01

    In this study, a fuzzy multiple criteria decision-making approach is proposed to select an industrial engineer among ten candidates in a manufacturing environment. The industrial engineer selection problem is a special case of the personal selection problem. This problem, which has hierarchical structure of criteria and many decision makers, contains many criteria. The evaluation process of decision makers also includes ambiguous parameters. The fuzzy AHP is used to determin...

  1. Preliminary selection criteria for the Yucca Mountain Project waste package container material

    International Nuclear Information System (INIS)

    Halsey, W.G.

    1991-01-01

    The Department of Energy's Yucca Mountain Project (YMP) is evaluating a site at Yucca Mountain in Nevada for construction of a geologic repository for the storage of high-level nuclear waste. Lawrence Livermore National Laboratory's (LLNL) Nuclear Waste Management Project (NWMP) has the responsibility for design, testing, and performance analysis of the waste packages. The design is performed in an iterative manner in three sequential phases (conceptual design, advanced conceptual design, and license application design). An important input to the start of the advanced conceptual design is the selection of the material for the waste containers. The container material is referred to as the 'metal barrier' portion of the waste package, and is the responsibility of the Metal Barrier Selection and Testing task at LLNL. The selection will consist of several steps. First, preliminary, material-independent selection criteria will be established based on the performance goals for the container. Second, a variety of engineering materials will be evaluated against these criteria in a screening process to identify candidate materials. Third, information will be obtained on the performance of the candidate materials, and final selection criteria and quantitative weighting factors will be established based on the waste package design requirements. Finally, the candidate materials will be ranked against these criteria to determine whether they meet the mandated performance requirements, and to provide a comparative score to choose the material for advanced conceptual design activities. This document sets forth the preliminary container material selection criteria to be used in screening candidate materials. 5 refs

  2. Danish Public Construction Counselling Selection and Assignment Criteria in European Tendering

    DEFF Research Database (Denmark)

    Larsen, Jesper Kranker; Ussing, Lene Faber; Brunø, Thomas Ditlev

    2014-01-01

    One of the largest customers in the Danish construction industry is public agencies that own and develop projects. For some of the counselling services, they recur to be put out in European tendering. The aim is to find which selection and assignment criteria are used most in public tendering. How...... projects use selection and assignment criteria for counselling services and finally if there is significant use of selection and assignment methods in public counselling. The method is based on 74 public counselling tenders from the European Tenders Electronic Daily database from January 2010 to March 2013...

  3. 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

  4. Engineering study of generic site criteria for selected DOE plutonium facilities

    International Nuclear Information System (INIS)

    Kingsbury, R.J.; Greenwood, J.M.; Sandoval, M.D.

    1980-09-01

    The objectives of this study were to identify criteria that would be applied to selection of a site for plutonium facilities such as those at the Rocky Flats Plant, to establish the relative importance of these criteria, and to identify suitable areas within the United States for location of plutonium facilities with respect to these criteria. Sources of the site criteria identified include federal laws, federal agency regulations, state laws and regulations, and requirements associated with operations to be performed at the site. The criteria identified during the study were organized into 14 major categories. The relative importnace of each category and each criterion within the categories were established using group decision-making techniques. The major criteria categories, their assigned weight on a scale of 1 to 10, and their relative priority ranks are as follows: geology/seismicity; public safety; environmental impact; meteorology; hydrology; topography; transportation; utilities; personnel; safeguards/security; land area and availability; land use compatibility; and, public acceptance. A suitability analysis of the continental United States was performed using only those criteria that could be mapped at a national scale. Suitability was assessed with respect to each of these criteria, and individual suitability maps were prepared. A composite suitability map was generated using computerized overlay techniques. This map provides a starting point for identifying specific candidate sites if an actual site selection were to be conducted

  5. Criteria for the selection of PEC primary circuit structural material

    International Nuclear Information System (INIS)

    Antoni, R.; Brunori, G.; Maesa, S.; Scibona, G.; Tomassetti, G.

    1977-01-01

    The choice of the structural materials is generally a compromise between the project requirements, the characteristics (mechanical and environmental) of the materials and the available technology to construct the various parts of the components. The criteria of selection of structural materials for the primary circuit of fast reactor are reported. The criteria concern both general and utilization aspects

  6. Criteria for selection and application of molecular markers for clinical studies of osteoarthritis.

    Science.gov (United States)

    Otterness, I G; Swindell, A C

    2003-03-01

    To develop criteria for the selection and application of molecular markers for the study of osteoarthritis (OA). Statistical criteria for marker selection for OA are developed. After studying more than 20 different molecular markers for monitoring OA, procedures for choosing markers for clinical studies have been developed. For a particular study, the process starts with the markers showing 'face-validity' for monitoring OA. They are next required to successfully distinguish OA patients from controls. This necessitates definition of the distribution of marker values in OA patients and controls. So far, they have been consistently log-normal. The difference (Delta) in marker values between OA and controls defines the opportunity for marker improvement. The between-visit standard deviation (S) in patients puts limits on the detection of marker changes. The two variables can be combined to estimate the practicality of a marker using a modified power analysis. The number of patients (N*) required to observe a 50% improvement with an alpha level of P=0.05 and with 80% certainty is estimated as 50(S/Delta)(2). N*, S and Delta should be used to characterize and compare markers. Marker efficiency can be refined by regressing on secondary variables, such as age, sex, BMI, severity, etc. Finally, the use of two or more markers may be required to improve marker prediction of clinical outcome. Correlated markers can be used to reinforce conclusions by essentially adding replicative data. Independent, complementary markers can be used to develop associations with clinical parameters, and perhaps diagnose and monitor disease status, activities that so far have not been possible with single markers.

  7. Evaluation of selection criteria for graduate students in radiation therapy.

    Science.gov (United States)

    Schneider-Kolsky, Michal; Wright, Caroline; Baird, Marilyn

    2006-12-01

    Selection of suitable students into graduate medical and specialist health professional courses can be difficult. Historically, selection of students was primarily based on prior academic performance. Recently, however, more emphasis has been placed on considering broader academic backgrounds and personal characteristics and attitudes of students, but no reliable measurement tool is available to predict student success and satisfaction with their choice of profession. The aim of this study was to survey practising radiation therapists in Australia to seek their opinions regarding suitable selection criteria for graduate entry radiation therapy (RT) students in order to optimize selection procedures for future applicants. Four hundred questionnaires were sent to nine RT centres in three states within Australia. All nine clinics participated in the survey and 189 questionnaires were returned. Results show that the majority of radiation therapists place a high level of importance upon a sound knowledge of physics and mathematics, as well as life experience, and agree that a visit to an RT clinic plus an interview comprise important components of the selection process. Humanities, psychology and a psychometric test were not viewed as essential entry requirements. Experienced radiation therapists placed less value on academic performance in the primary degree and were more likely to include an interview as a selection criterion than junior practitioners. Empathy for patients was identified as the most important personal attribute. It is thus recommended that not only cognitive but also personal skills be evaluated during the selection of prospective radiation therapists.

  8. Lean Information Management: Criteria For Selecting Key Performance Indicators At Shop Floor

    Science.gov (United States)

    Iuga, Maria Virginia; Kifor, Claudiu Vasile; Rosca, Liviu-Ion

    2015-07-01

    Most successful organizations worldwide use key performance indicators as an important part of their corporate strategy in order to forecast, measure and plan their businesses. Performance metrics vary in their purpose, definition and content. Therefore, the way organizations select what they think are the optimal indicators for their businesses varies from company to company, sometimes even from department to department. This study aims to answer the question of what is the most suitable way to define and select key performance indicators. More than that, it identifies the right criteria to select key performance indicators at shop floor level. This paper contributes to prior research by analysing and comparing previously researched selection criteria and proposes an original six-criteria-model, which caters towards choosing the most adequate KPIs. Furthermore, the authors take the research a step further by further steps to closed research gaps within this field of study.

  9. Eye bank procedures: donor selection criteria.

    Science.gov (United States)

    Sousa, Sidney Júlio de Faria E; Sousa, Stella Barretto de Faria E

    2018-01-01

    Eye banks use sterile procedures to manipulate the eye, antiseptic measures for ocular surface decontamination, and rigorous criteria for donor selection to minimize the possibility of disease transmission due to corneal grafting. Donor selection focuses on analysis of medical records and specific post-mortem serological tests. To guide and standardize procedures, eye bank associations and government agencies provide lists of absolute and relative contraindications for use of the tissue based on donor health history. These lists are guardians of the Hippocratic principle "primum non nocere." However, each transplantation carries risk of transmission of potentially harmful agents to the recipient. The aim of the procedures is not to eliminate risk, but limit it to a reasonable level. The balance between safety and corneal availability needs to be maintained by exercising prudence without disproportionate rigor.

  10. Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

    Science.gov (United States)

    Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

    2016-04-01

    More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

  11. Alternative microbial methods: An overview and selection criteria.

    NARCIS (Netherlands)

    Jasson, V.; Jacxsens, L.; Luning, P.A.; Rajkovic, A.; Uyttendaele, M.

    2010-01-01

    This study provides an overview and criteria for the selection of a method, other than the reference method, for microbial analysis of foods. In a first part an overview of the general characteristics of rapid methods available, both for enumeration and detection, is given with reference to relevant

  12. Dual Kidney Transplantation: Evaluation of Recipient Selection Criteria at Niguarda Hospital.

    Science.gov (United States)

    Mariani, A; Ferla, F; De Carlis, R; Rossetti, O; Covucci, E; Tripepi, M; Concone, G; Lauterio, A; Mangoni, I; De Carlis, L

    2016-03-01

    Dual kidney transplantation (DKT) is a largely accepted strategy to enlarge the donor pool. Niguarda Hospital started this program in December 2010, and 38 DKT have been performed. In our series, we included recipients older than those in the other series published in literature. The aim of this study was to know if our recipient selection criteria for DKT are safe. We reviewed our data base of DKT and analyzed recipients' medical history, surgical technique, post-operative complications, graft survival, morbidity, and mortality. We then compared our results with the literature. From December 2010 to April 2015, 38 DKT were performed in Niguarda Hospital. Delayed graft function was present in 21 recipients. Explantation of both kidneys was performed in 1 patient and explantation of 1 kidney in 6 patients. Post-operative complications were present in 8 patients. Five patients returned to hemodialysis after DKT. One recipient died of medical post-operative sepsis. The mean follow-up was 24 months. Graft survival and patient survival were 86.84% and 97.93%, respectively. Compared with the literature, our series had similar mortality and morbidity rates, even if recipients' age was higher than in other series. The strategy of DKT allocation in elderly recipients is safe. Further studies have to be performed to optimized selection of the recipients for DKT not to disadvantage younger patients in the transplant waiting list and to improve the technique of organ evaluation and preservation to refine graft allocation. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Comparison of Optimal Portfolios Selected by Multicriterial Model Using Absolute and Relative Criteria Values

    Directory of Open Access Journals (Sweden)

    Branka Marasović

    2009-03-01

    Full Text Available In this paper we select an optimal portfolio on the Croatian capital market by using the multicriterial programming. In accordance with the modern portfolio theory maximisation of returns at minimal risk should be the investment goal of any successful investor. However, contrary to the expectations of the modern portfolio theory, the tests carried out on a number of financial markets reveal the existence of other indicators important in portfolio selection. Considering the importance of variables other than return and risk, selection of the optimal portfolio becomes a multicriterial problem which should be solved by using the appropriate techniques.In order to select an optimal portfolio, absolute values of criteria, like return, risk, price to earning value ratio (P/E, price to book value ratio (P/B and price to sale value ratio (P/S are included in our multicriterial model. However the problem might occur as the mean values of some criteria are significantly different for different sectors and because financial managers emphasize that comparison of the same criteria for different sectors could lead us to wrong conclusions. In the second part of the paper, relative values of previously stated criteria (in relation to mean value of sector are included in model for selecting optimal portfolio. Furthermore, the paper shows that if relative values of criteria are included in multicriterial model for selecting optimal portfolio, return in subsequent period is considerably higher than if absolute values of the same criteria were used.

  14. Site selection criteria for the shallow land burial of low-level radioactive waste

    International Nuclear Information System (INIS)

    Falconer, K.L.; Hull, L.C.; Mizell, S.A.

    The shallow land burial of low-level waste must be accomplished in a manner that ensures the public and biosphere are protected from harmful amounts of radiation. This can be attained by selecting, designing, operating and closing sites such that contaminants never leave the site boundary in levels above regulatory limits. Site design, operation and closure are all functions of the characteristics of the site selected. As a result, the site selection process offers the most effective means for optimizing safe, efficient and economical low-level waste burial practices. The purpose of this document is to set forth criteria for the selection of shallow land burial sites. Criteria are standard rules, by which the ability of a site to meet waste management goals can be judged. They are comprehensive, universal, and qualitative and are applicable in any geologic environment. Site selection criteria provide the framework for the siting process

  15. Ventilator-Associated Pneumonia in Trauma Patients: Different Criteria, Different Rates.

    Science.gov (United States)

    Leonard, Kenji L; Borst, Gregory M; Davies, Stephen W; Coogan, Michael; Waibel, Brett H; Poulin, Nathaniel R; Bard, Michael R; Goettler, Claudia E; Rinehart, Shane M; Toschlog, Eric A

    2016-06-01

    No consensus exists regarding the definition of ventilator-associated pneumonia (VAP). Even within a single institution, inconsistent diagnostic criteria result in conflicting rates of VAP. As a Level 1 trauma center participating in the Trauma Quality Improvement Project (TQIP) and the National Healthcare Safety Network (NHSN), our institution showed inconsistencies in VAP rates depending on which criteria was applied. The purpose of this study was to compare VAP definitions, defined by culture-based criteria, National Trauma Data Bank (NTDB) and NHSN, using incidence in trauma patients. A retrospective chart review of consecutive trauma patients who were diagnosed with VAP and met pre-determined inclusion and exclusion criteria admitted to our rural, 861-bed, Level 1 trauma and tertiary care center between January 2008 and December 2011 was performed. These patients were identified from the National Trauma Registry of the American College of Surgeons (NTRACS) database and an in-house infection control database. Ventilator-associated pneumonia diagnosis criteria defined by the U.S. Center for Disease Control and Prevention (used by the NHSN), the NTDB, and our institutional, culture-based criteria gold standard were compared among patients. Two hundred seventy-nine patients were diagnosed with VAP (25.4% met NHSN criteria, 88.2% met NTDB, and 76.3% met culture-based criteria). Only 58 (20.1%) patients met all three criteria. When NHSN criteria were compared with culture-based criteria, NHSN showed a high specificity (92.5%) and low sensitivity (28.2%). The positive predictive value (PPV) was 84.5%, but the negative predictive value (NPV) was 47.1%. The agreement between the NHSN and the culture-based criteria was poor (κ = 0.18). Conversely, the NTDB showed a lower specificity (57.8%), but greater sensitivity (86.4%) compared with culture-based criteria. The PPV and NPV were both 74% and the two criteria showed fair agreement (κ = 0.41). The lack of

  16. Comparison of imaging selection criteria for intra-arterial thrombectomy in acute ischemic stroke with advanced CT

    International Nuclear Information System (INIS)

    Kim, Eung Yeop; Goh, Byeong Ho; Shin, Dong Hoon; Noh, Young; Lee, Yeong-Bae

    2016-01-01

    To compare two selection criteria (noncontrast CT [NCCT] with multi-phase CT Angiography [MPCTA] and CT perfusion [CTP]) for the determination of eligibility for thrombectomy. We retrospectively enrolled 71 patients who underwent head NCCT, 9.6-cm CTP, and craniocervical single-phase CTA (SPCTA) within 6 hours of onset. The simulated MPCTA was reconstructed from 1-mm CTP images for assessment of collateral circulation. Infarct core (relative CBF < 30 %) and penumbra (Tmax > 6 seconds) volumes were measured. The infarct core < 70 mL with a mismatch ratio > 1.2 (CTP-A), infarct core ≤ 40 mL with a mismatch ratio > 1.8 (CTP-B), and ASPECTS > 5 with good collaterals (50 % ≥ MCA territory) were used to determine eligibility for thrombectomy. SPCTA was compared with the simulated MPCTA for assessment of collaterals. CTP-B determined that 11 patients were ineligible for thrombectomy, of which three were eligible by NCCT with MPCTA and 6 by CTP-A. CTP-A and CTP-B showed discrepancy in determining eligibility for thrombectomy between NCCT with MPCTA in three patients each, rendering no significant statistical difference (P > 0.05). The number of patients with poor collaterals was significantly higher on SPCTA than MPCTA (n = 22 and 6 respectively; P < 0.0001). The two imaging selection criteria (NCCT with MPCTA and CTP) were statistically comparable for determining eligibility for thrombectomy. (orig.)

  17. Myth 6: Cosmetic Use of Multiple Selection Criteria

    Science.gov (United States)

    Friedman-Nimz, Reva

    2009-01-01

    Twenty-five years ago, armed with the courage of her convictions and a respectable collection of empirical evidence, the author articulated what she considered to be a compelling argument against the cosmetic use of multiple selection criteria as a guiding principle for identifying children and youth with high potential. To assess the current…

  18. Criteria for Performing Cranial Computed Tomography for Chinese Patients With Mild Traumatic Brain Injury: Canadian Computed Tomography Head Rule or New Orleans Criteria?

    Science.gov (United States)

    Yang, Xiao-Feng; Meng, Yuan-Yuan; Wen, Liang; Wang, Hao

    2017-09-01

    Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China. Patients with mild TBI who underwent cranial CT within 24 hours of the trauma were included in our institute. Two neurosurgeons reviewed the CT images independently to identify positive CT findings. The sensitivity and specificity of CCHR and NOC for positive CT findings related to TBI were analyzed. Finally, this study included 625 patients. Positive CT findings related to TBI were discovered in 13.12% (82/625) of these patients on cranial CT, and 6.88% (43/625) of them were admitted to the hospital for further management. Ultimately, 11 patients (1.76%, 11/625) underwent neurosurgery. In this study, the sensitivities of both the CCHR and NOC were 100%, but the specificity of CCHR was 43.36% and that of NOC was 33.12%. Based on our study, both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.

  19. HOSPITAL SITE SELECTION USING TWO-STAGE FUZZY MULTI-CRITERIA DECISION MAKING PROCESS

    Directory of Open Access Journals (Sweden)

    Ali Soltani

    2011-06-01

    Full Text Available Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS. The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.

  20. HOSPITAL SITE SELECTION USING TWO-STAGE FUZZY MULTI-CRITERIA DECISION MAKING PROCESS

    Directory of Open Access Journals (Sweden)

    Ali Soltani

    2011-01-01

    Full Text Available Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS. The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.

  1. 45 CFR 1232.11 - Employment and volunteer selection criteria.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Employment and volunteer selection criteria. 1232.11 Section 1232.11 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR... that impair sensory, manual, or speaking skills. ...

  2. Multi-criteria decision making on strategic selection of wind farms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Amy H.I. [Department of Industrial Engineering and System Management, Chung Hua University, Hsinchu (China); Chen, Hsing Hung [Faculty of Management and Administration, Macau University of Science and Technology, Taipa (Macau); Kang, He-Yau [Department of Industrial Engineering and Management, National Chin-Yi University of Technology, Taiping, Taichung (China)

    2009-01-15

    With maturity of advanced technologies and urgent requirement for maintaining a healthy environment with reasonable price, China is moving toward a trend of generating electricity from renewable wind resources. How to select a suitable wind farm becomes an important focus for stakeholders. This paper first briefly introduces wind farm and then develops its critical success criteria. A new multi-criteria decision-making (MCDM) model, based on the analytic hierarchy process (AHP) associated with benefits, opportunities, costs and risks (BOCR), is proposed to help select a suitable wind farm project. Multiple factors that affect the success of wind farm operations are analyzed by taking into account experts' opinions, and a performance ranking of the wind farms is generated. (author)

  3. Criteria of benchmark selection for efficient flexible multibody system formalisms

    Directory of Open Access Journals (Sweden)

    Valášek M.

    2007-10-01

    Full Text Available The paper deals with the selection process of benchmarks for testing and comparing efficient flexible multibody formalisms. The existing benchmarks are briefly summarized. The purposes for benchmark selection are investigated. The result of this analysis is the formulation of the criteria of benchmark selection for flexible multibody formalisms. Based on them the initial set of suitable benchmarks is described. Besides that the evaluation measures are revised and extended.

  4. 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...

  5. Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria.

    Science.gov (United States)

    Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D

    2018-05-01

    Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme. The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology. The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline-specific and discipline-independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self-management, insight and self-awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline-specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews. Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non-clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity. © 2017 Royal Australasian College of Surgeons.

  6. Subsurface arrangement constraints and selection criteria SOW, 4.5.1.2.1: Technical report, Revision 0

    International Nuclear Information System (INIS)

    1984-12-01

    The United States Department of Energy has the responsibility to develop an underground geological repository for the storage and isolation of nuclear waste. This report identifies design constraints and subsurface arrangement selection criteria for the subsurface portion of a repository in salt. These criteria provide a base from which subsurface layout will be selected for approval by the Department of Energy. This document provides the basic criteria for the architect/engineer to select the subsurface layout. While this document does not address site-specific criteria, it does act as a guideline for subsurface design allowing for exploration of any reasonable option of that design. The criteria developed in this report address specific areas and concerns within a subsurface layout plan. The subsurface layout selection criteria were developed from industry standards, federal regulations, and quality assurance standards. 18 refs., 7 figs., 5 tabs

  7. Examination of Students' Selection Criteria for International Education

    Science.gov (United States)

    Ahmad, Syed Zamberi; Buchanan, F. Robert; Ahmad, Norita

    2016-01-01

    Purpose: Motivations for study abroad in tourism and hospitality were examined as to the influence of a variety of personal criteria in the individual decision process of adult learners to select a host country and host institution of study. The paper aims to discuss this issue. Design/methodology/approach: Push-pull factors (Mazzarol and Soutar,…

  8. An Examination of Program Selection Criteria for Part-Time MBA Students

    Science.gov (United States)

    Colburn, Michael; Fox, Daniel E.; Westerfelt, Debra Kay

    2011-01-01

    Prospective graduate students select a graduate program as a result of a multifaceted decision-making process. This study examines the selection criteria that part-time MBA students used in selecting a program at a private university. Further, it analyzes the methods by which the students first learned of the MBA program. The authors posed the…

  9. Prevalence and clinical characteristics of white-coat hypertension based on different definition criteria in untreated and treated patients.

    Science.gov (United States)

    de la Sierra, Alejandro; Vinyoles, Ernest; Banegas, José R; Segura, Julián; Gorostidi, Manuel; de la Cruz, Juan J; Ruilope, Luis M

    2017-12-01

    The prevalence and associated risks of white-coat hypertension (WCH) are still a matter of debate. We aimed to assess differences in prevalence and associated conditions of WCH defined on the basis of the normality of all daytime, night-time, and 24-h blood pressure (BP), only daytime, or only 24-h BP. We selected 115 708 patients (45 020 untreated and 70 688 treated) from the Spanish Ambulatory BP Monitoring Registry. WCH was estimated in patients with elevated office BP (≥140 and/or 90 mmHg) by using normal daytime (definition criteria. Only diagnostic criteria which considers the normality of all ambulatory periods identifies patients with cardiovascular risk similar to normotensive patients. These results support using such criteria for a more accurate definition of WCH.

  10. A grey DEMATEL approach to develop third-party logistics provider selection criteria

    DEFF Research Database (Denmark)

    Govindan, Kannan; Khodaverdi, Roohollah; Vafadarnikjoo, Amin

    2016-01-01

    - The paper's results help managers of automotive industries, particularly in developing countries, to outsource logistics activities to 3PL providers effectively and to create a significant competitive advantage. Originality/value - The main contributions of this paper are twofold. First, this paper proposes...... an integrated grey DEMATEL method to consider interdependent relationships among the 3PL provider selection criteria. Second, this study is one of the first studies to consider 3PL provider selection in a developing country like Iran....... identifies important criteria for 3PL provider selection and evaluation, and the purpose of this paper is to select 3PL providers from the viewpoint of firms which were already outsourcing their logistics services. Design/methodology/approach - This study utilized the grey decision-making trial...

  11. Selection of materials using multi-criteria decision-making methods with minimum data

    Directory of Open Access Journals (Sweden)

    Shankar Chakraborty

    2013-07-01

    Full Text Available Selection of material for a specific engineering component, which plays a significant role in its design and proper functioning, is often treated as a multi-criteria decision-making (MCDM problem where the most suitable material is to be chosen based on a given set of conflicting criteria. For solving these MCDM problems, the designers do not generally know what should be the optimal number of criteria required for arriving at the best decisive action. Those criteria should be independent to each other and their number should usually limit to seven plus or minus two. In this paper, five material selection problems are solved using three common MCDM techniques to demonstrate the effect of number of criteria on the final rankings of the material alternatives. It is interesting to observe that the choices of the best suited materials solely depend on the criterion having the maximum priority value. It is also found that among the three MCDM methods, the ranking performance of VIKOR (Vlse Kriterijumska Optimizacija Kompromisno Resenje method is the best.

  12. Identification and evaluation of influential criteria for the selection of an environmental shipping carrier using DEMATEL

    DEFF Research Database (Denmark)

    Jia, Peng; Govindan, Kannan; Kannan, Devika

    2015-01-01

    The current environmental pollution is a major factor in economic development and vehicle pollution is ranked next to industrial emissions in total emissions worldwide. This study focuses on the selection of a suitable shipping carrier from an economic and environmental perspective. In practice......, there are many criteria's available to select a suitable shipping container. But, shipping container companies are struggling to identify the most influential criteria to select a shipping container as it requires in-depth analysis. So, the objective of this paper is to analyse the criteria and identify the most...... influential criteria from an environmental practices perspective. In this study, seventeen factors are identified from literature aimed at locating the most influential criteria to select a suitable shipping carrier using the decision making trial and evaluation laboratory (DEMATEL). This procedure helps...

  13. 40 CFR 228.6 - Specific criteria for site selection.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Specific criteria for site selection. 228.6 Section 228.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN..., nursery, feeding, or passage areas of living resources in adult or -juvenile phases; (3) Location in...

  14. A multi-criteria decision making approach for supplier selection in the flexible packaging industry

    Directory of Open Access Journals (Sweden)

    Cristea Ciprian

    2017-01-01

    Full Text Available The supplier selection problem represents one of the most important components of the supply chain management. This article presents a multiple criteria decision making analysis contributing to the selection of the most convenient supplier in the flexible packaging industry. Due to the fact that in today's supply chain management, the performance of potential suppliers is evaluated against multiple criteria rather than taking into account only the cost factor, the appropriate criteria in the supplier selection have been identified, and the considered variants are assessed, considering the decision maker’s preferences and existing constraints. The variants are ranked in terms of their suitability for selecting a supplier with the use of Electre III method. The results obtained from the simulation experiment suggest that this methodology is a feasible decision support model.

  15. Safety approach to the selection of design criteria for the CRBRP reactor refueling system

    International Nuclear Information System (INIS)

    Meisl, C.J.; Berg, G.E.; Sharkey, N.F.

    1979-01-01

    The selection of safety design criteria for Liquid Metal Fast Breeder Reactor (LMFBR) refueling systems required the extrapolation of regulations and guidelines intended for Light Water Reactor refueling systems and was encumbered by the lack of benefit from a commercially licensed predecessor other than Fermi. The overall approach and underlying logic are described for developing safety design criteria for the reactor refueling system (RRS) of the Clinch River Breeder Reactor Plant (CRBRP). The complete selection process used to establish the criteria is presented, from the definition of safety functions to the finalization of safety design criteria in the appropriate documents. The process steps are illustrated by examples

  16. QUANTITY DISCOUNTS IN SUPPLIER SELECTION PROBLEM BY USE OF FUZZY MULTI-CRITERIA PROGRAMMING

    Directory of Open Access Journals (Sweden)

    Tunjo Perić

    2011-02-01

    Full Text Available Supplier selection in supply chain is a multi-criteria problem that involves a number of quantitative and qualitative factors. This paper deals with a concrete problem of flour purchase by a company that manufactures bakery products and the purchasing price of flour depends on the quantity ordered. The criteria for supplier selection and quantities supplied by individual suppliers are: purchase costs, product quality and reliability of suppliers. The problem is solved using a model that combines revised weighting method and fuzzy multi-criteria linear programming (FMCLP. The paper highlights the efficiency of the proposed methodology in conditions when purchasing prices depend on order quantities.

  17. An integrated multi-criteria decision-making methodology for conveyor system selection

    Directory of Open Access Journals (Sweden)

    Pairat Jiamruangjarus

    2016-12-01

    Full Text Available Material handling equipment (MHE is important for every industry because it has an effect on the productivity of manufacturing. Conveyor systems are presently one popular type of MHE. This paper presents an integration of the analytic network process (ANP with the benefits, opportunities, costs and risk (BOCR model in order to select the best conveyor system. The proposed model established a network with four merits, six strategies criteria, and twenty six sub-criteria with four alternatives (present, roller conveyor, chain conveyor, and monorail. The ANP is to determine the relative weights of an evaluative criteria and decision alternatives. Therefore, the final ranking of the alternatives are calculated by synthesizing the score of each alternative under BOCR. The results showed that the best alternative under all five methods is the chain conveyor. These research results can be easily applied, adapted and used to improve performance of selecting the conveyer system in small and medium enterprises through large industries.

  18. 25 CFR 1001.8 - Selection criteria for tribes/consortia to receive a negotiation grant.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Selection criteria for tribes/consortia to receive a negotiation grant. 1001.8 Section 1001.8 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR SELF-GOVERNANCE PROGRAM § 1001.8 Selection criteria for tribes/consortia to receive a negotiation grant. (a) Who may be...

  19. Determination of Effective Criteria for Location Selection of Kiln Wood Drying Plants by AHP Technique

    Directory of Open Access Journals (Sweden)

    Rahim Mohebbi

    2011-12-01

    Full Text Available This study was aimed at determining the effective criteria for location selection of wood drying plants in Iran. For this purpose, after review and field visit of the industries, 35 key indicators were identified. These criteria were divided into five major groups as: materials, infrastructure, technical, economical and instructional indices. The priority rates of these criteria and sub-criteria were evaluated by AHP technique. The results indicated that among 35 effective sub-criteria in location selection of the plants, the sub-criteria of quality of raw materials(0.152, purchasing raw materials, land cost, profitability, reliability of supply, and sales had the highest priorities, which were rated as 0.118, 0.105, 0.067, 0.061 and 0.057, respectively

  20. Selection of disposal contractor by multi criteria decision making methods

    Directory of Open Access Journals (Sweden)

    Cenker Korkmazer

    2016-08-01

    Full Text Available Hazardous waste is substance that threaten people and environment in case of improper storage, disposal and transport due to its concentration, physical and chemical properties. Companies producing hazardous waste as a result of several activities mostly do not have any own disposal facilities. In addition, they do not pay attention enough to determine the right contractor as a disposal facility. On the other hand, there are various qualitative and quantitative criteria affecting the selection of the contractor and conflicting with each other. The aim of the performed study is to assist one of these companies producing hazardous waste in the selection of the best contractor that eliminates hazardous waste economic and harmless way. In the study, contractor weights in percentage is calculated by using Analytic Network Process (ANP as one of the multi-criteria decision making (MCDM methods and widely used in the literature which considers both qualitative and quantitative criteria. In the next step, by the help of the mathematical model, contractors that will be given which type of hazardous waste are identified. This integrated approach can be used as a guide for similar firms.

  1. 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

  2. Development of statewide geriatric patients trauma triage criteria.

    Science.gov (United States)

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

  3. Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

    Directory of Open Access Journals (Sweden)

    Bonet M

    2012-06-01

    Full Text Available Objective: The aims of this study were to identify potentially inappropriate prescribing using the Beers and STOPP criteria. The START criteria were applied to detect prescription omission in the geriatric population. We compared the utility of these criteria in institutionalised older people.Methods: Descriptive study reviewing the medication and clinical records of 81 residents (aged 65 years and more by pharmacists in a nursing home in the Lleida region (Spain.Results: The mean patients’ age was 84 (SD=8 years, with an average of 5 drugs per resident (total prescriptions: 416 medicines. The Beers criteria identified potentially inappropriate medication use in 25% of patients and 48% of patients used at least 1 inappropriate medication according to STOPP criteria. The most frequent potentially inappropriate medications for both criteria were long-acting benzodiazepines and NSAIDs. START detected 58 potential prescribing omissions in 44% of patients. Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%, but omissions corresponding to the cardiovascular system implied 23% of patients.Conclusion: The STOPP-START criteria reveal that potentially inappropriate prescribing (PIP is a highly prevalent problem among Spanish nursing home residents, and a statistically significant positive correlation was found between the number of medicines prescribed and the number of PIP detected in this study. The STOPP criteria detect a larger number of PI medications in this geriatric population than the Beers criteria. The prescribing omissions detected by the START criteria are relevant and require intervention. Pharmacists’ review of medications may help identify potentially inappropriate prescribing and, through an interdisciplinary approach, working with physicians may improve prescribing practices among geriatric residents of nursing homes.

  4. 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.

  5. Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul F

    2012-02-03

    INTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers\\' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers\\' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers\\' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.

  6. Radiation risk in pediatric patients: the need for criteria using radiopharmaceuticals activities

    International Nuclear Information System (INIS)

    Simas, Felipe; Instituto de Radioprotecao e Dosimetria; Velasques, Silvia M.

    2009-01-01

    The administration of radionuclides to children for diagnostic procedures should be carried out only if there is a strong clinical indication. The amount of activity administered may be reduced according to body weight, body surface area or other appropriate criteria. In Brazil, activities used for pediatric patients were evaluated (2003-2005) in sixteen selected public and private institutions in Northeast, Southeast and South geographical regions. The present work presents radiopharmaceuticals activities used in Brazil compared with international surveys performed in USA in 2005 and in the European Union in 2007. The activities per patient weight and minimum and maximum activities used per Brazilian installations were compared with those used in USA installations. Per patients, it was calculated the ideal minimum administered activity for each type of radiopharmaceutical by body weight according the Pediatric Dosage Card (PDC) criteria. It was not possible to compare activities for all radiopharmaceuticals used in Brazil because some are not more used outside, e.g. 131 I-NaI, which is replaced by 123 I-NaI for thyroid imaging. The discrepancy between activities used in Brazil compared with those used in USA and Europe may be attributed to the heterogeneity of Brazilian imaging equipment and lack for specific children protocols. The disadvantages for using fractions of adult activities are: necessity of minimum statistical counting for assurance of image quality and dependence upon equipment calibration. It was concluded that is necessary to establish standard criteria for radiopharmaceuticals activities applied to pediatric patients in Brazil and the risks due to additional activities should be estimated individually. (author)

  7. 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.

  8. Criteria for selecting measures of plant information with application to nuclear reactors

    International Nuclear Information System (INIS)

    Kiguchi, T.; Sheridan, T.B.

    1979-01-01

    Criteria for selecting from alternative measures of plant information have been derived by information theory and the expected-value model of decision theory. Two criteria derived by information theory are minimum ''uncertainty'' of judgement of plant states, and maximum ''surprise'' of human operators. Two criteria derived by decision theory are maximum expected reward to operators, and maximum ratio of the maximum and next-to-maximum expected rewards. These four criteria have been evaluated experimentally in application to human monitoring problems of three ''plants'': an abstract laboratory exercise, a small research reactor, and a conventional nuclear power plant (high-fidelity training simulator). The results show that the criteria derived by decision theory are superior to the others from the viewpoint of correct rate of human subjects' judgement

  9. Use of DOE site selection criteria for screening low-level waste disposal sites on the Oak Ridge Reservation

    International Nuclear Information System (INIS)

    Lee, D.W.; Ketelle, R.H.; Stinton, L.H.

    1983-09-01

    The proposed Department of Energy (DOE) site selection criteria were applied to the Oak Ridge Reservation, and the application was evaluated to determine the criteria's usefulness in the selection of a low-level waste disposal site. The application of the criteria required the development of a methodology to provide a framework for evaluation. The methodology is composed of site screening and site characterization stages. The site screening stage relies on reconnaissance data to identify a preferred site capable of satisfying the site selection criteria. The site characterization stage relies on a detailed site investigation to determine site acceptability. The site selection criteria were applied to the DOE Oak Ridge Reservation through the site screening stage. Results of this application were similar to those of a previous siting study on the Oak Ridge Reservation. The DOE site selection criteria when coupled with the methodology that was developed were easily applied and would be adaptable to any region of interest

  10. To Make Good Decision: A Group DSS for Multiple Criteria Alternative Rank and Selection

    Directory of Open Access Journals (Sweden)

    Chen-Shu Wang

    2015-01-01

    Full Text Available Decision making is a recursive process and usually involves multiple decision criteria. However, such multiple criteria decision making may have a problem in which partial decision criteria may conflict with each other. An information technology, such as the decision support system (DSS and group DSS (GDSS, emerges to assist decision maker for decision-making process. Both the DSS and GDSS should integrate with a symmetrical approach to assist decision maker to take all decision criteria into consideration simultaneously. This study proposes a GDSS architecture named hybrid decision-making support model (HDMSM and integrated four decision approaches (Delphi, DEMATEL, ANP, and MDS to help decision maker to rank and select appropriate alternatives. The HDMSM consists of five steps, namely, criteria identification, criteria correlation calculation, criteria evaluation, critical criteria selection, and alternative rank and comparison. Finally, to validate the proposed feasibility of the proposed model, this study also conducts a case study to find out the important indexes of corporate social responsibility (CSR from multiple perspectives. As the case study demonstrates the proposed HDMSM enables a group of decision makers to implement the MCDM effectively and help them to analyze the relation and degree of mutual influence among different evaluation factors.

  11. Technical Evaluation Report 27: Educational Wikis: Features and selection criteria

    Directory of Open Access Journals (Sweden)

    Jim Rudolph

    2004-04-01

    Full Text Available This report discusses the educational uses of the ‘wiki,’ an increasingly popular approach to online community development. Wikis are defined and compared with ‘blogging’ methods; characteristics of major wiki engines are described; and wiki features and selection criteria are examined.

  12. Comparing Western and Eastern criteria for sarcopenia and their association with survival in patients with pancreatic cancer.

    Science.gov (United States)

    Wu, Chih-Horng; Chang, Ming-Chu; Lyadov, Vladimir K; Liang, Po-Chin; Chen, Chyi-Mong; Shih, Tiffany Ting-Fang; Chang, Yu-Ting

    2018-02-20

    Sarcopenia and cachexia are associated with pancreatic cancer and serve as important adverse prognostic factors. Body composition can be analyzed by routine computed tomography (CT) for cancer staging and has been used to study many types of cancer. The CT measurements are robust, but the diagnostic criteria for sarcopenia vary among different studies. Age, sex and race are important factors that affect muscle and fat masses. This study aimed to analyze the effect of different sarcopenia diagnostic criteria on the prognosis of patients with pancreatic cancer. Patients with newly diagnosed pancreatic cancer at National Taiwan University Hospital between October 2013 and October 2016 were retrospectively reviewed in this study. Body composition was assessed using cross-sectional CT images to calculate the total skeletal muscle (TSM) index. The concordance and interobserver variability of the TSM measurements were evaluated using both the Western criteria and the Eastern criteria. Kaplan-Meier analyses and the Cox proportional hazard ratio with two different diagnostic criteria for sarcopenia were used to compare the effect on overall survival (OS). A total of 146 patients with pancreatic cancer were enrolled. The TSM index measured by the Western institute was highly correlated with that measured by the Eastern institute (r = 0.953, p Western criteria and 11.0% (16/146) by the Eastern criteria, and only low agreement was found between the Western and Eastern criteria (Kappa value = 0.028, p = 0.149). Patients who were sarcopenic by the Western criteria showed no significant difference in OS versus those who were not sarcopenic (p = 0.807). However, patients who were sarcopenic by the Eastern criteria showed a significant difference in OS versus those who were not sarcopenic in a univariate analysis (p = 0.008) and multivariate analysis after adjustment for AJCC stage (p = 0.014). Our study demonstrates that different diagnostic criteria may result in

  13. Methodology for Selecting Best Management Practices Integrating Multiple Stakeholders and Criteria. Part 1: Methodology

    Directory of Open Access Journals (Sweden)

    Mauricio Carvallo Aceves

    2016-02-01

    Full Text Available The implementation of stormwater Best Management Practices (BMPs could help re-establish the natural hydrological cycle of watersheds after urbanization, with each BMP presenting a different performance across a range of criteria (flood prevention, pollutant removal, etc.. Additionally, conflicting views from the relevant stakeholders may arise, resulting in a complex selection process. This paper proposes a methodology for BMP selection based on the application of multi-criteria decision aid (MCDA methods, integrating multiple stakeholder priorities and BMP combinations. First, in the problem definition, the MCDA methods, relevant criteria and design guidelines are selected. Next, information from the preliminary analysis of the watershed is used to obtain a list of relevant BMPs. The third step comprises the watershed modeling and analysis of the BMP alternatives to obtain performance values across purely objective criteria. Afterwards, a stakeholder analysis based on survey applications is carried out to obtain social performance values and criteria priorities. Then, the MCDA methods are applied to obtain the final BMP rankings. The last step considers the sensitivity analysis and rank comparisons in order to draw the final conclusions and recommendations. Future improvements to the methodology could explore inclusion of multiple objective analysis, and alternative means for obtaining social performance values.

  14. Fuzzy decision-making: a new method in model selection via various validity criteria

    International Nuclear Information System (INIS)

    Shakouri Ganjavi, H.; Nikravesh, K.

    2001-01-01

    Modeling is considered as the first step in scientific investigations. Several alternative models may be candida ted to express a phenomenon. Scientists use various criteria to select one model between the competing models. Based on the solution of a Fuzzy Decision-Making problem, this paper proposes a new method in model selection. The method enables the scientist to apply all desired validity criteria, systematically by defining a proper Possibility Distribution Function due to each criterion. Finally, minimization of a utility function composed of the Possibility Distribution Functions will determine the best selection. The method is illustrated through a modeling example for the A verage Daily Time Duration of Electrical Energy Consumption in Iran

  15. Multi-data integration of exploration criteria and selection of prospecting targets

    International Nuclear Information System (INIS)

    Dechang, L.; Jingke, Z.; Maorong, S.; Guojuan, W.

    1991-01-01

    In this paper based on the analysis of the exploration criteria for Shengyuan Basin-a uranium ore field, the multi-data integration and information extraction of exploration criteria are carried out on computer and image processing system so that the areas with best combinations of exploration criteria are directly displayed on the screen. Six prospecting targets are selected through the field examination. Shengyuan basin in Jiangxi province is a uranium-producing, Jurassic Cretaceous volcanic-sedimentary basin with an area of about 400 sq km. Its basement consists of Sinian-Cambrian rocks with Caledonian granites intruded. Several uranium deposits, occurrences and anomalies were discovered over the basin region which, therefore, becomes a very important uranium ore field in China

  16. Fuzzy Logic Based Multi-Criteria Wind Turbine Selection Strategy—A Case Study of Qassim, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Shafiqur Rehman

    2016-10-01

    Full Text Available The emergence of wind energy as a potential alternative to traditional sources of fuel has prompted notable research in recent years. One primary factor contributing to efficient utilization of wind energy from a wind farm is the type of turbines used. However, selection of a specific wind turbine type is a difficult task due to several criteria involved in the selection process. Important criteria include turbine’s power rating, height of tower, energy output, rotor diameter, cut-in wind speed, and rated wind speed. The complexity of this selection process is further amplified by the presence of conflicts between the decision criteria. Therefore, a decision is desired that provides the best balance between all selection criteria. Considering the complexities involved in the decision-making process, this paper proposes a two-level decision turbine selection strategy based on fuzzy logic and multi-criteria decision-making (MCDM approach. More specifically, the fuzzy arithmetic mean operator is used in the decision process. The proposed approach is applied to wind data collected from the site of Qassim, Saudi Arabia. Results indicate that the proposed approach was effective in finding the optimal turbine from a set of 20 turbines of various capacities.

  17. A Review on influencing criteria for selecting supplier of information technology services in the hospital

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals. PMID:25540781

  18. A Review on influencing criteria for selecting supplier of information technology services in the hospital.

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals.

  19. A F o cus on Far Eastern Tourists – Tour Operator Selection Criteria

    Directory of Open Access Journals (Sweden)

    Ayşe Çelik

    2014-03-01

    Full Text Available Tour operators are becoming more important in the long haul destination market. Identifying tour operator selection criteria is crucial to orientate marketing strategies. The aim of the study was to determine the tour operation selection criteria of a package holiday maker visiting Turkey from the Far East according to the nationality. Data was drawn up and analyzed from tourists who came from three of these countries namely: Japan, South Korea, and China between February and April 2013 in Cappadocia. Quantitative methodology employing One-way ANOVA analysis was used. Deduction was made by analysing the tour operator selection criteria data that nationality was not a meaningful differentiation for a tourist in their assessment of the “Service Quality’” and “Opportunity to interact with other people’” items referred to in the survey questionnaire. Other items from the resulting data gave meaningful differences in cross - cultural behaviour. Results from the study provide important cues for tour operator managers to consider developing different promotional strategy initiatives to engage and attract more Japanese, South Korean, and Chinese tourists to Turkey.

  20. Lyme Neuroborreliosis: Preliminary Results from an Urban Referral Center Employing Strict CDC Criteria for Case Selection

    Directory of Open Access Journals (Sweden)

    David S. Younger

    2010-01-01

    Full Text Available Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of 23 patients submitted to strict criteria for case selection of the Centers for Disease Control and Prevention employing a two-tier test to detect antibodies to Borrelia burgdorferi at a single institution. One patient had symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of early infection; and another had symptomatic small fiber sensory neuropathy, distal polyneuropathy, dysautonomia, and serological evidence of late infection. In the remaining patients symptoms initially ascribed to Lyme disease were probably unrelated to B. burgdorferi infection. Our findings suggest early susceptibility and protracted involvement of the nervous system most likely due to the immunological effects of B. burgdorferi infection, although the exact mechanisms remain uncertain.

  1. A two-phased multi-criteria decision-making approach for selecting the best smartphone

    Directory of Open Access Journals (Sweden)

    Yildiz, Aytac

    2015-11-01

    Full Text Available In the last 20 years, rapid and significant developments have occurred in communication and information technologies. In parallel with these developments, the importance of smartphones has increased. In addition, many smartphone manufacturers have launched and continue to launch a number of new models with many features. People who want to buy a new smartphone have difficulties selecting the best smartphone among the numerous models available on the technology markets. Therefore, smartphone selection has become a complex multi-criteria decision-making (MCDM problem for people. Hence, decision-making processes will be facilitated by using MCDM methods, and these will provide the most appropriate decision. In this paper, the best smartphone among the 28 alternatives determined by the person who will buy them are selected by using three main criteria and 17 sub-criteria with the help of a two-phased MCDM approach. In the first phase, 28 smartphone alternatives are ranked using the analytic network process (ANP. In the second phase, a model that includes the best four alternatives of ANP is created. Afterwards, the best smartphone is selected using the generalised Choquet integral (GCI method according to this model. Finally, the findings and the results are given.

  2. The Ideal Criteria of Supplier Selection for SMEs Food Processing Industry

    OpenAIRE

    Ramlan Rohaizan; Engku Abu Bakar Engku Muhammad Nazri; Mahmud Fatimah; Ng Hooi Keng

    2016-01-01

    Selection of good supplier is important to determine the performance and profitability of SMEs food processing industry. The lack of managerial capability on supplier selection in SMEs food processing industry affects the competitiveness of SMEs food processing industry. This research aims to determine the ideal criteria of supplier for food processing industry using Analytical Hierarchy Process (AHP). The research was carried out in a quantitative method by distributing questionnaires to 50 ...

  3. Integrated shape and material selection for single and multi-performance criteria

    International Nuclear Information System (INIS)

    Singh, Jasveer; Mirjalili, Vahid; Pasini, Damiano

    2011-01-01

    Research highlights: → The method of shape transformers is extended to torsional stiffness and combined load design. → The method is generalized for multi-criteria selection of shape and material. → Performance charts are presented for single and multi-objective selection of cross-section shape and material. → A four quadrant performance chart is presented to visualize the relation between objective function space and design variable space. -- Abstract: A shape and material selection method, based on the concept of shape transformers, has been recently introduced to characterize the mass efficiency of lightweight beams under bending and shear. This paper extends this method to deal with the case of torsional stiffness design, and generalize it to single and multi-crieria selection of lightweight shafts subjected to a combination of bending, shear, and torsional load. The novel feature of the paper is the useful integration of shape and material to model and visualize multi-objective selection problems. The scheme is centered on concept selection in structural design, and hinges on measures that govern the shape properties of a cross-section regardless of its size. These measures, referred as shape transformers, can classify shapes in a way similar to material classification. The procedure is exemplified by considering torsional stiffness as a constraint. The performance charts are developed for single and multi-criteria to visualize in a glance the whole range of cross-sectional shapes for each material. Each design chart is explained with a brief example.

  4. The evaluation of effective criteria on site selection for energy production units from cellulosic biomass in Iran

    Directory of Open Access Journals (Sweden)

    Majid Azizi

    2017-12-01

    Full Text Available Both Analytical Hierarchy Process (AHP and benefits, opportunities, costs and risks (BOCR techniques were used successfully to evaluate the effective criteria on site selection for energy production unit development from cellulosic biomass in Iran. The results showed that the benefits criteria was at the first level while the initial cellulosic raw materials and opportunities with the aim of the local economy had the second position as the most important indices on site selection. In addition, third criterion has been introduced for the costs criteria (transportation cost and social barriers by the experts. However, risks criteria which referred to instability of providing cellulosic raw materials is one of the less important effective indices on site selection to make energy production unit. The results illustrated that the economy and politics as two environmental effective factors affected on the site selection process generally.

  5. An analysis of project selection and assignment criteria of danish tenders in europe

    DEFF Research Database (Denmark)

    Larsen, Jesper Kranker; Ussing, Lene Faber; Brunø, Thomas Ditlev

    2013-01-01

    , and 3/ any significant difference between the use of selection and assignment criteria in Danish public construction projects. The study uses a quantitative research approach where 157 Danish public tender cases were selected from the European Tenders Electronic Daily database between the period...

  6. Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey

    Directory of Open Access Journals (Sweden)

    Farzam Gorouhi

    2014-01-01

    Full Text Available Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors’ (PDs’ perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs’ perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3% responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.” Conclusions. Our survey provides up-to-date factual data on dermatology PDs’ perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process.

  7. CRITERIA FOR SELECTION OF THE REINSURANCE COVERAGE FOR EXCESS OF LOSS TREATY

    Directory of Open Access Journals (Sweden)

    V. Veretnov

    2014-03-01

    Full Text Available Optimal reinsurance coverage, selected by the cedent, influenced by a number of internal, external, objective and subjective factors. Their accounting or ignoring depends on the individual conditions of the insurer, knowledge of the specific risk profiles of professional experience and decision-makers about the forms and methods of reinsurance coverage. Justified the selection criteria of reinsurance protection for the treaty excess of loss. Using these criteria makes it possible not only to optimize the reinsurance protection, but also to ensure a balance of interests in the long-term relationship of the cedent company and the reinsurer. The article also provides examples of how classes of insurance is advisable to use the obligatory contract portfolio sexcess of loss.

  8. Clinical impact of strict criteria for selectivity and lateralization in adrenal vein sampling.

    Science.gov (United States)

    Gasparetto, Alessandro; Angle, John F; Darvishi, Pasha; Freeman, Colbey W; Norby, Ray G; Carey, Robert M

    2015-04-01

    Selectivity index (SI) and lateralization index (LI) thresholds determine the adequacy of adrenal vein sampling (AVS) and the degree of lateralization. The purpose of this study was investigate the clinical outcome of patients whose adrenal vein sampling was interpreted using "strict criteria" (SC) (SIpre-stimuli≥3, SIpost-stimuli≥5 and LIpre-stimuli≥4, LIpost-stimuli≥4). A retrospective review of 73 consecutive AVS procedures was performed and 67 were technically successful. Forty-three patients showed lateralization and underwent surgery, while 24 did not lateralize and were managed conservatively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), kalemia (K(+)), and the change in number of blood pressure (BP) medications were recorded for each patient before and after AVS and potential surgery were performed. In the surgery group, BP and K(+) changed respectively from 160±5.3/100±2.0 mmHg to 127±3.3/80±1.9 (p blood pressure medications were six (14.0%) in the lateralized group and 22 (91.7%) in the non-lateralized group (p <0.001). AVS interpretation with SC leads to significant clinical improvement in both patients who underwent surgery and those managed conservatively.

  9. A MOORA based fuzzy multi-criteria decision making approach for supply chain strategy selection

    Directory of Open Access Journals (Sweden)

    Bijan Sarkar

    2012-08-01

    Full Text Available To acquire the competitive advantages in order to survive in the global business scenario, modern companies are now facing the problems of selecting key supply chain strategies. Strategy selection becomes difficult as the number of alternatives and conflicting criteria increases. Multi criteria decision making (MCDM methodologies help the supply chain managers take a lead in a complex industrial set-up. The present investigation applies fuzzy MCDM technique entailing multi-objective optimization on the basis of ratio analysis (MOORA in selection of alternatives in a supply chain. The MOORA method is utilized to three suitable numerical examples for the selection of supply chain strategies (warehouse location selection and vendor/supplier selection. The results obtained by using current approach almost match with those of previous research works published in various open journals. The empirical study has demonstrated the simplicity and applicability of this method as a strategic decision making tool in a supply chain.

  10. Criteria definition and approaches in green supplier selection – a case study for raw material and packaging of food industry

    OpenAIRE

    Narges Banaeian; Hossein Mobli; Izabela Ewa Nielsen; Mahmoud Omid

    2015-01-01

    This paper formulates an integrated framework for deciding about the green supplier selection criteria in food supply chain and also proposes different methods that account for single and multiple sourcing of supplier selection. Green supplier selection relies on green criteria, so determination of suitable set of criteria will affect decision-maker results directly. In this research, an operational model including combination of general and environmental criteria is introduced for green supp...

  11. Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

    Science.gov (United States)

    Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

    2017-08-01

    The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

  12. Supplier selection criteria for sustainable supply chain management in thermal power plant

    Science.gov (United States)

    Firoz, Faisal; Narayan Biswal, Jitendra; Satapathy, Suchismita

    2018-02-01

    Supplies are always in great demand when it comes to industrial operations. The quality of raw material their price accompanied by sustainability and environmental effects are a major concern for industrial operators these days. Supply Chain Management is the subject which is focused on how the supply of different products is carried out. The motive is that each operation performed can be optimized and inherently the efficiency of the whole chain is integrated. In this paper we will be dealing with all the criteria that are required to be evaluated before selecting a supplier, in particular, focusing on Thermal Power Plant. The most suppliers of the thermal power plant are the coal suppliers. The quality of coal directly determines the efficiency of the whole plant. And when there are matters concerning coal environmental pollution plays a very crucial role. ANP method has been used here to select suppliers of thermal power sectors in Indian context. After applying ANP to prioritize the sustainable supplier selection criteria, it is found that for thermal power industries best suppliers are Nationalized/State owned suppliers then 2nd ranked suppliers are imported supplier. Private owned suppliers are ranked least. So private owned suppliers must be more concerned about their performance. Among these suppliers it is found that to compete in the global market privatized suppliers have to give more emphasize on most important criteria like sustainability, then fuel cost and quality. Still some sub-criteria like a clean program, environmental issues, quality, reliability, service rate, investment in high technology, green transportation channel, waste management etc needs for continuous improvement as per their priority.

  13. The selection criteria elements of X-ray optics system

    Science.gov (United States)

    Plotnikova, I. V.; Chicherina, N. V.; Bays, S. S.; Bildanov, R. G.; Stary, O.

    2018-01-01

    At the design of new modifications of x-ray tomography there are difficulties in the right choice of elements of X-ray optical system. Now this problem is solved by practical consideration, selection of values of the corresponding parameters - tension on an x-ray tube taking into account the thickness and type of the studied material. For reduction of time and labor input of design it is necessary to create the criteria of the choice, to determine key parameters and characteristics of elements. In the article two main elements of X-ray optical system - an x-ray tube and the detector of x-ray radiation - are considered. Criteria of the choice of elements, their key characteristics, the main dependences of parameters, quality indicators and also recommendations according to the choice of elements of x-ray systems are received.

  14. Multiple criteria decision making with life cycle assessment for material selection of composites

    Directory of Open Access Journals (Sweden)

    A. S. Milani

    2011-12-01

    Full Text Available With the advancement of interdisciplinary approaches in today’s modern engineering, current efforts in optimal design of composites include seeking material selection protocols that can (1 simultaneously consider a series of mechanical/electrical/chemical cost criteria over a set of alternative material options, and (2 closely take into account environmental aspects of final products including recycling and end-of-life disposal options. In this paper, in addition to a review of some recent experimental and methodological advances in the above areas, a new application of multiple criteria decision making (MCDM is presented to deal with decision conflicts often seen among design criteria in composite material selection with the help of life cycle assessment (LCA. To show the application, an illustrative case study on a plastic gear material selection is conducted where the cost, mechanical and thermal properties along with environmental impact criteria are to be satisfied simultaneously. A pure plastic gear is compared to a Polyethylene terephthalate (PET/aluminum-powder composite alternative. Results suggest that simple MCDM models, including a signal-to-noise measure adapted to MCDM in the same case study, can be used to explore both trade-offs and design break-even points in large decision spaces as the decision maker’s perspective over environmental, material performance and cost attributes change during the design process. More advanced topics including the account of material data uncertainties are addressed.

  15. Assessing the Job Selection Criteria of Accounting Students: a Normative Approach

    OpenAIRE

    zubairu, umaru; Ismail, Suhaiza; Abdul Hamid, Fatima

    2017-01-01

    This research assessed to what extent final-year Muslim accounting students in Malaysia considered Islamic principles when choosing a job after graduation. 356 final-year Muslim accounting students in four Malaysian universities were surveyed using an open-ended job selection scenario. The result shows that reality does not live up to the ideal. Only 16% of the respondents apply Islamic principles in making a job selection decision. The remaining 84% are more concerned with other criteria suc...

  16. Multi-criteria selection of offshore wind farms: Case study for the Baltic States

    International Nuclear Information System (INIS)

    Chaouachi, Aymen; Covrig, Catalin Felix; Ardelean, Mircea

    2017-01-01

    This paper presents a multi-criteria selection approach for offshore wind sites assessment. The proposed site selection framework takes into consideration the electricity network’s operating security aspects, economic investment, operation costs and capacity performances relative to each potential site. The selection decision is made through Analytic Hierarchy Process (AHP), with an inherited flexibility that aims to allow end users to adjust the expected benefits accordingly to their respective and global priorities. The proposed site selection framework is implemented as an interactive case study for three Baltic States in the 2020 time horizon, based on real data and exhaustive power network models, taking into consideration the foreseen upgrades and network reinforcements. For each country the optimal offshore wind sites are assessed under multiple weight contribution scenarios, reflecting the characteristics of market design, regulatory aspects or renewable integration targets. - Highlights: • We use a multi-criteria selection approach for offshore wind sites assessment. • Security aspects, economic investment, operation costs and capacity performances are included. • The selection decision is made through an Analytic Hierarchy Process (AHP). • We implement the methodology as a case study for three Baltic States in the 2020 time horizon.

  17. Procurement selection criteria for projects in the public sector: evidence from Nigeria

    Directory of Open Access Journals (Sweden)

    Richard Ajayi Jimoh

    2016-12-01

    Full Text Available The selection of suitable procurement practice for construction projects is a very complex and demanding tasks for stakeholders in the construction industry. In spite of the overabundance of techniques and tools accessible to the stakeholders in selecting an appropriate procurement method, clients are faced with the decision as to which of the selection criteria can be adopted for a given construction project to achieve project goals and objectives. This paper focused on evaluating the existing procurement methods being practised in the Nigerian construction industry with a view to identifying and establishing the parameters for selection that will improve contract delivery systems. In this research, quantitative approach was used to collect data from 420 contractors, consultants and clients based in the Federal Capital Territory, Abuja where large numbers of building projects are being procured. The findings revealed six most commonly considered criteria and deduced that, the quality, cost and duration of the project determines the type of procurement method to adopt. It is therefore stated that in selecting any particular procurement method for building construction projects, the complexity of such project should be clearly defined and the other performance indicators be given adequate consideration for a successful project delivery that will enhance the achievement of the client’s goal.

  18. Seronegative neuromyelitis optica spectrum disorder patients diagnosed using new diagnostic criteria.

    Science.gov (United States)

    Uzawa, Akiyuki; Mori, Masahiro; Uchida, Tomohiko; Masuda, Hiroki; Ohtani, Ryohei; Kuwabara, Satoshi

    2016-09-01

    Recently, new diagnostic criteria for neuromyelitis optica spectrum disorders (NMOSD) were published. Our primary aim was to evaluate the usefulness of the new diagnostic criteria in anti-aquaporin 4 (AQP4) antibody-negative cases. Consecutive 471 patients whose anti-AQP4 antibody was measured at Chiba University were reviewed. Four anti-AQP4 antibody negative-patients, who fulfilled the new diagnostic criteria for NMOSD but not 2006 diagnostic criteria for neuromyelitis optica (NMO), were identified. They showed high cerebrospinal fluid interleukin-6 and glial fibrillary acidic protein levels, an absence of oligoclonal bands and/or cloud-like enhancement on magnetic resonance imaging, which are compatible findings for NMO. The new diagnostic criteria are clinically useful in seronegative NMOSD. © The Author(s), 2015.

  19. A Hybrid Multiple-Criteria Decision-Making Approach for Photovoltaic Solar Plant Location Selection

    Directory of Open Access Journals (Sweden)

    Amy H. I. Lee

    2017-01-01

    Full Text Available Due to decaying fossil resource and increasing environmental consciousness, the demand of renewable energy resources is escalating these days. Photovoltaic solar energy is one of the most popular renewable energy resources in places where sunlight is abundant. The selection of a desirable location for constructing a photovoltaic solar plant is the first and one of the most important stages in the plant construction to provide a long-term energy production. In this paper, a comprehensive multiple-criteria decision-making model, which incorporates the interpretive structural modeling (ISM, fuzzy analytic network process (FANP and VIKOR (VlseKriterijumska OptimizacijaI Kompromisno Resenje in Serbian,meaning multi-criteria optimization and compromise solution, is proposed to select the most suitable photovoltaic solar plant location. The ISM is applied first to determine the interrelationships among the criteria and among the sub-criteria,andtheresults are used to construct a decision-making network. The FANP is applied next to solve the network and to calculate the importance weights of the sub-criteria. Finally, the VIKOR is adopted to determine the ranking of the photovoltaic solar plant locations. The proposed model is applied in a case study in evaluating photovoltaic solar plant locations in Taiwan. By applying the proposed model, decision makers can have a better thinking process and make more appropriate decisions justifiably.

  20. 34 CFR 658.31 - What selection criteria does the Secretary use?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What selection criteria does the Secretary use? 658.31 Section 658.31 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION UNDERGRADUATE INTERNATIONAL STUDIES AND FOREIGN LANGUAGE...

  1. Release criteria for patients having undergone radionuclide therapy and criteria for their crossing the state border of the Russian Federation

    International Nuclear Information System (INIS)

    Zvonova, I.; Balonov, M.; Golikov, V.

    2011-01-01

    By means of a conservative dosimetry model, the values of operational radiological criteria for patients released from hospital-residual activity in a body and dose rate near the patient's body-are substantiated based on the effective dose limit of 5 mSv for persons helping the patient or living with him and 1 mSv for other adults and children. Two sets of operative criteria for radionuclides 125 I, 131 I, 153 Sm and 188 Re used in Russia for radionuclide therapy were derived. Release criteria for 125 I well differ from such values in other countries because in this work absorption of 125 I low-energy photon radiation in the patient was taken into account. When a patient having undergone radionuclide therapy crosses the frontier of Russia, high-sensitivity devices for radiation control at the custom can detect the patient. A simplified radiological assessment of the patient was suggested aimed at provision of radiation safety for patient companions in transport. (authors)

  2. 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.

  3. Selection Criteria for Water Disinfection Techniques in Agricultural Practices

    OpenAIRE

    Haute, Sam van; Sampers, Imca; Jacxsens, Liesbeth; Uyttendaele, Mieke

    2013-01-01

    This paper comprises a selection tool for water disinfection methods for fresh produce pre- and postharvest practices. A variety of water disinfection technologies is available on the market and no single technology is the best choice for all applications. It can be difficult for end users to choose the technology that is best fit for a specific application. Therefore, the different technologies were characterized in order to identify criteria that influence the suitability of a technology fo...

  4. Statin Selection in Qatar Based on Multi-indication Pharmacotherapeutic Multi-criteria Scoring Model, and Clinician Preference.

    Science.gov (United States)

    Al-Badriyeh, Daoud; Fahey, Michael; Alabbadi, Ibrahim; Al-Khal, Abdullatif; Zaidan, Manal

    2015-12-01

    Statin selection for the largest hospital formulary in Qatar is not systematic, not comparative, and does not consider the multi-indication nature of statins. There are no reports in the literature of multi-indication-based comparative scoring models of statins or of statin selection criteria weights that are based primarily on local clinicians' preferences and experiences. This study sought to comparatively evaluate statins for first-line therapy in Qatar, and to quantify the economic impact of this. An evidence-based, multi-indication, multi-criteria pharmacotherapeutic model was developed for the scoring of statins from the perspective of the main health care provider in Qatar. The literature and an expert panel informed the selection criteria of statins. Relative weighting of selection criteria was based on the input of the relevant local clinician population. Statins were comparatively scored based on literature evidence, with those exceeding a defined scoring threshold being recommended for use. With 95% CI and 5% margin of error, the scoring model was successfully developed. Selection criteria comprised 28 subcriteria under the following main criteria: clinical efficacy, best publish evidence and experience, adverse effects, drug interaction, dosing time, and fixed dose combination availability. Outcome measures for multiple indications were related to effects on LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, and C-reactive protein. Atorvastatin, pravastatin, and rosuvastatin exceeded defined pharmacotherapeutic thresholds. Atorvastatin and pravastatin were recommended as first-line use and rosuvastatin as a nonformulary alternative. It was estimated that this would produce a 17.6% cost savings in statins expenditure. Sensitivity analyses confirmed the robustness of the evaluation's outcomes against input uncertainties. Incorporating a comparative evaluation of statins in Qatari practices based on a locally developed, transparent, multi

  5. The Predictive Value of Selection Criteria in an Urban Magnet School

    Science.gov (United States)

    Lohmeier, Jill Hendrickson; Raad, Jennifer

    2012-01-01

    The predictive value of selection criteria on outcome data from two cohorts of students (Total N = 525) accepted to an urban magnet high school were evaluated. Regression analyses of typical screening variables (suspensions, absences, metropolitan achievement tests, middle school grade point averages [GPAs], Matrix Analogies test scores, and…

  6. 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…

  7. Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

    OpenAIRE

    Jason, Leonard A; McManimen, Stephanie; Sunnquist, Madison; Newton, Julia L; Strand, Elin Bolle

    2017-01-01

    The Institute of Medicine (IOM) recently developed clinical criteria for chronic fatigue syndrome (CFS). There might be additional criteria that could select a more homogenous and impaired group of patients, particularly those with pain. The current study focused on criteria which involved meeting the four IOM criteria, excluding medical and psychiatric co-morbidities, along with having fibromyalgia (FM). Findings indicated that those meeting the IOM clinical criteria plus FM were more impair...

  8. Improved selection criteria for H II regions, based on IRAS sources

    Science.gov (United States)

    Yan, Qing-Zeng; Xu, Ye; Walsh, A. J.; Macquart, J. P.; MacLeod, G. C.; Zhang, Bo; Hancock, P. J.; Chen, Xi; Tang, Zheng-Hong

    2018-05-01

    We present new criteria for selecting H II regions from the Infrared Astronomical Satellite (IRAS) Point Source Catalogue (PSC), based on an H II region catalogue derived manually from the all-sky Wide-field Infrared Survey Explorer (WISE). The criteria are used to augment the number of H II region candidates in the Milky Way. The criteria are defined by the linear decision boundary of two samples: IRAS point sources associated with known H II regions, which serve as the H II region sample, and IRAS point sources at high Galactic latitudes, which serve as the non-H II region sample. A machine learning classifier, specifically a support vector machine, is used to determine the decision boundary. We investigate all combinations of four IRAS bands and suggest that the optimal criterion is log(F_{60}/F_{12})≥ ( -0.19 × log(F_{100}/F_{25})+ 1.52), with detections at 60 and 100 {μ}m. This selects 3041 H II region candidates from the IRAS PSC. We find that IRAS H II region candidates show evidence of evolution on the two-colour diagram. Merging the WISE H II catalogue with IRAS H II region candidates, we estimate a lower limit of approximately 10 200 for the number of H II regions in the Milky Way.

  9. Benchmarking the Performance of Construction Procurement Methods against Selection Criteria in Nigeria

    Directory of Open Access Journals (Sweden)

    Stephen Okunlola Ojo

    2009-01-01

    Full Text Available The study developed performance indices by the widely used procurement options in Nigeria on selection criteria. The traditional mean and standardized ratio were used to form the utility coefficients. Results revealed that performance by the procurement options depended on the respondents’ categorization and cost categorization of projects. Public clients ranked the lump sum contracts more able to achieve speed for projects up to N100 million (Naira while the private clients believe it is the design-build. As regards quality, public clients rated the Build-Own-Operate-Transfer (BOOT system as most able to achieve the quality criterion whereas private clients rated design-build for projects up to N100 million (Naira. The study then concluded that, in the Nigerian construction industry participants do not agree on the performance of the procurement options on selection criteria.

  10. Site selection criteria for shallow land burial of low-level radioactive waste

    International Nuclear Information System (INIS)

    Falconer, K.L.; Hull, L.C.; Mizell, S.A.

    1982-01-01

    Twelve site selection criteria are presented. These are: (1) site shall be of sufficient area and depth to accommodate the projected volume of waste and a three dimensional buffer zone; (2) site should allow waste to be buried either completely above or below the transition zone between the unsaturated and saturated zones; (3) site should be located where flooding will not jeopardize performance; (4) site should be located where erosion will not jeopardize performance; (5) site should be located in areas where hydrogeologic conditions allow reliable performance prediction; (6) site should be located where geologic hazards will not jeopardize performance; (7) site should be selected with considerations given to those characteristics of earth materials and water chemistry that favor increased residence times and/or attenuation of radionuclide concentrations within site boundaries; (8) site should be selected with consideration given to current and projected population distributions; (9) site should be selected with consideration given to current and projected land use and resource development; (10) site should be selected with consideration given to location of waste generation, access to all-weather highway and rail routes, and access utilities; (11) site should be selected consistent with federal laws and regulations; (12) site should not be located within areas that are protected from such use by federal laws and regulations. These criteria are considered preliminary and do not necessarily represent the position of the Department of Energy's Low-Level Waste Management Program

  11. A new spatial multi-criteria decision support tool for site selection for implementation of managed aquifer recharge.

    Science.gov (United States)

    Rahman, M Azizur; Rusteberg, Bernd; Gogu, R C; Lobo Ferreira, J P; Sauter, Martin

    2012-05-30

    This study reports the development of a new spatial multi-criteria decision analysis (SMCDA) software tool for selecting suitable sites for Managed Aquifer Recharge (MAR) systems. The new SMCDA software tool functions based on the combination of existing multi-criteria evaluation methods with modern decision analysis techniques. More specifically, non-compensatory screening, criteria standardization and weighting, and Analytical Hierarchy Process (AHP) have been combined with Weighted Linear Combination (WLC) and Ordered Weighted Averaging (OWA). This SMCDA tool may be implemented with a wide range of decision maker's preferences. The tool's user-friendly interface helps guide the decision maker through the sequential steps for site selection, those steps namely being constraint mapping, criteria hierarchy, criteria standardization and weighting, and criteria overlay. The tool offers some predetermined default criteria and standard methods to increase the trade-off between ease-of-use and efficiency. Integrated into ArcGIS, the tool has the advantage of using GIS tools for spatial analysis, and herein data may be processed and displayed. The tool is non-site specific, adaptive, and comprehensive, and may be applied to any type of site-selection problem. For demonstrating the robustness of the new tool, a case study was planned and executed at Algarve Region, Portugal. The efficiency of the SMCDA tool in the decision making process for selecting suitable sites for MAR was also demonstrated. Specific aspects of the tool such as built-in default criteria, explicit decision steps, and flexibility in choosing different options were key features, which benefited the study. The new SMCDA tool can be augmented by groundwater flow and transport modeling so as to achieve a more comprehensive approach to the selection process for the best locations of the MAR infiltration basins, as well as the locations of recovery wells and areas of groundwater protection. The new spatial

  12. Study-design selection criteria in systematic reviews of effectiveness of health systems interventions and reforms: A meta-review.

    Science.gov (United States)

    Rockers, Peter C; Feigl, Andrea B; Røttingen, John-Arne; Fretheim, Atle; de Ferranti, David; Lavis, John N; Melberg, Hans Olav; Bärnighausen, Till

    2012-03-01

    At present, there exists no widely agreed upon set of study-design selection criteria for systematic reviews of health systems research, except for those proposed by the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) review group (which comprises randomized controlled trials, controlled clinical trials, controlled before-after studies, and interrupted time series). We conducted a meta-review of the study-design selection criteria used in systematic reviews available in the McMaster University's Health Systems Evidence or the EPOC database. Of 414 systematic reviews, 13% did not indicate any study-design selection criteria. Of the 359 studies that described such criteria, 50% limited their synthesis to controlled trials and 68% to some or all of the designs defined by the EPOC criteria. Seven out of eight reviews identified at least one controlled trial that was relevant for the review topic. Seven percent of the reviews included either no or only one relevant primary study. Our meta-review reveals reviewers' preferences for restricting synthesis to controlled experiments or study designs that comply with the EPOC criteria. We discuss the advantages and disadvantages of the current practices regarding study-design selection in systematic reviews of health systems research as well as alternative approaches. Copyright © 2012. Published by Elsevier Ireland Ltd.

  13. Selection criteria for building performance simulation tools : contrasting architects' and engineers' needs

    NARCIS (Netherlands)

    Attia, S.G.; Hensen, J.L.M.; Beltran, L.; De Herde, A.

    2012-01-01

    This article summarises a study undertaken to reveal potential challenges and opportunities for using building performance simulation (BPS) tools. The article reviews current trends in building simulation and outlines major criteria for BPS tool selection and evaluation based on analysing users'

  14. Some selection criteria for computers in real-time systems for high energy physics

    International Nuclear Information System (INIS)

    Kolpakov, I.F.

    1980-01-01

    The right choice of program source is for the organization of real-time systems of great importance as cost and reliability are decisive factors. Some selection criteria for program sources for high energy physics multiwire chamber spectrometers (MWCS) are considered in this report. MWCS's accept bits of information from event pattens. Large and small computers, microcomputers and intelligent controllers in CAMAC crates are compared with respect to the following characteristics: data exchange speed, number of addresses for peripheral devices, cost of interfacing a peripheral device, sizes of buffer and mass memory, configuration costs, and the mean time between failures (MTBF). The results of comparisons are shown by plots and histograms which allow the selection of program sources according to the above criteria. (Auth.)

  15. Airbreathing engine selection criteria for SSTO propulsion system

    Science.gov (United States)

    Ohkami, Yoshiaki; Maita, Masataka

    1995-02-01

    This paper presents airbreathing engine selection criteria to be applied to the propulsion system of a Single Stage To Orbit (SSTO). To establish the criteria, a relation among three major parameters, i.e., delta-V capability, weight penalty, and effective specific impulse of the engine subsystem, is derived as compared to these parameters of the LH2/LOX rocket engine. The effective specific impulse is a function of the engine I(sub sp) and vehicle thrust-to-drag ratio which is approximated by a function of the vehicle velocity. The weight penalty includes the engine dry weight, cooling subsystem weight. The delta-V capability is defined by the velocity region starting from the minimum operating velocity up to the maximum velocity. The vehicle feasibility is investigated in terms of the structural and propellant weights, which requires an iteration process adjusting the system parameters. The system parameters are computed by iteration based on the Newton-Raphson method. It has been concluded that performance in the higher velocity region is extremely important so that the airbreathing engines are required to operate beyond the velocity equivalent to the rocket engine exhaust velocity (approximately 4500 m/s).

  16. Assessing the Job Selection Criteria of Accounting Students: A Normative Approach

    Directory of Open Access Journals (Sweden)

    Umaru Zubairu

    2017-08-01

    Full Text Available This research assessed to what extent final-year Muslim accounting students in Malaysia considered Islamic principles when choosing a job after graduation. 356 final-year Muslim accounting students in four Malaysian universities were surveyed using an open-ended job selection scenario. The result shows that reality does not live up to the ideal. Only 16% of the respondents apply Islamic principles in making a job selection decision. The remaining 84% are more concerned with other criteria such as personal interests, salary considerations, and company reputation.

  17. Impact of UCSF criteria according to pre- and post-OLT tumor features: analysis of 479 patients listed for HCC with a short waiting time.

    Science.gov (United States)

    Decaens, Thomas; Roudot-Thoraval, Françoise; Hadni-Bresson, Solange; Meyer, Carole; Gugenheim, Jean; Durand, Francois; Bernard, Pierre-Henri; Boillot, Olivier; Sulpice, Laurent; Calmus, Yvon; Hardwigsen, Jean; Ducerf, Christian; Pageaux, Georges-Philippe; Dharancy, Sebastien; Chazouilleres, Olivier; Cherqui, Daniel; Duvoux, Christophe

    2006-12-01

    Orthotopic liver transplantation (OLT) indication for hepatocellular carcinoma (HCC) is currently based on the Milan criteria. The University of California, San Francisco (UCSF) recently proposed an expansion of the selection criteria according to tumors characteristics on the explanted liver. This study: 1) assessed the validity of these criteria in an independent large series and 2) tested for the usefulness of these criteria when applied to pre-OLT tumor evaluation. Between 1985 and 1998, 479 patients were listed for liver transplantation (LT) for HCC and 467 were transplanted. According to pre-OLT (imaging at date of listing) or post-OLT (explanted liver) tumor characteristics, patients were retrospectively classified according to both the Milan and UCSF criteria. The 5-yr survival statistics were assessed by the Kaplan-Meier method and compared by the log-rank test. Pre-OLT UCSF criteria were analyzed according to an intention-to-treat principle. Based on the pre-OLT evaluation, 279 patients were Milan+, 44 patients were UCSF+ but Milan- (subgroup of patients that might benefit from the expansion), and 145 patients were UCSF- and Milan-. With a short median waiting time of 4 months, 5-yr survival was 60.1 +/- 3.0%, 45.6 +/- 7.8%, and 34.7 +/- 4.0%, respectively (P OLT evaluation, the UCSF criteria are associated with a 5-yr survival below 50%. Their applicability is therefore limited, despite similar survival rates compared to the Milan criteria, when the explanted liver is taken into account.

  18. 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...

  19. Determination of Effective Criteria for location Selection of WPC Plants from agricultural residues in Iran by AHP Technique

    Directory of Open Access Journals (Sweden)

    hasan alizadeh

    2017-02-01

    Full Text Available This study was aimed at determining the effective criteria for location selection of WPC Plants from agricultural residues in Iran. For this purpose, after review and studies papers and books, Six criteria" products and materials, regulations, technical and human, economic, infrastructure and environmental and also 30 sub-criteria were identified. The priority rates of these criteria and sub-criteria were evaluated by AHP technique. The results indicated that among 30 effective sub-criteria in location selection of the WPC plants from agricultural residues, amount of wastes supply (0.087, continuity of wastes supply, cost of wastes supply, amount of sales and export, granted facilities and less Hazards for the environment and forest had the highest priorities, which were rated as 0.071, 0.067, 0.065, 0.064 and 0.062 respectively.

  20. 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

  1. A Multi-criteria neutrosophic group decision making metod based TOPSIS for supplier selection

    OpenAIRE

    Şahin, Rıdvan; Yiğider, Muhammed

    2014-01-01

    The process of multiple criteria decision making (MCDM) is of determining the best choice among all of the probable alternatives. The problem of supplier selection on which decision maker has usually vague and imprecise knowledge is a typical example of multi criteria group decision-making problem. The conventional crisp techniques has not much effective for solving MCDM problems because of imprecise or fuzziness nature of the linguistic assessments. To find the exact values for MCDM problems...

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

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

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

  3. Selection of boron based tribological hard coatings using multi-criteria decision making methods

    International Nuclear Information System (INIS)

    Çalışkan, Halil

    2013-01-01

    Highlights: • Boron based coating selection problem for cutting tools was solved. • EXPROM2, TOPSIS and VIKOR methods were used for ranking the alternative materials. • The best coatings for cutting tool were selected as TiBN and TiSiBN. • The ranking results are in good agreement with cutting test results in literature. - Abstract: Mechanical and tribological properties of hard coatings can be enhanced using boron as alloying element. Therefore, multicomponent nanostructured boron based hard coatings are deposited on cutting tools by different methods at different parameters. Different mechanical and tribological properties are obtained after deposition, and it is a difficult task to select the best coating material. In this paper, therefore, a systematic evaluation model was proposed to tackle the difficulty of the material selection with specific properties among a set of available alternatives. The alternatives consist of multicomponent nanostructured TiBN, TiCrBN, TiSiBN and TiAlSiBN coatings deposited by magnetron sputtering and ion implantation assisted magnetron sputtering at different parameters. The alternative coating materials were ranked by using three multi-criteria decision-making (MCDM) methods, i.e. EXPROM2 (preference ranking organization method for enrichment evaluation), TOPSIS (technique for order performance by similarity to ideal solution) and VIKOR (VIšekriterijumsko KOmpromisno Rangiranje), in order to determine the best coating material for cutting tools. Hardness (H), Young’s modulus (E), elastic recovery, friction coefficient, critical load, H/E and H 3 /E 2 ratios were considered as material selection criteria. In order to determine the importance weights of the evaluation criteria, a compromised weighting method, which composes of the analytic hierarchy process and Entropy methods, were used. The ranking results showed that TiBN and TiSiBN coatings deposited at given parameters are the best coatings for cutting tools

  4. An improved hybrid multi-criteria/multidimensional model for strategic industrial location selection: Casablanca industrial zones as a case study.

    Science.gov (United States)

    Boutkhoum, Omar; Hanine, Mohamed; Agouti, Tarik; Tikniouine, Abdessadek

    2015-01-01

    In this paper, we examine the issue of strategic industrial location selection in uncertain decision making environments for implanting new industrial corporation. In fact, the industrial location issue is typically considered as a crucial factor in business research field which is related to many calculations about natural resources, distributors, suppliers, customers, and most other things. Based on the integration of environmental, economic and social decisive elements of sustainable development, this paper presents a hybrid decision making model combining fuzzy multi-criteria analysis with analytical capabilities that OLAP systems can provide for successful and optimal industrial location selection. The proposed model mainly consists in three stages. In the first stage, a decision-making committee has been established to identify the evaluation criteria impacting the location selection process. In the second stage, we develop fuzzy AHP software based on the extent analysis method to assign the importance weights to the selected criteria, which allows us to model the linguistic vagueness, ambiguity, and incomplete knowledge. In the last stage, OLAP analysis integrated with multi-criteria analysis employs these weighted criteria as inputs to evaluate, rank and select the strategic industrial location for implanting new business corporation in the region of Casablanca, Morocco. Finally, a sensitivity analysis is performed to evaluate the impact of criteria weights and the preferences given by decision makers on the final rankings of strategic industrial locations.

  5. Multi-criteria analysis on how to select solar radiation hydrogen production system

    Energy Technology Data Exchange (ETDEWEB)

    Badea, G.; Naghiu, G. S., E-mail: naghiu.george@gmail.com; Felseghi, R.-A.; Giurca, I., E-mail: giurca-ioan@yahoo.com [Technical University of Cluj-Napoca, Faculty of Building Services Engineering, Boulevard December 21, no. 128-130, Cluj-Napoca, 400604 (Romania); Răboacă, S. [National R& D Institute for Cryogenic and Isotopic Technologies, str. Uzinei, no. 4, Rm. Vălcea, 240050 (Romania); Aşchilean, I. [SC ACI Cluj SA, Avenue Dorobanţilor, no. 70, Cluj-Napoca, 400609 (Romania)

    2015-12-23

    The purpose of this article is to present a method of selecting hydrogen-production systems using the electric power obtained in photovoltaic systems, and as a selecting method, we suggest the use of the Advanced Multi-Criteria Analysis based on the FRISCO formula. According to the case study on how to select the solar radiation hydrogen production system, the most convenient alternative is the alternative A4, namely the technical solution involving a hydrogen production system based on the electrolysis of water vapor obtained with concentrated solar thermal systems and electrical power obtained using concentrating photovoltaic systems.

  6. Analysis of Satellite AIS Data to Derive Weather Judging Criteria for Voyage Route Selection

    Directory of Open Access Journals (Sweden)

    Michio Fujii

    2017-06-01

    Full Text Available The operational limitations are discussed at the IMO as a part of the second generation intact stability criteria. Since it is a first attempt to introduce operational efforts into safety regulations, comprehensive discussions are necessary to realize practically acceptable ones. Therefore this study investigates actual navigation routes of container ships and pure car carriers in the trans-North Pacific Ocean in winter, because they are prone to suffer significant parametric roll which is one of stability failure modes. Firstly, interviews are made to shipmasters who have experiences to have operated the subject ships to identify major elements for route selection in the North Pacific Ocean. Secondly, sufficient number of actual navigation records is collected from Satellite AIS data to derive the weather criteria for the route selection in severe weather condition. Finally, shipmaster’s on-board decision-making criteria are discussed by analysing the ship tracking data and weather data.

  7. Selection of suitable e-learning approach using TOPSIS technique with best ranked criteria weights

    Science.gov (United States)

    Mohammed, Husam Jasim; Kasim, Maznah Mat; Shaharanee, Izwan Nizal Mohd

    2017-11-01

    This paper compares the performances of four rank-based weighting assessment techniques, Rank Sum (RS), Rank Reciprocal (RR), Rank Exponent (RE), and Rank Order Centroid (ROC) on five identified e-learning criteria to select the best weights method. A total of 35 experts in a public university in Malaysia were asked to rank the criteria and to evaluate five e-learning approaches which include blended learning, flipped classroom, ICT supported face to face learning, synchronous learning, and asynchronous learning. The best ranked criteria weights are defined as weights that have the least total absolute differences with the geometric mean of all weights, were then used to select the most suitable e-learning approach by using TOPSIS method. The results show that RR weights are the best, while flipped classroom approach implementation is the most suitable approach. This paper has developed a decision framework to aid decision makers (DMs) in choosing the most suitable weighting method for solving MCDM problems.

  8. Multi criteria decision making methods for location selection of distribution centers

    Directory of Open Access Journals (Sweden)

    Romita Chakraborty

    2013-10-01

    Full Text Available In recent years, major challenges such as, increase in inflexible consumer demands and to improve the competitive advantage, it has become necessary for various industrial organizations all over the world to focus on strategies that will help them achieve cost reduction, continual quality improvement, increased customer satisfaction and on time delivery performance. As a result, selection of the most suitable and optimal facility location for a new organization or expansion of an existing location is one of the most important strategic issues, required to fulfill all of these above mentioned objectives. In order to sustain in the global competitive market of 21st century, many industrial organizations have begun to concentrate on the proper selection of the plant site or best facility location. The best location is that which results in higher economic benefits through increased productivity and good distribution network. When a choice is to be made from among several alternative facility locations, it is necessary to compare their performance characteristics in a decisive way. As the facility location selection problem involves multiple conflicting criteria and a finite set of potential candidate alternatives, different multi-criteria decision-making (MCDM methods can be effectively applied to solve such type of problem. In this paper, four well known MCDM methods have been applied on a facility location selection problem and their relative ranking performances are compared. Because of disagreement in the ranks obtained by the four different MCDM methods a final ranking method based on REGIME has been proposed by the authors to facilitate the decision making process.

  9. Relationship between Admission Selection Criteria and Academic Progression for Student Nurse Anesthetists

    Science.gov (United States)

    Burns, Sharon M.

    2009-01-01

    Today's admission selection criteria require refinement with the intention of fostering academic progression for students entering nurse anesthesia programs (Reese, 2002).With the escalating cost of graduate education coupled with the current economic crisis, efforts by educational leaders to minimize attrition remains pivotal (Andrews, Johansson,…

  10. Fuzzy Logic Based Multi-Criteria Wind Turbine Selection Strategy—A Case Study of Qassim, Saudi Arabia

    OpenAIRE

    Shafiqur Rehman; Salman A. Khan

    2016-01-01

    The emergence of wind energy as a potential alternative to traditional sources of fuel has prompted notable research in recent years. One primary factor contributing to efficient utilization of wind energy from a wind farm is the type of turbines used. However, selection of a specific wind turbine type is a difficult task due to several criteria involved in the selection process. Important criteria include turbine’s power rating, height of tower, energy output, rotor diameter, cut-in wind spe...

  11. Early Site Permit Demonstration Program: Siting Guide, Site selection and evaluation criteria for an early site permit application

    International Nuclear Information System (INIS)

    1993-01-01

    In August 1991, the Joint Contractors came to agreement with Sandia National Laboratories (SNL) and the Department of Energy (DOE) on a workscope for the cost-shared Early Site Permit Demonstration Program. One task within the scope was the development of a guide for site selection criteria and procedures. A generic Siting Guide his been prepared that is a roadmap and tool for applicants to use developing detailed siting plans for their specific region of the country. The guide presents three fundamental principles that, if used, ensure a high degree of success for an ESP applicant. First, the site selection process should take into consideration environmentally diverse site locations within a given region of interest. Second, the process should contain appropriate opportunities for input from the public. Third, the process should be applied so that it is clearly reasonable to an impartial observer, based on appropriately selected criteria, including criteria which demonstrate that the site can host an advanced light water reactor (ALWR). The Siting Guide provides for a systematic, comprehensive site selection process in which three basic types of criteria (exclusionary, avoidance, and suitability) are presented via a four-step procedure. It provides a check list of the criteria for each one of these steps. Criteria are applied qualitatively, as well as presented numerically, within the guide. The applicant should use the generic guide as an exhaustive checklist, customizing the guide to his individual situation

  12. Aluminum toxicity in dialysis patients: Radiographic findings and establishment of biopsy-sparing criteria

    International Nuclear Information System (INIS)

    Kriegshauser, J.S.; Swee, R.G.; McCarthy, J.T.; Hauser, M.F.

    1986-01-01

    Aluminum toxicity in dialysis patients currently requires bone biopsy for diagnosis. The authors retrospectively reviewed the findings in 63 dialysis patients who had undergone bone biopsies. In 30 patients biopsies were negative for aluminum toxicity and in 33 patients biopsies were positive. In 17 of the 30 biopsy-negative patients, absence of aluminum toxicity could be predicted by a high parathyroid hormone (iPTH) level (>200 μEq/ml) and fewer than three fractures, or by the presence of osteosclerosis on radiographs. No biopsy-positive patients met these criteria (P < .001). In 16 of 33 biopsy-positive patients aluminum toxicity could be predicted by a low iPTH level (<500 μEq/ml) and more than three fractures. No biopsy-negative patient met these criteria (P < .001). Thus, based on the criteria we have identified, 52.4% of the patients could have been spared biopsy

  13. 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

  14. Trees in Urban and City Environments: a review of the selection criteria with particular reference to nature conservation in New Zealand Cities

    Directory of Open Access Journals (Sweden)

    (Late David Given

    2008-07-01

    Full Text Available The overall aim of this research was to review the general criteria for selection of trees for urban environments and city environments. The reason for this research was to assess the extent to which criteria for tree selection can contribute to nature conservation in cities. We conducted an extensive review of the literature, looking for publications about the selection criteria. In particular, we looked for any previous published reviews of the criteria. With reference to the criteria used in New Zealand, we undertook an unstructured review of the practices adopted in most cities. A review of the literature revealed many publications about different criteria but only one publication in which there was a general review of the criteria used for selecting trees for urban environments. By way of contrast, lists of tree species deemed to be suitable (or unsuitable for urban planting are widely available, and some include information about selection criteria, but often with little background explanation. Worldwide, commonly used criteria included commercial availability of species, compatibility with urban environments, landscape design, low maintenance, avoidance of nuisance factors and historical practice. The most common criteria are concerned with the concept of choosing species compatible with local climate and soils. Anecdotal evidence suggests that more and more cities are using a mix of criteria including those that may contribute to conservation and restoration of native biota. We suggest that there should be greater use of ecological, genetic and biogeographical criteria to meet the needs of nature conservation in New Zealand cities.

  15. 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.

  16. Using multi-criteria decision methods for selecting a language school

    Directory of Open Access Journals (Sweden)

    Mileine Henriques Elias Velasco

    2014-11-01

    Full Text Available Nowadays, the interest of organizations by professionals who have deep knowledge concerning more than one language has been increasing. In this scenario, the choice of a language school has been one of the most common decision problems, which has been often made on the basis of word-of-mouth, marketing activities of schools and trials without criteria. In order to contribute to this problem, this paper presents a study in which two multi-criteria decision aid methods (AHP and Weighted Average were used to select a language school. Thus, the degree of importance of criteria relating to the problem and the degree of satisfaction of undergraduate and postgraduate students in relation to language schools they study were taken into account. The best ranked language school was the same for both MCDA methods, although some schools have obtained different positions. It was found that the analysis with AHP is richer and more elaborate than with the Weighted Average method. However, the large number of pairwise comparisons which were required to the study demanded significant attention and cognitive effort from the decision maker, and more time to perform the analysis - aspects that may contribute to the preference for the Weighted Average method in similar studies.

  17. Utility of the American-European Consensus Group and American College of Rheumatology Classification Criteria for Sjögren's syndrome in patients with systemic autoimmune diseases in the clinical setting.

    Science.gov (United States)

    Hernández-Molina, Gabriela; Avila-Casado, Carmen; Nuñez-Alvarez, Carlos; Cárdenas-Velázquez, Francisco; Hernández-Hernández, Carlos; Luisa Calderillo, María; Marroquín, Verónica; Recillas-Gispert, Claudia; Romero-Díaz, Juanita; Sánchez-Guerrero, Jorge

    2015-03-01

    The aim of this study was to evaluate the feasibility and performance of the American-European Consensus Group (AECG) and ACR Classification Criteria for SS in patients with systemic autoimmune diseases. Three hundred and fifty patients with primary SS, SLE, RA or scleroderma were randomly selected from our patient registry. Each patient was clinically diagnosed as probable/definitive SS or non-SS following a standardized evaluation including clinical symptoms and manifestations, confirmatory tests, fluorescein staining test, autoantibodies, lip biopsy and medical chart review. Using the clinical diagnosis as the gold standard, the degree of agreement with each criteria set and between the criteria sets was estimated. One hundred fifty-four (44%) patients were diagnosed with SS. The AECG criteria were incomplete in 36 patients (10.3%) and the ACR criteria in 96 (27.4%; P vs 62.3 and a specificity of 94.3 vs 91.3, respectively. Either set of criteria was met by 123 patients (80%); 95 (61.7%) met the AECG criteria and 96 (62.3%) met the ACR criteria, but only 68 (44.2%) patients met both sets. The concordance rate between clinical diagnosis and AECG or ACR criteria was moderate (k statistic 0.58 and 0.55, respectively). Among 99 patients with definitive SS sensitivity was 83.3 vs 77.7 and specificity was 90.8 vs 85.6, respectively. A discrepancy between clinical diagnosis and criteria was seen in 59 patients (17%). The feasibility of the SS AECG criteria is superior to that of the ACR criteria, however, their performance was similar among patients with systemic autoimmune diseases. A subset of SS patients is still missed by both criteria sets. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Clinical Criteria Versus a Possible Research Case Definition in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

    Science.gov (United States)

    Jason, Leonard A; McManimen, Stephanie; Sunnquist, Madison; Newton, Julia L; Strand, Elin Bolle

    2017-01-01

    The Institute of Medicine (IOM) recently developed clinical criteria for what had been known as chronic fatigue syndrome (CFS). Given the broad nature of the clinical IOM criteria, there is a need for a research definition that would select a more homogenous and impaired group of patients than the IOM clinical criteria. At the present time, it is unclear what will serve as the research definition. The current study focused on a research definition which selected homebound individuals who met the four IOM criteria, excluding medical and psychiatric co-morbidities. Our research criteria were compared to those participants meeting the IOM criteria. Those not meeting either of these criteria sets were placed in a separate group defined by 6 or more months of fatigue. Data analyzed were from the DePaul Symptom Questionnaire and the SF-36. Due to unequal sample sizes and variances, Welch's F tests and Games-Howell post hoc tests were conducted. Using a large database of over 1,000 patients from several countries, we found that those meeting a more restrictive research definition were even more impaired and more symptomatic than those meeting criteria for the other two groups. Deciding on a particular research case definition would allow researchers to select more comparable patient samples across settings, and this would represent one of the most significant methodologic advances for this field of study.

  19. Analysis of Multi-Criteria Evaluation Method of Landfill Site Selection for Municipal Solid Waste Management

    Science.gov (United States)

    Mohammed, Habiba Ibrahim; Majid, Zulkepli; Yusof, Norhakim Bin; Bello Yamusa, Yamusa

    2018-03-01

    Landfilling remains the most common systematic technique of solid waste disposal in most of the developed and developing countries. Finding a suitable site for landfill is a very challenging task. Landfill site selection process aims to provide suitable areas that will protect the environment and public health from pollution and hazards. Therefore, various factors such as environmental, physical, socio-economic, and geological criteria must be considered before siting any landfill. This makes the site selection process vigorous and tedious because it involves the processing of large amount of spatial data, rules and regulations from different agencies and also policy from decision makers. This allows the incorporation of conflicting objectives and decision maker preferences into spatial decision models. This paper particularly analyzes the multi-criteria evaluation (MCE) method of landfill site selection for solid waste management by means of literature reviews and surveys. The study will help the decision makers and waste management authorities to choose the most effective method when considering landfill site selection.

  20. Analysis of Multi-Criteria Evaluation Method of Landfill Site Selection for Municipal Solid Waste Management

    Directory of Open Access Journals (Sweden)

    Ibrahim Mohammed Habiba

    2018-01-01

    Full Text Available Landfilling remains the most common systematic technique of solid waste disposal in most of the developed and developing countries. Finding a suitable site for landfill is a very challenging task. Landfill site selection process aims to provide suitable areas that will protect the environment and public health from pollution and hazards. Therefore, various factors such as environmental, physical, socio-economic, and geological criteria must be considered before siting any landfill. This makes the site selection process vigorous and tedious because it involves the processing of large amount of spatial data, rules and regulations from different agencies and also policy from decision makers. This allows the incorporation of conflicting objectives and decision maker preferences into spatial decision models. This paper particularly analyzes the multi-criteria evaluation (MCE method of landfill site selection for solid waste management by means of literature reviews and surveys. The study will help the decision makers and waste management authorities to choose the most effective method when considering landfill site selection.

  1. Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia.

    Science.gov (United States)

    Jason, Leonard A; McManimen, Stephanie; Sunnquist, Madison; Newton, Julia L; Strand, Elin Bolle

    2017-01-01

    The Institute of Medicine (IOM) recently developed clinical criteria for chronic fatigue syndrome (CFS). There might be additional criteria that could select a more homogenous and impaired group of patients, particularly those with pain. The current study focused on criteria which involved meeting the four IOM criteria, excluding medical and psychiatric co-morbidities, along with having fibromyalgia (FM). Findings indicated that those meeting the IOM clinical criteria plus FM were more impaired on a wide variety of symptoms and functional areas than those meeting on the IOM criteria or those with just 6 months of fatigue. The implications of using such research criteria are discussed.

  2. Regulatory analysis on criteria for the release of patients administered radioactive material

    International Nuclear Information System (INIS)

    Schneider, S.; McGuire, S.A.

    1994-05-01

    The Nuclear Regulatory Commission (NRC) has received two petitions to amend its regulations in 10 CFR Parts 20 and 35 as they apply to doses received by members of the public exposed to patients released from a hospital after they have been administered radioactive material. While the two petitions are not identical they both request that the NRC establish a dose limit of 5 millisieverts (0.5 rem) per year for individuals exposed to patients who have been administered radioactive materials. This Regulatory Analysis evaluates three alternatives. Alternative 1 is for the NRC to amend its patient release criteria in 10 CFR 35.75 to use the more stringent dose limit of 1 millisievert per year in 10 CFR 20.1301(a) for its patient release criteria. Alternative 2 is for the NRC to continue using the existing patient release criteria in 10 CFR 35.75 of 1,110 megabecquerels of activity or a dose rate at one meter from the patient of 0.05 millisievert per hour. Alternative 3 is for the NRC to amend the patient release criteria in 10 CFR 35.75 to specify a dose limit of 5 millisieverts for patient release. The evaluation indicates that Alternative 1 would cause a prohibitively large increase in the national health care cost from retaining patients in a hospital longer and would cause significant personal and psychological costs to patients and their families. The choice of Alternatives 2 or 3 would affect only thyroid cancer patients treated with iodine-131. For those patients, Alternative 3 would result in less hospitalization than Alternative 2. Alternative 3 has a potential decrease in national health care cost of $30,000,000 per year but would increase the potential collective dose from released therapy patients by about 2,700 person-rem per year, mainly to family members

  3. Regulatory analysis on criteria for the release of patients administered radioactive material

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, S.; McGuire, S.A. [Nuclear Regulatory Commission, Washington, DC (United States). Div. of Regulatory Applications; Behling, U.H.; Behling, K.; Goldin, D. [Cohen (S.) and Associates, Inc., McLean, VA (United States)

    1994-05-01

    The Nuclear Regulatory Commission (NRC) has received two petitions to amend its regulations in 10 CFR Parts 20 and 35 as they apply to doses received by members of the public exposed to patients released from a hospital after they have been administered radioactive material. While the two petitions are not identical they both request that the NRC establish a dose limit of 5 millisieverts (0.5 rem) per year for individuals exposed to patients who have been administered radioactive materials. This Regulatory Analysis evaluates three alternatives. Alternative 1 is for the NRC to amend its patient release criteria in 10 CFR 35.75 to use the more stringent dose limit of 1 millisievert per year in 10 CFR 20.1301(a) for its patient release criteria. Alternative 2 is for the NRC to continue using the existing patient release criteria in 10 CFR 35.75 of 1,110 megabecquerels of activity or a dose rate at one meter from the patient of 0.05 millisievert per hour. Alternative 3 is for the NRC to amend the patient release criteria in 10 CFR 35.75 to specify a dose limit of 5 millisieverts for patient release. The evaluation indicates that Alternative 1 would cause a prohibitively large increase in the national health care cost from retaining patients in a hospital longer and would cause significant personal and psychological costs to patients and their families. The choice of Alternatives 2 or 3 would affect only thyroid cancer patients treated with iodine-131. For those patients, Alternative 3 would result in less hospitalization than Alternative 2. Alternative 3 has a potential decrease in national health care cost of $30,000,000 per year but would increase the potential collective dose from released therapy patients by about 2,700 person-rem per year, mainly to family members.

  4. Analysis of Paper reduction schemes to develop selection criteria for ofdm signals

    International Nuclear Information System (INIS)

    Abro, F.R.

    2015-01-01

    This paper presents a review of different PAPR (Peak to Average Power Ratio) reduction schemes of OFDM (Orthogonal Frequency Division Multiplexing) signals. The schemes that have been considered include Clipping and Filtering, Coding, ACE (Active Contstellation Extension), SLM (Selected Mapping), PTS (Partial Transmit Sequence), TI (Tone Injection) and TR (Tone Reservation). A comparative analysis has been carried out qualitatively. It has been demonstrated how these schemes can be combined with MIMO (Multiple Input Multiple Output) technologies. Finally, criteria for selection of PAPR reduction schemes of OFDM systems are discussed. (author)

  5. Geological Storage of CO2. Site Selection Criteria

    International Nuclear Information System (INIS)

    Ruiz, C.; Martinez, R.; Recreo, F.; Prado, P.; Campos, R.; Pelayo, M.; Losa, A. de la; Hurtado, A.; Lomba, L.; Perez del Villar, L.; Ortiz, G.; Sastre, J.; Zapatero, M. A.; Suarez, I.; Arenillas, A.

    2007-01-01

    In year 2002 the Spanish Parliament unanimously passed the ratification of the Kyoto Protocol, signed December 1997, compromising to limiting the greenhouse gas emissions increase. Later on, the Environment Ministry submitted the Spanish National Assignment Emissions Plan to the European Union and in year 2005 the Spanish Greenhouse Gas market started working, establishing taxes to pay in case of exceeding the assigned emissions limits. So, the avoided emissions of CO2 have now an economic value that is promoting new anthropogenic CO2 emissions reduction technologies. Carbon Capture and Storage (CCS) are among these new technological developments for mitigating or eliminate climate change. CO2 can be stored in geological formations such as depleted oil or gas fields, deep permeable saline water saturated formations and unmailable coal seams, among others. This report seeks to establish the selection criteria for suitable geological formations for CO2 storage in the Spanish national territory, paying attention to both the operational and performance requirements of these storage systems. The report presents the physical and chemical properties and performance of CO2 under storage conditions, the transport and reaction processes of both supercritical and gaseous CO2, and CO2 trapping mechanisms in geological formations. The main part of the report is devoted to geological criteria at watershed, site and formation scales. (Author) 100 refs

  6. Geological Storage of CO2. Site Selection Criteria

    International Nuclear Information System (INIS)

    Ruiz, C.; Martinez, R.; Recreo, F.; Prado, P.; Campos, R.; Pelayo, M.; Losa, A. de la; Hurtado, A.; Lomba, L.; Perez del Villar, L.; Ortiz, G.; Sastre, J.

    2006-01-01

    In year 2002 the Spanish Parliament unanimously passed the ratification of the Kyoto Protocol, signed December 1997, compromising to limiting the greenhouse gas emissions increase. Later on, the Environment Ministry submitted the Spanish National Assignment Emissions Plan to the European Union and in year 2005 the Spanish Greenhouse Gas market started working, establishing taxes to pay in case of exceeding the assigned emissions limits. So, the avoided emissions of CO2 have now an economic value that is promoting new anthropogenic CO2 emissions reduction technologies. Carbon Capture and Storage (CCS) are among these new technological developments for mitigating or eliminate climate change. CO2 can be stored in geological formations such as depleted oil or gas fields, deep permeable saline water saturated formations and unmineable coal seams, among others. This report seeks to establish the selection criteria for suitable geological formations for CO2 storage in the Spanish national territory, paying attention to both the operational and performance requirements of these storage systems. The report presents the physical and chemical properties and performance of CO2 under storage conditions, the transport and reaction processes of both supercritical and gaseous CO2, and CO2 trapping mechanisms in geological formations. The main part of the report is devoted to geological criteria at watershed, site and formation scales. (Author) 100 ref

  7. Who Should They Relate To? A Study For the Identification and Analysis of Criteria to the Partners’ Selection in Inter-Organizational Networks

    Directory of Open Access Journals (Sweden)

    Denise Rossato Quatrin

    2017-01-01

    Full Text Available The selection of partners is strategic in inter-organizational networks. One of the most important aspects is the definition of criteria for selection, that are the minimal characteristics required from those prospected. This study aimed to identify the most important criteria for the selection of members in horizontal inter-organizational networks, also describing their influence on network activities. First, we applied 120 questionnaires to managers of inter-organizational networks to identify the degree of importance of criteria previously treated in the literature. After, we interviewed 16 managers enabling us to identify other criteria, as well as understanding their influence on network activities. All of the 20 criteria from the literature were considered with significant importance by managers and the following criteria were added: trustworthiness, entrepreneur’s profile and company lifetime. The results aim to contribute to the selection of partners and provide information for the construction of the inter-organizational networks literature.

  8. Survey on patient doses in cardiology in Latin America. Criteria for high skin doses follow up

    International Nuclear Information System (INIS)

    Duran, Ariel; Duro, Ivanna; Lopez, Leonardo; Ramirez, Alfredo; Herrera, Carlos; Navarro, Joaquin; Rivarola, Carlos; Lopez, Jose A.

    2008-01-01

    Full text: As part of the International Action Plan for Protection of Patients and supporting by the IAEA, a survey on patient doses in fluoroscopy guided procedures in cardiology in Latin America has been conducted since 2006. One of the objectives of the survey was to set criteria for the identification and evaluation of high skin doses in a certain number of patients to recommend a clinical follow up for potential radiation injuries (more than 3 Gy at the skin). The used methodology for the survey was initiated with two dedicated workshops held in Santiago de Chile (2005) and San Jose de Costa Rica (2007) involving relevant cardiologists from 15 different Latin American Countries. Some sessions were also attended by experts from the Regulatory and Health Authorities. Standardized forms to collect demographic and patient dosimetric data were agreed. Considering that most of the involved centres had still not dosimeters installed in the cardiology x-ray systems, it was agreed to collect data on fluoroscopy time and total number of cine frames per procedure. Relevant factors influencing radio sensitivity of the skin were also collected. Data from 10 countries representing a sample of 709 patients were received during the first year. Procedures included were diagnostic (DG) (coronary angiography and electrophysiology studies), therapeutic (TH) (percutaneous transluminal coronary angioplasties, cardiac ablations and valvuloplasties) or including both DG and TH. A total of 26 patients (3.7%) were selected for potential high skin doses. Initial considered criteria for selection were more than 30 minutes of fluoroscopy, more than 3,000 cine frames per procedure or patients with more than 100 kg of weight. Maximum reported values were 72 minutes and 8,100 frames. In addition, 5 of these patients were diabetic, 6 have previous fluoroscopy procedures and 5 were over 95 kg. The percentage of selected cases for clinical follow up derived from potential skin injuries seem

  9. FSAW for REIT selection in multi-criteria decision making

    Science.gov (United States)

    Adawiyah, C. W. Rabiatul; Abdullah, Lazim

    2014-07-01

    Real Estate Investment Trust (REIT) is profitable investments that gain Malaysian investors' attention. It can be a great way to increase our net worth. Due to the existence of many property trusts, investors face difficulties in determining the best property trusts to invest their wealth. This high risk investment makes investors cautious in choosing the platform for investing their wealth. In real world situation, the data collected are inexact and ambiguous. Investment reminds investors to beware because it carries risk no matter low or high. There are lots of things that investors need to consider before invest in any property or trust. The aim of this paper is to identify the best criteria of REIT and determine the best property trust that helps investors gain profits in their investment. Four experts in areas of investment are randomly selected to assess and provide information regarding to Malaysia's REITs. Decision makers were asked to rate the criteria for every alternatives by using the linguistic variables. The five linguistic variables were used as input data to test fuzzy simple additive weighting (FSAW) model. From the study conducted, transparency indicates the necessary criteria for each property trust. This decision making model used to be possible to test FSAW model in investment sector. The decision makers also asked to evaluate the alternatives based on the linguistic ranking variables to rank the alternatives and the result shows the best alternative in this case is Amanah Harta Tanah PNB. The ranking signifies the impact of the criterion and alternatives to investors especially REITs investors.

  10. Supplier Selection in the Thermal Tourism Enterprises with Using Multi Criteria Decision Making Techniques

    Directory of Open Access Journals (Sweden)

    Hatice Gündüz

    2015-06-01

    Full Text Available Turkey has many natural health resources and the interest in Thermal Tourism has increased. Thermal Tourism Enterprises serve their experienced medical staff, treatment methods and the curative springs for the purpose of care services. On the other hand, these enterprises are also the place to have both a rest and a good time. In this study, the supplier selection application is performed in the Thermal Tourism Enterprise that offers a combination of services as health, recreation and entertainment. The criteria as product quality and performance, product information, product arrival time, price, quality practices, flexibility and the collaboration level have been considered. By using multi-criteria decision making techniques as Analytic Hierarchy Process (AHP and TOPSIS then the suggestions on the selecting the best supplier are offered.

  11. [Inappropriate prescription in older patients: the STOPP/START criteria].

    LENUS (Irish Health Repository)

    Delgado Silveira, Eva

    2009-09-01

    Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

  12. 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

  13. What constitutes evidence-based patient information? Overview of discussed criteria.

    Science.gov (United States)

    Bunge, Martina; Mühlhauser, Ingrid; Steckelberg, Anke

    2010-03-01

    To survey quality criteria for evidence-based patient information (EBPI) and to compile the evidence for the identified criteria. Databases PubMed, Cochrane Library, PsycINFO, PSYNDEX and Education Research Information Center (ERIC) were searched to update the pool of criteria for EBPI. A subsequent search aimed to identify evidence for each criterion. Only studies on health issues with cognitive outcome measures were included. Evidence for each criterion is presented using descriptive methods. 3 systematic reviews, 24 randomized-controlled studies and 1 non-systematic review were included. Presentation of numerical data, verbal presentation of risks and diagrams, graphics and charts are based on good evidence. Content of information and meta-information, loss- and gain-framing and patient-oriented outcome measures are based on ethical guidelines. There is a lack of studies on quality of evidence, pictures and drawings, patient narratives, cultural aspects, layout, language and development process. The results of this review allow specification of EBPI and may help to advance the discourse among related disciplines. Research gaps are highlighted. Findings outline the type and extent of content of EBPI, guide the presentation of information and describe the development process. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  14. 25 CFR 1001.10 - Selection criteria for other planning and negotiating financial assistance.

    Science.gov (United States)

    2010-04-01

    ... for other financial assistance for planning and negotiating of a DOI non-BIA program, service... circumstances may planning and negotiation financial assistance be made available to tribes/consortia? At the... 25 Indians 2 2010-04-01 2010-04-01 false Selection criteria for other planning and negotiating...

  15. Criteria for nonoperative management of blunt splenic trauma

    Directory of Open Access Journals (Sweden)

    Sarmast Shoushtary MH

    2009-02-01

    Full Text Available "nBackground: Although nonoperative management is as an alternative method for surgery in the management of blunt splenic trauma, there are many contraversies in criteria for appropriate selection of the best method of management in patients. This study was conducted to find clinical and diagnostic criteria for selection of patients for surgery. "nMethods: One hundred and one patients with blunt splenic injury entered in our prospective observational and cross sectional study. Patients with unstable hemodyna-mics and obvious abdominal symptoms underwent emergency splenectomy was performed. In stable patients, abdominal and pelvic CT scan with IV contrast was performed. Patients with stable hemodynamics who lack obvious abdominal symptoms, admitted in ICU ward. Patients' demographics, blood pressure changes, hemoglobin concertration, severity of trauma with injury severity score (ISS scoring system, CT scan findings, amount of blood transfusion; Hospitalization time and mechanism of injury were recorded. "nResults: From 101 patients, 61(60.3% underwent early laparotomy. 40 patients were planned for conservative management. In 30 patients (29.7% nonoperative management was successful. In 10 patients (9.9% This management failed and they underwent surgery. Hypotension, hemoglobin concentration dropping more than one episode and blood transfusion requirement more than one time, increased the risk of operation. Higher ISS number and ISS≥16 had a direct relation with operative management. In patients who underwent early laparotomy CT grade of injury was higher. CT findings correlated well with laparotomy findings. "nConclusion: Nonoperative management was successful in 75% of selected patients. With correct selection of patients and concerning to homodynamic status, hemoglobin concentration changes and injury severity score in conjunction with CT findings, we can use this management in greater number of patients.

  16. Downstaging therapy followed by liver transplantation for hepatocellular carcinoma beyond Milan criteria.

    Science.gov (United States)

    Kim, Young; Stahl, Christopher C; Makramalla, Abouelmagd; Olowokure, Olugbenga O; Ristagno, Ross L; Dhar, Vikrom K; Schoech, Michael R; Chadalavada, Seetharam; Latif, Tahir; Kharofa, Jordan; Bari, Khurram; Shah, Shimul A

    2017-12-01

    Orthotopic liver transplantation is a curative treatment for hepatocellular carcinoma within Milan criteria, but these criteria preclude many patients from transplant candidacy. Recent studies have demonstrated that downstaging therapy can reduce tumor burden to meet conventional criteria. The present study reports a single-center experience with tumor downstaging and its effects on post-orthotopic liver transplantation outcomes. All patients with hepatocellular carcinoma who were evaluated by our multidisciplinary liver services team from 2012 to 2016 were identified (N = 214). Orthotopic liver transplantation candidates presenting outside of Milan criteria at initial radiographic diagnosis and/or an initial alpha-fetoprotein >400 ng/mL were categorized as at high risk for tumor recurrence and post-transplant mortality. Of the 214 patients newly diagnosed with hepatocellular carcinoma, 73 (34.1%) eventually underwent orthotopic liver transplantation. The majority of patients who did not undergo orthotopic liver transplantation were deceased or lost to follow-up (47.5%), with 14 of 141 (9.9%) currently listed for transplantation. Among transplanted patients, 21 of 73 (28.8%) were considered high-risk candidates. All 21 patients were downstaged to within Milan criteria with an alpha-fetoprotein hepatocellular carcinoma was higher but acceptable between downstaged high-risk and traditional candidates (9.5% vs 1.9%; P > .05) at a median follow-up period of 17 months. Downstaged high-risk candidates had a similar overall survival compared with those transplanted within Milan criteria (log-rank P > .05). In highly selected cases, patients with hepatocellular carcinoma outside of traditional criteria for orthotopic liver transplantation may undergo downstaging therapy in a multidisciplinary fashion with excellent post-transplant outcomes. These data support an aggressive downstaging approach for selected patients who would otherwise be deemed ineligible for

  17. Trauma team activation criteria in managing trauma patients at an emergency room in Thailand.

    Science.gov (United States)

    Wuthisuthimethawee, P

    2017-02-01

    Trauma team activation (TTA) criteria were first implemented in the Emergency Department (ED) of Songklanagarind Hospital in 2009 to treat severe trauma patients. To determine the efficacy of the TTA criteria on the acute trauma care process in the ED and the 28-day mortality rate. A 1-year prospective cohort study was conducted at the ED. Trauma patients who were 18 years old and over who met the TTA criteria were enrolled. Demographic data, physiologic parameters, ED length of stay (EDLOS), and the injury severity score (ISS) were recorded. Multiple logistic regression was used to determine the factors affecting 28-day mortality. Institutional review board approval was obtained from the Prince of Songkla University. A total of 80 patients (74 male and 6 female) were eligible with a mean age of 34.3 years old. Shock, penetrating torso injury, and pulse rate >120 beats per minute were the three most common criteria for trauma team consultation. At the ED, 9 patients (11.3 %) were non-survivors, 30 patients (37.5 %) needed immediate operation, and 41 patients (51.2 %) were admitted. All of the arrest patients died (p team activation criteria improved acute trauma care in the ED which was demonstrated by the decreased EDLOS and mortality rate. A high ISS is the sole parameter predicting mortality.

  18. Racial and ethnic disparities in meeting MTM eligibility criteria among patients with asthma.

    Science.gov (United States)

    Lu, Degan; Qiao, Yanru; Johnson, Karen C; Wang, Junling

    2017-06-01

    Asthma is one of the most frequently targeted chronic diseases in the medication therapy management (MTM) programs of the Medicare prescription drug (Part D) benefits. Although racial and ethnic disparities in meeting eligibility criteria for MTM services have been reported, little is known about whether there would be similar disparities among adults with asthma in the United States. Adult patients with asthma (age ≥ 18) from Medical Expenditure Panel Survey (2011-2012) were analyzed. Bivariate analyses were conducted to compare the proportions of patients who would meet Medicare MTM eligibility criteria between non-Hispanic Blacks (Blacks), Hispanics and non-Hispanic Whites (Whites). Survey-weighted logistic regression was performed to adjust for patient characteristics. Main and sensitivity analyses were conducted to cover the entire range of the eligibility thresholds used by Part D plans in 2011-2012. The sample included 4,455 patients with asthma, including 2,294 Whites, 1,218 Blacks, and 943 Hispanics. Blacks and Hispanics had lower proportions of meeting MTM eligibility criteria than did Whites (P asthma. Future studies should examine the implications of such disparities on health outcomes of patients with asthma and explore alternative MTM eligibility criteria.

  19. Amplifying Each Patient's Voice: A Systematic Review of Multi-criteria Decision Analyses Involving Patients.

    Science.gov (United States)

    Marsh, Kevin; Caro, J Jaime; Hamed, Alaa; Zaiser, Erica

    2017-04-01

    Qualitative methods tend to be used to incorporate patient preferences into healthcare decision making. However, for patient preferences to be given adequate consideration by decision makers they need to be quantified. Multi-criteria decision analysis (MCDA) is one way to quantify and capture the patient voice. The objective of this review was to report on existing MCDAs involving patients to support the future use of MCDA to capture the patient voice. MEDLINE and EMBASE were searched in June 2014 for English-language papers with no date restriction. The following search terms were used: 'multi-criteria decision*', 'multiple criteria decision*', 'MCDA', 'benefit risk assessment*', 'risk benefit assessment*', 'multicriteri* decision*', 'MCDM', 'multi-criteri* decision*'. Abstracts were included if they reported the application of MCDA to assess healthcare interventions where patients were the source of weights. Abstracts were excluded if they did not apply MCDA, such as discussions of how MCDA could be used; or did not evaluate healthcare interventions, such as MCDAs to assess the level of health need in a locality. Data were extracted on weighting method, variation in patient and expert preferences, and discussion on different weighting techniques. The review identified ten English-language studies that reported an MCDA to assess healthcare interventions and involved patients as a source of weights. These studies reported 12 applications of MCDA. Different methods of preference elicitation were employed: direct weighting in workshops; discrete choice experiment surveys; and the analytical hierarchy process using both workshops and surveys. There was significant heterogeneity in patient responses and differences between patients, who put greater weight on disease characteristics and treatment convenience, and experts, who put more weight on efficacy. The studies highlighted cognitive challenges associated with some weighting methods, though patients' views on their

  20. [Social and ethical criteria for prioritizing patients: a survey of students and health professionals in Portugal].

    Science.gov (United States)

    Pinho, Micaela Moreira

    2016-12-01

    This qualitative/quantitative study examines the ethical dilemma of microallocation of health resources. It seeks to identify and compare the opinion of two groups in Portuguese society - students and health professionals - on the importance of personal characteristics of patients at the moment of prioritizing them and if the choices can be explained by bioethical references of a utilitarian or deontological nature. Data were collected by means of a questionnaire administered to a sample of 180 students and 60 health professionals. Faced with hypothetical emergency scenarios, the respondents had to choose between two patients (distinguished by: age, gender, social responsibility, economic and employment situation, harmful health behaviors and criminal record), duly selecting who to treat and then justifying their choice. The results suggest the existence of differences in choices between the two groups, with health professionals revealing they are less prepared to accept the use of social criteria in a context of scarce resources and co-existence of utilitarian and deontological criteria, with a predominance of efficiency on the part of health professionals and equity on the part of students.

  1. Criteria for Selection and Rejection of Social Relationships among Children in Urban and Rural Kindergartens in Greece

    Science.gov (United States)

    Rekalidou, Galini; Petrogiannis, Konstantinos

    2012-01-01

    This paper reports on preschool children's social relationships developed in urban and rural kindergarten classes in Greece. We investigated the selection and rejection criteria children use and examined potential criteria differences as a function of a number of socio-demographic variables (children's age group, gender, parental job status,…

  2. 77 FR 5243 - Proposed Priority, Requirements, Definitions, and Selection Criteria-Arts in Education National...

    Science.gov (United States)

    2012-02-02

    ...-quality arts education and arts integration activities and services in music, dance, theater, media arts... DEPARTMENT OF EDUCATION Proposed Priority, Requirements, Definitions, and Selection Criteria--Arts in Education National Program (AENP) AGENCY: Office of Innovation and Improvement, Department of...

  3. South African medical schools: Current state of selection criteria and medical students' demographic profile.

    Science.gov (United States)

    van der Merwe, L J; van Zyl, G J; St Clair Gibson, A; Viljoen, M; Iputo, J E; Mammen, M; Chitha, W; Perez, A M; Hartman, N; Fonn, S; Green-Thompson, L; Ayo-Ysuf, O A; Botha, G C; Manning, D; Botha, S J; Hift, R; Retief, P; van Heerden, B B; Volmink, J

    2015-12-16

    Selection of medical students at South African (SA) medical schools must promote equitable and fair access to students from all population groups, while ensuring optimal student throughput and success, and training future healthcare practitioners who will fulfil the needs of the local society. In keeping with international practices, a variety of academic and non-academic measures are used to select applicants for medical training programmes in SA medical schools. To provide an overview of the selection procedures used by all eight medical schools in SA, and the student demographics (race and gender) at these medical schools, and to determine to what extent collective practices are achieving the goals of student diversity and inclusivity. A retrospective, quantitative, descriptive study design was used. All eight medical schools in SA provided information regarding selection criteria, selection procedures, and student demographics (race and gender). Descriptive analysis of data was done by calculating frequencies and percentages of the variables measured. Medical schools in SA make use of academic and non-academic criteria in their selection processes. The latter include indices of socioeconomic disadvantage. Most undergraduate medical students in SA are black (38.7%), followed by white (33.0%), coloured (13.4%) and Indian/Asian (13.6%). The majority of students are female (62.2%). The number of black students is still proportionately lower than in the general population, while other groups are overrepresented. Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

  4. A fuzzy multi-criteria decision model for integrated suppliers selection and optimal order allocation in the green supply chain

    Directory of Open Access Journals (Sweden)

    Hamzeh Amin-Tahmasbi

    2018-09-01

    Full Text Available Today, with the advancement of technology in the production process of various products, the achievement of sustainable production and development has become one of the main concerns of factories and manufacturing organizations. In the same vein, many manufacturers try to select suppliers in their upstream supply chains that have the best performance in terms of sustainable development criteria. In this research, a new multi-criteria decision-making model for selecting suppliers and assigning orders in the green supply chain is presented with a fuzzy optimization approach. Due to uncertainty in supplier capacity as well as customer demand, the problem is formulated as a fuzzy multi-objective linear programming (FMOLP. The proposed model for the selection of suppliers of SAPCO Corporation is evaluated. Firstly, in order to select and rank suppliers in a green supply chain, a network structure of criteria has defined with five main criteria of cost, quality, delivery, technology and environmental benefits. Subsequently, using incomplete fuzzy linguistic relationships, pair-wise comparisons between the criteria and sub-criteria as well as the operation of the options will be assessed. The results of these comparisons rank the existing suppliers in terms of performance and determine the utility of them. The output of these calculations (utility index is used in the optimization model. Subsequently, in the order allocation process, the two functions of the target cost of purchase and purchase value are optimized simultaneously. Finally, the order quantity is determined for each supplier in each period.

  5. The Problem of Multiple Criteria Selection of the Surface Mining Haul Trucks

    Science.gov (United States)

    Bodziony, Przemysław; Kasztelewicz, Zbigniew; Sawicki, Piotr

    2016-06-01

    Vehicle transport is a dominant type of technological processes in rock mines, and its profit ability is strictly dependent on overall cost of its exploitation, especially on diesel oil consumption. Thus, a rational design of transportation system based on haul trucks should result from thorough analysis of technical and economic issues, including both cost of purchase and its further exploitation, having a crucial impact on the cost of minerals extraction. Moreover, off-highway trucks should be selected with respect to all specific exploitation conditions and even the user's preferences and experience. In this paper a development of universal family of evaluation criteria as well as application of evaluation method for haul truck selection process for a specific exploitation conditions in surface mining have been carried out. The methodology presented in the paper is based on the principles of multiple criteria decision aiding (MCDA) using one of the ranking method, i.e. ELECTRE III. The applied methodology has been allowed for ranking of alternative solution (variants), on the considered set of haul trucks. The result of the research is a universal methodology, and it consequently may be applied in other surface mines with similar exploitation parametres.

  6. Selection of response criteria for clinical trials of sarcoma treatment.

    Science.gov (United States)

    Schuetze, Scott M; Baker, Laurence H; Benjamin, Robert S; Canetta, Renzo

    2008-01-01

    Soft tissue sarcomas are a heterogeneous group of malignancies arising from mesenchymal tissues. A large number of new therapies are being evaluated in patients with sarcomas, and consensus criteria defining treatment responses are essential for comparison of results from studies completed by different research groups. The 1979 World Health Organization (WHO) handbook set forth operationally defined criteria for response evaluation in solid tumors that were updated in 2000 with the publication of the Response Evaluation Criteria in Solid Tumors (RECIST). There have been significant advances in tumor imaging, however, that are not reflected in the RECIST. For example, computed tomography (CT) slice thickness has been reduced from 10 mm to < or =2.5 mm, allowing for more reproducible and accurate measurement of smaller lesions. Combination of imaging techniques, such as positron emission tomography with fluorine-18-fluorodeoxyglucose (18FDG-PET) and CT can provide investigators and clinicians with both anatomical and functional information regarding tumors, and there is now a large body of evidence demonstrating the effectiveness of PET/CT and other newer imaging methods for the detection and staging of tumors as well as early determination of responses to therapy. The application of newer imaging methods has the potential to decrease both the sample sizes required for, and duration of, clinical trials by providing an early indication of therapeutic response that is well correlated with clinical outcomes, such as time to tumor progression or overall survival. The results summarized in this review support the conclusion that the RECIST and the WHO criteria for evaluation of response in solid tumors need to be modernized. In addition, there is a current need for prospective trials to compare new response criteria with established endpoints and to validate imaging-based response rates as surrogate endpoints for clinical trials of new agents for sarcoma and other solid

  7. Anatomical criteria of malignancy by computed tomography angiography in patients with anomalous coronary arteries with an interarterial course

    Energy Technology Data Exchange (ETDEWEB)

    Ashrafpoor, Golmehr [Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Universite Paris Descartes, Department of Radiology, Cardiovascular Imaging Unit, Paris (France); Danchin, Nicolas [Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Universite Paris Descartes, Department of Cardiology, Paris (France); Houyel, Lucile; Belli, Emre [Centre Chirurgical Marie-Lannelongue, Department of Congenital Cardiac Surgery, Le Plessis-Robinson (France); Ramadan, Ramzi [Centre Chirurgical Marie-Lannelongue, Department of Cardiac Surgery, Le Plessis-Robinson (France); Paul, Jean-Francois [Institut Mutualiste Montsouris, Department of Radiology, Paris (France)

    2014-10-11

    We sought to determine the relation between major adverse cardiac events (MACE) and anatomical criteria assessed by coronary computed tomography angiography (CCTA) in patients with an anomalous coronary artery with an interarterial course (ACAIAC). We selected CCTA studies of patients with an ACAIAC from a database of 4,160 examinations and studied anatomical criteria according to the presence of prior MACE, defined as syncope, unstable angina, myocardial infarction and resuscitated sudden cardiac death. There were 19 patients (18 males) with an ACAIAC during the study period (incidence 0.46 %). Seven patients with prior MACE were younger (26 years vs 59 years, p < 0.001), had a smaller minimal lumen area (3.6 mm{sup 2} vs 9.0 mm{sup 2}, p = 0.001), a higher degree of area stenosis (57 % vs 24 %, p = 0.001), a longer interarterial course (14.7 vs 8.6 mm, p = 0.003) and a smaller proximal segment width (1.6 mm vs 2.5 mm, p = 0.02) compared with the 12 patients without prior MACE. All patients with MACE had the following concomitant anatomical characteristics: minimum lumen area ≤4 mm{sup 2}, an area stenosis ≥50 % and intra-arterial length >10 mm Prior MACE is associated with specific anatomical CCTA characteristics among patients with ACAIAC. CCTA may therefore contribute to distinguish patients at risk of adverse events. (orig.)

  8. CLOTHING BUYING MOTIVES AND STORE SELECTION CRITERIA – THE CASE OF CROATIAN ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    Blaženka Knežević

    2016-12-01

    Full Text Available The aim of this paper is to analyse Croatian adolescents’ clothing buying motives and their retail store selection criteria. The paper examined their preferences, attitudes and behaviours when buying clothes - whether adolescents with different primary clothing motives would have similar or different store selection criteria. Also, the paper determined how today’s adolescents spend money on clothes and whether they are more inclined to purchase branded clothes or not. Finally, the paper explained whether Croatian adolescents prefer purchasing in small or large specialized apparel stores, or whether they are more prone to online purchasing or even buying clothes in second-hand shops. Also, the society influences in forming adolescents’ attitudes and decisions towards store selection and purchasing preferences of clothes were examined. The research findings showed that shopping centres are the preferred retail format. In addition, adolescents do not have a fully developed attitude on fashion and clothing. Therefore, they strongly refer to opinions of family and friends when choosing clothes. Moreover, the Internet and TV are evaluated as influential channels of consumer communication within this particular group of consumers. Based on the findings, suggestions for service management and marketing strategies are provided for apparel retail companies that target adolescents.

  9. The effect of different criteria on the number of patients blind from open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Heijl Anders

    2011-11-01

    Full Text Available Abstract Background The prevalence of blindness and visual impairment from glaucoma is influenced by the criteria used to define these entities, which differ between countries and regions, as well as among published reports. The objective of the present study was to ascertain the extent to which different criteria of blindness and visual impairment influence estimates of the number of patients classified as blind or visually impaired by glaucoma in a clinic-based population. Methods We conducted a retrospective chart review of 914 patients with open-angle glaucoma to compare numbers of patients identified as visually impaired with and without considering visual field status. We also compared proportions classified using World Health Organisation (WHO and United States (US blindness criteria, and applying a new US Social Security Administration (SSA disability criterion: perimetric mean deviation (MD ≤ -22 dB. Results Forty patients (4.4% were bilaterally blind from glaucoma by the WHO criteria. Fifty-two (5.7% were blind by the the US criterion. Assessing only visual acuity, 14 (1.5% patients were blind by the WHO criteria and 24 (2.6% by the US definition. Eighty-five (9.3% met the US SSA disability criterion. Among those, 52 were impaired also by the WHO definition. No patients impaired according to the WHO criteria had MD values better than -22 dB. Conclusions Excluding visual field status will seriously underestimate the prevalence of glaucoma blindness. In our patient population, 30% more patients were classified as blind by the US than by the WHO definition. Also, 60% more were identified as visually impaired by the US SSA criterion than by the WHO criteria. Visual field assessment is vital to determine visual impairment caused by glaucoma.

  10. Application of multi-criteria material selection techniques to constituent refinement in biobased composites

    International Nuclear Information System (INIS)

    Miller, Sabbie A.; Lepech, Michael D.; Billington, Sarah L.

    2013-01-01

    Highlights: • Biobased composites have the potential to replace certain engineered materials. • Woven reinforcement can provide better material properties in biobased composites. • Short fiber filler can provide lower environmental impact in biobased composites. • Per function, different fibers are desired to lower composite environmental impact. - Abstract: Biobased composites offer a potentially low environmental impact material option for the construction industries. Designing these materials to meet both performance requirements for an application and minimize environmental impacts requires the ability to refine composite constituents based on environmental impact and mechanical properties. In this research, biobased composites with varying natural fiber reinforcement in a poly(β-hydroxybutyrate)-co-(β-hydroxyvalerate) matrix were characterized based on material properties through experiments and environmental impact through life cycle assessments. Using experimental results, these biobased composites were found to have competitive flexural properties and thermal conductivity with certain short-chopped glass fiber reinforced plastics. Multi-criteria material selection techniques were applied to weigh desired material properties with greenhouse gas emissions, fossil fuel demand, and Eco-Indicator ’99 score. The effects of using different reinforcing fibers in biobased composites were analyzed using the developed selection scheme as a tool for choosing constituents. The use of multi-criteria material selection provided the ability to select fiber reinforcement for biobased composites and showed when it would be more appropriate to use a novel biobased composite or a currently available engineered material

  11. Degree of agreement among sepsis diagnosis criteria in adult emergency room patients with infection

    Science.gov (United States)

    Sinto, R.; Chandra, A. T.; Lie, K. C.; Suwarto, S.

    2018-03-01

    The study on the degree of agreement among three established sepsis diagnosis criteria become the necessity to investigate the best sepsis diagnosis criteria in Indonesia further. A cross-sectional study of adult Emergency Room patients hospitalized with a diagnosis of infection in CiptoMangunkusumo Hospital, Indonesia was conducted during March and April 2017. We recorded diagnosis, gender, age, comorbidities, infection source, and origin. Every subject was classified into sepsis and non-sepsis based on 1991, 2001 and sepsis-3 criteria. Raw % and Kappa agreement coefficients (κ) were calculated according to previously established formula to measure the degree of agreement among three diagnostic criteria. As many as 278 subjects were included in this study. The raw % agreement and κ between 1991 and 2001 criteria is 69.07% and 0.34 respectively. The raw % agreement and κ between 2001 and sepsis-3 criteria is 56.12% and 0.15 respectively. The raw % agreement and κ between 1991 and sepsis-3 criteria is 48.19% and -0.02. In conclusions, there is afair agreement between 1991 and 2001 criteria, poor agreement between 2001 and sepsis-3 criteria, and poor disagreement between 1991 and sepsis-3 criteria. This necessitates further Indonesian study of the best diagnosis criteria to diagnose an infected patient with sepsis.

  12. Application of ecological criteria in selecting marine reserves and developing reserve networks

    Science.gov (United States)

    Roberts, Callum M.; Branch, George; Bustamante, Rodrigo H.; Castilla, Juan Carlos; Dugan, Jenifer; Halpern, Benjamin S.; Lafferty, Kevin D.; Leslie, Heather; McArdle, Deborah; Ruckelshaus, Mary; Warner, Robert R.

    2003-01-01

    Marine reserves are being established worldwide in response to a growing recognition of the conservation crisis that is building in the oceans. However, designation of reserves has been largely opportunistic, or protective measures have been implemented (often overlapping and sometimes in conflict) by different entities seeking to achieve different ends. This has created confusion among both users and enforcers, and the proliferation of different measures provides a false sense of protection where little is offered. This paper sets out a procedure grounded in current understanding of ecological processes, that allows the evaluation and selection of reserve sites in order to develop functional, interconnected networks of fully protected reserves that will fulfill multiple objectives. By fully protected we mean permanently closed to fishing and other resource extraction. We provide a framework that unifies the central aims of conservation and fishery management, while also meeting other human needs such as the provision of ecosystem services (e.g., maintenance of coastal water quality, shoreline protection, and recreational opportunities). In our scheme, candidate sites for reserves are evaluated against 12 criteria focused toward sustaining the biological integrity and productivity of marine systems at both local and regional scales. While a limited number of sites will be indispensable in a network, many will be of similar value as reserves, allowing the design of numerous alternative, biologically adequate networks. Devising multiple network designs will help ensure that ecological functionality is preserved throughout the socioeconomic evaluation process. Too often, socioeconomic criteria have dominated the process of reserve selection, potentially undermining their efficacy. We argue that application of biological criteria must precede and inform socioeconomic evaluation, since maintenance of ecosystem functioning is essential for meeting all of the goals for

  13. Behçet's disease patients with multiple sclerosis-like features: discriminative value of Barkhof criteria.

    Science.gov (United States)

    Akman-Demir, Gulsen; Mutlu, Melike; Kiyat-Atamer, Asli; Shugaiv, Erkingul; Kurtuncu, Murat; Tugal-Tutkun, Ilknur; Tuzun, Erdem; Eraksoy, Mefkure; Bahar, Sara

    2015-01-01

    Behçet's disease (BD) is a systemic auto-inflammatory disorder of unknown cause, which may affect the central nervous system in around 5% of the patients [neuro-BD (NBD)], usually causing large lesions encompassing brainstem, diencephalon and basal ganglia regions. Occasionally NBD patients present with white matter lesions necessitating differential diagnosis from multiple sclerosis (MS). In this study, the efficacy of Barkhof criteria was tested in diagnostic differentiation of NBD and MS. Charts and MRIs of 84 NBD patients were retrospectively evaluated. Clinical and radiological features of NBD patients fulfilling (Barkhof+) and not fulfilling Barkhof criteria (Barkhof-) were compared. While the Barkhof- patients (n=73) mostly displayed typical large lesions covering brainstem, diencephalon and basal ganglia regions and neurological findings consistent with brainstem involvement, all Barkhof+ (n=11) patients demonstrated MS-like white matter lesions, fulfilled McDonald's criteria and showed reduced frequency of brainstem symptoms and increased frequency of hemiparesis, hemihypesthesia and spinal cord symptoms. Moreover, the Barkhof+ group had more female patients, increased number of attacks, higher rate of oligoclonal band positivity and less patients with cerebrospinal fluid pleocytosis. A subgroup of BD patients with neurological complaints displays MS-like lesions, fulfills the clinical and radiological criteria of MS and presents with clinical and laboratory features resembling those of MS rather than NBD. These results suggest that Barkhof+ patients are either an overlapping group between NBD and MS, or they represent MS patients with concomitant systemic findings of BD, rather than NBD. Barkhof criteria appear to be effective in discriminating these patients.

  14. Early Site Permit Demonstration Program: Siting Guide, Site selection and evaluation criteria for an early site permit application. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1993-03-24

    In August 1991, the Joint Contractors came to agreement with Sandia National Laboratories (SNL) and the Department of Energy (DOE) on a workscope for the cost-shared Early Site Permit Demonstration Program. One task within the scope was the development of a guide for site selection criteria and procedures. A generic Siting Guide his been prepared that is a roadmap and tool for applicants to use developing detailed siting plans for their specific region of the country. The guide presents three fundamental principles that, if used, ensure a high degree of success for an ESP applicant. First, the site selection process should take into consideration environmentally diverse site locations within a given region of interest. Second, the process should contain appropriate opportunities for input from the public. Third, the process should be applied so that it is clearly reasonable to an impartial observer, based on appropriately selected criteria, including criteria which demonstrate that the site can host an advanced light water reactor (ALWR). The Siting Guide provides for a systematic, comprehensive site selection process in which three basic types of criteria (exclusionary, avoidance, and suitability) are presented via a four-step procedure. It provides a check list of the criteria for each one of these steps. Criteria are applied qualitatively, as well as presented numerically, within the guide. The applicant should use the generic guide as an exhaustive checklist, customizing the guide to his individual situation.

  15. Determination and evaluation of effective criteria to location selection the optimal for establishing fluting paper mills from agricultural residues of Mazandaran province

    Directory of Open Access Journals (Sweden)

    Abdollah barimani

    2013-11-01

    Full Text Available Location selection for factory competitiveness in the market place plays an important role and should be chosen so that will leads achievement of the strategic advantages compared with other competitors. The objective of this study was determination of the effective criteria for decision making to select the most suitable location for establishing a fluting paper mills from agricultural residues. For this purpose, effective criteria were divided into five major groups: Material and Product, Facilities and limitations of regional (infrastructure, Technical and Human, Economical, Rules & Regulations as well as 33 sub-criteria, after preliminary investigation, preparatory observation, and an interview with some of the paper producers and relevant experts. A hierarchy was designed based on five major groups of criteria and then the priority rates of obtained criteria and sub-criteria were determined by Analytical Hierarchy Process (AHP after compiling expert's opinions via questionnaire. Results have shown that among 33 determined effective criteria in location selection of fluting paper mills from agricultural residues , the sub-criteria of Supply residual amount, Ensure the supply of residual, Cost purchasing of raw material, Cost of transporting raw material have the highest priorities, respectively

  16. Correlations between PANCE performance, physician assistant program grade point average, and selection criteria.

    Science.gov (United States)

    Brown, Gina; Imel, Brittany; Nelson, Alyssa; Hale, LaDonna S; Jansen, Nick

    2013-01-01

    The purpose of this study was to examine correlations between first-time Physician Assistant National Certifying Exam (PANCE) scores and pass/fail status, physician assistant (PA) program didactic grade point average (GPA), and specific selection criteria. This retrospective study evaluated graduating classes from 2007, 2008, and 2009 at a single program (N = 119). There was no correlation between PANCE performance and undergraduate grade point average (GPA), science prerequisite GPA, or health care experience. There was a moderate correlation between PANCE pass/fail and where students took science prerequisites (r = 0.27, P = .003) but not with the PANCE score. PANCE scores were correlated with overall PA program GPA (r = 0.67), PA pharmacology grade (r = 0.68), and PA anatomy grade (r = 0.41) but not with PANCE pass/fail. Correlations between selection criteria and PANCE performance were limited, but further research regarding the influence of prerequisite institution type may be warranted and may improve admission decisions. PANCE scores and PA program GPA correlations may guide academic advising and remediation decisions for current students.

  17. 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.

  18. Applicability of the 2001 revised diagnostic criteria in Brazilian Vogt-Koyanagi-Harada disease patients.

    Science.gov (United States)

    Cardoso, Isabel Habeyche; Zajdenweber, Moysés Eduardo; Muccioli, Cristina; Fimamor, Luciana Peixoto; Belfort, Rubens

    2008-01-01

    To determine the applicability of the international revised diagnostic criteria for Vogt-Koyanagi-Harada disease. Retrospective study. Medical charts of 140 patients with the diagnosis of Vogt-Koyanagi-Harada disease, from the Uveitis Sector of the Federal University of Sao Paulo (UNIFESP), were revised and classified following the revised diagnostic criteria. Of the 140 patients, 12.85% fulfilled the criteria for complete disease, 29.28% incomplete disease, 28.57% "probable" Vogt-Koyanagi-Harada disease and 28.27% were considered not Vogt-Koyanagi-Harada disease. The authors consider that the international revised diagnostic criteria have good applicability and are very useful to help in the diagnosis of Vogt-Koyanagi-Harada disease.

  19. Selection criteria for container materials at the proposed Yucca Mountain high level nuclear waste repository

    International Nuclear Information System (INIS)

    Halsey, W.G.

    1989-11-01

    A geological repository has been proposed for the permanent disposal of the nation's high level nuclear waste at Yucca Mountain in the Nevada desert. The containers for this waste must remain intact for the unprecedented service lifetime of 1000 years. A combination of engineering, regulatory, and licensing requirements complicate the container material selection. In parallel to gathering information regarding the Yucca Mountain service environment and material performance data, a set of selection criteria have been established which compare candidate materials to the performance requirements, and allow a quantitative comparison of candidates. These criteria assign relative weighting to varied topic areas such as mechanical properties, corrosion resistance, fabricability, and cost. Considering the long service life of the waste containers, it is not surprising that the corrosion behavior of the material is a dominant factor. 7 refs

  20. Metabolic syndrome criteria as predictors of insulin resistance, inflammation and mortality in chronic hemodialysis patients.

    Science.gov (United States)

    Vogt, Barbara Perez; Souza, Priscilla L; Minicucci, Marcos Ferreira; Martin, Luis Cuadrado; Barretti, Pasqual; Caramori, Jacqueline Teixeira

    2014-10-01

    Abstract Background: Chronic kidney disease (CKD) and metabolic syndrome are characterized by overlapping disorders, including glucose intolerance, hypertension, dyslipidemia, and, in some cases, obesity. However, there are no specific criteria for the diagnosis of metabolic syndrome in CKD. Metabolic syndrome can also be associated with increased risk of mortality. Some traditional risk factors may protect dialysis patients from mortality, known as "reverse epidemiology." Metabolic syndrome might undergo reverse epidemiology. The objectives were to detect differences in frequency and metabolic characteristics associated with three sets of diagnostic criteria for metabolic syndrome, to evaluate the accuracy of insulin resistance (IR) and inflammation to identify patients with metabolic syndrome, and to investigate the effects of metabolic syndrome by three sets of diagnostic criteria on mortality in chronic hemodialysis patients. An observational study was conducted. Diagnostic criteria for metabolic syndrome proposed by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF), and Harmonizing the Metabolic Syndrome (HMetS) statement were applied to 98 hemodialysis patients. The prevalence of metabolic syndrome was 51%, 66.3%, and 75.3% according to NCEP ATP III, IDF, and HMetS criteria, respectively. Diagnosis of metabolic syndrome by HMetS was simultaneously capable of revealing both inflammation and IR, whereas NCEP ATP III and IDF criteria were only able to identify IR. Mortality risk increased in the presence of metabolic syndrome regardless of the criteria used. The prevalence of metabolic syndrome in hemodialysis varies according to the diagnostic criteria used. IR and inflammation predict metabolic syndrome only when diagnosed by HMetS criteria. HMetS was the diagnostic criteria that can predict the highest risk of mortality.

  1. ASSESSMENT OF THE SENSITIVITY OF NEW CRITERIA FOR SYSTEMIC SCLEROSIS IN RUSSIAN PATIENT POPULATION

    Directory of Open Access Journals (Sweden)

    O. A. Koneva

    2015-01-01

    Full Text Available Systemic sclerosis (SS is a progressive connective tissue disease, the prognosis of which largely depends on the time of adequate therapy initiation. Low sensitivity of the 1980 American College of Rheumatology (ACR SS classification criteria for identifying patients with early stage of the disease, and with its limited form in particular, has necessitated revision of existing SS diagnostic standards and elaboration of more sensitive criteria that allow to establish the diagnosis when the first sign of the disease appear.Objective: to compare the sensitivity of the novel SS criteria of ACR and European League against Rheumatism (ACR/EULAR 2013 and the 1980 ACR criteria in different stages of the disease.Subjects and methods. The investigation enrolled 302 patients who had been diagnosed by experts as having SS and followed up at the V.A. Nasonova Research Institute of Rheumatology in 2007–2013. The patients’ mean age was 49±13 years (18 to 80 years; male to female ratio – 1:9 (31 and 271, that of patients with diffuse and limited SS – 1:2 (105 and 197; mean duration of the disease from the first non-Raynaud’s syndrome was 8.2±7.0 years (6 months to 36 years. Physical examination, nailfold capillaroscopy, chest radiography or computed tomography, echocardiography for the determination of pulmonary artery systolic pressure and SS-specific antibodies evaluation were performed.Results. 273 (90% patients fulfilled the novel ACR/EULAR 2013 SS criteria. 76 (25% patients had skin thickening above the metacarpophalangeal (MPC joints in both hands; 263 (87% – finger skin thickening [70 (23% – finger swelling, 192 (64% – thickening of all fingers distal to the MPC joints], 141 (47% – digital ischemia [79 (26% – digital pitting scars, 20 (7% – digital ulcers, 42 (14% – digital pitting scars and ulcers], 134 (44% – telangiectasias, 276 (91% – capillaroscopic changes, 225 (78% – pulmonary hypertension (PH or

  2. Referral Criteria from Community Clinics to Pediatric Emergency Departments

    Directory of Open Access Journals (Sweden)

    Jacob Urkin

    2008-01-01

    Full Text Available Referral of patients to a pediatric emergency department (PED should be medically justified and the need for referral well communicated. The objectives of this paper were (1 to create a list of criteria for referral from the community to the PED, (2 to describe how community physicians categorize their need for referral, and (3 to determine agreement between the physician's referral letter and the selected criteria. We present a descriptive study of referrals to the PED of Soroka University Medical Center, Beer-Sheva, Israel, during February to April 2003. A list of 22 criteria for referral was created, using the Delphi method for reaching consensus. One or more criteria could be selected from this list for each referral, by the referring community physicians and, independently, based on the physicians' referral letters, by two consultants, and compared. There were 140 referrals included in the study. A total of 262 criteria for referral were selected by the referring community physicians. The criteria most frequently selected were: “Need for same-day consultation/laboratory/imaging result not available in the community” (32.1%, “Suspected life- or organ-threatening infection” (16.4%, and “Need for hospitalization” (15.7%. Rates of agreement regarding criteria for referral between the referring physicians and the two consultants, and a senior community pediatrician and a senior PED pediatrician, were 57.9 and 48.6%, respectively. We conclude that the standard referral letter does not convey in full the level of need for referral to the PED. A list of criteria for referral could augment efficient utilization of emergency department services and improve communication between community physicians and the PED.

  3. Criteria of selection of basic linguacultural units within the context of cross-cultural communication

    Directory of Open Access Journals (Sweden)

    Khalupo Olga Ivanovna

    2016-03-01

    Full Text Available The article considers the problems associated with the analysis and selection of basic linguacultural units that are necessary for a more effective cross-cultural communication. To make the process of dialogue between different cultures and languages more appropriate and productive, it is necessary to possess certain knowledge, skills, which are acquired by man in the process of learning. Important in our opinion in this area are the mastery means which will prepare the person to communicate in a different communicative space. Such means, in our opinion, are the basic linguacultural units, which are considered as carriers of information and expression of cultural identity. They inform choice contributes to a worldview, understanding linguacultural picture of the world community. The basis of selection of linguistic units on the following criteria: the information content, functionality, sufficiency, cultural identity, realism, pivotal importance to the basic sense, social and cultural significance. Application of the proposed criteria allowing more appropriate to make the selection of the material and linguacultural integral components of the scope of cross-cultural interaction, which are characterized by their relevant material necessary for an adequate understanding of the processes occurring in different communicative space.

  4. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

    Science.gov (United States)

    Dolan, James G

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

  5. Analysis of Different Feature Selection Criteria Based on a Covariance Convergence Perspective for a SLAM Algorithm

    Science.gov (United States)

    Auat Cheein, Fernando A.; Carelli, Ricardo

    2011-01-01

    This paper introduces several non-arbitrary feature selection techniques for a Simultaneous Localization and Mapping (SLAM) algorithm. The feature selection criteria are based on the determination of the most significant features from a SLAM convergence perspective. The SLAM algorithm implemented in this work is a sequential EKF (Extended Kalman filter) SLAM. The feature selection criteria are applied on the correction stage of the SLAM algorithm, restricting it to correct the SLAM algorithm with the most significant features. This restriction also causes a decrement in the processing time of the SLAM. Several experiments with a mobile robot are shown in this work. The experiments concern the map reconstruction and a comparison between the different proposed techniques performance. The experiments were carried out at an outdoor environment composed by trees, although the results shown herein are not restricted to a special type of features. PMID:22346568

  6. 78 FR 12955 - Final Requirements, Definitions, and Selection Criteria-Native American Career and Technical...

    Science.gov (United States)

    2013-02-26

    ... career and technical education programs (20 U.S.C. 2326(e)). This notice does not preclude us from... DEPARTMENT OF EDUCATION 34 CFR Chapter IV [Docket ID ED-2012-OVAE-0053] Final Requirements, Definitions, and Selection Criteria--Native American Career and Technical Education Program (NACTEP) [Catalog...

  7. SENDS criteria from the diversification of MAST procedures. Implementation of preoperative simulation

    International Nuclear Information System (INIS)

    Rieger, B.

    2015-01-01

    Minimal access spinal technologies (MAST) lead to a diversification of surgical procedures, which requires careful selection of the procedure and outcome monitoring. For a rational selection of the procedure simulation, endoscopy, navigation, decompression and stabilization (SENDS) criteria can be derived from the development of the MAST procedures. Preoperative simulation has diagnostic and therapeutic values. The SENDS criteria can be verified indirectly via outcome control. Biomechanically meaningful diagnostic x-rays of the spinal segment to be surgically treated are currently carried out with the patient in inclination and reclination. Software-related preoperative simulation based on these x-ray images facilitates the selection and implementation of the MAST procedure. For preoperative simulation motion shots are needed in inclination, neutral position and reclination and the dimensions can be obtained using an x-ray ball or a computed tomography (CT) scan. The SENDS criteria are useful because established procedures based on these criteria reach a comparable outcome. Preoperative simulation appears to be a useful selection criterion. Preoperatively it is necessary to collate patient and segment information in order to provide each patient with individualized treatment. So far there is no evidence for a better outcome after preoperative simulation but a reduction of surgery time and intraoperative radiation exposure could already be demonstrated. Minimally invasive methods should be preferred if there is a comparable outcome. The establishment of new procedures has to be accompanied by the maintenance of a spine register. Minimally invasive surgical procedures should be individualized for each patient and segment. Mobility X-ray images should be prepared for use with the preoperative simulation as the information content significantly increases with respect to the MAST procedure. (orig.) [de

  8. 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....

  9. A Novel Approach to Site Selection: Collaborative Multi-Criteria Decision Making through Geo-Social Network (Case Study: Public Parking

    Directory of Open Access Journals (Sweden)

    Zeinab Neisani Samani

    2018-03-01

    Full Text Available There are many potential factors that are involved in the decision making process of site selection, which makes it a challenging issue. This paper addresses the collaborative decision making concept through a geo-social network to predict site selection for public parking in Tehran, Iran. The presented approach utilized the analytic hierarchy process (AHP as a multi-criteria decision method (MCDM for weighting the criteria, which was completed in two stages; once by 50 experts, and then by three different levels of users, including 50 experts, 25 urban managers, and 150 pubic citizens, with respect to the case study area. The fuzzy majority method aggregates the archived results of AHP to determine the preferred locations that are suitable for public parking. The proposed method was implemented using a telegram bot platform. Two main advantages of the collaborative decision making scenario for public urban site selection are the fair distribution of the selected locations and the high satisfaction of users, which increased from 65% to 85%. This study presents an application for site selection based on multi-criteria decision making in a geo-social network context.

  10. Selecting essential information for biosurveillance--a multi-criteria decision analysis.

    Directory of Open Access Journals (Sweden)

    Nicholas Generous

    Full Text Available The National Strategy for Biosurveillance defines biosurveillance as "the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels." However, the strategy does not specify how "essential information" is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being "essential". The question of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of "essential information" for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system.

  11. Selecting essential information for biosurveillance--a multi-criteria decision analysis.

    Science.gov (United States)

    Generous, Nicholas; Margevicius, Kristen J; Taylor-McCabe, Kirsten J; Brown, Mac; Daniel, W Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

    2014-01-01

    The National Strategy for Biosurveillance defines biosurveillance as "the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels." However, the strategy does not specify how "essential information" is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being "essential". The question of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of "essential information" for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system.

  12. Application of an integrated multi-criteria decision making AHP-TOPSIS methodology for ETL software selection.

    Science.gov (United States)

    Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

    2016-01-01

    Actually, a set of ETL software (Extract, Transform and Load) is available to constitute a major investment market. Each ETL uses its own techniques for extracting, transforming and loading data into data warehouse, which makes the task of evaluating ETL software very difficult. However, choosing the right software of ETL is critical to the success or failure of any Business Intelligence project. As there are many impacting factors in the selection of ETL software, the same process is considered as a complex multi-criteria decision making (MCDM) problem. In this study, an application of decision-making methodology that employs the two well-known MCDM techniques, namely Analytic Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) methods is designed. In this respect, the aim of using AHP is to analyze the structure of the ETL software selection problem and obtain weights of the selected criteria. Then, TOPSIS technique is used to calculate the alternatives' ratings. An example is given to illustrate the proposed methodology. Finally, a software prototype for demonstrating both methods is implemented.

  13. Study on analysing the criteria's for selection of shipping carriers in Chinese shipping market using analytical hierarchy process

    DEFF Research Database (Denmark)

    Shen, Lixin; Mathiyazhagan, K.; Kannan, Devika

    2015-01-01

    Globalisation has led to the increased export and import of goods worldwide. Due to this, the selection of the right mode of transportation for heavy (huge) goods items is a challenging task for industries. In this regard, maritime transport is the best way to send huge goods compared to other...... are cargoes' damage degree when they are received (R2). It is acting as an important criteria and reliability for on-time delivery (R1) and the carrier's ability of multimodal transportation (C1) are the next priority criteria's for the selection of shipping carrier....

  14. Novel Integrated Multi-Criteria Model for Supplier Selection: Case Study Construction Company

    Directory of Open Access Journals (Sweden)

    Željko Stević

    2017-11-01

    Full Text Available Supply chain presents a very complex field involving a large number of participants. The aim of the complete supply chain is finding an optimum from the aspect of all participants, which is a rather complex task. In order to ensure optimum satisfaction for all participants, it is necessary that the beginning phase consists of correct evaluations and supplier selection. In this study, the supplier selection was performed in the construction company, on the basis of a new approach in the field of multi-criteria model. Weight coefficients were obtained by DEMATEL (Decision Making Trial and Evaluation Laboratory method, based on the rough numbers. Evaluation and the supplier selection were made on the basis of a new Rough EDAS (Evaluation based on Distance from Average Solution method, which presents one of the latest methods in this field. In order to determine the stability of the model and the applicability of the proposed Rough EDAS method, an extension of the COPRAS and MULTIMOORA method by rough numbers was also performed in this study, and the findings of the comparative analysis were presented. Besides the new approaches based on the extension by rough numbers, the results are also compared with the Rough MABAC (MultiAttributive Border Approximation area Comparison and Rough MAIRCA (MultiAttributive Ideal-Real Comparative Analysis. In addition, in the sensitivity analysis, 18 different scenarios were formed, the ones in which criteria change their original values. At the end of the sensitivity analysis, SCC (Spearman Correlation Coefficient of the obtained ranges was carried out, confirming the applicability of the proposed approaches.

  15. 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

  16. Improving selection of markers in nutrition research: evaluation of the criteria proposed by the ILSI Europe Marker Validation Initiative.

    Science.gov (United States)

    Calder, Philip C; Boobis, Alan; Braun, Deborah; Champ, Claire L; Dye, Louise; Einöther, Suzanne; Greyling, Arno; Matthys, Christophe; Putz, Peter; Wopereis, Suzan; Woodside, Jayne V; Antoine, Jean-Michel

    2017-06-01

    The conduct of high-quality nutrition research requires the selection of appropriate markers as outcomes, for example as indicators of food or nutrient intake, nutritional status, health status or disease risk. Such selection requires detailed knowledge of the markers, and consideration of the factors that may influence their measurement, other than the effects of nutritional change. A framework to guide selection of markers within nutrition research studies would be a valuable tool for researchers. A multidisciplinary Expert Group set out to test criteria designed to aid the evaluation of candidate markers for their usefulness in nutrition research and subsequently to develop a scoring system for markers. The proposed criteria were tested using thirteen markers selected from a broad range of nutrition research fields. The result of this testing was a modified list of criteria and a template for evaluating a potential marker against the criteria. Subsequently, a semi-quantitative system for scoring a marker and an associated template were developed. This system will enable the evaluation and comparison of different candidate markers within the same field of nutrition research in order to identify their relative usefulness. The ranking criteria of proven, strong, medium or low are likely to vary according to research setting, research field and the type of tool used to assess the marker and therefore the considerations for scoring need to be determined in a setting-, field- and tool-specific manner. A database of such markers, their interpretation and range of possible values would be valuable to nutrition researchers.

  17. The QUANTEC criteria for parotid gland dose and their efficacy to prevent moderate to severe patient-rated xerostomia.

    Science.gov (United States)

    Beetz, Ivo; Steenbakkers, Roel J H M; Chouvalova, Olga; Leemans, Charles R; Doornaert, Patricia; van der Laan, Bernard F A M; Christianen, Miranda E M C; Vissink, Arjan; Bijl, Henk P; van Luijk, Peter; Langendijk, Johannes A

    2014-05-01

    Recently, the Quantitative Analysis of Normal Tissue Effect in the Clinic (QUANTEC) Group defined dose-volume constraints for the parotid glands to avoid severe xerostomia. The aim of this study was to determine if application of these QUANTEC criteria also protected against moderate-to-severe patient-rated xerostomia. The study population consisted of 307 head and neck cancer patients treated with primary (chemo)radiotherapy, either with 3D-CRT (56%) or with IMRT (44%). All patients participated in a standard follow-up program in which radiation-induced toxicity and quality of life were prospectively assessed. Patients who met the QUANTEC criteria were classified as low risk and otherwise as high risk. In total, 41% of the patients (treated with 3D-CRT and IMRT) were classified as low risk patients. In the group treated with 3D-CRT and IMRT, it was possible to meet the QUANTEC criteria in 47% and 32% of the patients, respectively. Sparing the parotid glands with IMRT was considerably more difficult in patients with lymph node metastases and in patients with nasopharyngeal and oropharyngeal tumours. Low risk patients reported significantly less moderate-to-severe xerostomia than high risk patients. However, the predicted risk of elderly patients and patients with pre-existing minor patient-rated xerostomia at baseline was > 20%, even when the QUANTEC criteria were met. Significantly lower rates of radiation-induced patient-rated xerostomia were found among low risk patients treated according to the QUANTEC criteria, but these criteria do not completely protect against xerostomia. Particularly in elderly patients and patients already suffering from minor xerostomia at baseline, the QUANTEC criteria do not sufficiently protect against persistent, moderate-to-severe patient-rated xerostomia.

  18. APPLICATION OF AHP METHOD IN THE IDENTIFICATION AND CLASSIFICATION OF PROJECT SELECTION CRITERIA: AN ENERGY SECTOR CASE STUDY

    Directory of Open Access Journals (Sweden)

    Silvério, Adriano Augusto

    2015-07-01

    Full Text Available Choosing from several alternative investment projects in hydropower to build a portfolio of projects is a complex matter. The most commonly used selection model for building the portfolio is the financial method, however it constraints options investments to the economic and financial parameters, which are limiting in nature. Alternatively, this paper proposes the use of multicriterial method Analytic Hierarchy Process – AHP, which incorporates measures to evaluate both quantitative and qualitative data. This method is based on criteria or parameters of operational processes that hinder or facilitate the execution of projects. In order to get the definition of the set of criteria, the Delphi technique was applied to a group of seven experts in managing hydropower projects. Main results show that essential criteria for selection of project investment portfolio, are not limited to financial aspects, but it involves criteria of bureaucratic, organizational, and political environment and technological characters. The conclusion is that the financial potential of hydropower projects are not the only determinants for investments on hydropower projects and, at large, these project are conditioned to other criteria such as, those of bureaucratic and technological nature.

  19. Application of multi-criteria decision analysis in selecting of sustainable investments

    Science.gov (United States)

    Kozik, Renata

    2017-07-01

    Investors of construction projects, especially financed with public money, quite slowly adapt environmentally friendly solutions, e.g. passive buildings. Practice shows that the use of green public procurement among the public investors is negligible. Energy-saving technologies and equipment are expensive at the construction phase and investors less or not at all take into account the future operating costs. The aim of this article is to apply the method of multi-criteria analysis ELECTRE to select the best investment in terms of cost of implementation, operation, as well as the impact on the environment.

  20. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Kühr, Marietta; Wolfgarten, Matthias; Stölzle, Marco; Leutner, Claudia; Höller, Tobias; Schrading, Simone; Kuhl, Christiane; Schild, Hans; Kuhn, Walther; Braun, Michael

    2011-01-01

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size ≤3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget’s disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  1. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kuehr, Marietta, E-mail: marietta.kuehr@ukb.uni-bonn.de [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Wolfgarten, Matthias; Stoelzle, Marco [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Leutner, Claudia [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Hoeller, Tobias [Department of Medical Statistics and Epidemiology, University of Bonn, Bonn (Germany); Schrading, Simone; Kuhl, Christiane; Schild, Hans [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Kuhn, Walther; Braun, Michael [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany)

    2011-11-15

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size {<=}3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  2. 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.

  3. Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches.

    Science.gov (United States)

    Booth, Andrew; Noyes, Jane; Flemming, Kate; Gerhardus, Ansgar; Wahlster, Philip; van der Wilt, Gert Jan; Mozygemba, Kati; Refolo, Pietro; Sacchini, Dario; Tummers, Marcia; Rehfuess, Eva

    2018-07-01

    To compare and contrast different methods of qualitative evidence synthesis (QES) against criteria identified from the literature and to map their attributes to inform selection of the most appropriate QES method to answer research questions addressed by qualitative research. Electronic databases, citation searching, and a study register were used to identify studies reporting QES methods. Attributes compiled from 26 methodological papers (2001-2014) were used as a framework for data extraction. Data were extracted into summary tables by one reviewer and then considered within the author team. We identified seven considerations determining choice of methods from the methodological literature, encapsulated within the mnemonic Review question-Epistemology-Time/Timescale-Resources-Expertise-Audience and purpose-Type of data. We mapped 15 different published QES methods against these seven criteria. The final framework focuses on stand-alone QES methods but may also hold potential when integrating quantitative and qualitative data. These findings offer a contemporary perspective as a conceptual basis for future empirical investigation of the advantages and disadvantages of different methods of QES. It is hoped that this will inform appropriate selection of QES approaches. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

    OpenAIRE

    Rita Aleksandrovna Osipyants; D E Karateev; E Yu Panasyuk; G V Lukina; A V Smirnov; S I Glukhova; E N Aleksandrova; A V Volkov; E L Nasonov

    2013-01-01

    Objective: to study the association of ultrasound (US) remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA) during tocilizumab (TCZ) therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR) criteria) who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-C...

  5. Disappointing performance of literature-derived selective screening criteria for asymptomatic Chlamydia trachomatis infection in an inner-city population

    NARCIS (Netherlands)

    van Valkengoed, I G; Boeke, A J; Morré, S A; van den Brule, A J; Meijer, C J; Devillé, W; Bouter, L M

    2000-01-01

    BACKGROUND: In an inner-city population with a low prevalence of Chlamydia trachomatis infection, selective screening may be indicated to increase the efficiency of screening. GOAL: To evaluate the performance of sets of selective screening criteria for asymptomatic Chlamydia trachomatis infection

  6. Multi-criteria decision aid approach for the selection of the best compromise management scheme for ELVs: the case of Cyprus.

    Science.gov (United States)

    Mergias, I; Moustakas, K; Papadopoulos, A; Loizidou, M

    2007-08-25

    Each alternative scheme for treating a vehicle at its end of life has its own consequences from a social, environmental, economic and technical point of view. Furthermore, the criteria used to determine these consequences are often contradictory and not equally important. In the presence of multiple conflicting criteria, an optimal alternative scheme never exists. A multiple-criteria decision aid (MCDA) method to aid the Decision Maker (DM) in selecting the best compromise scheme for the management of End-of-Life Vehicles (ELVs) is presented in this paper. The constitution of a set of alternatives schemes, the selection of a list of relevant criteria to evaluate these alternative schemes and the choice of an appropriate management system are also analyzed in this framework. The proposed procedure relies on the PROMETHEE method which belongs to the well-known family of multiple criteria outranking methods. For this purpose, level, linear and Gaussian functions are used as preference functions.

  7. Fuels planning: science synthesis and integration; economic uses fact sheet 06: selection criteria analysis

    Science.gov (United States)

    Rocky Mountain Research Station USDA Forest Service

    2004-01-01

    Confidence in decisionmaking can often come from knowing if others in similar circumstances would choose the same management strategy. Researchers at the USDA FS Pacific Northwest Research Station and the University of Saskatchewan have developed a Selection Criteria Analysis for answering this very question. This fact sheet discusses factors affecting the choice of...

  8. Psychophysiological and psychological criteria for professional selection of reactor operators - a review

    International Nuclear Information System (INIS)

    Jonkova, A.

    1992-01-01

    The professional activity of reactor operators is determined according to some modern classification schemes. The NPP operation staff's classification containing groups of operators-supervisors, operators-manipulators and operators-managers (Zinchenko and Munipov) is discussed. The author specifies the functions of the operators-supervisors in more detail. The requirements for selection of operators are given and the significance of mind, memory, attention, differentiative sensomotorics, emotional and stress-stability is emphasized. An own set of criteria for professional selection of reactor operators is proposed based on the definition of reliability concepts -adequacy, timeliness and lack of outages. The requirements for psychological structure of personality are well-grounded also by the collective character of this kind of professional activity also. 28 refs., 1 fig. (A.B.)

  9. Analysis of patterns of three-phase bone scintigraphy for patients with complex regional pain syndrome diagnosed using the proposed research criteria (the 'Budapest Criteria').

    Science.gov (United States)

    Moon, J Y; Park, S Y; Kim, Y C; Lee, S C; Nahm, F S; Kim, J H; Kim, H; Oh, S W

    2012-04-01

    Three-phase bone scintigraphy (TPBS) is an established objective diagnostic method for complex regional pain syndrome (CRPS), but its validity remains controversial. The aims of this study were: (i) to re-evaluate the diagnostic performance of TPBS, and (ii) to suggest new TPBS criteria based on the proposed research criteria for CPRS in Budapest (the 2003 Budapest research criteria). The medical records of 228 consecutive patients, evaluated using the Budapest research criteria, were retrospectively analysed. Of these, 116 patients were included in the present study, and 69 of 116 were diagnosed to have CRPS based on these criteria. The diagnostic performance of TPBS was assessed by determining its sensitivity, specificity, and positive and negative likelihood ratios, and new criteria for TPBS were identified by pattern analysis using the Budapest research criteria. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of TPBS for the diagnosis of CRPS according to the Budapest research criteria were 40.0, 76.5, 1.73, and 0.78, respectively. Furthermore, D-D-D, D-D-S, and D-D-I patterns [i.e. according to decreased (D), symmetrical (S), or increased (I) tracer uptake during Phases I, II, and III] of TPBS were found to be positively predictive for CRPS. The diagnostic value of a positive TPBS for CRPS is low from the view point of the Budapest research criteria. Our findings suggest that a diagnosis of CRPS using the Budapest research criteria should be considered when decreased patterns of TPBS are observed during Phases I and II.

  10. Customers’ Perceptions on the Objectives, Characteristics and Selection Criteria of Islamic Bank in Thailand

    Directory of Open Access Journals (Sweden)

    Nasrina Lateh

    2009-05-01

    Full Text Available Due to relatively new establishment of islamic bank in Thailand and paucity of empirical research undertaken in the area, this study intends to capture the perceptions of Thai customers towards the objectives and characteristics of the islamic bank. In addition, this study aims to determine the important bank selection criteria as perceived by the customers and the differences in the perceptions of moslem and non-moslem customers were identified. The study surveys a sample of 462 respondents. The empirical findings show that the Thai customers know that the essential characteristic of the islamic bank is interest prohibition. They tend to support the idea that the islamic bank should strive to achieve its social objectives more than the commercial objectives. In addition, the results showed that there are differences between the Thai moslem and non-moslem customers’ preferences toward various bank selection criteria. The moslems highly considered the interest-free saving facilities, while the non-moslems tended to concern more about its reputation and image, and knowledgeable and competent personnel.

  11. Multi-criteria analysis for site selection for the reuse of reclaimed water and biosolids

    Directory of Open Access Journals (Sweden)

    António Albuquerque

    2015-01-01

    Full Text Available Low pH soils with insufficient organic matter can benefit from the application of reclaimed water (RW and biosolids. The presence of nutrients also aids plant growth. This paper presents the results of two integrated research studies, both carried out in the Beira Interior Region (Covilhã, Portugal; one used RW for irrigation, the other applied paper mill sludge to agricultural land. In both cases, multiple criteria based on GIS tools were used for site selection. In the first study, the characteristics of RW analyzed over 2 years were found suitable for crop irrigation. The RW had moderate organic content, low electrical conductivity (CE, high nutrient content (N, P, and low concentrations of nitrate, metals and phytotoxic elements (Al, B, Cl and Na. The multi-criteria analysis was carried out taking into account environmental, technical and economic criteria and a suitable area of 30.5 ha was found for RW irrigation. In the second work, the paper mill sludge was considered suitable for application to agricultural land. Its concentrations of N, P and heavy metals did not a present risk for soil contamination and were suitable for soil improvement and crop production. A multi-criteria analysis based on similar criteria was conducted and a suitable area of 253 ha was found for sludge application.

  12. Sorafenib for hepatocellular carcinoma patients beyond Milan criteria after orthotopic liver transplantation: a case control study

    Directory of Open Access Journals (Sweden)

    Teng Chieh-Lin

    2012-02-01

    Full Text Available Abstract Background Orthotopic liver transplantation (OLT is one of the most effective treatments for patients with hepatocellular carcinoma (HCC within the Milan criteria. However, for patients beyond these criteria, the recurrence rate is higher and the prognosis is worse. Sorafenib is the only drug showing survival benefits in advanced HCC patients; however, its role in patients beyond the Milan criteria after OLT remains unclear and requires further investigation. Methods As a case-control study, we retrospectively analyzed 17 Chinese patients beyond Milan criteria undergoing OLT for HCC. These patients were stratified into adjuvant (n = 5, palliative (n = 6, and control groups (n = 6. Results Nine of 11 patients who received sorafenib after OLT needed dose reduction due to more than grade 2 side effects. The disease-free survival rates for patients with or without adjuvant sorafenib were 100% versus 37.5% (p = 0.034 at 6 months, 66.7% versus 9.4% (p = 0.026 at 12 months, and 66.7% versus 0.0% (p = 0.011 at 18 months, respectively. The overall survival rates for patients in palliative and control groups were 66.7% versus 40.0% (p = 0.248 at 6 months, 66.7% versus 40.0% (p = 0.248 at 12 months, and 50.0% versus 20.0% (p = 0.17 at 18 months, respectively. Patients in the adjuvant group had better overall survival rates than those in the palliative and control groups (p = 0.031 at 24-month follow-up. Conclusions Adjuvant sorafenib could possibly extend both disease-free and overall survival for HCC patients beyond Milan criteria after OLT.

  13. Criteria for validation and selection of cognitive tests for investigating the effects of foods and nutrients.

    Science.gov (United States)

    de Jager, Celeste A; Dye, Louise; de Bruin, Eveline A; Butler, Laurie; Fletcher, John; Lamport, Daniel J; Latulippe, Marie E; Spencer, Jeremy P E; Wesnes, Keith

    2014-03-01

    This review is an output of the International Life Sciences Institute (ILSI) Europe Marker Initiative, which aims to identify evidence-based criteria for selecting adequate measures of nutrient effects on health through comprehensive literature review. Experts in cognitive and nutrition sciences examined the applicability of these proposed criteria to the field of cognition with respect to the various cognitive domains usually assessed to reflect brain or neurological function. This review covers cognitive domains important in the assessment of neuronal integrity and function, commonly used tests and their state of validation, and the application of the measures to studies of nutrition and nutritional intervention trials. The aim is to identify domain-specific cognitive tests that are sensitive to nutrient interventions and from which guidance can be provided to aid the application of selection criteria for choosing the most suitable tests for proposed nutritional intervention studies using cognitive outcomes. The material in this review serves as a background and guidance document for nutritionists, neuropsychologists, psychiatrists, and neurologists interested in assessing mental health in terms of cognitive test performance and for scientists intending to test the effects of food or food components on cognitive function.

  14. 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) 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.

  15. New decision criteria for selecting delta check methods based on the ratio of the delta difference to the width of the reference range can be generally applicable for each clinical chemistry test item.

    Science.gov (United States)

    Park, Sang Hyuk; Kim, So-Young; Lee, Woochang; Chun, Sail; Min, Won-Ki

    2012-09-01

    Many laboratories use 4 delta check methods: delta difference, delta percent change, rate difference, and rate percent change. However, guidelines regarding decision criteria for selecting delta check methods have not yet been provided. We present new decision criteria for selecting delta check methods for each clinical chemistry test item. We collected 811,920 and 669,750 paired (present and previous) test results for 27 clinical chemistry test items from inpatients and outpatients, respectively. We devised new decision criteria for the selection of delta check methods based on the ratio of the delta difference to the width of the reference range (DD/RR). Delta check methods based on these criteria were compared with those based on the CV% of the absolute delta difference (ADD) as well as those reported in 2 previous studies. The delta check methods suggested by new decision criteria based on the DD/RR ratio corresponded well with those based on the CV% of the ADD except for only 2 items each in inpatients and outpatients. Delta check methods based on the DD/RR ratio also corresponded with those suggested in the 2 previous studies, except for 1 and 7 items in inpatients and outpatients, respectively. The DD/RR method appears to yield more feasible and intuitive selection criteria and can easily explain changes in the results by reflecting both the biological variation of the test item and the clinical characteristics of patients in each laboratory. We suggest this as a measure to determine delta check methods.

  16. Novel and conventional working fluid mixtures for solar Rankine cycles: Performance assessment and multi-criteria selection

    International Nuclear Information System (INIS)

    Mavrou, Paschalia; Papadopoulos, Athanasios I.; Stijepovic, Mirko Z.; Seferlis, Panos; Linke, Patrick; Voutetakis, Spyros

    2015-01-01

    This work investigates the performance of working fluid mixtures for use in solar ORC (Organic Rankine Cycle systems) with heat storage employing FPC (Flat Plate Collectors). Several mixtures are considered including conventional choices often utilized in ORC as well as novel mixtures previously designed using advanced computer aided molecular design methods (Papadopoulos et al., 2013). The impact of heat source variability on the ORC performance is assessed for different working fluid mixtures. Solar radiation is represented in detail through actual, hourly averaged data for an entire year. A multi-criteria mixture selection methodology unveils important trade-offs among several important system operating parameters and efficiently highlights optimum operating ranges. Such parameters include the ORC thermal efficiency, the net generated power, the volume ratio across the turbine, the mass flow rate of the ORC working fluid, the evaporator temperature glide, the temperature drop in the storage tank, the ORC total yearly operating duration, the required collector aperture area to generate 1 kW of power and the irreversibility. A mixture of neopentane – 2-fluoromethoxy-2-methylpropane at 70% neopentane is found to be the most efficient in all the considered criteria simultaneously. - Highlights: • Investigation of novel and conventional working fluid mixtures for solar ORCs. • Systematic, multi-criteria assessment methodology for mixture selection. • Simultaneous consideration of multiple important mixture performance criteria. • Effects of year-round solar variability in a solar ORC with heat storage tank

  17. IT OUTSOURCING: METHODOLOGY FOR SUPPLIER SELECTION CRITERIA FOR COMPETITIVE ADVANTAGE

    Directory of Open Access Journals (Sweden)

    Sergio Alexandre Simões

    2012-04-01

    Full Text Available Abstract: Two criteria are usually adopted to select the provider of IT: lower prices or better service qualification of the supplier. This article proposes a strategic approach: the company should hire the provider that best leverage their competitive advantages. This approach implied the need to develop a methodology. To support it, the authors analyzed four models, Porter, RBV (Resource-Based View, Balanced Scorecard and the Weapons and Field Competition. Preferred the latter to be the most complete, qualiquantitative technique and able to accurately align the goals of the IT service firm's to competitive contracting strategy. The methodology was developed and applied to an insurance company and in face of the excellent results, decided to write this article to disclose it.

  18. Criteria for selecting children with special needs for dental treatment under general anaesthesia

    OpenAIRE

    Nova García, M. Joaquín de; Gallardo López, Nuria E.; Martín Sanjuán, Carmen; Mourelle Martínez, M. Rosa; Alonso García, Yolanda; Carracedo Cabaleiro, Esther

    2007-01-01

    Objective: To study criteria for helping to select children with special needs for dental treatment under general anaesthesia. Materials and methods: Group of 30 children (aged under 18) examined on the Course at the Universidad Complutense de Madrid (UCM) (Specialisation on holistic dental treatment of children with special needs) and subsequently referred to the Disabled Children’s Oral Health Unit (DCOHU) within Primary Health Care Area 2 of the Madrid Health Service (SERMAS) where dental ...

  19. Liver Transplantation for Hepatocellular Carcinoma beyond Milan Criteria: Multidisciplinary Approach to Improve Outcome

    Science.gov (United States)

    Kornberg, A.

    2014-01-01

    The implementation of the Milan criteria (MC) in 1996 has dramatically improved prognosis after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Liver transplantation has, thereby, become the standard therapy for patients with “early-stage” HCC on liver cirrhosis. The MC were consequently adopted by United Network of Organ Sharing (UNOS) and Eurotransplant for prioritization of patients with HCC. Recent advancements in the knowledge about tumor biology, radiographic imaging techniques, locoregional interventional treatments, and immunosuppressive medications have raised a critical discussion, if the MC might be too restrictive and unjustified keeping away many patients from potentially curative LT. Numerous transplant groups have, therefore, increasingly focussed on a stepwise expansion of selection criteria, mainly based on tumor macromorphology, such as size and number of HCC nodules. Against the background of a dramatic shortage of donor organs, however, simple expansion of tumor macromorphology may not be appropriate to create a safe extended criteria system. In contrast, rather the implementation of reliable prognostic parameters of tumor biology into selection process prior to LT is mandatory. Furthermore, a multidisciplinary approach of pre-, peri-, and posttransplant modulating of the tumor and/or the patient has to be established for improving prognosis in this special subset of patients. PMID:27335840

  20. 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.

  1. Multi criteria decision making to select the best method for the preparation of solid lipid nanoparticles of rasagiline mesylate using analytic hierarchy process

    Directory of Open Access Journals (Sweden)

    Viveksarathi Kunasekaran

    2014-01-01

    Full Text Available The objective of this study was to select best method for the development of rasagiline mesylate (RM loaded nanoscale solid lipid particles using analytic hierarchy process (AHP. Improper method selection may lead to waste of time, loss of material and financial resources. One of the possibilities to overcome these difficulties, AHP was employed to find the suitable method. In the AHP, a decision of hierarchy was constructed with a goal, criteria, sub-criteria, and alternatives. After constructing the AHP, the expert choice software was used to compute the overall priority of criteria, sub-criteria and alternatives. The best alternative selected was based on the highest priority. Nanoscale solid lipid particles of RM was formulated by the selected microemulsion method (M4 and it shows the particle size, polydispersity index and zeta potential were within acceptable limits. Drug content and entrapment efficiency of the RM-solid lipid nanoparticles were 97.26% and 86.57%, respectively. This study concludes that the AHP was viable and effective tool for selecting a most suitable method for the fabrication of RM loaded nanoscale solid lipid particles.

  2. Selection and specification criteria for fills for cut-and-fill mining

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, E. G.

    1980-05-15

    Because of significant differences in placement and loading conditions, the ideal fill material for a cut-and-fill operation has different characteristics to those for a fill for a filled open stoping operation. The differing requirements of the two mining operations must be understood and accounted for in establishing fill selection and specification criteria. Within the paper, aspects of the particular requirements of cut-and-fill mining are analyzed and related to the specific fill tests and properties required. Emphasis is placed upon the role of fill in ground support, though this cannot be isolated from overall fill performance. Where appropriate, test data are introduced and areas requiring continuing research highlighted.

  3. A hybrid method for information technology selection combining multi-criteria decision making (MCDM) with technology roadmapping

    OpenAIRE

    García Mejía, Jaime Andrés

    2013-01-01

    Abstract: Strategic information technology (IT) management has been recognized as vital for achieving competitive advantage. IT selection, the process of choosing the best technology alternative from a number of available options, is an important part of IT management. The IT selection is a multi-criteria decision making process, where relative importance of each criterion is determined and the degree of satisfaction of every criterion from each alternative is evaluated. Decision makers (DMs)...

  4. Patient selection, echocardiographic screening and treatment strategies for interventional tricuspid repair using the edge-to-edge repair technique.

    Science.gov (United States)

    Hausleiter, Jörg; Braun, Daniel; Orban, Mathias; Latib, Azeem; Lurz, Philipp; Boekstegers, Peter; von Bardeleben, Ralph Stephan; Kowalski, Marek; Hahn, Rebecca T; Maisano, Francesco; Hagl, Christian; Massberg, Steffen; Nabauer, Michael

    2018-04-24

    Severe tricuspid regurgitation (TR) has long been neglected despite its well known association with mortality. While surgical mortality rates remain high in isolated tricuspid valve surgery, interventional TR repair is rapidly evolving as an alternative to cardiac surgery in selected patients at high surgical risk. Currently, interventional edge-to-edge repair is the most frequently applied technique for TR repair even though the device has not been developed for this particular indication. Due to the inherent differences in tricuspid and mitral valve anatomy and pathology, percutaneous repair of the tricuspid valve is challenging due to a variety of factors including the complexity and variability of tricuspid valve anatomy, echocardiographic visibility of the valve leaflets, and device steering to the tricuspid valve. Furthermore, it remains to be clarified which patients are suitable for a percutaneous tricuspid repair and which features predict a successful procedure. On the basis of the available experience, we describe criteria for patient selection including morphological valve features, a standardized process for echocardiographic screening, and a strategy for clip placement. These criteria will help to achieve standardization of valve assessment and the procedural approach, and to further develop interventional tricuspid valve repair using either currently available devices or dedicated tricuspid edge-to-edge repair devices in the future. In summary, this manuscript will provide guidance for patient selection and echocardiographic screening when considering edge-to-edge repair for severe TR.

  5. Magnetic resonance imaging criteria for thrombolysis in hyperacute cerebral infarction.

    Science.gov (United States)

    Ahmetgjekaj, Ilir; Kabashi-Muçaj, Serbeze; Lascu, Luana Corina; Kabashi, Antigona; Bondari, A; Bondari, Simona; Dedushi-Hoti, Kreshnike; Biçaku, Ardian; Shatri, Jeton

    2014-01-01

    Selection of patients with cerebral infarction for MRI that is suitable for thrombolytic therapy as an emerging application. Although the efficiency of the therapy with i.v. tissue plasminogen activator (tPA) within 3 hours after onset of symptoms has been proven in selected patients with CT, now these criteria are determined by MRI, as the data we gather are fast and accurate in the first hours. MRI screening in patients with acute cerebral infarction before application of thrombolytic therapy was done in a UCC Mannheim in Germany. Unlike trials with CT, MRI studies demonstrated the benefits of therapy up to 6 hours after the onset of symptoms. We studied 21 patients hospitalized in Clinic of Neuroradiology at University Clinical Centre in Mannheim-Germany. They all undergo brain MRI evaluation for stroke. This article reviews literature that has followed application of thrombolysis in patients with cerebral infarction based on MRI. We have analyzed the MRI criteria for i.v. application of tPA at this University Centre. Alongside the personal viewpoints of clinicians, survey reveals a variety of clinical aspects and MRI features that are opened for further more exploration: therapeutic effects, the use of the MRI angiography, dynamics, and other. MRI is a tested imaging method for rapid evaluation of patients with hyperacute cerebral infarction, replacing the use of CT imaging and clinical features. MRI criteria for thrombolytic therapy are being applied in some cerebral vascular centres. In Kosovo, the application of thrombolytic therapy has not started yet.

  6. Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

    Science.gov (United States)

    Grilo, C M

    2004-01-01

    This study examined the diagnostic efficiency of the DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive adult patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. Conditional probabilities-sensitivity, specificity, positive predictive power (PPP), and negative predictive power (NPP)-were calculated for each of the eight criteria for OCPD, using the 'best-estimate' OCPD diagnosis as the standard. The diagnostic efficiencies of the OCPD criteria were variable, with three criteria failing to have predictive value (PPPOCPD based on performance and call into question the utility of some criteria.

  7. 7 CFR 170.12 - What are the selection criteria for participation in the USDA Farmers Market?

    Science.gov (United States)

    2010-01-01

    ... referred to the Internal Revenue Service or a tax advisor. Receipts for donated foods may be obtained from... Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices... Farmers Market? The selection criteria are designed to ensure a consistently high level of quality and...

  8. Medicatiescreening met Beers-criteria en STOPP/START-criteria bij de ouedere patient: associatie tussen potentieel ongewenst geneesmiddelengebruik en geneesmiddelgerelateerde ziekenhuisopnamen

    NARCIS (Netherlands)

    Stelt, CAK; Vermeulen Windsant - van der Tweel, AMA; Egberts, ACG; Van Den Bemt, Patricia M L A; Leendertse, AJ; Hermens, W.Th.; van Marum, R.J.; Derijks, H.J.

    2015-01-01

    Medication screening using Beers and stopp/start criteria for elderly patients: association between potentially inappropriate medication and medication-related hospital admissions OBJECTIVE To assess the risk of medication-related hospital admissions associated with inappropriate medication use

  9. 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.

  10. Selection of a suitable method for the preparation of polymeric nanoparticles: multi-criteria decision making approach.

    Science.gov (United States)

    Krishnamoorthy, Kannan; Mahalingam, Manikandan

    2015-03-01

    The present study is aimed to select the suitable method for preparation of camptothecin loaded polymeric nanoparticles by utilizing the multi-criteria decision making method. Novel approaches of drug delivery by formulation using nanotechnology are revolutionizing the future of medicine. Recent years have witnessed unprecedented growth of research and application in the area of nanotechnology. Nanoparticles have become an important area of research in the field of drug delivery because they have the ability to deliver a wide range of drug to varying areas of body. Despite of extensive research and development, polymeric nanoparticles are frequently used to improve the therapeutic effect of drugs. A number of techniques are available for the preparation of polymeric nanoparticles. The Analytical Hierarchy Process (AHP) is a method for decision making, which are derived from individual judgements for qualitative factors, using the pair-wise comparison matrix. In AHP, a decision hierarchy is constructed with a goal, criteria and alternatives. The model uses three main criteria 1) Instrument, 2) Process and Output and 3) Cost. In addition, there are eight sub-criteria's as well as eight alternatives. Pair-wise comparison matrixes are used to obtain the overall priority weight and ranking for the selection of suitable method. Nanoprecipitation technique is the most suitable method for the preparation of camptothecin loaded polymeric nanoparticles with the highest overall priority weight of 0.297 CONCLUSION: In particular, the result indicates that the priority weights obtained from AHP could be defined as a multiple output for finding out the most suitable method for preparation of camptothecin loaded polymeric nanoparticles.

  11. Characteristics of Criteria for Selecting Investment Projects under Uncertainty

    Directory of Open Access Journals (Sweden)

    Adrian ENCIU

    2011-07-01

    Full Text Available Within financial theory and practice, there are used five main criteria for selecting investment projects: the net present value (NPV criterion, the internal rate of return (IRR criterion, the return term (RT criterion, the profitability ratio (PR criterion and the supplementary return (SR criterion. The assay will emphasize several new properties of said indexes for investment assessment, having as starting point the hypotheses of (approximately normal repartition of cash-flows generated by an investment project. The obtained results point to the fact that the NPV indexes (the analysis of this criterion was carried out in the article “The NPV Criterion for Valuing Investments under Uncertainty”, Daniel Armeanu, Leonard Lache, Economic Computation and Economic Cybernetics Studies and Research no. 4/2009, pp. 133-143, IRR, PR, RT and SR register normal repartitions, therefore simplifying the investment analysis under economic uncertainty, by the capacity of building confidence intervals and assessing probabilities for the inferior limits of said investment assessment indexes.

  12. Symptom presentations and other characteristics of colorectal cancer patients and the diagnostic performance of the Auckland Regional Grading Criteria for Suspected Colorectal Cancer in the South Auckland population.

    Science.gov (United States)

    Hsiang, John C; Bai, Wayne; Lal, Dinesh

    2013-09-13

    This study reviews the presenting symptoms of colorectal cancer in the ethnically diverse Middlemore Hospital referral population of South Auckland, New Zealand. The performance of the newly introduced Auckland Regional Grading Criteria as prediction tool for selecting colorectal cancer cases referred from primary care was evaluated in this group. Retrospective review of all colorectal cancer (CRC) cases diagnosed between January 2006 and January 2011. Information extracted from case note review was used to grade patients using the Auckland Regional Grading Criteria. A total of 799 patients were included. The commonest symptoms were: rectal bleeding (25.5-42.3%) and change in bowel habit (20.6-26.8%). Low-risk symptoms including abdominal pain (16.3-46.8%) and weight loss (18.4-26.1%) were not uncommon. 64.4% of Maori and 64.9% of Pacific patients had stage III or IV cancers. Pacific patients had more stage IV disease, 37.7% (pAuckland Regional Grading Criteria would miss 24.7% of the patients with CRC in the referral population. While rectal bleeding and change in bowel habit are frequent presenting symptoms, low-risk atypical symptoms including constipation, weight loss and abdominal pain were not uncommon. Significant proportion of Pacific patients present with late-stage disease. The current Auckland Regional grading criteria would miss significant proportion of our study population with colorectal cancer.

  13. Coastal flooding as a parameter in multi-criteria analysis for industrial site selection

    Science.gov (United States)

    Christina, C.; Memos, C.; Diakoulaki, D.

    2014-12-01

    Natural hazards can trigger major industrial accidents, which apart from affecting industrial installations may cause a series of accidents with serious impacts on human health and the environment far beyond the site boundary. Such accidents, also called Na-Tech (natural - technical) accidents, deserve particular attention since they can cause release of hazardous substances possibly resulting in severe environmental pollution, explosions and/or fires. There are different kinds of natural events or, in general terms, of natural causes of industrial accidents, such as landslides, hurricanes, high winds, tsunamis, lightning, cold/hot temperature, floods, heavy rains etc that have caused accidents. The scope of this paper is to examine the coastal flooding as a parameter in causing an industrial accident, such as the nuclear disaster in Fukushima, Japan, and the critical role of this parameter in industrial site selection. Land use planning is a complex procedure that requires multi-criteria decision analysis involving economic, environmental and social parameters. In this context the parameter of a natural hazard occurrence, such as coastal flooding, for industrial site selection should be set by the decision makers. In this paper it is evaluated the influence that has in the outcome of a multi-criteria decision analysis for industrial spatial planning the parameter of an accident risk triggered by coastal flooding. The latter is analyzed in the context of both sea-and-inland induced flooding.

  14. Chapter 3: detailed discussion on the site selection criteria; Capitulo 3: discussao detalhada dos criterios de selecao de sitio

    Energy Technology Data Exchange (ETDEWEB)

    Atala, Drausio Lima

    2009-07-01

    This chapter discusses full detail each selection criterion and their application. A certain degree of 'customization' can be necessary for each region of interest. Some criteria can be applied depending upon the situation. Some of those criteria can be modified due to the modification on the regulation, advances of the knowledge or specific conditions which can be introduced.

  15. Selection of bioaccumulation criteria for environmental emergency (E2) planning

    International Nuclear Information System (INIS)

    Ketcheson, K.; Hradecky, K.; Gagne, M.; St-Amant-Verret, M.

    2006-01-01

    Environment Canada's Environmental Emergency regulations require the evaluation of a substance by a Risk Evaluation Framework (REF). Bioaccumulation criteria are used within the environmental hazard ratings section of the REF to determine the risk of a substance to organisms and are obtained from 3 types of measurements depending on data reliability: (1) bioaccumulation factors (BAF); (2) bioconcentration factors (BCF); and (3) an octanol-water partition coefficient (log K ow ). This paper presented details of a study of international and regional bioaccumulation criteria conducted to aid in determining appropriate criteria for E2 regulations and plans, with specific reference to substances toxic to aquatic organisms. An E2 plan is required if a substance has a bioconcentration factor of more than 500 in conjunction with aquatic toxicity. Bioaccumulation criteria from several sources for 745 substances were obtained to aid in choosing the most important parameters. Various international and regional criteria were examined and corresponding sources were summarized, and different source criteria was compared with empirical chemical data. The criteria chosen included both log K ow values and BCF values, although it was suggested that BCF and BAF are more realistic measures of bioaccumulation than log K ow , as they are derived from animal studies. The chosen values agreed with the virtual elimination criteria set out by the Canadian Environmental Protection Act (CEPA) 1999 as well as United States Environmental Protection Agency (EPA) criteria. It was concluded that the bioaccumulation criteria for E2 planning will help Environment Canada ensure the protection of the environment from hazardous substances. 11 refs., 3 tabs., 5 figs

  16. An Exploratory Analysis for the Selection and Implementation of Advanced Manufacturing Technology by Fuzzy Multi-criteria Decision Making Methods: A Comparative Study

    Science.gov (United States)

    Nath, Surajit; Sarkar, Bijan

    2017-08-01

    Advanced Manufacturing Technologies (AMTs) offer opportunities for the manufacturing organizations to excel their competitiveness and in turn their effectiveness in manufacturing. Proper selection and evaluation of AMTs is the most significant task in today's modern world. But this involves a lot of uncertainty and vagueness as it requires many conflicting criteria to deal with. So the task of selection and evaluation of AMTs becomes very tedious for the evaluators as they are not able to provide crisp data for the criteria. Different Fuzzy Multi-criteria Decision Making (MCDM) methods help greatly in dealing with this problem. This paper focuses on the application of two very much potential Fuzzy MCDM methods namely COPRAS-G, EVAMIX and a comparative study between them on some rarely mentioned criteria. Each of the two methods is very powerful evaluation tool and has beauty in its own. Although, performance wise these two methods are almost at same level, but, the approach of each one of them are quite unique. This uniqueness is revealed by introducing a numerical example of selection of AMT.

  17. A review of multi-criteria decision making techniques for supplier evaluation and selection

    Directory of Open Access Journals (Sweden)

    Prince Agarwal

    2011-10-01

    Full Text Available Supplier evaluation and selection has been a vital issue of strategic importance for long time. Different multi-criteria decision making (MCDM approaches have been proposed by the researchers in past, to solve the supplier evaluation and selection problem. In this paper, we present a review of various MCDM methodologies reported in the literature for solving the supplier evaluation and selection process. The review is solely based on sixty-eight research articles, including eight review articles in the academic literature from 2000 to 2011. We try to find out the most prevalent approach in the articles and thereby present the future scope of arriving at an optimal solution to the problem, based on the specifications, the strategies and the requirements of the buyers. The study presents that with the change in processes and the requirements, how the approach of the manufacturing industry has shifted from striving for operational effectiveness to the strategic partnership in the dyadic relationship.

  18. A COPRAS-F base multi-criteria group decision making approach for site selection of wind farm

    Directory of Open Access Journals (Sweden)

    Nikhil Chandra Chatterjee

    2013-01-01

    Full Text Available Today global warming is on the rise and the natural resources are getting consumed at a faster rate. Power consumption has increased many folds to cater the human need. Thus renewable energy resources are the only option available at this juncture. Wind energy is one of the renewable energy. Location selection for wind farm takes an important role on power generation. However, the location selection is a complex multicriteria problem due to the criteria factors which are conflicting in nature as well as uncertain. The process becomes more complex when a group of decision makers are involved in decision making. In the present study, a COPRAS (COmplex PRoportional ASsessment based multi-criteria decision-making (MCDM methodology is done under fuzzy environment with the help of multiple decision makers. More specifically, this study is aimed to focus the applicability of COPRAS-F as a strategic decision making tools to handle the group decision-making problems.

  19. 49 CFR Appendix C to Part 541 - Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates

    Science.gov (United States)

    2010-10-01

    ... Likely To Have High Theft Rates C Appendix C to Part 541 Transportation Other Regulations Relating to... MOTOR VEHICLE THEFT PREVENTION STANDARD Pt. 541, App. C Appendix C to Part 541—Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates Scope These criteria specify the factors the...

  20. Path analysis and multi-criteria decision making: an approach for multivariate model selection and analysis in health.

    Science.gov (United States)

    Vasconcelos, A G; Almeida, R M; Nobre, F F

    2001-08-01

    This paper introduces an approach that includes non-quantitative factors for the selection and assessment of multivariate complex models in health. A goodness-of-fit based methodology combined with fuzzy multi-criteria decision-making approach is proposed for model selection. Models were obtained using the Path Analysis (PA) methodology in order to explain the interrelationship between health determinants and the post-neonatal component of infant mortality in 59 municipalities of Brazil in the year 1991. Socioeconomic and demographic factors were used as exogenous variables, and environmental, health service and agglomeration as endogenous variables. Five PA models were developed and accepted by statistical criteria of goodness-of fit. These models were then submitted to a group of experts, seeking to characterize their preferences, according to predefined criteria that tried to evaluate model relevance and plausibility. Fuzzy set techniques were used to rank the alternative models according to the number of times a model was superior to ("dominated") the others. The best-ranked model explained above 90% of the endogenous variables variation, and showed the favorable influences of income and education levels on post-neonatal mortality. It also showed the unfavorable effect on mortality of fast population growth, through precarious dwelling conditions and decreased access to sanitation. It was possible to aggregate expert opinions in model evaluation. The proposed procedure for model selection allowed the inclusion of subjective information in a clear and systematic manner.

  1. A multi-criteria decision making approach for the selection of a flexible packaging equipment

    Directory of Open Access Journals (Sweden)

    Cristea Ciprian

    2017-01-01

    Full Text Available Flexible packaging is one of the fastest growing segments of the packaging industry, combining paper, plastic film and aluminum foil to deliver a broad array of products for food and beverage, personal care products, and pharmaceutical industries. In order to preserve the quality and safety of the product contained in them, there are currently a variety of flexible packaging equipment options available. However their relative costs and performance differ. This study proposes an application of a ranking methodology to assess a selection of the most suitable flexible packaging equipment. The adequate criteria in the selection of equipment have been identified, and the considered options are assessed, considering the decision maker’s preferences and existing constraints. The options are ranked in terms of their suitability for selecting equipment by using the Electre III method. The results obtained from the simulation experiment highlight the effectiveness of the model in outranking different options in the process of equipment selection.

  2. Personel Seçiminde Çok Kriterli Karar Verme: Bulanık Topsis Uygulaması - Multi-Criteria Approach to Personnel Selection: Fuzzy Topsis Applications

    Directory of Open Access Journals (Sweden)

    Nalan Gülten AKIN

    2016-06-01

    Full Text Available Which are very important in terms of human resource management, personnel selection, it expressed as a process of determining the appropriate personnel hired to perform the work. Personnel selection, often occurs as a result of decisions made by a group decision based on the evaluation of candidates by various criteria and subjective judgment transmitter. Whereas the organization that they can gain competitive advantage and this advantage can continue, according to the right personnel for the right job it depends on the objective criteria chosen. Personnel selection problems, decision-making and be more than the number of candidates and the terms of a number of criteria involved in the decision to take effect on multi-criteria decision problems. Decisions based on personal jurisdiction includes the uncertainty. Therefore, one of the multiple-criteria decision analysis techniques in this study preferred method of fuzzy TOPSIS. In the process of recruiting a research assistant in a public university under study, which will be invited to the scientific examination of the candidates who apply, with proximity to the ranking made by calculating the coefficients for each candidate is determined based on objective criteria

  3. Multi-criteria approach for selecting the best solid waste management technologies

    International Nuclear Information System (INIS)

    Latifah, A.M.; Hassan Basri; Noor Ezlin Ahmad Basri

    2010-01-01

    The growth in urbanization and industrial activities has caused solid waste management problems. As a solution the integrated approach has been chosen to manage the solid waste. Developing and implementing integrated solid waste management involve combined technologies and alternatives which are suitable with local laws condition. This research showed that Analytical Hierarchy Process (AHP) has the potential as a decision making tool that can be used in selecting process of solid waste management technology. Three levels hierarchy was developed with the goal at the top level, followed by criteria and alternatives. By using this technique, the priority of each considered technology will be determined where technology with the highest priority is more suitable to be developed. Sensitivity analysis was carried out to test the sensitivity of final decision towards inconsistency of judgement. Application of AHP to determine priority in selecting solid waste management technology was explained in this research based on a case study in the Port Dickson Municipal Council. Analysis of result showed that the combination of recycling technology and composting are suitable to be applied in the Port Dickson district. (author)

  4. Automated classification of eligibility criteria in clinical trials to facilitate patient-trial matching for specific patient populations.

    Science.gov (United States)

    Zhang, Kevin; Demner-Fushman, Dina

    2017-07-01

    To develop automated classification methods for eligibility criteria in ClinicalTrials.gov to facilitate patient-trial matching for specific populations such as persons living with HIV or pregnant women. We annotated 891 interventional cancer trials from ClinicalTrials.gov based on their eligibility for human immunodeficiency virus (HIV)-positive patients using their eligibility criteria. These annotations were used to develop classifiers based on regular expressions and machine learning (ML). After evaluating classification of cancer trials for eligibility of HIV-positive patients, we sought to evaluate the generalizability of our approach to more general diseases and conditions. We annotated the eligibility criteria for 1570 of the most recent interventional trials from ClinicalTrials.gov for HIV-positive and pregnancy eligibility, and the classifiers were retrained and reevaluated using these data. On the cancer-HIV dataset, the baseline regex model, the bag-of-words ML classifier, and the ML classifier with named entity recognition (NER) achieved macro-averaged F2 scores of 0.77, 0.87, and 0.87, respectively; the addition of NER did not result in a significant performance improvement. On the general dataset, ML + NER achieved macro-averaged F2 scores of 0.91 and 0.85 for HIV and pregnancy, respectively. The eligibility status of specific patient populations, such as persons living with HIV and pregnant women, for clinical trials is of interest to both patients and clinicians. We show that it is feasible to develop a high-performing, automated trial classification system for eligibility status that can be integrated into consumer-facing search engines as well as patient-trial matching systems. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

  5. A COPRAS-F base multi-criteria group decision making approach for site selection of wind farm

    OpenAIRE

    Nikhil Chandra Chatterjee; Goutam Kumar Bose

    2013-01-01

    Today global warming is on the rise and the natural resources are getting consumed at a faster rate. Power consumption has increased many folds to cater the human need. Thus renewable energy resources are the only option available at this juncture. Wind energy is one of the renewable energy. Location selection for wind farm takes an important role on power generation. However, the location selection is a complex multicriteria problem due to the criteria factors which are conflicting in nature...

  6. Selection criteria limit generalizability of smoking pharmacotherapy studies differentially across clinical trials and laboratory studies: A systematic review on varenicline.

    Science.gov (United States)

    Motschman, Courtney A; Gass, Julie C; Wray, Jennifer M; Germeroth, Lisa J; Schlienz, Nicolas J; Munoz, Diana A; Moore, Faith E; Rhodes, Jessica D; Hawk, Larry W; Tiffany, Stephen T

    2016-12-01

    The selection criteria used in clinical trials for smoking cessation and in laboratory studies that seek to understand mechanisms responsible for treatment outcomes may limit their generalizability to one another and to the general population. We reviewed studies on varenicline versus placebo and compared eligibility criteria and participant characteristics of clinical trials (N=23) and laboratory studies (N=22) across study type and to nationally representative survey data on adult, daily USA smokers (2014 National Health Interview Survey; 2014 National Survey on Drug Use and Health). Relative to laboratory studies, clinical trials more commonly reported excluding smokers who were unmotivated to quit and for specific medical conditions (e.g., cardiovascular disease, COPD), although both study types frequently reported excluding for general medical or psychiatric reasons. Laboratory versus clinical samples smoked less, had lower nicotine dependence, were younger, and more homogeneous with respect to smoking level and nicotine dependence. Application of common eligibility criteria to national survey data resulted in considerable elimination of the daily-smoking population for both clinical trials (≥47%) and laboratory studies (≥39%). Relative to the target population, studies in this review recruited participants who smoked considerably more and had a later smoking onset age, and were under-representative of Caucasians. Results suggest that selection criteria of varenicline studies limit generalizability in meaningful ways, and differences in criteria across study type may undermine efforts at translational research. Recommendations for improvements in participant selection and reporting standards are discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Surgical outcome of patients with ischemic cardiomyopathy selected by the results of myocardial viability by preoperative F-18 FDG PET

    International Nuclear Information System (INIS)

    Kim, Jae Sung; Hong, Suk Keun; Lee, Young Tak; Kim, Youn Jung; Moon, Keon Sik; Won, Tae Kyoung; Hwang, Hweung Kon; Lee, Dong Soo; Kim, Yu Kyeong

    2000-01-01

    We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.=20

  8. 20 CFR 670.450 - How are applicants who meet eligibility and selection criteria assigned to centers?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are applicants who meet eligibility and selection criteria assigned to centers? 670.450 Section 670.450 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Recruitment...

  9. A Hybrid Multiple Criteria Group Decision-Making Approach for Green Supplier Selection in the TFT-LCD Industry

    Directory of Open Access Journals (Sweden)

    Che-Wei Tsui

    2014-01-01

    Full Text Available The awareness of the need for environmental protection is increasing throughout the world. The focuses of green supplier selection are on considering environmental criteria and strengthening the competitiveness of the entire supply chain. The purpose of this study is to develop a green supplier selection procedure for the thin film transistor liquid crystal display (TFT-LCD industry using polarizer suppliers as an example. First, a decision framework for green supplier selection is developed based on literatures and the supplier audit forms provided by an anonymous flat panel display manufacturer in Taiwan. Then, a hybrid multiple criteria group decision-making (MCGDM method is proposed based on analytic hierarchy process (AHP, entropy, elimination and choice expressing the reality III (ELECTRE III, and the linear assignment method to assist the manufacturer in choosing among four polarizer suppliers. The final ranking results for green supplier selection and different opinions from each department are provided. An improvement report is suggested to enhance suppliers’ performance. For the evaluation procedure, most managers emphasize the importance of current capability and the capability of research and development. Furthermore, we found that the subsidiary supplier should improve quality control competence immediately to be considered as the potential candidate of primary supplier.

  10. Selection criteria for oxidation method in total organic carbon measurement.

    Science.gov (United States)

    Yoon, GeunSeok; Park, Sang-Min; Yang, Heuiwon; Tsang, Daniel C W; Alessi, Daniel S; Baek, Kitae

    2018-05-01

    During the measurement of total organic carbon (TOC), dissolved organic carbon is converted into CO 2 by using high temperature combustion (HTC) or wet chemical oxidation (WCO). However, the criteria for selecting the oxidation methods are not clear. In this study, the chemical structures of organic material were considered as a key factor to select the oxidation method used. Most non-degradable organic compounds showed a similar oxidation efficiency in both methods, including natural organic compounds, dyes, and pharmaceuticals, and thus both methods are appropriate to measure TOC in waters containing these compounds. However, only a fraction of the carbon in the halogenated compounds (perfluorooctanoic acid and trifluoroacetic acid) were oxidized using WCO, resulting in measured TOC values that are considerably lower than those determined by HTC. This result is likely due to the electronegativity of halogen elements which inhibits the approach of electron-rich sulfate radicals in the WCO, and the higher bond strength of carbon-halogen pairs as compared to carbon-hydrogen bonds, which results in a lower degree of oxidation of the compounds. Our results indicate that WCO could be used to oxidize most organic compounds, but may not be appropriate to quantify TOC in organic carbon pools that contain certain halogenated compounds. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    Macrosomia or at least one adverse outcome were more likely in GDM patients who met the diagnostic criteria by both the IADPSG and WHO criteria (P = 0.001). Conclusion: A diagnosis of GDM that meets both the WHO and IADPSG criteria provides stronger prediction for adverse pregnancy outcome than a diagnosis that ...

  12. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

    Directory of Open Access Journals (Sweden)

    John Tran

    2016-05-01

    Full Text Available Introduction: The National Emergency X-radiography Utilization Study (NEXUS criteria are used extensively in emergency departments to rule out C-spine injuries (CSI in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods: This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results: We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101. The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4% cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100] with a negative predictive value of 100 (98.7-100. Conclusion: Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  13. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients.

    Science.gov (United States)

    Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K

    2016-05-01

    The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100]) with a negative predictive value of 100 (98.7-100). Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  14. USING A MULTI CRITERIA DECISION MAKING APPROACH FOR OPEN AND DISTANCE LEARNING SYSTEM SELECTION

    OpenAIRE

    KAMIŞLI ÖZTÜRK, Zehra

    2015-01-01

    Today, there's a wide variety of open and distance learning (ODL) systems around the world. Herein, for lifelong learning how to select an ODL program becomes a critic question for a learner who wants to extent abilities on his/her career path. This is a complex decision problem with interdependent criteria. The Analytic Network Process (ANP) is a multicriteria decision making methodology  that  reflects  these  interdependencies.  Within &...

  15. Methodology for Selecting Best Management Practices Integrating Multiple Stakeholders and Criteria. Part 2: Case Study

    Directory of Open Access Journals (Sweden)

    Mauricio Carvallo Aceves

    2016-02-01

    Full Text Available The selection of stormwater Best Management Practices (BMPs for mitigating the effects of urbanization on the hydrological cycle could be a complex process due to conflicting stakeholder views, and varying levels of performance of BMPs across a range of criteria (runoff reduction, erosion control, etc.. Part 1 of this article proposed a methodology based on the application of multi-criteria decision aid (MCDA methods, which was tested here on a residential stormwater network in the Montreal area. The case study considered green roofs, rain gardens, rain barrels and pervious pavement over a range of economic, social, and water quality and quantity criteria by applying 4 MCDA methods under three different stakeholder views. The results indicated Elimination et Choix Traduisant la Réalité (ELECTRE III to be the most appropriate method for the methodology, presenting flexibility concerning threshold values, criteria weights, and showing shared top choices across stakeholders (rain gardens, and rain gardens in combination with pervious pavement. The methodology shows potential for more formal applications and research opportunities. Future work may lie in the inclusion of multiple objective optimization, better stakeholder engagement, estimation of economic benefits, water quality modeling, long-term hydrological simulations, and estimating real BMP pollutant removal rates.

  16. Regulatory principles, criteria and guidelines for site selection, design, construction and operation of uranium tailings retention systems

    International Nuclear Information System (INIS)

    Coady, J.R.; Henry, L.C.

    1978-01-01

    Principles, criteria and guidelines developed by the Atomic Energy Control Board for the management of uranium mill tailings are discussed. The application of these concepts is considered in relation to site selection, design and construction, operation and decommissioning of tailings retention facilities

  17. Clinical utility of new bleeding criteria: a prospective study of evaluation for the Bleeding Academic Research Consortium definition of bleeding in patients undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Choi, Jae-Hyuk; Seo, Jeong-Min; Lee, Dong Hyun; Park, Kyungil; Kim, Young-Dae

    2015-04-01

    The aim of this study was to evaluate the clinical utility of the new bleeding criteria, proposed by the Bleeding Academic Research Consortium (BARC), compared with the old criteria for determining the action of physicians in contact with bleeding events, after percutaneous coronary intervention (PCI). The BARC criteria were independently associated with an increased risk of 1-year mortality after PCI, and provided a predictive value, in regard to 1-year mortality. The standardized bleeding definitions will be expected to help the physician to correctly analyze the bleeding events, to select an optimal treatment, and to objectively compare the results of multiple trials and registries. All the patients undergoing PCI from June to September 2012 were prospectively enrolled. Patients who experienced a bleeding event were further classified, based on three different bleeding severity criteria: BARC, Thrombolysis In Myocardial Infarction (TIMI), and Global Use of Strategies To Open coronary arteries (GUSTO). The primary outcome was the occurrence of bleeding events requiring interruption of antiplatelet therapy (IAT) by physicians. A total of 376 consecutive patients were included in this study. Total bleeding events occurred in 46 patients (12.2%). BARC type ≥2 bleeding occurred in 30 patients (8.0%); however, TIMI major or minor bleeding, and GUSTO moderate or severe bleeding occurred in 6 (1.6%) and 11 patients (2.9%), respectively. Of the 46 patients, 28 (60.9% of patients) required IAT. On receiver-operating characteristic curve analysis, bleeding defined BARC type ≥2 effectively predicted IAT, with a sensitivity of 89.3%, and a specificity of 98.5% (pdefinition may be a more useful tool for the detection of bleeding with clinical relevance, for patients undergoing PCI. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  18. Performance Evaluation of Five Different Disseminated Intravascular Coagulation (DIC) Diagnostic Criteria for Predicting Mortality in Patients with Complicated Sepsis.

    Science.gov (United States)

    Ha, Sang Ook; Park, Sang Hyuk; Hong, Sang Bum; Jang, Seongsoo

    2016-11-01

    Disseminated intravascular coagulation (DIC) is a major complication in sepsis patients. We compared the performance of five DIC diagnostic criteria, focusing on the prediction of mortality. One hundred patients with severe sepsis or septic shock admitted to intensive care unit (ICU) were enrolled. Routine DIC laboratory tests were performed over the first 4 days after admission. The overall ICU and 28-day mortality in DIC patients diagnosed from five criteria (International Society on Thrombosis and Haemostasis [ISTH], the Japanese Association for Acute Medicine [JAAM], the revised JAAM [R-JAAM], the Japanese Ministry of Health and Welfare [JMHW] and the Korean Society on Thrombosis and Hemostasis [KSTH]) were compared. Both KSTH and JMHW criteria showed superior performance than ISTH, JAAM and R-JAAM criteria in the prediction of overall ICU mortality in DIC patients (odds ratio 3.828 and 5.181, P = 0.018 and 0.006, 95% confidence interval 1.256-11.667 and 1.622-16.554, respectively) when applied at day 1 after admission, and survival analysis demonstrated significant prognostic impact of KSTH and JMHW criteria on the prediction of 28-day mortality (P = 0.007 and 0.049, respectively) when applied at day 1 after admission. In conclusion, both KSTH and JMHW criteria would be more useful than other three criteria in predicting prognosis in DIC patients with severe sepsis or septic shock.

  19. Endoscopic Criteria for Evaluating Tumor Stage after Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer.

    Science.gov (United States)

    Han, Kyung Su; Sohn, Dae Kyung; Kim, Dae Yong; Kim, Byung Chang; Hong, Chang Won; Chang, Hee Jin; Kim, Sun Young; Baek, Ji Yeon; Park, Sung Chan; Kim, Min Ju; Oh, Jae Hwan

    2016-04-01

    Local excision may be an another option for selected patients with markedly down-staged rectal cancer after preoperative chemoradiation therapy (CRT), and proper evaluation of post-CRT tumor stage (ypT) is essential prior to local excision of these tumors. This study was designed to determine the correlations between endoscopic findings and ypT of rectal cancer. In this study, 481 patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection between 2004 and 2013 at a single institution were evaluated retrospectively. Pathological good response (p-GR) was defined as ypT ≤ 1, and pathological minimal or no response (p-MR) as ypT ≥ 2. The patients were randomly classified according to two groups, a testing (n=193) and a validation (n=288) group. Endoscopic criteria were determined from endoscopic findings and ypT in the testing group and used in classifying patients in the validation group as achieving or not achieving p-GR. Based on findings in the testing group, the endoscopic criteria for p-GR included scarring, telangiectasia, and erythema, whereas criteria for p-MR included nodules, ulcers, strictures, and remnant tumors. In the validation group, the kappa statistic was 0.965 (p < 0.001), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.362, 0.963, 0.654, and 0.885, respectively. The endoscopic criteria presented are easily applicable for evaluation of ypT after preoperative CRT for rectal cancer. These criteria may be used for selection of patients for local excision of down-staged rectal tumors, because patients with p-MR could be easily ruled out.

  20. Selection of suitable alternatives to reduce the environmental impact of road traffic noise using a fuzzy multi-criteria decision model

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz-Padillo, Alejandro, E-mail: aruizp@correo.ugr.es [Industrial Engineering and Transportation Department, Federal University of Rio Grande do Sul (UFRGS), Av. Osvaldo Aranha, 99 – 5° andar, Porto Alegre - CEP 90.035-190, Rio Grande do Sul (Brazil); Civil Engineering Department, University of Granada, Av. Fuentenueva s/n, 18071 Granada (Spain); Ruiz, Diego P., E-mail: druiz@ugr.es [Information Technology and Communication Research Center (CITIC-UGR), Applied Physics Department, University of Granada, Av. Fuentenueva s/n, 18071 Granada (Spain); Torija, Antonio J., E-mail: ajtorija@ugr.es [ISVR, University of Southampton, Highfield Campus, SO17 1BJ Southampton (United Kingdom); Ramos-Ridao, Ángel, E-mail: ramosr@ugr.es [Civil Engineering Department, University of Granada, Av. Fuentenueva s/n, 18071 Granada (Spain)

    2016-11-15

    Road traffic noise is one of the most significant environmental impacts generated by transport systems. To this regard, the recent implementation of the European Environmental Noise Directive by Public Administrations of the European Union member countries has led to various noise action plans (NAPs) for reducing the noise exposure of EU inhabitants. Every country or administration is responsible for applying criteria based on their own experience or expert knowledge, but there is no regulated process for the prioritization of technical measures within these plans. This paper proposes a multi-criteria decision methodology for the selection of suitable alternatives against traffic noise in each of the road stretches included in the NAPs. The methodology first defines the main criteria and alternatives to be considered. Secondly, it determines the relative weights for the criteria and sub-criteria using the fuzzy extended analytical hierarchy process as applied to the results from an expert panel, thereby allowing expert knowledge to be captured in an automated way. A final step comprises the use of discrete multi-criteria analysis methods such as weighted sum, ELECTRE and TOPSIS, to rank the alternatives by suitability. To illustrate an application of the proposed methodology, this paper describes its implementation in a complex real case study: the selection of optimal technical solutions against traffic noise in the top priority road stretch included in the revision of the NAP of the regional road network in the province of Almeria (Spain).

  1. Selection of suitable alternatives to reduce the environmental impact of road traffic noise using a fuzzy multi-criteria decision model

    International Nuclear Information System (INIS)

    Ruiz-Padillo, Alejandro; Ruiz, Diego P.; Torija, Antonio J.; Ramos-Ridao, Ángel

    2016-01-01

    Road traffic noise is one of the most significant environmental impacts generated by transport systems. To this regard, the recent implementation of the European Environmental Noise Directive by Public Administrations of the European Union member countries has led to various noise action plans (NAPs) for reducing the noise exposure of EU inhabitants. Every country or administration is responsible for applying criteria based on their own experience or expert knowledge, but there is no regulated process for the prioritization of technical measures within these plans. This paper proposes a multi-criteria decision methodology for the selection of suitable alternatives against traffic noise in each of the road stretches included in the NAPs. The methodology first defines the main criteria and alternatives to be considered. Secondly, it determines the relative weights for the criteria and sub-criteria using the fuzzy extended analytical hierarchy process as applied to the results from an expert panel, thereby allowing expert knowledge to be captured in an automated way. A final step comprises the use of discrete multi-criteria analysis methods such as weighted sum, ELECTRE and TOPSIS, to rank the alternatives by suitability. To illustrate an application of the proposed methodology, this paper describes its implementation in a complex real case study: the selection of optimal technical solutions against traffic noise in the top priority road stretch included in the revision of the NAP of the regional road network in the province of Almeria (Spain).

  2. Benchmarking whole-building energy performance with multi-criteria technique for order preference by similarity to ideal solution using a selective objective-weighting approach

    International Nuclear Information System (INIS)

    Wang, Endong

    2015-01-01

    Highlights: • A TOPSIS based multi-criteria whole-building energy benchmarking is developed. • A selective objective-weighting procedure is used for a cost-accuracy tradeoff. • Results from a real case validated the benefits of the presented approach. - Abstract: This paper develops a robust multi-criteria Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) based building energy efficiency benchmarking approach. The approach is explicitly selective to address multicollinearity trap due to the subjectivity in selecting energy variables by considering cost-accuracy trade-off. It objectively weights the relative importance of individual pertinent efficiency measuring criteria using either multiple linear regression or principal component analysis contingent on meta data quality. Through this approach, building energy performance is comprehensively evaluated and optimized. Simultaneously, the significant challenges associated with conventional single-criterion benchmarking models can be avoided. Together with a clustering algorithm on a three-year panel dataset, the benchmarking case of 324 single-family dwellings demonstrated an improved robustness of the presented multi-criteria benchmarking approach over the conventional single-criterion ones

  3. Capability of multiple selection criteria to evaluate contrasting spring wheat germplasms under arid conditions

    International Nuclear Information System (INIS)

    Al-Suhaibani, N. A.; SALAH, E.; El-Hendawy, S. E.; Al-Gaadi, K.; Rehman, S. U.

    2015-01-01

    Selection criteria that would evaluate a large number of germplasm in a rapid and non-destructive manner would be considered advantageous in plant breeding programs. Trade-off between traditional and non-destructive screening criteria in evaluating 90 wheat accessions under water shortage was tested using multivariate statistical techniques. Only three irrigations during the growing cycle of germplasm were applied with the amount of water totalling 2550 m /sup 3/ ha /sup -1/. Sequential path analysis identified one traditional trait (grain weight per plant) and two non-destructive traits (leaf area index and stomatal conductance) as important first-order traits that influenced final grain yield. The three traits, taken together, explained 96.8 percentage of the total variation in grain yield. Total dry weight per plant, green leaf area per plant, harvest index, grain number per plant, leaf water content and canopy temperature were identified as important second-order traits that influenced grain yield. Although canopy temperature was ranked as a second-order trait, it explained 64.4 percentage of the total variation in stomatal conductance. Approximately 78.0 percentage of the total variation in grain weight or leaf area index was explained by the leaf water content (66.2 percentage) and total dry weight (11.5 percentage). The 90 examined spring wheat germplasms were grouped into five clusters based on all agro-physiological traits using the centroid linkage method. The tested wheat germplasm that produce high grain yield under water shortage were characterised by good performance of certain rapid, easy and non-destructive physiological traits such as high leaf area index, high stomatal conductance and low canopy temperature. Therefore, these three traits could be used in combination as quick and easy screening criteria to select suitable genotypes for water-limiting conditions. (author)

  4. Development of a novel set of criteria to select methodology for designing product service systems

    Directory of Open Access Journals (Sweden)

    Tuananh Tran

    2016-04-01

    Full Text Available This paper proposes eight groups of twenty nine scoring criteria that can help designers and practitioners to compare and select an appropriate methodology for a certain problem in designing product service system (PSS. PSS has been researched for more than a decade and is now becoming more and more popular in academia as well as industry. Despite that fact, the adoption of PSS is still limited for its potential. One of the main reasons is that designing PSS itself is a challenge. Designers and developers face difficulties in choosing appropriate PSS design methodologies for their projects so that they can design effective PSS offerings. By proposing eight groups of twenty nine scoring criteria, this paper enables a “step by step” process to identify the most appropriate design methodology for a company’s PSS problem. An example is also introduced to illustrate the use of the proposed scoring criteria and provide a clear picture of how different design methodologies can be utilized at their best in terms of application.

  5. Multifocal manifestation does not affect vascular invasion of hepatocellular carcinoma: implications for patient selection in liver transplantation.

    Science.gov (United States)

    Löhe, Florian; Angele, Martin K; Rentsch, Markus; Graeb, Christian; Gerbes, Alexander; Löhrs, Udo; Beuers, Ulrich; Jauch, Karl-Walter

    2007-01-01

    Liver transplantation (OLT) for hepatocellular carcinoma (HCC) improves patient survival when tumor size and number are limited according to the Milan criteria. However, the impact of tumor size vs. the number of lesions for tumor recurrence after OLT is unclear. Microvascular invasion appears to be a significant risk factor for tumor recurrence. Therefore, it was the aim of this study to investigate tumor differentiation and microvascular invasion in relation to tumor number and size and their impact on survival after transplantation. In 97 adult HCC patients who underwent OLT between June 1985 and December 2005 the incidence of microvascular invasion, tumor differentiation, and the number and size of tumor lesions were analyzed retrospectively. Their impact on survival was studied by multivariate analysis. Microvascular invasion was the only independent negative predictor of survival after OLT for HCC (p = 0.025). Tumor size > 5 cm was predictive for microvascular invasion (p = 0.007). In contrast, tumor number did not affect the incidence of microvascular invasion or cumulative survival. The size of the largest HCC lesion, but not the number of tumors, determined microvascular invasion, a predictor of the outcome following OLT for HCC. Thus, the number of HCC lesions should not be applied to patient selection prior to OLT. These data support the extension of the Milan criteria for the selection of HCC patients for OLT with regard to tumor number, but not tumor size.

  6. A geographic information system and multi criteria analysis method for site selection of spent nuclear fuel disposal

    International Nuclear Information System (INIS)

    Martins, Vivian Borges

    2009-01-01

    This thesis aims to develop a site selection methodology for the construction of final repository for the spent nuclear fuel disposal, by using geographic information systems (GIS) and multi-criteria decision analysis. Decision making processes of this kind are often complex, given the great number of space parameters to consider and also the typically conflicting opinions of the diverse stake holders. By using GIS, data from different space parameters can be quickly and reliably stored, treated and analyzed. Multi-criteria techniques allow for the incorporation of different stake holders' opinions. These tools, when jointly used, allow for the decision process to be more transparent, quick and reliable. The method developed was applied to the particular case of the state of Rio de Janeiro. Weights obtained from an expert panel and also by using the Hierarchical Analysis Method and cartographic data were combined in the GIS. The application showed that it is possible not only to select and classify areas as to their aptness for the proposed objective, but also to exclude those clearly inadequate areas, thus optimizing the selection process by reducing the search space and consequently minimizing costs and the time spent in the search. (author)

  7. Customers’ Perceptions on the Objectives, Characteristics and Selection Criteria of Islamic Bank in Thailand

    OpenAIRE

    Lateh, Nasrina; Ismail, Suhaiza; Ariffin, Noraini Mohd

    2009-01-01

    Due to relatively new establishment of islamic bank in Thailand and paucity of empirical research undertaken in the area, this study intends to capture the perceptions of Thai customers towards the objectives and characteristics of the islamic bank. In addition, this study aims to determine the important bank selection criteria as perceived by the customers and the differences in the perceptions of moslem and non-moslem customers were identified. The study surveys a sample of 462 respondents....

  8. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys.

    Science.gov (United States)

    Akamizu, Takashi; Satoh, Tetsurou; Isozaki, Osamu; Suzuki, Atsushi; Wakino, Shu; Iburi, Tadao; Tsuboi, Kumiko; Monden, Tsuyoshi; Kouki, Tsuyoshi; Otani, Hajime; Teramukai, Satoshi; Uehara, Ritei; Nakamura, Yosikazu; Nagai, Masaki; Mori, Masatomo

    2012-07-01

    Thyroid storm (TS) is life threatening. Its incidence is poorly defined, few series are available, and population-based diagnostic criteria have not been established. We surveyed TS in Japan, defined its characteristics, and formulated diagnostic criteria, FINAL-CRITERIA1 and FINAL-CRITERIA2, for two grades of TS, TS1, and TS2 respectively. We first developed diagnostic criteria based on 99 patients in the literature and 7 of our patients (LIT-CRITERIA1 for TS1 and LIT-CRITERIA2 for TS2). Thyrotoxicosis was a prerequisite for TS1 and TS2 as well as for combinations of the central nervous system manifestations, fever, tachycardia, congestive heart failure (CHF), and gastrointestinal (GI)/hepatic disturbances. We then conducted initial and follow-up surveys from 2004 through 2008, targeting all hospitals in Japan, with an eight-layered random extraction selection process to obtain and verify information on patients who met LIT-CRITERIA1 and LIT-CRITERIA2. We identified 282 patients with TS1 and 74 patients with TS2. Based on these data and information from the Ministry of Health, Labor, and Welfare of Japan, we estimated the incidence of TS in hospitalized patients in Japan to be 0.20 per 100,000 per year. Serum-free thyroxine and free triiodothyroine concentrations were similar among patients with TS in the literature, Japanese patients with TS1 or TS2, and a group of patients with thyrotoxicosis without TS (Tox-NoTS). The mortality rate was 11.0% in TS1, 9.5% in TS2, and 0% in Tox-NoTS patients. Multiple organ failure was the most common cause of death in TS1 and TS2, followed by CHF, respiratory failure, arrhythmia, disseminated intravascular coagulation, GI perforation, hypoxic brain syndrome, and sepsis. Glasgow Coma Scale results and blood urea nitrogen (BUN) were associated with irreversible damages in 22 survivors. The only change in our final diagnostic criteria for TS as compared with our initial criteria related to serum bilirubin concentration >3 mg

  9. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    Science.gov (United States)

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva

  10. [Targeted pharmacist-led medication order review in hospital: Assessment of a selection method for drug prescriptions].

    Science.gov (United States)

    Jarre, C; Bouchet, J; Hellot-Guersing, M; Leromain, A-S; Derharoutunian, C; Gadot, A; Roubille, R

    2017-11-01

    The aim of this study was to assess a selection method for drug prescriptions developed at the hospital level that allows to target pharmacist-led medication order review for at-risk patients and drugs. A one-month study has been conducted on all targeted medication orders in 19 care units. Selection criteria have been identified: biological criteria, alert medications and drug interactions. Pharmacists' interventions proposed during medication order review were listed and the possible links to the selection criteria were determined. A total of 1612 prescriptions were analysed and 236 pharmacists' interventions were performed (14.6 interventions per 100 prescriptions). Physicians' acceptance rate was 60.6%. The percentage of pharmacists' interventions linked to the selection criteria was 35.6%. The relevance of the biological criteria was identified, particularly the one identifying patients with creatinine clearance below 30ml/min. Six alert medications were also relevant selection criteria: dabigatran, morphine, gentamicin, methotrexate, potassium chloride and trimethoprim sulfamethoxazole. Drug interactions criteria was irrelevant. This study allowed a first assessment of the selection criteria used. A largest study seems necessary to continue the analysis of this selection method for prescriptions, especially the assessment of the alert medications list, in order to refine the prescriptions targeting. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  11. 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

  12. Can multi-criteria analysis models support the site selection for a repository for heat-generating waste?

    International Nuclear Information System (INIS)

    Gutberlet, Daniela

    2015-01-01

    The decision for or against a potential site for a nuclear waste repository is highly complex and requires decision-makers to consider multiple assessment criteria. The complexity of each site and its characteristics, and the differing opinions among members of the public and advocacy groups mean t hat conflicts of interest are likely to arise. In this paper, the author suggests that multi-criteria analysis models could be used to provide methodological support during the selection process. The models can map these types of decision situations and suggest coherent solutions with relatively little formal effort. They allow users to compare different opt ions simultaneously and ensure that t heir decision-making Is conscious rather than arbitrary.

  13. Predictive validity of proposed remission criteria in first-episode schizophrenic patients responding to antipsychotics

    NARCIS (Netherlands)

    Wunderink, Lex; Nienhuis, Fokko J.; Sytema, Sjoerd; Wiersma, Durk

    The objective of this study was to examine the predictive validity of the remission criteria proposed by Andreasen et all in first-episode patients responding to antipsychotics. Antipsychotic responsive patients with first-episode schizophrenia showing symptom remission (n = 60) were compared with

  14. POD NUMBER AND PHOTOSYNTHESIS AS PHYSIOLOGICAL SELECTION CRITERIA IN SOYBEAN (Glycine max L. Merrill BREEDING FOR HIGH YIELD

    Directory of Open Access Journals (Sweden)

    S.M. Sitompul

    2015-02-01

    Full Text Available Field studies were conducted in two years using 638 F2 and 1185 F3 lines of selected 16 F1 and 15 F2 parent lines (³80 pods plant-1 to evaluate pod number and CO2 exchange rate (CER as selection criteria. Pod and seed number, and seed weight of individual lines were observed during harvesting time, and CER of randomly selected 32 F2 and 30 F3 lines was measured at initial seed filling stage. The selection of F2 lines based on pod number to generate F3 lines increased the average of seed yield by 39%, and pod number by 77% in F3 lines compared with F2 lines. A close relationships was found between seed weight and pod or seed number per plant. Net CER responded sensitively to a reduction of light in a short-term and showed 78% of F2 lines and all F3 lines with maximum CER (Pmax³20 mmolCO2.m-2.s-1. The ratio of pod number per plant and Pmax varied between lines and were used to group lines resulting in close relationships between Pmax and pod number. It is concluded that the use of pod number and CER (Pmax as selection criteria offers an alternative approach in soybean breeding for high yield.

  15. Prevalence of the metabolic syndrome in patients with carotid disease according to NHLBI/AHA and IDF criteria: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Maksimovic Milos Z

    2012-01-01

    Full Text Available Abstract Background Metabolic syndrome (MetS has been related to type 2 diabetes and cardiovascular diseases. Different criteria for diagnosis of MetS have been recommended, but there is no agreement about which criteria are best to use. The aim of the present study was to investigate agreement between the National Heart, Lung, and Blood Institute, American Heart Association (NHLBI/AHA and the International Diabetes Federation (IDF definitions of MetS in patients with symptomatic carotid disease and to compare the frequency of cardiovascular risk factor in patients with MetS diagnosed by these two sets of criteria. Methods The study was a cross-sectional one involving 644 consecutive patients with verified carotid disease who referred to the Vascular Surgery Clinic Dedinje in Belgrade during the period April 2006 - November 2007. Anthropometric parameters blood pressure, fasting plasma glucose and lipoproteins were measured using standard procedures. Results MetS was present in 67.9% of participants, according to IDF criteria, and in 64.9% of participants, according to the NHLBI/AHA criteria. A total of 119 patients were categorized differently by the two definitions. Out of all participants 10.7% had MetS by IDF criteria only and 7.8% of patients had MetS by NHLBI/AHA criteria only. The overall agreement of IDF and NHLBI/AHA criteria was 81.5% (Kappa 0.59, p Conclusion The MetS prevalence in patients with symptomatic carotid disease was high regardless of criteria used for its diagnosis. Since some patients with known cardiovascular risk factors were lost by the use of IDF criteria it seems that NHLBI/AHA definition is more suitable for diagnosis of MetS. Large follow-up studies are needed to test prognostic value of these definitions.

  16. Reliability of Left Ventricular Hypertrophy by ECG Criteria in Children with Syncope: Do the Criteria Need to be Revised?

    Science.gov (United States)

    Banerjee, Maalika M; Ramesh Iyer, V; Nandi, Deipanjan; Vetter, Victoria L; Banerjee, Anirban

    2016-04-01

    In the outpatient setting, children who present with syncope routinely undergo electrocardiograms (ECG). Because of concerns for hypertrophic cardiomyopathy, children with syncope meeting ECG criteria for left ventricular hypertrophy (LVH) will frequently undergo an echocardiogram. Our objectives were to determine whether Davignon criteria for ECG waves overestimate LVH in children presenting with syncope, and to study the usefulness of echocardiography in these children. We hypothesize that the Davignon criteria presently used for interpretation of ECGs overestimate LVH, resulting in unnecessary echocardiography in this clinical setting. The clinical database of The Children's Hospital of Philadelphia was evaluated from 2002 to 2012 to identify children between 9 and 16 years of age, who presented with non-exercise-induced, isolated syncope. From this group of patients, only those with clear-cut evidence of LVH (by Davignon criteria), who also underwent an echocardiogram, were selected. A total of 136 children with syncope were identified as having LVH by Davignon ECG criteria. None of these patients manifested any evidence of hypertrophic cardiomyopathy, with normal ventricular septum (average Z-score -0.68 ± 0.84), LV posterior wall (average Z-score -0.66 ± 1.18) and LV mass (average Z-score 0.52 ± 1.29). No significant correlation was found between summed RV6 plus SV1 and LV mass. Correlations between additional ECG parameters and measures of LVH by echocardiography were similarly poor. In children presenting with syncope and LVH by ECG, there was no evidence of true LVH by echocardiography. We propose that the Davignon ECG criteria for interpreting LVH in children overestimate the degree of hypertrophy in these children and the yield of echocardiography is extremely low.

  17. Factor structure of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

    Science.gov (United States)

    Grilo, C M

    2004-01-01

    To examine the factor structure of DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive out-patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. The eight criteria for the OCPD diagnosis were examined with reliability and correlational analyses. Exploratory factor analysis was performed to identify potential components. Cronbach's coefficient alpha for the OCPD criteria was 0.77. Principal components factor analysis with varimax rotation revealed a three-factor solution (rigidity, perfectionism, and miserliness), which accounted for 65% of variance. The DSM-IV criteria for OCPD showed good internal consistency. Exploratory factor analysis, however, revealed three components that may reflect distinct interpersonal, intrapersonal (cognitive), and behavioral features.

  18. A criticism of applications with multi-criteria decision analysis that are used for the site selection for the disposal of municipal solid wastes

    International Nuclear Information System (INIS)

    Kemal Korucu, M.; Erdagi, Bora

    2012-01-01

    Highlights: ► The existing structure of the multi-criteria decision analysis for site selection is criticized. ► Fundamental problematic points based on the critics are defined. ► Some modifications are suggested in order to provide solutions to these problematical points. ► A new structure for the decision making mechanism is proposed. ► The feasibility of the new method is subjected to an evaluation process. - Abstract: The main aim of this study is to criticize the process of selecting the most appropriate site for the disposal of municipal solid wastes which is one of the problematic issues of waste management operations. These kinds of problems are pathological symptoms of existing problematical human–nature relationship which is related to the syndrome called ecological crisis. In this regard, solving the site selection problem, which is just a small part of a larger entity, for the good of ecological rationality and social justice is only possible by founding a new and extensive type of human–nature relationship. In this study, as a problematic point regarding the discussions on ecological problems, the existing structure of the applications using multi-criteria decision analysis in the process of site selection with three main criteria is criticized. Based on this critique, fundamental problematic points (to which applications are insufficient to find solutions) will be defined. Later, some modifications will be suggested in order to provide solutions to these problematical points. Finally, the criticism addressed to the structure of the method with three main criteria and the feasibility of the new method with four main criteria is subjected to an evaluation process. As a result, it is emphasized that the new structure with four main criteria may be effective in solution of the fundamental problematic points.

  19. A criticism of applications with multi-criteria decision analysis that are used for the site selection for the disposal of municipal solid wastes

    Energy Technology Data Exchange (ETDEWEB)

    Kemal Korucu, M., E-mail: kemal.korucu@kocaeli.edu.tr [University of Kocaeli, Department of Environmental Engineering, 41380 Kocaeli (Turkey); Erdagi, Bora [University of Kocaeli, Department of Philosophy, 41380 Kocaeli (Turkey)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer The existing structure of the multi-criteria decision analysis for site selection is criticized. Black-Right-Pointing-Pointer Fundamental problematic points based on the critics are defined. Black-Right-Pointing-Pointer Some modifications are suggested in order to provide solutions to these problematical points. Black-Right-Pointing-Pointer A new structure for the decision making mechanism is proposed. Black-Right-Pointing-Pointer The feasibility of the new method is subjected to an evaluation process. - Abstract: The main aim of this study is to criticize the process of selecting the most appropriate site for the disposal of municipal solid wastes which is one of the problematic issues of waste management operations. These kinds of problems are pathological symptoms of existing problematical human-nature relationship which is related to the syndrome called ecological crisis. In this regard, solving the site selection problem, which is just a small part of a larger entity, for the good of ecological rationality and social justice is only possible by founding a new and extensive type of human-nature relationship. In this study, as a problematic point regarding the discussions on ecological problems, the existing structure of the applications using multi-criteria decision analysis in the process of site selection with three main criteria is criticized. Based on this critique, fundamental problematic points (to which applications are insufficient to find solutions) will be defined. Later, some modifications will be suggested in order to provide solutions to these problematical points. Finally, the criticism addressed to the structure of the method with three main criteria and the feasibility of the new method with four main criteria is subjected to an evaluation process. As a result, it is emphasized that the new structure with four main criteria may be effective in solution of the fundamental problematic points.

  20. InterTechnology Corporation proposed criteria and recommendations for selection of PON non-residential demonstration sites

    Energy Technology Data Exchange (ETDEWEB)

    None

    1976-12-01

    This report has been prepared with the objective of providing ERDA with recommended procedures for implementing the strategies set forth in the Systems Level Plan which are considered essential to the success of the National Demonstration Program. In order to logically develop these recommendations, this report is divided into three sections: A. Overview of the Demonstration Program to date. B. Essential Overall Program Strategies. C. Candidate Screening and Selection Criteria. (WDM)

  1. 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

  2. Relaxing decision criteria does not improve recognition memory in amnesic patients.

    Science.gov (United States)

    Reber, P J; Squire, L R

    1999-05-01

    An important question about the organization of memory is whether information available in non-declarative memory can contribute to performance on tasks of declarative memory. Dorfman, Kihlstrom, Cork, and Misiaszek (1995) described a circumstance in which the phenomenon of priming might benefit recognition memory performance. They reported that patients receiving electroconvulsive therapy improved their recognition performance when they were encouraged to relax their criteria for endorsing test items as familiar. It was suggested that priming improved recognition by making information available about the familiarity of test items. In three experiments, we sought unsuccessfully to reproduce this phenomenon in amnesic patients. In Experiment 3, we reproduced the methods and procedure used by Dorfman et al. but still found no evidence for improved recognition memory following the manipulation of decision criteria. Although negative findings have their own limitations, our findings suggest that the phenomenon reported by Dorfman et al. does not generalize well. Our results agree with several recent findings that suggest that priming is independent of recognition memory and does not contribute to recognition memory scores.

  3. Relevance of Follow-Up in Patients with Core Clinical Criteria for Alzheimer Disease and Normal CSF biomarkers.

    Science.gov (United States)

    Vercruysse, Olivier; Paquet, Claire; Gabelle, Audrey; Delbeuck, Xavier; Blanc, Frederic; Wallon, David; Dumurgier, Julien; Magnin, Eloi; Martinaud, Olivier; Jung, Barbara; Bousiges, Olivier; Lehmann, Sylvain; Delaby, Constance; Quillard-Murain, Muriel; Peoc'h, Katell; Laplanche, Jean-Louis; Bouaziz-Amar, Elodie; Hannequin, Didier; Sablonniere, Bernard; Buee, Luc; Hugon, Jacques; Schraen, Susanna; Pasquier, Florence; Bombois, Stephanie

    2018-01-09

    Few patients with a normal cerebrospinal fluid (CSF) biomarker profile fulfill the clinical criteria for Alzheimer disease (AD). The aim of this study was to test the hypothesis of misdiagnoses for these patients. Patients from the e-PLM centers fulfilling the core clinical criteria for probable AD dementia or mild cognitive impairment due to AD (AD-MCI), with normal CSF A1-42, T-tau and P-tau biomarkers and clinical follow-up, were included. Clinical and imaging data were reviewed by an independent board, from baseline (visit with clinical evaluation and CSF analysis) to the end of the follow-up, for a final diagnosis. In the e-PLM cohort of 1098 AD patients with CSF analysis, 37 (3.3%) patients (20 with AD dementia core clinical criteria and 17 with AD-MCI core clinical criteria) had normal CSF biomarker profile and a clinical follow-up. All patients presented with episodic memory impairment and 27 (73%) had medial temporal lobe atrophy on MRI-scan. After a median follow-up of 36 months (range 7-74), the final diagnosis was AD MCI or dementia for 9 (24%) patients, and unlikely due to AD for 28 (76%) patients. A misdiagnosis was corrected in 18 (49%) patients (mood disorders, non-AD degenerative dementia, vascular cognitive impairment, alcohol cognitive disorders, temporal epilepsy and hippocampal sclerosis), and 10 (27%) patients had cognitive disorders of undetermined etiology. AD diagnosis (MCI or dementia) with normal CSF biomarkers is a rare condition. A clinical follow-up is particularly recommended to consider an alternative diagnosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria

    Directory of Open Access Journals (Sweden)

    José Raimundo Araújo de Azevedo

    2010-06-01

    Full Text Available OBJECTIVE: To compare the renal outcome in patients submitted to two different regimens of glycemic control, using the RIFLE criteria to define acute kidney injury. INTRODUCTION: The impact of intensive insulin therapy on renal function outcome is controversial. The lack of a criterion for AKI definition may play a role on that. METHODS: Included as the subjects were 228 randomly selected, critically ill patients engaged in intensive insulin therapyor in a carbohydrate-restrictive strategy. Renal outcome was evaluated through the comparison of the last RIFLE score obtained during the ICU stay and the RIFLE score at admission; the outcome was classified as favorable, stable or unfavorable. RESULTS: The two groups were comparable regarding demographic data. AKI developed in 52% of the patients and was associated with a higher mortality (39.4% compared with those who did not have AKI (8.2% (p60, acute kidney injury and hypoglycemia were risk factors for mortality. CONCLUSION: Intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria.

  5. 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.

  6. Rating of environmental criteria

    Energy Technology Data Exchange (ETDEWEB)

    Glueck, K; Krasser, G

    1980-01-01

    After a general theoretical discussion on the question of rating within a framework of cost-benefit studies, first trials as to the quantification and standardisation of twelve selected environmental criteria by means of an indicator system are worked out and compiled. The selection includes the criteria exhaust gas, dust, micro climate, water pollution, water regime, land requirement, vibrations, traffic noise, landscape scene, urban scene, effect of separation and safety risks. An insight is given of the rating practice using an evaluation of the available literature, of a household interview and of an interview of experts. The interviewing of 156 experts as to their rating conception of ten criteria in the second round has provided contributions to the general problem of the evaluation estimate based on multi criteria analysis as well as differentiation of the twelve or ten environmental criteria. The following criteria ratings given by the experts and which are averaged and smoothed are: traffic noise 20,0% +- 8,5; air pollution 15,0% +- 7,0; safety risk 13,0% +- 7,0; soil and water pollution 8,5% +- 5,0; landscape scene 8,0% +- 4,5; urban scene 8,0% +- 4,5; water regime 6,5% +- 3,5 and vibrations 4,5% +- 2,5.

  7. STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2012-02-03

    Introduction: STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) is a new, systems-defined medicine review tool. We compared the performance of STOPP to that of established Beers\\' criteria in detecting potentially inappropriate medicines (PIMs) and related adverse drug events (ADEs) in older patients presenting for hospital admission. METHODS: we prospectively studied 715 consecutive acute admissions to a university teaching hospital. Diagnoses, reason for admission and concurrent medications were recorded. STOPP and Beers\\' criteria were applied. PIMs with clear causal connection or contribution to the principal reason for admission were determined. RESULTS: median patient age (interquartile range) was 77 (72-82) years. Median number of prescription medicines was 6 (range 0-21). STOPP identified 336 PIMs affecting 247 patients (35%), of whom one-third (n = 82) presented with an associated ADE. Beers\\' criteria identified 226 PIMs affecting 177 patients (25%), of whom 43 presented with an associated ADE. STOPP-related PIMs contributed to 11.5% of all admissions. Beers\\' criteria-related PIMs contributed to significantly fewer admissions (6%). CONCLUSION: STOPP criteria identified a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events than Beers\\' criteria. This finding has significant implications for hospital geriatric practice.

  8. A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.

    Science.gov (United States)

    Armstrong, James; Forrest, Helen; Crawford, Mark W

    2015-10-01

    Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. We recorded physiological observations from consecutive American Society of Anesthesiologists physical status I-III patients aged 1-18 yr who were admitted to the PACU after undergoing ambulatory surgery in a tertiary academic pediatric hospital. The physiological score was a combination of the Aldrete and Chung systems. Scores were recorded every 15 min starting upon arrival in the PACU. Patients were considered fit for discharge once they attained a score ≥12 (maximum score, 14), provided no score was zero, with the time to achieve a score ≥12 defining the criteria-based discharge (CBD) time. Patients were discharged from the PACU when both the CBD and the existing time-based discharge (TBD) criteria were met. The CBD and TBD data were compared using Kaplan-Meier and log-rank analysis. Observations from 506 children are presented. Median (interquartile range [IQR]) age was 5.5 [2.8-9.9] yr. Median [IQR] CBD and TBD PACU discharge readiness times were 30 [15-45] min and 60 [45-60] min, respectively. Analysis of Kaplan-Meier curves indicated a significant difference in discharge times using the different criteria (hazard ratio, 5.43; 95% confidence interval, 4.51 to 6.53; P < 0.001). All patients were discharged home without incident. This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.

  9. PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES.

    Science.gov (United States)

    Marsh, Kevin; Caro, J Jaime; Zaiser, Erica; Heywood, James; Hamed, Alaa

    2018-01-01

    Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered. This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences. The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported. The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

  10. Application of a multi-criteria analysis for the selection of the most suitable energy source and water desalination system in Mauritania

    International Nuclear Information System (INIS)

    Bayod Rujula, Angel Antonio; Dia, Nourou Khalidou

    2010-01-01

    Water deficits and their associated shortages are serious problems in many areas of the world. The paper presents a multi-criteria analysis for selection of the most suitable system in Mauritania. Six scenarios, different energy sources, technologies of water desalination processes and water use and five criteria are analyzed. The multi-criteria analysis shows that the optimal solution is different for each scenario; in some cases the photovoltaic-reverse osmosis option is preferable; in others, the best option is reverse-osmosis powered by wind energy or concentrating solar parabolic.

  11. Material selection for the tool holder working under hard milling conditions using different multi criteria decision making methods

    International Nuclear Information System (INIS)

    Çalışkan, Halil; Kurşuncu, Bilal; Kurbanoğlu, Cahit; Güven, Şevki Yılmaz

    2013-01-01

    Highlights: ► The material selection problem for tool holders used in hard milling was solved. ► EXPROM2, TOPSIS and VIKOR methods were used for ranking the alternative materials. ► The weighting of criteria was performed by compromised weighting method. ► The best material for the tool holder was selected as Fe–5Cr–Mo–V aircraft steel. -- Abstract: Nowadays machining of materials in their hardened state, also called hard machining, is a challenge in production of tools and molds. It has some advantages such as lower process time and lower manufacturing cost when compared to conventional machining. In machining of hard workpiece materials, however, very high stresses act on the tool holder through the cutting tool. These stresses necessitate the tool holder to have some specific properties. Especially in hard milling, the tool holder should have high stiffness and should be able to dissipate the energy generated during interrupted cutting. Material cost of the tool holder is also important since lower costs provide a competitive advantage for manufacturers. The material selection for the tool holder should be conducted considering aforementioned requirements. To tackle the difficulty of the material selection with specific properties from a large number of alternatives, multi-criteria decision-making (MCDM) methods have been used. In this paper a decision model including extended PROMETHEE II (EXPROM2) (preference ranking organization method for enrichment evaluation), TOPSIS (technique for order performance by similarity to ideal solution) and VIKOR (VIšekriterijumsko KOmpromisno Rangiranje) methods were used for the selection of the best material for the tool holder used in hard milling. The criteria weighting was performed by compromised weighting method composed of AHP (analytic hierarchy process) and Entropy methods. The candidate materials were ranked by using these methods and the results obtained by each method were compared. It was confirmed

  12. 34 CFR 225.11 - What selection criteria does the Secretary use in evaluating an application for a Credit...

    Science.gov (United States)

    2010-07-01

    ... EDUCATION, DEPARTMENT OF EDUCATION CREDIT ENHANCEMENT FOR CHARTER SCHOOL FACILITIES PROGRAM How Does the... school facilities programs, their performance in implementing these grants. (d) Quality of project... 34 Education 1 2010-07-01 2010-07-01 false What selection criteria does the Secretary use in...

  13. Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Monique Nakayama Ohe

    2014-07-01

    Full Text Available INTRODUCTION: Several methods have been proposed to improve operative success in renal hyperparathyroidism. OBJECTIVE: To evaluate stereomicroscopy in parathyroid tissue selection for total parathyroidectomy with autotransplantation in secondary (SHPT/tertiary (THPT hyperparathyroidism. METHODS: 118 renal patients underwent surgery from April of 2000 to October 2009. They were divided into two groups: G1, 66 patients operated from April of 2000 to May of 2005, with tissue selection based on macroscopic observation; G2, 52 patients operated from March of 2008 to October 2009 with stereomicroscopy for tissue selection searching for the presence of adipose cells. All surgeries were performed by the same surgeon. Patients presented SHPT (dialysis treatment or THPT (renal-grafted. Follow-up was 12-36 months. Intra-operative parathyroid hormone (PTH was measured in 100/118 (84.7% patients. RESULTS: Data are presented as means. G1 included 66 patients (38 SHPT, 24 females/14 males; 40.0 years of age; 28 THPT, 14 females/14 males; 44 years of age. G2 included 52 patients (29 SHPT, 11 females/18 males; 50.7 years of age; 23 THPT, 13 females/10 males, 44.4 years of age. SHPT patients from G2 presented preoperative serum calcium higher than those of SHPT patients in G1 (p < 0.05, suggesting a more severe disease. Definitive hypoparathyroidism was found in seven of 118 patients (5.9%. Graft-dependent recurrence occurred in four patients, two in each group. All occurred in dialysis patients. CONCLUSION: Stereomicroscopy in SHPT/THPT surgical treatment may be a useful tool to standardize parathyroid tissue selection.

  14. Comparing new diagnostic criteria of 2010 ACR/EULAR with 1987 ACR criteria in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Fatemeh Shirani

    2017-01-01

    Full Text Available Background: Rheumatoid Arthritis (RA is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology criteria and 2010 ACR/EULAR (European League Against Rheumatism classification criteria for diagnosis of rheumatoid arthritis. Methods: In this Cohort prospective study, patients with early arthritis were evaluated   according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013 in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, anti-cyclic citrullinated peptide (Anti-CCP and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9% and 76 females (73.1% with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA rather than other arthritis (P=0.0001. Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints

  15. Criteria of medical care evaluation in daily in-patient department in pediatrics

    Directory of Open Access Journals (Sweden)

    Grozdova T.U.

    2011-06-01

    Full Text Available The research goal is to work out criteria for the evaluation of medical care quality. Materials included 386 medical cards of daily in-patients, 216 medical cards of in-patients; 602 cards of analysis of case histories; 4 computer data bases. Methods of mathematical statistics were successfully used in the study. The comparative method of data analysis was applied to the research work. Intensity of medical care in values from 0,1 to 0,5 conditional units corresponded to requirements of criterion of estimation of medical care quality. Parameters of medicinal treatment were close to the standards of treatment in interval from 44,4 to 100%, as criterion of quality of medical care. Specific weight of apparatus and instrumental researches constituted an interval from 7, 4% to 22, 6%, forming corresponding criterion. Interval of effectiveness according to standards of consultations is from 0, 26 to 1, 04 conditional units. In conclusion the article stated that the characteristics for criteria to evaluate medical care in daily in-patient departments were worked out on the basis of indices obtained during the research work

  16. 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.)

  17. 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.)

  18. 2016 Updates to US Medical Eligibility Criteria for Contraceptive Use and Selected Practice Recommendations for Contraceptive Use: Highlights for Adolescent Patients.

    Science.gov (United States)

    Hoopes, Andrea J; Simmons, Katharine B; Godfrey, Emily M; Sucato, Gina S

    2017-04-01

    The US Medical Eligibility Criteria for Contraceptive Use (MEC) and US Selected Practice Recommendations for Contraceptive Use (SPR) provide evidence-based guidance to safely provide contraception counseling and services. Both documents were updated in 2016 and are endorsed by the North American Society for Pediatric and Adolescent Gynecology. The purpose of this mini-review is to highlight updates to the US MEC and US SPR that are most relevant to health care providers of adolescents to support dissemination and implementation of these evidence-based best practices. This document is intended to highlight these changes and to complement, not replace, the detailed practice guidance within the US MEC and US SPR. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017)

    DEFF Research Database (Denmark)

    Younes, A; Hilden, P; Coiffier, B

    2017-01-01

    of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria...... enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category...

  20. Evaluation of Immune-Related Response Criteria and RECIST v1.1 in Patients With Advanced Melanoma Treated With Pembrolizumab.

    Science.gov (United States)

    Hodi, F Stephen; Hwu, Wen-Jen; Kefford, Richard; Weber, Jeffrey S; Daud, Adil; Hamid, Omid; Patnaik, Amita; Ribas, Antoni; Robert, Caroline; Gangadhar, Tara C; Joshua, Anthony M; Hersey, Peter; Dronca, Roxana; Joseph, Richard; Hille, Darcy; Xue, Dahai; Li, Xiaoyun Nicole; Kang, S Peter; Ebbinghaus, Scot; Perrone, Andrea; Wolchok, Jedd D

    2016-05-01

    We evaluated atypical response patterns and the relationship between overall survival and best overall response measured per immune-related response criteria (irRC) and Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) in patients with advanced melanoma treated with pembrolizumab in the phase Ib KEYNOTE-001 study (clinical trial information: NCT01295827). Patients received pembrolizumab 2 or 10 mg/kg every 2 weeks or every 3 weeks. Atypical responses were identified by using centrally assessed irRC data in patients with ≥ 28 weeks of imaging. Pseudoprogression was defined as ≥ 25% increase in tumor burden at week 12 (early) or any assessment after week 12 (delayed) that was not confirmed as progressive disease at next assessment. Response was assessed centrally per irRC and RECIST v1.1. Of the 655 patients with melanoma enrolled, 327 had ≥ 28 weeks of imaging follow-up. Twenty-four (7%) of these 327 patients had atypical responses (15 [5%] with early pseudoprogression and nine [3%] with delayed pseudoprogression). Of the 592 patients who survived ≥ 12 weeks, 84 (14%) experienced progressive disease per RECIST v1.1 but nonprogressive disease per irRC. Two-year overall survival rates were 77.6% in patients with nonprogressive disease per both criteria (n = 331), 37.5% in patients with progressive disease per RECIST v1.1 but nonprogressive disease per irRC (n = 84), and 17.3% in patients with progressive disease per both criteria (n = 177). Atypical responses were observed in patients with melanoma treated with pembrolizumab. Based on survival analysis, conventional RECIST might underestimate the benefit of pembrolizumab in approximately 15% of patients; modified criteria that permit treatment beyond initial progression per RECIST v1.1 might prevent premature cessation of treatment. © 2016 by American Society of Clinical Oncology.

  1. Assessment of Newly Proposed Clinical Criteria to Identify HNF1A MODY in Patients with an Initial Diagnosis of Type 1 or Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Malgorzata Grzanka

    2016-01-01

    Full Text Available The most common form of maturity-onset diabetes of the young (MODY is caused by mutations in the hepatocyte nuclear factor 1A (HNF1A gene. However, most HNF1A mutation-carriers are initially misdiagnosed with type 1 (T1DM or type 2 (T2DM diabetes mellitus; hence, they often receive nonoptimal treatment. The aim of our study was to test newly proposed clinical criteria for the identification of HNF1A MODY in patients with a diagnosis of T1DM or T2DM. To achieve this, the following criteria to preselect patients for screening were used: for T1DM: TDIR (total daily insulin requirement > 0.3 IU of insulin/kg and the percentage of basal insulin > 30% of TDIR; for T2DM: sulphonylurea- (SU- based oral treatment (monotherapy or combined with Metformin > 15 years and BMI < 30 kg/m2. We reviewed the clinical data of 140 patients with T1DM and 524 clinically diagnosed with T2DM. On the basis of these criteria, we found a HNF1A mutation in 1 out of 2 individuals with a diagnosis of T1DM and 1 out of 11 selected individuals with a diagnosis of T2DM. We believe that the simplicity of the proposed criteria might prove useful in clinical practice, as an alternative to more time-consuming classical diagnostic techniques.

  2. Assessment of Newly Proposed Clinical Criteria to Identify HNF1A MODY in Patients with an Initial Diagnosis of Type 1 or Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Grzanka, Malgorzata; Matejko, Bartlomiej; Szopa, Magdalena; Kiec-Wilk, Beata; Malecki, Maciej T; Klupa, Tomasz

    2016-01-01

    The most common form of maturity-onset diabetes of the young (MODY) is caused by mutations in the hepatocyte nuclear factor 1A (HNF1A) gene. However, most HNF1A mutation-carriers are initially misdiagnosed with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus; hence, they often receive nonoptimal treatment. The aim of our study was to test newly proposed clinical criteria for the identification of HNF1A MODY in patients with a diagnosis of T1DM or T2DM. To achieve this, the following criteria to preselect patients for screening were used: for T1DM: TDIR (total daily insulin requirement) > 0.3 IU of insulin/kg and the percentage of basal insulin > 30% of TDIR; for T2DM: sulphonylurea- (SU-) based oral treatment (monotherapy or combined with Metformin) > 15 years and BMI < 30 kg/m(2). We reviewed the clinical data of 140 patients with T1DM and 524 clinically diagnosed with T2DM. On the basis of these criteria, we found a HNF1A mutation in 1 out of 2 individuals with a diagnosis of T1DM and 1 out of 11 selected individuals with a diagnosis of T2DM. We believe that the simplicity of the proposed criteria might prove useful in clinical practice, as an alternative to more time-consuming classical diagnostic techniques.

  3. 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

  4. 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

  5. Assessment of Non-Financial Criteria in the Selection of Investment Projects for Seed Capital Funding: the Contribution of Scientometrics and Patentometrics

    Directory of Open Access Journals (Sweden)

    Gustavo da Silva Motta

    2012-09-01

    Full Text Available The aim of this article is to assess the potential of using scientometric and patentometric indicators as a way of instrumentalizing the selection process of projects for seed capital funding. There is an increasing interest in technology based enterprises for their capacity to contribute to economic and social development, but there is also some difficulty in assessing non-financial criteria associated with technology for the purposes of financial funding. Thus, this research selected the case of the first enterprise invested in by the largest seed capital fund in Brazil, in order to create scientific and technological indicators and to assess the extent to which these indicators may contribute to understanding the market potential of the technology once it is assessed. It was concluded that scientometric and patentometric indicators favour the assessment process for non-financial criteria, in particular those criteria dealt with in this study: technology, market, divestment, and team.

  6. Modern digital plain-radiography of the whole spine in scoliosis patients. Dose reduction and quality criteria

    International Nuclear Information System (INIS)

    Kloth, Jost Karsten; Stiller, W.; Kauczor, H.U.; Weber, M.A.

    2013-01-01

    To reduce the radiation exposure of plain radiographs of the entire spine depending on specific indications, since these are frequently performed examinations of children and young adults with scoliosis and to determine objective quality control criteria to ensure accurate assessment. In this prospective randomized study 323 patients underwent plain-radiography of the entire spine with standard and 50 % reduced dose. In an experimental pilot-study this target-dose was determined using an Alderson-Phantom. The evaluation of the experimental radiographs, as well as, the randomized plain-radiographs was conducted using the following criteria: endplates (Cobb-angle), spinal process and pedicel (rotation), lateral margin of the vertebral body (lateral alignment), identification of C7 / S1 (perpendicular). Two radiologists evaluated these criteria using a score ranging from 1 (definitely assessable) to 4 (not assessable). If one single criteria was evaluated with a score of 3 or more points or more than 2 criteria with 2 points, the radiograph was scored as ''not assessable''. The statistical analysis was conducted as a non-inferiority-trial. Seven (2.4 %) of the 290 examined x-rays were scored as not assessable. There was no statistic inferiority between the examinations with standard or reduced dose, while singular assessment of the defined criteria was likewise dose-independent. Plain-radiography of the total spine in patients with scoliosis can be performed with a dose reduction of 50 % without a loss of validity. The obtained quality control criteria were clinically applicable. (orig.)

  7. Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation.

    Science.gov (United States)

    Wallace, W Hamish B; Smith, Alice Grove; Kelsey, Thomas W; Edgar, Angela E; Anderson, Richard A

    2014-09-01

    Ovarian tissue cryopreservation with later reimplantation has been shown to preserve fertility in adult women, but this approach remains unproven and experimental in children and adolescents. We aimed to assess the use of the Edinburgh selection criteria for ovarian tissue cryopreservation in girls and young women with cancer to determine whether we are offering this invasive procedure to the patients who are most at risk of premature ovarian insufficiency. Cryopreservation of ovarian tissue has been selectively offered to girls and young women with cancer who met the Edinburgh selection criteria since 1996. Between Jan 1, 1996, and June 30, 2012, 410 female patients younger than 18 years at diagnosis were treated for cancer (including leukaemia and brain tumours) at the Edinburgh Children's Cancer Centre, which serves the whole South East of Scotland region. We determined the ovarian status of these patients from review of clinical records and classified them as having premature ovarian insufficiency or not, or as unable to be determined. Patients younger than 12 years at time of data cutoff (Jan 31, 2013) were excluded from the analysis. 34 (8%) of the 410 patients met the Edinburgh selection criteria and were offered ovarian tissue cryopreservation before starting cancer treatment. 13 patients declined the procedure and 21 consented, and the procedure was completed successfully in 20 patients. Of the 20 patients who had ovarian tissue successfully cryopreserved, 14 were available for assessment of ovarian function. Of the 13 patients who had declined the procedure, six were available for assessment of ovarian function. Median age at the time of follow-up for the 20 assessable patients was 16·9 years (IQR 15·5-21·8). Of the 14 assessable patients who had successfully undergone ovarian cryopreservation, six had developed premature ovarian insufficiency at a median age of 13·4 years (IQR 12·5-14·6), one of whom also had a natural pregnancy. Of the six

  8. Significance of supplier selection criteria evolvment in IT outsourcing to emerging economies: lessons from a global IT outsourcing project

    OpenAIRE

    Hyvonen, H.; Helminen, M.; Watanabe, C.

    2015-01-01

    In line with the increasing significance of the acceleration of information technology (IT) advancement and also of harnessing the vigor of emerging economies, IT outsourcing to emerging economies has become global concerns. This enables global companies to enjoy a critical competitive edge by choosing the best option in outsourcing strategy and supplier selection. Consequently, supplier selection criteria have become critical issues for both suppliers and customers. This paper a...

  9. Regulatory analysis on criteria for the release of patients administered radioactive material. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, S.; McGuire, S.A.

    1997-02-01

    This regulatory analysis was developed to respond to three petitions for rulemaking to amend 10 CFR parts 20 and 35 regarding release of patients administered radioactive material. The petitions requested revision of these regulations to remove the ambiguity that existed between the 1-millisievert (0.1-rem) total effective dose equivalent (TEDE) public dose limit in Part 20, adopted in 1991, and the activity-based release limit in 10 CFR 35.75 that, in some instances, would permit release of individuals in excess of the current public dose limit. Three alternatives for resolution of the petitions were evaluated. Under Alternative 1, NRC would amend its patient release criteria in 10 CFR 35.75 to match the annual public dose limit in Part 20 of 1 millisievert (0.1 rem) TEDE. Alternative 2 would maintain the status quo of using the activity-based release criteria currently found in 10 CFR 35.75. Under Alternative 3, the NRC would revise the release criteria in 10 CFR 35.75 to specify a dose limit of 5 millisieverts (0.5 rem) TEDE.

  10. Regulatory analysis on criteria for the release of patients administered radioactive material. Final report

    International Nuclear Information System (INIS)

    Schneider, S.; McGuire, S.A.

    1997-02-01

    This regulatory analysis was developed to respond to three petitions for rulemaking to amend 10 CFR parts 20 and 35 regarding release of patients administered radioactive material. The petitions requested revision of these regulations to remove the ambiguity that existed between the 1-millisievert (0.1-rem) total effective dose equivalent (TEDE) public dose limit in Part 20, adopted in 1991, and the activity-based release limit in 10 CFR 35.75 that, in some instances, would permit release of individuals in excess of the current public dose limit. Three alternatives for resolution of the petitions were evaluated. Under Alternative 1, NRC would amend its patient release criteria in 10 CFR 35.75 to match the annual public dose limit in Part 20 of 1 millisievert (0.1 rem) TEDE. Alternative 2 would maintain the status quo of using the activity-based release criteria currently found in 10 CFR 35.75. Under Alternative 3, the NRC would revise the release criteria in 10 CFR 35.75 to specify a dose limit of 5 millisieverts (0.5 rem) TEDE

  11. 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.

  12. Diagnostic criteria for DCD : Past and future

    NARCIS (Netherlands)

    Smits-Engelsman, Bouwien; Schoemaker, Marina; Delabastita, Tijs; Hoskens, Jasmine; Geuze, Reint

    The aim of this review was to gather information on how well authors comply to DSM criteria in their description and selection of children with DCD. We investigated which selection criteria were used in experimental and intervention studies published in the last 5 years (2010-2014). Results on 176

  13. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    The International Association of Diabetes in Pregnancy Study Group (IADPSG) and World Health ... Macrosomia or at least one adverse outcome were more likely in GDM patients who ... criteria for GDM in the ADA's more recent position statement.[18] .... at risk for postpartum type 2 DM;[27] the IADPSG criteria on the other ...

  14. Diagnostic criteria for CRPS I: differences between patient profiles using three different diagnostic sets.

    Science.gov (United States)

    Perez, Roberto S G M; Collins, Susan; Marinus, Johan; Zuurmond, Wouter W A; de Lange, Jaap J

    2007-11-01

    Complex Regional Pain Syndrome type I (CRPS I) is an illness which usually occurs due to major or minor tissue injury to the extremities. Because a unique pathophysiological mechanism for CRPS I has not yet been established, the diagnosis is based on observation and measurement of clinical symptoms and signs. In this study, a comparison was made between three sets of diagnostic criteria (the IASP, Bruehl et al. and Veldman et al.) based on patient reports and physicians' assessments of signs and symptoms associated with CRPS I, in 372 outpatients suspected of having CRPS I. Agreement between CRPS I diagnosis among the three sets was poor (kappa-range: 0.29-0.42), leading to positive CRPS I diagnoses according to Veldman et al.'s criteria in 218 cases (59%), according to the IASP in 268 cases (72%), and according to Bruehl et al. in 129 cases (35%). Significant differences in patient profiles were found between the diagnostic sets for the number of patients reporting continuing disproportionate pain, larger area affected than the initial trauma (both pCRPS I were found for reported hyperesthesia (SE+SP:165%), allodynia (160%), observed color asymmetry (162%), hyperesthesia (157%), temperature asymmetry (154%) and edema (152%). The lack of agreement between the different diagnostic sets for CRPS I and the different clinical profiles that result from it may lead to different therapeutic and study populations, hampering adequate treatment and scientific development for this illness. We propose explicit reference to diagnostic criteria used in studies, and registration in trials of a broad variety of CRPS I features, as used in this study, to make subgroup phenotyping and post hoc analyses based on different diagnostic criteria possible.

  15. Criteria for selecting a CO2/climate change region of study

    International Nuclear Information System (INIS)

    Cushman, R.; Easterling, W.; Rosenberg, N.; Malone, T.; Edmonds, J.; Scott, M.; Stoke, G.

    1989-01-01

    This effort has three near-term goals: (1) to develop robust methods of analysis including the analysis of uncertainty; (2) to develop information systems to support CO 2 /climate change analysis; and (3) to develop channels of communication among researchers and between researchers and parties potentially affected by CO 2 /climate change. Initially, the program will focus on a single region of the United States, employ a historical analog climate, and analyze the interactions of all of the resources resident within that region as they might evolve under current conditions and under evolving CO 2 /climate change over the next 50 years. Five elements of the program will address the issues of: Analysis, Information Systems, Uncertainty, Knowledge Transfer, and Coordination. This paper will give special attention to the analytical framework and in particular to the criteria for selecting a region for study. 19 refs., 2 figs

  16. 76 FR 28308 - Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects-Criteria for...

    Science.gov (United States)

    2011-05-17

    .... FDA-2011-D-0258] Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects... Compliance Policy Guide Sec. 335.700, Surgeons' Gloves and Patient Examination Gloves; Defects--Criteria for... FDA staff on the submission of seizure recommendations for medical gloves that exceed the defect...

  17. ASYMMETRIC PRICE TRANSMISSION MODELING: THE IMPORTANCE OF MODEL COMPLEXITY AND THE PERFORMANCE OF THE SELECTION CRITERIA

    Directory of Open Access Journals (Sweden)

    Henry de-Graft Acquah

    2013-01-01

    Full Text Available Information Criteria provides an attractive basis for selecting the best model from a set of competing asymmetric price transmission models or theories. However, little is understood about the sensitivity of the model selection methods to model complexity. This study therefore fits competing asymmetric price transmission models that differ in complexity to simulated data and evaluates the ability of the model selection methods to recover the true model. The results of Monte Carlo experimentation suggest that in general BIC, CAIC and DIC were superior to AIC when the true data generating process was the standard error correction model, whereas AIC was more successful when the true model was the complex error correction model. It is also shown that the model selection methods performed better in large samples for a complex asymmetric data generating process than with a standard asymmetric data generating process. Except for complex models, AIC's performance did not make substantial gains in recovery rates as sample size increased. The research findings demonstrate the influence of model complexity in asymmetric price transmission model comparison and selection.

  18. High-consequence analysis, evaluation, and application of select criteria

    International Nuclear Information System (INIS)

    Gutmanis, I.; Jaksch, J.A.

    1984-01-01

    A number of characteristics distinguish environmental risk from pollution problems. The characteristics make environmental risk problems harder to manage through existing regulatory, legal, and economic institutions. Hence, technologies involving environmental risk impose on society extremely difficult collective decisions. This paper is concerned with the process of reaching social decisions that involve low-probability, high-consequence outcomes. It is divided into five major parts. Part I contains the introduction. Part II reviews the two main classes of criteria that have been proposed for social decisions: approaches based on market mechanisms and their extension, and approaches associated with Rawls and Buchanan, which not only focus on outcomes, but also impose a set of minimal constraints on the process for reaching decisions and social consensus. Part III proposes a set of eight criteria for evaluating social decision processes. In Parts IV and V we investigate applying the criteria to two case studies -- one on nuclear waste disposal and the other on transportation of liquefied natural gas

  19. Prediction of Depression in Cancer Patients With Different Classification Criteria, Linear Discriminant Analysis versus Logistic Regression.

    Science.gov (United States)

    Shayan, Zahra; Mohammad Gholi Mezerji, Naser; Shayan, Leila; Naseri, Parisa

    2015-11-03

    Logistic regression (LR) and linear discriminant analysis (LDA) are two popular statistical models for prediction of group membership. Although they are very similar, the LDA makes more assumptions about the data. When categorical and continuous variables used simultaneously, the optimal choice between the two models is questionable. In most studies, classification error (CE) is used to discriminate between subjects in several groups, but this index is not suitable to predict the accuracy of the outcome. The present study compared LR and LDA models using classification indices. This cross-sectional study selected 243 cancer patients. Sample sets of different sizes (n = 50, 100, 150, 200, 220) were randomly selected and the CE, B, and Q classification indices were calculated by the LR and LDA models. CE revealed the a lack of superiority for one model over the other, but the results showed that LR performed better than LDA for the B and Q indices in all situations. No significant effect for sample size on CE was noted for selection of an optimal model. Assessment of the accuracy of prediction of real data indicated that the B and Q indices are appropriate for selection of an optimal model. The results of this study showed that LR performs better in some cases and LDA in others when based on CE. The CE index is not appropriate for classification, although the B and Q indices performed better and offered more efficient criteria for comparison and discrimination between groups.

  20. Predicting Outcomes After Chemo-Embolization in Patients with Advanced-Stage Hepatocellular Carcinoma: An Evaluation of Different Radiologic Response Criteria

    International Nuclear Information System (INIS)

    Gunn, Andrew J.; Sheth, Rahul A.; Luber, Brandon; Huynh, Minh-Huy; Rachamreddy, Niranjan R.; Kalva, Sanjeeva P.

    2017-01-01

    PurposeThe purpse of this study was to evaluate the ability of various radiologic response criteria to predict patient outcomes after trans-arterial chemo-embolization with drug-eluting beads (DEB-TACE) in patients with advanced-stage (BCLC C) hepatocellular carcinoma (HCC).Materials and methodsHospital records from 2005 to 2011 were retrospectively reviewed. Non-infiltrative lesions were measured at baseline and on follow-up scans after DEB-TACE according to various common radiologic response criteria, including guidelines of the World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), the European Association for the Study of the Liver (EASL), and modified RECIST (mRECIST). Statistical analysis was performed to see which, if any, of the response criteria could be used as a predictor of overall survival (OS) or time-to-progression (TTP).Results75 patients met inclusion criteria. Median OS and TTP were 22.6 months (95 % CI 11.6–24.8) and 9.8 months (95 % CI 7.1–21.6), respectively. Univariate and multivariate Cox analyses revealed that none of the evaluated criteria had the ability to be used as a predictor for OS or TTP. Analysis of the C index in both univariate and multivariate models showed that the evaluated criteria were not accurate predictors of either OS (C-statistic range: 0.51–0.58 in the univariate model; range: 0.54–0.58 in the multivariate model) or TTP (C-statistic range: 0.55–0.59 in the univariate model; range: 0.57–0.61 in the multivariate model).ConclusionCurrent response criteria are not accurate predictors of OS or TTP in patients with advanced-stage HCC after DEB-TACE.

  1. Predicting Outcomes After Chemo-Embolization in Patients with Advanced-Stage Hepatocellular Carcinoma: An Evaluation of Different Radiologic Response Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Gunn, Andrew J., E-mail: agunn@uabmc.edu [University of Alabama at Birmingham, Division of Vascular and Interventional Radiology (United States); Sheth, Rahul A. [MD Anderson Cancer Center, Division of Interventional Radiology (United States); Luber, Brandon [Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Divison of Biostatistics and Bioinformatics (United States); Huynh, Minh-Huy [Johns Hopkins University School of Medicine (United States); Rachamreddy, Niranjan R. [Massachusetts General Hospital/Harvard Medical School, Department of Radiology (United States); Kalva, Sanjeeva P. [University of Texas Southwestern Medical Center, Division of Interventional Radiology, Department of Radiology (United States)

    2017-01-15

    PurposeThe purpse of this study was to evaluate the ability of various radiologic response criteria to predict patient outcomes after trans-arterial chemo-embolization with drug-eluting beads (DEB-TACE) in patients with advanced-stage (BCLC C) hepatocellular carcinoma (HCC).Materials and methodsHospital records from 2005 to 2011 were retrospectively reviewed. Non-infiltrative lesions were measured at baseline and on follow-up scans after DEB-TACE according to various common radiologic response criteria, including guidelines of the World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), the European Association for the Study of the Liver (EASL), and modified RECIST (mRECIST). Statistical analysis was performed to see which, if any, of the response criteria could be used as a predictor of overall survival (OS) or time-to-progression (TTP).Results75 patients met inclusion criteria. Median OS and TTP were 22.6 months (95 % CI 11.6–24.8) and 9.8 months (95 % CI 7.1–21.6), respectively. Univariate and multivariate Cox analyses revealed that none of the evaluated criteria had the ability to be used as a predictor for OS or TTP. Analysis of the C index in both univariate and multivariate models showed that the evaluated criteria were not accurate predictors of either OS (C-statistic range: 0.51–0.58 in the univariate model; range: 0.54–0.58 in the multivariate model) or TTP (C-statistic range: 0.55–0.59 in the univariate model; range: 0.57–0.61 in the multivariate model).ConclusionCurrent response criteria are not accurate predictors of OS or TTP in patients with advanced-stage HCC after DEB-TACE.

  2. Investigating the Effect of Normalization Norms in Flexible Manufacturing Sytem Selection Using Multi-Criteria Decision-Making Methods

    Directory of Open Access Journals (Sweden)

    Prasenjit Chatterjee

    2014-07-01

    Full Text Available The main objective of this paper is to assess the effect of different normalization norms within multi-criteria decisionmaking (MADM models. Three well accepted MCDM tools, namely, preference ranking organization method for enrichment evaluation (PROMETHEE, grey relation analysis (GRA and technique for order preference by similarity to ideal solution (TOPSIS methods are applied for solving a flexible manufacturing system (FMS selection problem in a discrete manufacturing environment. Finally, by the introduction of different normalization norms to the decision algorithms, its effct on the FMS selection problem using these MCDM models are also studied.

  3. An assessment of Prostate Cancer Research International: Active Surveillance (PRIAS) criteria for active surveillance of clinically low-risk prostate cancer patients

    Science.gov (United States)

    da Silva, Vitor; Cagiannos, Ilias; Lavallée, Luke T.; Mallick, Ranjeeta; Witiuk, Kelsey; Cnossen, Sonya; Eastham, James A.; Fergusson, Dean A.; Morash, Chris; Breau, Rodney H.

    2017-01-01

    Introduction Active surveillance is a strategy to delay or prevent treatment of indolent prostate cancer. The Prostate Cancer Research International: Active Surveillance (PRIAS) criteria were developed to select patients for prostate cancer active surveillance. The objective of this study was to compare pathological findings from PRIAS-eligible and PRIAS-ineligible clinically low-risk prostate cancer patients. Methods A D’Amico low-risk cohort of 1512 radical prostatectomy patients treated at The Ottawa Hospital or Memorial Sloan Kettering Cancer Centre between January 1995 and December 2007 was reviewed. Pathological outcomes (pT3 tumours, Gleason sum ≥7, lymph node metastases, or a composite) and clinical outcomes (prostate-specific antigen [PSA] recurrence, secondary cancer treatments, and death) were compared between PRIAS-eligible and PRIAS-ineligible cohorts. Results The PRIAS-eligible cohort (n=945) was less likely to have Gleason score ≥7 (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.49–0.75), pT3 (OR 0.41; 95% CI 0.31–0.55), nodal metastases (OR 0.37; 95% CI 0.10–1.31), or any adverse feature (OR 0.56; 95% CI 0.45–0.69) compared to the PRIAS-ineligible cohort. The probability of any adverse pathology in the PRIAS-eligible cohort was 41% vs. 56% in the PRIAS-ineligible cohort. At median follow-up of 3.7 years, 72 (4.8%) patients had a PSA recurrence, 24 (1.6%) received pelvic radiation, and 13 (0.9%) received androgen deprivation. No difference was detected for recurrence-free and overall survival between groups (recurrence hazard ratio [HR] 0.71; 95% CI 0.46–1.09 and survival HR 0.72; 95% CI 0.36–1.47). Conclusions Low-risk prostate cancer patients who met PRIAS eligibility criteria are less likely to have higher-risk cancer compared to those who did not meet at least one of these criteria. PMID:28798822

  4. 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...

  5. Characterization of Emissions from Building Products: Selection Criteria, Storage and Handling of Indoor Materials for Experiments

    DEFF Research Database (Denmark)

    Kjær, Ulla Dorte; Nielsen, Peter A.; Marcussen, Lis

    1996-01-01

    In research projects it is usually impossible to study more than a very limited aount of different products. Care and consideration must therefore be taken in the selection. The following criteria were used to select five products for chemical and sensory emission testing: The products should...... be indoor climate relevant, meaning that they should be in direct contact with indoor air when used in buildings, and their emission should contribute significantly to the indoor air concentrations for instance due to a large surface area. They should be representative in terms of being widely used, now...... that the emission mechanisms do not change as a consequence of physical processes or chemical reactions. The five products selected were PVC flooring, waterborne varnish on beechwood parquet, carpet, sealant, and waterborne paint on gypsum board. The products were brought to the laboratory immediately after...

  6. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II)

    DEFF Research Database (Denmark)

    Rudwaleit, M; van der Heijde, D; Landewé, R

    2009-01-01

    OBJECTIVE: To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA). METHODS: All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back...... pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%. RESULTS: Upon diagnostic work-up, axial Sp...

  7. EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

    Directory of Open Access Journals (Sweden)

    Rita Aleksandrovna Osipyants

    2013-01-01

    Full Text Available Objective: to study the association of ultrasound (US remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA during tocilizumab (TCZ therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR criteria who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-CRP, and SDAI, functional impairments (HAQ index and US verification of wrist joint synovitis (a Voluson-i device, GE, 4-13-MHz linear transducer at baseline and 6 months after therapy. No signs of grey-scale (B-mode and power Doppler (PD synovitis (B = 0; PD = 0 or minimal B-mode synovitis, and not more one PD hypervascular signal (В ≤1; PD ≤1 were arbitrarily taken as US remission criteria. Destruction changes were evaluated by hand and foot X-ray using the Sharp method modified by van der Heijde (SHS.Results. After 6 months of therapy, about 80% of the patients in clinical remission retained moderate or significant synovitis, as evidenced by US studies. There were no clinical differences in clinical activity indices and functional impairments between the patients who were and were not in US remission (p > 0.05. The 12-month follow-up SHS score was significantly higher with the preservation of 6-month therapy signs of B-mode synovitis and PD hypervascularization (of not more than one signal than that in US remission (p < 0.05. There was no relationship of X-ray progression to the clinical and functional statuses (p > 0.05.Conclusion. Subclinical synovitis is observed even in clinical remission of RA. Destruction progression is significantlyrelated to synovitis persistence, as shown by ultrasonography.

  8. Low sensitivity of qSOFA, SIRS criteria and sepsis definition to identify infected patients at risk of complication in the prehospital setting and at the emergency department triage.

    Science.gov (United States)

    Tusgul, Selin; Carron, Pierre-Nicolas; Yersin, Bertrand; Calandra, Thierry; Dami, Fabrice

    2017-11-03

    of sepsis in the ED among patients transported by ambulance was 3.8 percent. This rate, associated to the mortality of sepsis, confirms the necessity to dispose of a test to early identify those patients. The sensitivity performance of all three tools was suboptimal. The qSOFA score, SIRS criteria and sepsis definition have low identification sensitivity in selecting septic patients in the pre-hospital setting or upon arrival in the ED at risk of complication.

  9. Photovoltaic system criteria documents. Volume 3: Environmental issues and evaluation criteria for photovoltaic applications

    Science.gov (United States)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    The environmental issues and evaluation criteria relating to the suitability of sites proposed for photovoltaic (PV) system deployment are identified. The important issues are defined, briefly discussed and then developed into evaluation criteria. System designers are provided with information on the environmental sensitivity of PV systems in realistic applications, background material which indicates the applicability of the siting issues identified, and evaluation criteria are defined to facilitate the selection of sites that maximize PV system operation.

  10. Criteria for selecting organ donors and recipients.

    Science.gov (United States)

    Michielsen, P

    1990-11-01

    As there is a world-wide shortage of organs for transplantation, the selection of the patients is more defined by the availability of transplantable organs than by the medical condition of the potential recipient. This shortage of cadaveric organs is mainly responsible for the use of living donors. With HLA identical sibling donors the results are better than with cadaveric organs, but the ethical problems are usually underestimated. For the parent-to-child donation, the HLA compatibility is less than what could be achieved with well-matched cadaveric donors. The use of genetically unrelated donors is unacceptable from the ethical as well as from the medical point of view. The short- and long-term risk of donation has been insufficiently documented. The experience with the introduction of an opting-out legislation in Belgium in 1987 demonstrates that the shortage of cadaveric organs can be overcome. Harmonization of the legislation is, however, necessary so as to achieve comparable organ retrieval rates between countries participating in organ-exchange organisations.

  11. 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.

  12. Early response to sibutramine in patients not meeting current label criteria: preliminary analysis of SCOUT lead-in period

    DEFF Research Database (Denmark)

    Caterson, Ian; Coutinho, Walmir; Finer, Nick

    2010-01-01

    The Sibutramine Cardiovascular Outcomes (SCOUT) trial protocol defines a patient population predominantly outside current European Union label criteria. This article explores responses to sibutramine during the 6-week, single-blind, lead-in period between patients who conformed to the label...... requirements ("conformers") and those who did not ("nonconformers"). SCOUT is an ongoing, randomized, double-blind, placebo-controlled outcome trial in overweight/obese patients at high risk of a cardiovascular event. In total, 10,742 patients received sibutramine and weight management during the lead...... with sibutramine confirms its good tolerability and efficacy in patients who meet current label criteria. Preliminary data from high-risk patients for whom sibutramine is currently contraindicated suggest a low discontinuation rate and few serious adverse events but confirmation from the SCOUT outcome data...

  13. Criteria for the selective use of chest computed tomography in blunt trauma patients.

    NARCIS (Netherlands)

    Brink, M.; Deunk, J.; Dekker, H.M.; Edwards, M.J.R.; Kool, D.R.; Vugt, A.B. van; Kuijk, C. van; Blickman, J.G.

    2010-01-01

    PURPOSE: 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. METHODS: This observational study prospectively included consecutive patients (>or=16 years old) who underwent

  14. 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

  15. Defining criteria related to wastes for use in multi-criteria decision tool for nuclear accidents

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Diogo N.G.; Guimaraes, Jean R.D., E-mail: dneves@biof.ufrj.br, E-mail: jeanrdg@biof.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Biofisica Carlos Chagas Filho; Rochedo, Elaine R.R.; De Luca, Christiano, E-mail: elainerochedo@gmail.com, E-mail: christiano_luca@hotmail.com [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Rochedo, Pedro R.R., E-mail: rochedopedro@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto Alberto Luiz Coimbra de Pos-Graduacao e Pesquisa de Engenharia

    2013-07-01

    The selection of protective measures and strategies for remediation of contaminated areas after a nuclear accident must be based on previously established criteria in order to prevent stress of the population and the unnecessary exposure of workers. After a nuclear accident resulting in environmental contamination, decisions on remediation of areas is complex due to the large numbers of factors involved in decontamination processes. This work is part of a project which aims to develop a multi-criteria tool to support a decision-making process in cases of a radiological or a nuclear accident in Brazil. First, a database of remediation strategies for contaminated areas was created. In this process, the most relevant aspects for the implementation of these strategies were considered, including technical criteria regarding aspects related to the generation of wastes in a reference urban area, which are discussed in this paper. The specific objective of this study is to define criteria for the aspects of radioactive wastes, resulted by the implementation of some urban measures, in order to be incorporated in a multi-criteria decision tool. Main aspects considered were the type, the amount and the type of treatment necessary for each procedure. The decontamination procedures are then classified according to the selected criteria in order to feed the multi-criteria decision tool. This paper describes the steps for the establishment of these criteria and evaluates the potential for future applications in order to improve predictions and to support the decisions to be made. (author)

  16. Defining criteria related to wastes for use in multi-criteria decision tool for nuclear accidents

    International Nuclear Information System (INIS)

    Silva, Diogo N.G.; Guimaraes, Jean R.D.; Rochedo, Elaine R.R.; De Luca, Christiano; Rochedo, Pedro R.R.

    2013-01-01

    The selection of protective measures and strategies for remediation of contaminated areas after a nuclear accident must be based on previously established criteria in order to prevent stress of the population and the unnecessary exposure of workers. After a nuclear accident resulting in environmental contamination, decisions on remediation of areas is complex due to the large numbers of factors involved in decontamination processes. This work is part of a project which aims to develop a multi-criteria tool to support a decision-making process in cases of a radiological or a nuclear accident in Brazil. First, a database of remediation strategies for contaminated areas was created. In this process, the most relevant aspects for the implementation of these strategies were considered, including technical criteria regarding aspects related to the generation of wastes in a reference urban area, which are discussed in this paper. The specific objective of this study is to define criteria for the aspects of radioactive wastes, resulted by the implementation of some urban measures, in order to be incorporated in a multi-criteria decision tool. Main aspects considered were the type, the amount and the type of treatment necessary for each procedure. The decontamination procedures are then classified according to the selected criteria in order to feed the multi-criteria decision tool. This paper describes the steps for the establishment of these criteria and evaluates the potential for future applications in order to improve predictions and to support the decisions to be made. (author)

  17. Implementation of multi-criteria decision making approach for the team leader selection in IT sector

    Directory of Open Access Journals (Sweden)

    Sandhya

    2016-12-01

    Full Text Available In the era of technology, the demand of the software development increases at a very high speed, as software has touched the human’s life in all aspects. The better quality software development acquiring minimum development time leads to the team work in which a group of people has been formed that work together in a team for the software development. One of the most signifi-cant issues in effective and efficient teamwork is the team leader selection because the team lead-er is the person in any team that is going to handle all types of managerial activities such as lead-ership, motivation to others, etc. The team leader selection process may be dependent on numer-ous conflicting selection indexes that make it a Multi-Criteria Decision Making (MCDM prob-lem. In the present research, an MCDM approach namely, Euclidean Distance Based Approxi-mation (EDBA which is based on the calculation of the composite distance value for each alter-native from a hypothetical optimal point is presented. The result of this study provides a compre-hensive ranking of team leaders that leads to the right selection of team leader in information technology (IT sector.

  18. Habitat suitability criteria via parametric distributions: estimation, model selection and uncertainty

    Science.gov (United States)

    Som, Nicholas A.; Goodman, Damon H.; Perry, Russell W.; Hardy, Thomas B.

    2016-01-01

    Previous methods for constructing univariate habitat suitability criteria (HSC) curves have ranged from professional judgement to kernel-smoothed density functions or combinations thereof. We present a new method of generating HSC curves that applies probability density functions as the mathematical representation of the curves. Compared with previous approaches, benefits of our method include (1) estimation of probability density function parameters directly from raw data, (2) quantitative methods for selecting among several candidate probability density functions, and (3) concise methods for expressing estimation uncertainty in the HSC curves. We demonstrate our method with a thorough example using data collected on the depth of water used by juvenile Chinook salmon (Oncorhynchus tschawytscha) in the Klamath River of northern California and southern Oregon. All R code needed to implement our example is provided in the appendix. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  19. TLG-S criteria are superior to both EORTC and PERCIST for predicting outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Kung-Chu [National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, Taipei (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Taoyuan (China); Fang, Yu-Hua Dean [National Cheng Kung University, Department of Biomedical Engineering, Tainan (China); Chung, Hsiao-Wen [National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, Taipei (China); Liu, Yuan-Chang [Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Imaging and Intervention, Taoyuan (China); Chang, John Wen-Cheng; Hou, Ming-Mo [Chang Gung Memorial Hospital and Chang Gung University, Division of Hematology-Oncology, Department of Internal Medicine, Taoyuan (China); Yang, Cheng-Ta [Chang Gung Memorial Hospital and Chang Gung University, Department of Thoracic Medicine, Taoyuan (China); Cheng, Nai-Ming; Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Taoyuan (China); Su, Tzu-Pei [Chang Gung Memorial Hospital, Department of Nuclear Medicine, Keelung (China)

    2016-11-15

    In this retrospective review of prospectively collected data, we sought to investigate whether early FDG-PET assessment of treatment response based on total lesion glycolysis measured using a systemic approach (TLG-S) would be superior to either local assessment with EORTC (European Organization for Research and Treatment of Cancer) criteria or single-lesion assessment with PERCIST (PET Response Criteria in Solid Tumors) for predicting clinical outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib. We also examined the effect of bone flares on tumor response evaluation by single-lesion assessment with PERCIST in patients with metastatic bone lesions. We performed a retrospective review of prospectively collected data from 23 patients with metastatic lung adenocarcinoma treated with erlotinib. All participants underwent FDG-PET imaging at baseline and on days 14 and 56 after completion of erlotinib treatment. In addition, diagnostic CT scans were performed at baseline and on day 56. FDG-PET response was assessed with TLG-S, EORTC, and PERCIST criteria. Response assessment based on RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) from diagnostic CT imaging was used as the reference standard. Two-year progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. We identified 13 patients with bone metastases. Of these, four (31 %) with persistent bone uptake due to bone flares on day 14 were erroneously classified as non-responders according to the PERCIST criteria, but they were correctly classified as responders according to both the EORTC and TLG-S criteria. Patients who were classified as responders on day 14 based on TLG-S criteria had higher rates of 2-year PFS (26.7 % vs. 0 %, P = 0.007) and OS (40.0 % vs. 7.7 %, P = 0.018). Similar rates were observed in patients who showed a response on day 56 based on CT imaging according to the RECIST criteria. Patients classified as responders on day 14

  20. 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.

  1. Accuracy of Carotid Duplex Criteria in Diagnosis of Significant Carotid Stenosis in Asian Patients.

    Science.gov (United States)

    Dharmasaroja, Pornpatr A; Uransilp, Nattaphol; Watcharakorn, Arvemas; Piyabhan, Pritsana

    2018-03-01

    Extracranial carotid stenosis can be diagnosed by velocity criteria of carotid duplex. Whether they are accurately applied to define severity of internal carotid artery (ICA) stenosis in Asian patients needs to be proved. The purpose of this study was to evaluate the accuracy of 2 carotid duplex velocity criteria in defining significant carotid stenosis. Carotid duplex studies and magnetic resonance angiography were reviewed. Criteria 1 was recommended by the Society of Radiologists in Ultrasound; moderate stenosis (50%-69%): peak systolic velocity (PSV) 125-230 cm/s, diastolic velocity (DV) 40-100 cm/s; severe stenosis (>70%): PSV greater than 230 cm/s, DV greater than 100 cm/s. Criteria 2 used PSV greater than 140 cm/s, DV less than 110 cm/s to define moderate stenosis (50%-75%) and PSV greater than 140 cm/s, DV greater than 110 cm/s for severe stenosis (76%-95%). A total of 854 ICA segments were reviewed. There was moderate stenosis in 72 ICAs, severe stenosis in 50 ICAs, and occlusion in 78 ICAs. Criteria 2 had slightly lower sensitivity, whereas higher specificity and accuracy than criteria 1 were observed in detecting moderate stenosis (criteria 1: sensitivity 95%, specificity 83%, accuracy 84%; criteria 2: sensitivity 92%, specificity 92%, and accuracy 92%). However, in detection of severe ICA stenosis, no significant difference in sensitivity, specificity, and accuracy was found (criteria 1: sensitivity 82%, specificity 99.57%, accuracy 98%; criteria 2: sensitivity 86%, specificity 99.68%, and accuracy 99%). In the subgroup of moderate stenosis, the criteria using ICA PSV greater than 140 cm/s had higher specificity and accuracy than the criteria using ICA PSV 125-230 cm/s. However, there was no significant difference in detection of severe stenosis or occlusion of ICA. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol.

    Science.gov (United States)

    Mucalo, Iva; Hadžiabdić, Maja Ortner; Brajković, Andrea; Lukić, Sonja; Marić, Patricia; Marinović, Ivana; Bačić-Vrca, Vesna

    2017-08-01

    The aim of this study was to measure the prevalence of potentially inappropriate medications (PIMs) by using the EU(7)-PIM list, STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) version 2 criteria and the new comprehensive protocol. This prospective study involved a sample of 276 consecutive elderly patients discharged from the university teaching hospital. Age, gender, diagnoses, medication history and medicines at discharge were recorded. The main outcome measure was the prevalence of PIMs according to each set of criteria: EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. The median patient age (range) was 74 (65-92) years. The median number of prescribed medications was 7 (1-17). STOPP identified 393 PIMs affecting 190 patients (69%), EU(7)-PIM list identified 330 PIMs in 184 patients (66.7%) whilst the comprehensive protocol identified 134 PIMs in 102 patients (37%). STOPP version 2 criteria identified significantly more PIMs per patient than the other two protocols (p comprehensive protocol and was found as a more sensitive tool for PIM detection.

  3. A multi-criteria analysis approach for ranking and selection of microorganisms for the production of oils for biodiesel production.

    Science.gov (United States)

    Ahmad, Farah B; Zhang, Zhanying; Doherty, William O S; O'Hara, Ian M

    2015-08-01

    Oleaginous microorganisms have potential to be used to produce oils as alternative feedstock for biodiesel production. Microalgae (Chlorella protothecoides and Chlorella zofingiensis), yeasts (Cryptococcus albidus and Rhodotorula mucilaginosa), and fungi (Aspergillus oryzae and Mucor plumbeus) were investigated for their ability to produce oil from glucose, xylose and glycerol. Multi-criteria analysis (MCA) using analytic hierarchy process (AHP) and preference ranking organization method for the enrichment of evaluations (PROMETHEE) with graphical analysis for interactive aid (GAIA), was used to rank and select the preferred microorganisms for oil production for biodiesel application. This was based on a number of criteria viz., oil concentration, content, production rate and yield, substrate consumption rate, fatty acids composition, biomass harvesting and nutrient costs. PROMETHEE selected A. oryzae, M. plumbeus and R. mucilaginosa as the most prospective species for oil production. However, further analysis by GAIA Webs identified A. oryzae and M. plumbeus as the best performing microorganisms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Multi-criteria site selection for fire services: the interaction with analytic hierarchy process and geographic information systems

    Directory of Open Access Journals (Sweden)

    T. Erden

    2010-10-01

    Full Text Available This study combines AHP and GIS to provide decision makers with a model to ensure optimal site location(s for fire stations selected. The roles of AHP and GIS in determining optimal locations are explained, criteria for site selection are outlined, and case study results for finding the optimal fire station locations in Istanbul, Turkey are included. The city of Istanbul has about 13 million residents and is the largest and most populated city in Turkey. The rapid and constant growth of Istanbul has resulted in the increased number of fire related cases. Fire incidents tend to increase year by year in parallel with city expansion, population and hazardous material facilities. Istanbul has seen a rise in reported fire incidents from 12 769 in 1994 to 30 089 in 2009 according to the interim report of Istanbul Metropolitan Municipality Department of Fire Brigade. The average response time was approximately 7 min 3 s in 2009. The goal of this study is to propose optimal sites for new fire station creation to allow the Fire Brigade in Istanbul to reduce the average response time to 5 min or less. After determining the necessity of suggesting additional fire stations, the following steps are taken into account: six criteria are considered in this analysis. They are: High Population Density (HPD; Proximity to Main Roads (PMR; Distance from Existing Fire Stations (DEF; Distance from Hazardous Material Facilities (DHM; Wooden Building Density (WBD; and Distance from the Areas Subjected to Earthquake Risk (DER. DHM criterion, with the weight of 40%, is the most important criterion in this analysis. The remaining criteria have a weight range from 9% to 16%. Moreover, the following steps are performed: representation of criterion map layers in GIS environment; classification of raster datasets; calculating the result raster map (suitability map for potential fire stations; and offering a model that supports decision makers in selecting fire station sites

  5. The majority of patients with metastatic melanoma are not represented in pivotal phase III immunotherapy trials

    DEFF Research Database (Denmark)

    Donia, Marco; Kimper-Karl, Marie Louise; Høyer, Katrine Lundby

    2017-01-01

    BACKGROUND: Recent randomised phase III trials have led to the approval of several immune checkpoint inhibitors for unresectable or metastatic melanoma (MM). These trials all employed strict patient selection criteria, and it is currently unknown how large proportion of 'real-world' patients diag...... a huge knowledge gap regarding the usefulness of new immunotherapies in the 'real-world' patient population, and urge additional testing of known regimens in selected poor prognosis cohorts.......BACKGROUND: Recent randomised phase III trials have led to the approval of several immune checkpoint inhibitors for unresectable or metastatic melanoma (MM). These trials all employed strict patient selection criteria, and it is currently unknown how large proportion of 'real-world' patients...... in 2014, were included in the analysis. Seven pre-defined eligibility criteria, all used to select patients for enrolment in five recent randomised phase III immunotherapy trials, were analysed. RESULTS: Fifty-five percent of the total population with MM did not meet one or more eligibility criteria ('not...

  6. FDG PET/CT criteria for diagnosing mediastinal lymph node metastasis in patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    Cho, Y. S.; Choi, J. Y.; Lee, K. S.; Kwon, O. J.; Sim, Y. M.; Lee, S. J.; Hyun, S. H.; Lee, J. Y.; Lee, K. H.; Kim, B. T.

    2007-01-01

    We investigated the most accurate FDG PET/CT criteria using various PET and CT parameters for diagnosing metastatic mediastinal lymph nodes in patients with untreated NSCLC. Subjects were 178 consecutive patients with NSCLC undergoing PET/CT and surgical nodal staging. Diagnostic criteria of PET/CT for involvement of each mediastinal nodal station were max. SUV (mSUV), average SUV (aSUV), max. CT Hounsfield unit (mHU), average CT Hounsfield unit (aHU), and 5-point visual grading for CT attenuation; normal, suspicious/definite high attenuation (HA), partial/definite calcification (CAL). ROC curve analysis was done to assess the performance of each PET/CT criterion for detection of metastatic mediastinal nodal station. Of the pathologically examined 649 mediastinal nodal stations, 50 stations in 39 patients were proven to be malignant. The areas under curve (AUC) of ROC analysis for each criteria were 0.8882 (mSUV), 0.8875 (aSUV), 0.5668 (mHU), 0.5468 (aHU), and 0.4369 (VA), respectively. There were no malignant lymph nodes with increased FDG uptake having mHU > 120, aHU > 90, visually definite HA, or CAL. Using the benign criteria of mHU > 120, the AUCs of PET were significantly improved to 0.9233 (mSUV) and 0.9080 (aSUV), respectively (p 90, the AUCs of PET were improved to 0.8991 (mSUV, p 0.05), respectively. Using the benign criteria of visually definite HA or CAL, the AUCs of PET were significantly improved to 0.9094 (mSUV) and 0.9091 (aSUV), respectively (p 120, and visually definite HA or CAL can be used as PET/CT diagnostic criteria suggesting benign mediastinal lymph nodes in patients with NSCLC, irrespective of FDG uptake

  7. CCS site characterisation criteria

    Energy Technology Data Exchange (ETDEWEB)

    Bachu, S.; Hawkes, C.; Lawton, D.; Pooladi-Darvish, M.; Perkins, E.

    2009-12-15

    IEA GHG recently commissioned the Alberta Research Counil in Canada to conduct a review of storage site selection criteria and site characterisation methods in order to produce a synthesis report. This report reviews the literature on the subject on the site seleciton and characterisation since the publication of the IPCC Special Report on CCS, and provides a synthesis and classification of criteria. 161 refs.

  8. Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis.

    Science.gov (United States)

    Haydar, Samir; Spanier, Matthew; Weems, Patricia; Wood, Samantha; Strout, Tania

    2017-11-01

    The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis. Electronic health records of 200 patients who were treated for suspected sepsis in our ED and ultimately discharged from our hospital with a diagnosis of sepsis were randomly selected for review from a population of adult ED patients (N=1880). Data extracted included the presence of SIRS criteria and the qSOFA score as well as time required to meet said criteria. In this cohort, 94.5% met SIRS criteria while in the ED whereas only 58.3% met qSOFA. The mean time from arrival to SIRS documentation was 47.1min (95% CI: 36.5-57.8) compared to 84.0min (95% CI: 62.2-105.8) for qSOFA. The median ED "door" to positive SIRS criteria was 12min and 29min for qSOFA. Although qSOFA may be valuable in predicting sepsis-related mortality, it performed poorly as a screening tool for identifying sepsis in the ED. As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Medical student selection criteria as predictors of intended rural practice following graduation.

    Science.gov (United States)

    Puddey, Ian B; Mercer, Annette; Playford, Denese E; Pougnault, Sue; Riley, Geoffrey J

    2014-10-14

    Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students' intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. The study cohort included 538 secondary school-leaver entrants to The University of Western Australia Medical School from 2006 to 2011. On entry they completed a questionnaire indicating intention for either urban or rural practice following graduation. Selection factors (standardised interview score, percentile score from the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance (Australian Tertiary Admissions Rank), together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and an index of rurality) were examined in relation to intended rural or urban destination of practice. In multivariate logistic regression, students from a rural background had a nearly 8-fold increase in the odds of intention to practice rurally after graduation compared to those from urban backgrounds (OR 7.84, 95% CI 4.10, 14.99, P practice rurally (OR 4.36, 95% CI 1.69, 11.22, P medical school entry may have the unintended consequence of selecting fewer graduates interested in a rural practice destination. Increased efforts to recruit students from lower socioeconomic backgrounds may be beneficial in terms of an ultimate intended rural practice destination.

  10. Targeted Screening With Combined Age- and Morphology-Based Criteria Enriches Detection of Lynch Syndrome in Endometrial Cancer.

    Science.gov (United States)

    Lin, Douglas I; Hecht, Jonathan L

    2016-06-01

    Endometrial cancer is associated with Lynch syndrome in 2% to 6% of cases. Adequate screening may prevent of a second cancer and incident cancers in family members via risk-reducing strategies. The goal of the study was to evaluate the detection rate of Lynch syndrome via a targeted screening approach. In 2009, we incorporated targeted Lynch syndrome screening via immunohistochemistry for MLH1, PMS2, MSH2, and MSH6, followed by MLH1 promoter hypermethylation, in select cases of endometrial carcinoma. Criteria for patient selection included (1) all patients Lynch syndrome. Therefore, targeted screening with combined age and morphology based criteria enriches detection of Lynch syndrome in endometrial cancer. However, the detection rate is lower than the rates from published series that offer universal screening. © The Author(s) 2016.

  11. 34 CFR 226.12 - What selection criteria does the Secretary use in evaluating an application for a State Charter...

    Science.gov (United States)

    2010-07-01

    ... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION STATE CHARTER SCHOOL FACILITIES INCENTIVE PROGRAM How Does the... facilities on a per-pupil basis. (b) Quality of plan. (1) The likelihood that the proposed grant project will... 34 Education 1 2010-07-01 2010-07-01 false What selection criteria does the Secretary use in...

  12. Traction batteries for industrial trucks. Technical aspects, selection criteria, operation. Antriebsbatterien fuer Flurfoerderzeuge. Technik, Auswahlkriterien und Betrieb

    Energy Technology Data Exchange (ETDEWEB)

    Roedig, W

    1987-01-01

    This lavishly illustrated booklet presents an introduction to the technology of the lead battery, which is commonly used as traction battery for industrial trucks. Technical specifications and standards, selection criteria for batteries and the novel CSM battery technology are mentioned. Most of the book deals with the practical aspects of batteries, e.g. installation, starting, maintenance, servicing, battery change, battery charging, monitoring, measurement, etc.). Battery recycling is briefly gone into.

  13. Temporal stability of diagnostic criteria for antisocial personality disorder in male alcohol dependent patients

    NARCIS (Netherlands)

    Verheul, R.; van den Brink, W.; Koeter, M. W.

    1998-01-01

    We evaluated the temporal stability of diagnostic criteria for antisocial personality disorder in 432 male alcohol dependent patients. Indicators for temporal stability were criterion continuation (i.e., the proportion of current or recent diagnoses among those with a lifetime diagnosis) and

  14. 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

  15. 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

  16. 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

  17. Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes.

    Science.gov (United States)

    Russ, Eric; Shedler, Jonathan; Bradley, Rebekah; Westen, Drew

    2008-11-01

    Narcissistic personality disorder has received relatively little empirical attention. This study was designed to provide an empirically valid and clinically rich portrait of narcissistic personality disorder and to identify subtypes of the disorder. A random national sample of psychiatrists and clinical psychologists (N=1,201) described a randomly selected current patient with personality pathology. Clinicians provided detailed psychological descriptions of the patients using the Shedler-Westen Assessment Procedure-II (SWAP-II), completed a checklist of axis II diagnostic criteria, and provided construct ratings for each axis II personality disorder. Descriptions of narcissistic patients based on both raw and standardized SWAP-II item scores were aggregated to identify, respectively, the most characteristic and the most distinctive features of narcissistic personality disorder. A total of 255 patients met DSM-IV criteria for narcissistic personality disorder based on the checklist and 122 based on the construct ratings; 101 patients met criteria by both methods. Q-factor analysis identified three subtypes of narcissistic personality disorder, which the authors labeled grandiose/malignant, fragile, and high-functioning/exhibitionistic. Core features of the disorder included interpersonal vulnerability and underlying emotional distress, along with anger, difficulty in regulating affect, and interpersonal competitiveness, features that are absent from the DSM-IV description of narcissistic personality disorder. These findings suggest that DSM-IV criteria for narcissistic personality disorder are too narrow, underemphasizing aspects of personality and inner experience that are empirically central to the disorder. The richer and more differentiated view of narcissistic personality disorder suggested by this study may have treatment implications and may help bridge the gap between empirically and clinically derived concepts of the disorder.

  18. Analysis of 2000 cases treated with gamma knife surgery: validating eligibility criteria for a prospective multi-institutional study of stereotactic radiosurgery alone for treatment of patients with 1-10 brain metastases (JLGK0901) in Japan

    Science.gov (United States)

    Higuchi, Yoshinori; Nagano, Osamu; Sato, Yasunori; Yamamoto, Masaaki; Ono, Junichi; Saeki, Naokatsu; Miyakawa, Akifumi; Hirai, Tatsuo

    2012-01-01

    Objective The Japan Leksell Gamma Knife (JLGK) Society has conducted a prospective multi-institute study (JLGK0901, UNIN000001812) for selected patients in order to prove the effectiveness of stereotactic radiosurgery (SRS) alone using the gamma knife (GK) for 1-10 brain lesions. Herein, we verify the validity of 5 major patient selection criteria for the JLGK0901 trial. Materials and Methods Between 1998 and 2010, 2246 consecutive cases with 10352 brain metastases treated with GK were analyzed to determine the validity of the following 5 major JLGK0901 criteria; 1) 1-10 brain lesions, 2) less than 10 cm3 volume of the largest tumor, 3) no more than 15 cm3 total tumor volume, 4) no cerebrospinal fluid (CSF) dissemination, 5) Karnofsky performance status (KPS) score ≥70. Results For cases with >10 brain metastases, salvage treatments for new lesions were needed more frequently. The tumor control rate for lesions larger than 10 cm3 was significantly lower than that of tumors 15 cm3 total tumor volume or positive magnetic resonance imaging findings of CSF were significantly poorer. Outcomes in cases with KPS <70 were significantly poorer in terms of OS. Conclusion Our retrospective results of 2246 GK-treated cases verified the validity of the 5 major JLGK0901 criteria. The inclusion criteria for the JLGK0901 study are appearently good indications for SRS. PMID:29296339

  19. Accident analysis and DOE criteria

    International Nuclear Information System (INIS)

    Graf, J.M.; Elder, J.C.

    1982-01-01

    In analyzing the radiological consequences of major accidents at DOE facilities one finds that many facilities fall so far below the limits of DOE Order 6430 that compliance is easily demonstrated by simple analysis. For those cases where the amount of radioactive material and the dispersive energy available are enough for accident consequences to approach the limits, the models and assumptions used become critical. In some cases the models themselves are the difference between meeting the criteria or not meeting them. Further, in one case, we found that not only did the selection of models determine compliance but the selection of applicable criteria from different chapters of Order 6430 also made the difference. DOE has recognized the problem of different criteria in different chapters applying to one facility, and has proceeded to make changes for the sake of consistency. We have proposed to outline the specific steps needed in an accident analysis and suggest appropriate models, parameters, and assumptions. As a result we feed DOE siting and design criteria will be more fairly and consistently applied

  20. Validity and reliability problems with patient global as a component of the ACR/EULAR remission criteria as used in clinical practice.

    Science.gov (United States)

    Masri, Karim R; Shaver, Timothy S; Shahouri, Shadi H; Wang, Shirley; Anderson, James D; Busch, Ruth E; Michaud, Kaleb; Mikuls, Ted R; Caplan, Liron; Wolfe, Frederick

    2012-06-01

    To investigate what factors influence patient global health assessment (PtGlobal), and how those factors and the reliability of PtGlobal affect the rate, reliability, and validity of recently published American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) remission criteria when used in clinical practice. We examined consecutive patients with RA in clinical practice and identified 77 who met ACR/EULAR joint criteria for remission (≤ 1 swollen joint and ≤ 1 tender joint). We evaluated factors associated with a PtGlobal > 1, because a PtGlobal ≤ 1 defined ACR/EULAR remission in this group of patients who had already met ACR/EULAR joint criteria. Of the 77 patients examined, only 17 (22.1%) had PtGlobal ≤ 1 and thus fully satisfied ACR/EULAR criteria. A large proportion of patients not in remission by ACR/EULAR criteria had high PtGlobal related to noninflammatory issues, including low back pain, fatigue, and functional limitations, and a number of patients clustered in the range of PtGlobal > 1 and ≤ 2. However, the minimal detectable difference for PtGlobal was 2.3. In addition, compared with a PtGlobal severity score, a PtGlobal activity score was 3.3% less likely to be abnormal (> 1). Noninflammatory factors contribute to the level of PtGlobal and result in the exclusion of many patients who would otherwise be in "true" remission according to the ACR/EULAR definition. Reliability problems associated with PtGlobal can also result in misclassification, and may explain the observation of low longterm remission rates in RA. As currently constituted, the use of the ACR/EULAR remission criteria in clinical practice appears to be problematic.

  1. Accuracy of Methotrexate Use in Rheumatoid Arthritis Patients in Emanuel Klampok Hospital based on Explicit Criteria

    Directory of Open Access Journals (Sweden)

    Rizki Puspitasari

    2014-09-01

    Full Text Available Methotrexate (MTX is the first line therapy for rheumatoid arthritis (RA as an antiinflammatory and immunosuppressant agent. The purpose of this study was to evaluate the use of MTX in patients with rheumatoid arthritis at Emanuel Klampok Hospital based on criteria, including the indication, process indicators, complication, and outcome indicators. The medical record from 13 inpatients and 27 outpatients who used MTX were compared with the criteria. The results of this study demonstrated that all of the patients had appropriately indications to use MTX. Patients with risk factors that lead to GI disorders, hepatotoxicity, and bone marrow toxicity were 35 patients, 19 patients, and 15 patients respectively. There were 32 patients used MTX with the correct dosage, meanwhile incorrect dosage was showed in 3 patients with ClCr 61–80 mL/minute, 2 patients with ClCr 51–60 mL/minute, 1 patient with ClCr 10–50 mL/minute, and 2 patients with SGPT >3 normal value. The interaction with NSAID was happened in 35 patients and the interaction with hepatotoxicity agents in 19 patients. Complication occurred in 7 patients with effects that occur were GI disorders and 1 patient with chirrosis. There were 10 patients with clinical complaints reduced and 2 patients with the better condition. Indication of use MTX had appropriately, but process indicators, complication, and outcome indicators still not appropriate.

  2. 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.

  3. Criteria-based audit on management of eclampsia patients at a tertiary hospital in Dar es Salaam, Tanzania

    Science.gov (United States)

    Kidanto, Hussein Lesio; Mogren, Ingrid; Massawe, Siriel N; Lindmark, Gunilla; Nystrom, Lennarth

    2009-01-01

    Background Criteria-based audits have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the introduction of a criteria-based audit in a tertiary hospital in an African setting, assesses the quality of care among eclampsia patients and discusses possible interventions in order to improve the quality of care. Methods We conducted a criteria based audit of 389 eclampsia patients admitted to Muhimbili National Hospital (MNH), Dar es Salaam Tanzania between April 14, 2006 and December 31, 2006. Cases were assessed using evidence-based criteria for appropriate care. Results Antepartum, intrapartum and postpartum eclampsia constituted 47%, 41% and 12% of the eclampsia cases respectively. Antepartum eclampsia was mostly (73%) preterm whereas the majority (71%) of postpartum eclampsia cases ware at term. The case fatality rate for eclampsia was 7.7%. Medical histories were incomplete, the majority (75%) of management plans were not reviewed by specialists in obstetrics, specialist doctors live far from the hospital and do not spend nights in hospital even when they are on duty, monitoring of patients on magnesium sulphate was inadequate, and important biochemical tests were not routinely done. Two thirds of the patient scheduled for caesarean section did not undergo surgery within agreed time. Conclusion Potential areas for further improvement in quality of emergency care for eclampsia relate to standardizing management guidelines, greater involvement of specialists in the management of eclampsia and continued medical education on current management of eclampsia for junior staff. PMID:19323846

  4. Criteria-based audit on management of eclampsia patients at a tertiary hospital in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Lindmark Gunilla

    2009-03-01

    Full Text Available Abstract Background Criteria-based audits have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the introduction of a criteria-based audit in a tertiary hospital in an African setting, assesses the quality of care among eclampsia patients and discusses possible interventions in order to improve the quality of care. Methods We conducted a criteria based audit of 389 eclampsia patients admitted to Muhimbili National Hospital (MNH, Dar es Salaam Tanzania between April 14, 2006 and December 31, 2006. Cases were assessed using evidence-based criteria for appropriate care. Results Antepartum, intrapartum and postpartum eclampsia constituted 47%, 41% and 12% of the eclampsia cases respectively. Antepartum eclampsia was mostly (73% preterm whereas the majority (71% of postpartum eclampsia cases ware at term. The case fatality rate for eclampsia was 7.7%. Medical histories were incomplete, the majority (75% of management plans were not reviewed by specialists in obstetrics, specialist doctors live far from the hospital and do not spend nights in hospital even when they are on duty, monitoring of patients on magnesium sulphate was inadequate, and important biochemical tests were not routinely done. Two thirds of the patient scheduled for caesarean section did not undergo surgery within agreed time. Conclusion Potential areas for further improvement in quality of emergency care for eclampsia relate to standardizing management guidelines, greater involvement of specialists in the management of eclampsia and continued medical education on current management of eclampsia for junior staff.

  5. Comparison of RECIST, EORTC criteria and PERCIST for evaluation of early response to chemotherapy in patients with non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shang, Jingjie; Ling, Xueying; Zhang, Linyue; Tang, Yongjin; Xiao, Zeyu; Cheng, Yong; Guo, Bin; Gong, Jian; Huang, Li; Xu, Hao [The First Affiliated Hospital of Jinan University, Department of Nuclear Medicine and PET/CT-MRI Centre, Guangzhou (China)

    2016-10-15

    To compare the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, the European Organization for Research and Treatment of Cancer (EORTC) criteria and the Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) 1.0 using PET volume computer-assisted reading (PET VCAR) for response evaluation in patients with advanced non-small-cell lung cancer (NSCLC) treated with chemotherapy. A total of 35 patients with NSCLC were included in this prospective study. All patients received standard chemotherapy and underwent {sup 18}F-FDG PET/CT scans before and after treatment. With the assistance of PET VCAR, the chemotherapeutic responses were evaluated according to the RECIST 1.1, EORTC criteria and PERCIST 1.0. Concordance among these protocols was assessed using Cohen's κ coefficient and Wilcoxon's signed-ranks test. Progression-free survival (PFS) was calculated using the Kaplan-Meier test. RECIST 1.1 and EORTC response classifications were discordant in 20 patients (57.1 %; κ = 0.194, P < 0.05), and RECIST 1.1 and PERCIST 1.0 classifications were discordant in 22 patients (62.9 %; κ = 0.139, P < 0.05). EORTC and PERCIST 1.0 classifications were discordant in only 4 patients (11.4 %), resulting in better concordance (κ = 0.804, P > 0.05). Patients with a partial remission according to RECIST 1.1 had significantly longer PFS (P < 0.001) than patients with progressive disease, but not significantly longer than patients with stable disease (P = 0.855). According to both the EORTC criteria and PERCIST 1.0, patients with a partial metabolic response had a significantly longer PFS than those with stable metabolic disease and those with progressive metabolic disease (P = 0.020 and P < 0.001, respectively, for EORTC; both P < 0.001 for PERCIST 1.0). EORTC criteria and PERCIST 1.0 are more sensitive and accurate than RECIST 1.1 for the detection of an early therapeutic response to chemotherapy in patients with NSCLC. Although EORTC criteria and

  6. Comparison of RECIST, EORTC criteria and PERCIST for evaluation of early response to chemotherapy in patients with non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Shang, Jingjie; Ling, Xueying; Zhang, Linyue; Tang, Yongjin; Xiao, Zeyu; Cheng, Yong; Guo, Bin; Gong, Jian; Huang, Li; Xu, Hao

    2016-01-01

    To compare the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, the European Organization for Research and Treatment of Cancer (EORTC) criteria and the Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) 1.0 using PET volume computer-assisted reading (PET VCAR) for response evaluation in patients with advanced non-small-cell lung cancer (NSCLC) treated with chemotherapy. A total of 35 patients with NSCLC were included in this prospective study. All patients received standard chemotherapy and underwent 18 F-FDG PET/CT scans before and after treatment. With the assistance of PET VCAR, the chemotherapeutic responses were evaluated according to the RECIST 1.1, EORTC criteria and PERCIST 1.0. Concordance among these protocols was assessed using Cohen's κ coefficient and Wilcoxon's signed-ranks test. Progression-free survival (PFS) was calculated using the Kaplan-Meier test. RECIST 1.1 and EORTC response classifications were discordant in 20 patients (57.1 %; κ = 0.194, P < 0.05), and RECIST 1.1 and PERCIST 1.0 classifications were discordant in 22 patients (62.9 %; κ = 0.139, P < 0.05). EORTC and PERCIST 1.0 classifications were discordant in only 4 patients (11.4 %), resulting in better concordance (κ = 0.804, P > 0.05). Patients with a partial remission according to RECIST 1.1 had significantly longer PFS (P < 0.001) than patients with progressive disease, but not significantly longer than patients with stable disease (P = 0.855). According to both the EORTC criteria and PERCIST 1.0, patients with a partial metabolic response had a significantly longer PFS than those with stable metabolic disease and those with progressive metabolic disease (P = 0.020 and P < 0.001, respectively, for EORTC; both P < 0.001 for PERCIST 1.0). EORTC criteria and PERCIST 1.0 are more sensitive and accurate than RECIST 1.1 for the detection of an early therapeutic response to chemotherapy in patients with NSCLC. Although EORTC criteria and

  7. Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial.

    Science.gov (United States)

    Takahashi, Traci; Lapham, Gwen; Chavez, Laura J; Lee, Amy K; Williams, Emily C; Richards, Julie E; Greenberg, Diane; Rubinsky, Anna; Berger, Douglas; Hawkins, Eric J; Merrill, Joseph O; Bradley, Katharine A

    2017-07-18

    Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17.

  8. Multi-criteria decision making in the selection of machining parameters for Inconel 718

    International Nuclear Information System (INIS)

    Thirumalai, R.; Senthilkumaar, J. S.

    2013-01-01

    Taguchi's methods and design of experiments are invariably used and adopted as quality improvement techniques in several manufacturing industries as tools for offline quality control. These methods optimize single-response processes. However, Taguchi's method is not appropriate for optimizing a multi-response problem. In other situations, multi-responses need to be optimized simultaneously. This paper presents multi-response optimization techniques. A set of non-dominated solutions are obtained using non-sorted genetic algorithm for multi-objective functions. Multi-criteria decision making (MCDM) is proposed in this work for selecting a single solution from nondominated solutions. This paper addresses a new method of MCDM concept based on technique for order preference by similarity to ideal solution (TOPSIS). TOPSIS determines the shortest distance to the positive-ideal solution and the greatest distance from the negative-ideal solution. This work involves the high-speed machining of Inconel 718 using carbide cutting tool with six objective functions that are considered as attributes against the process variables of cutting speed, feed, and depth of cut. The higher-ranked solution is selected as the best solution for the machining of Inconel 718 in its respective environment.

  9. Multi-criteria decision making in the selection of machining parameters for Inconel 718

    Energy Technology Data Exchange (ETDEWEB)

    Thirumalai, R. [SNS College of Technology, Coimbatore (India); Senthilkumaar, J. S. [Bharathithasan Engineering College, Nattrampalli (India)

    2013-04-15

    Taguchi's methods and design of experiments are invariably used and adopted as quality improvement techniques in several manufacturing industries as tools for offline quality control. These methods optimize single-response processes. However, Taguchi's method is not appropriate for optimizing a multi-response problem. In other situations, multi-responses need to be optimized simultaneously. This paper presents multi-response optimization techniques. A set of non-dominated solutions are obtained using non-sorted genetic algorithm for multi-objective functions. Multi-criteria decision making (MCDM) is proposed in this work for selecting a single solution from nondominated solutions. This paper addresses a new method of MCDM concept based on technique for order preference by similarity to ideal solution (TOPSIS). TOPSIS determines the shortest distance to the positive-ideal solution and the greatest distance from the negative-ideal solution. This work involves the high-speed machining of Inconel 718 using carbide cutting tool with six objective functions that are considered as attributes against the process variables of cutting speed, feed, and depth of cut. The higher-ranked solution is selected as the best solution for the machining of Inconel 718 in its respective environment.

  10. Testing some of Benjamin Graham’s Stock Selection Criteria: A Case of the FTSE Bursa Malaysia EMAS Index from Year 2000 to 2009

    Directory of Open Access Journals (Sweden)

    Desmond Chang

    2011-01-01

    Full Text Available Benjamin Graham, also known as the “father of value investing” proposed that investment in the stock exchange can be a safe endeavor while receiving gains that outperform the market if the investor makes carefully thought out purchases. This study aims to determine if the use of some of Benjamin Graham’s stock selection criteria is able to generate returns that are significantly greater than the returns in the stock exchange of Malaysia, particularly, the comprehensive FTSE Bursa Malaysia EMAS Index. This study collected secondary data regarding fundamentals of companies listed in the FTSE Bursa Malaysia EMAS Index from the year 2000 to 2009. Five criteria were set up in this research based on one or a combination of price-to-earnings ratio, price-to-book value, current ratio and dividend yield. The listed companies were screened using those criteria. An equally weighted portfolio was created using the screened companies and their one-year and two-year returns calculated. The returns were compared to the market return. Hypotheses of this research were tested using t-test statistic to determine the significance of the data. This research found that most of the screening criteria used generated returns that were higher than the market return in almost every year they were tested in. Benjamin Graham’s stock selection criteria although have been conceived over 80 years ago is still applicable today in the Malaysian market. Further research can be conducted with different criteria with varying holding periods and in different markets.

  11. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome.

    Science.gov (United States)

    Harden, R Norman; Bruehl, Stephen; Perez, Roberto S G M; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Chont, Melissa; Vatine, Jean-Jacques

    2010-08-01

    Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS. Copyright (c) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  12. Evaluation of criteria for clinical control in a prospective, international, multicenter study of patients with COPD

    DEFF Research Database (Denmark)

    Miravitlles, Marc; Sliwinski, Pawel; Rhee, Chin Kook

    2018-01-01

    BACKGROUND: The concept of clinical control in COPD has been developed to help in treatment decisions, but it requires validation in prospective studies. METHOD: This international, multicenter, prospective study aimed to validate the concept of control in COPD [control = stability (no...... exacerbations or impairment in CAT scores) + low impact (low level of symptoms)]. Data from the screening visit was used to: investigate the level of control, compare characteristics of patients according to the control status, and perform a sensitivity analysis of the levels of control using either clinical...... criteria or questionnaires (COPD Assessment Test -CAT- or Clinical COPD Questionnaire -CCQ-). RESULTS: A total of 314 patients were analysed, mean age was 68.5 years and mean FEV1 was 52.6% of predicted. According to the prespecified criteria 21% of patients were classified as controlled, all of them...

  13. Prevalence of sarcopenia in elderly maintenance hemodialysis patients: the impact of different diagnostic criteria.

    Science.gov (United States)

    Lamarca, F; Carrero, J J; Rodrigues, J C D; Bigogno, F G; Fetter, R L; Avesani, C M

    2014-07-01

    The prevalence of sarcopenia on elderly maintenance hemodialysis (MHD) has been scarcely investigated. To investigate the prevalence of decreased muscle mass and strength alone or combined (true sarcopenia) in elderly patients on MHD according to different methods and cutoff limits. Additionally, we evaluated the agreement between dual energy x-ray absorptiometry (DXA) and surrogate methods for the assessment of muscle mass. Observational and cross-sectional study. Non-institutionalized 102 elderly (age > 60 years) patients on MHD. Sarcopenia was considered when the patient fit one criteria for low muscle mass assessed by DXA, bioelectrical impedance (BIA), sum of skinfold thicknesses (SKF), calf circumference and mid-arm muscle circumference (MAMC) and one for low muscle strength evaluated by handgrip dynamometer. Decreased muscle strength was found in 85% of the patients. The prevalence of decreased muscle mass varied from 4 to 73.5% and of sarcopenia (decreased muscle mass and strength combined) from 4 to 63%, depending on the method and cutoff limit applied. A small percentage of patients (2 to 15%) were classified as sarcopenic by more than one diagnostic criteria. The agreement between DXA and the surrogate methods to assess muscle mass showed better kappa coefficients with BIA (r=0.36; Psarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

  14. 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.

  15. A review of odour impact criteria in selected countries around the world.

    Science.gov (United States)

    Brancher, Marlon; Griffiths, K David; Franco, Davide; de Melo Lisboa, Henrique

    2017-02-01

    Exposure to environmental odour can result in annoyance, health effects and depreciation of property values. Therefore, many jurisdictions classify odour as an atmospheric pollutant and regulate emissions and/or impacts from odour generating activities at a national, state or municipal level. In this work, a critical review of odour regulations in selected jurisdictions of 28 countries is presented. Individual approaches were identified as: comparing ambient air odour concentration and individual chemicals statistics against impact criteria (maximum impact standard); using fixed and variable separation distances (separation distance standard); maximum emission rate for mixtures of odorants and individual chemical species (maximum emission standard); number of complaints received or annoyance level determined via community surveys (maximum annoyance standard); and requiring use of best available technologies (BAT) to minimize odour emissions (technology standard). The comparison of model-predicted odour concentration statistics against odour impact criteria (OIC) is identified as one of the most common tools used by regulators to evaluate the risk of odour impacts in planning stage assessments and is also used to inform assessment of odour impacts of existing facilities. Special emphasis is given to summarizing OIC (concentration percentile and threshold) and the manner in which they are applied. The way short term odour peak to model time-step mean (peak-to-mean) effects is also captured. Furthermore, the fundamentals of odorant properties, dimensions of nuisance odour, odour sampling and analysis methods and dispersion modelling guidance are provided. Common elements of mature and effective odour regulation frameworks are identified and an integrated multi-tool strategy is recommended. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef

    2003-01-01

    Full Text Available Abstract The criteria for the diagnosis of HNPCC established by the ICG-HNPCC are very restrictive as they do not allow for the diagnosis of a large number of "suspected HNPCC" cases - these are families which do no fulfill the strict diagnostic "Amsterdam criteria", but do present with several pedigree and clinical features characteristic for HNPCC. Several series of families suspected of harboring germline mutations in DNA mismatch repair genes have been studied for germline changes in DNA mismatch repair genes and a mutation rate of somewhere between 8-60% was found. Therefore a subgroup of members of the ICG-HNPCC has been working on pedigree/clinical diagnostic criteria for suspected HNPCC. Materials and methods Part I The study was based on two series of colorectal cancer (CRC cases: 1 HNPCC - this group comprised 190 patients affected by CRC from randomly selected families which fulfilled the Amsterdam II criteria registered in Düsseldorf, Germany (102 cases of CRC, Denmark (18 CRCs, Leiden, Holland (23 CRCs and Szczecin, Poland (47 CRCs. 2 Consecutive CRCs - this group comprised 629 (78.0% of 806 individuals with CRC diagnosed in 1991-1997 in the city of Szczecin (ca. 400,000 of inhabitants, Poland. Nuclear pedigrees in both groups were compared for frequency of occurrence of clinical features, that have been shown to be associated with HNPCC. Part II 52 consecutive CRC cases from Szczecin, matching the criteria recognized in part I as appropriate for diagnosis of cases "suspected of HNPCC" were studied for the occurrence of germline hMSH2/hMLH1 constitutional mutations using "exon by exon" sequencing. Results The combination of features - i.e. the occurrence of an HNPCC associated cancer (CRC or cancer of the endometrium, small bowel or urinary tract in a 1st degree relative of a CRC patient; at least one of the patients being diagnosed under age of 50 - appeared to be strongly associated to HNPCC with an OR - 161. Constitutional

  17. CRITERIA OF LANGUAGE AND PROGRAMMING ENVIRONMENT SELECTION FOR USE IN THE CAPACITY OF EDUCATIONAL AIDS

    Directory of Open Access Journals (Sweden)

    Petro H. Shevchuk

    2010-09-01

    Full Text Available The role of educational aids is to a large degree treated to be determinative in provision with its efficiency. The languages and programming environments are stated in the article as those that belong to educational aids. The criteria and backgrounds of their selection for educational purpose at the lessons of programming at comprehensive school are treated in the article. The examples of principle characteristics comparison of Pascal and C# are also cited. The article points at the necessity of further analysis of programming languages sampling for use as educational aids in teaching programming.

  18. Use of routinely available clinical, nutritional, and functional criteria to classify cachexia in advanced cancer patients.

    Science.gov (United States)

    Vigano, Antonio A L; Morais, José A; Ciutto, Lorella; Rosenthall, Leonard; di Tomasso, Jonathan; Khan, Sarah; Olders, Henry; Borod, Manuel; Kilgour, Robert D

    2017-10-01

    Cachexia is a highly prevalent syndrome in cancer and chronic diseases. However, due to the heterogeneous features of cancer cachexia, its identification and classification challenge clinical practitioners. To determine the clinical relevance of a cancer cachexia classification system in advanced cancer patients. Beginning with the four-stage classification system proposed for cachexia [non-cachexia (NCa), pre-cachexia (PCa), cachexia (Ca) and refractory cachexia (RCa)], we assigned patients to these cachexia stages according to five classification criteria available in clinical practice: 1) biochemistry (high C-reactive protein or leukocytes, or hypoalbuminemia, or anemia), 2) food intake (normal/decreased), weight loss: 3) moderate (≤5%) or 4) significant (>5%/past six months) and 5) performance status (Eastern Cooperative Oncology Group Performance Status ≥ 3). We then determined if symptom severity, body composition changes, functional levels, hospitalizations and survival rates varied significantly across cachexia stages. Two-hundred and ninety-seven advanced cancer patients with primary gastrointestinal and lung tumors were included. Patients were classified into Ca (36%), PCa and RCa (21%, respectively) and NCa (15%). Significant (p cachexia stages for most of the outcome measures (symptoms, body composition, handgrip strength, emergency room visits and length of hospital stays) according to cachexia severity. Survival also differed between cachexia stages (except between PCa and Ca). Five clinical criteria can be used to stage cancer cachexia patients and predict important clinical, nutritional and functional outcomes. The lack of statistical difference between PCa and Ca in almost all clinical outcomes examined suggests either that the PCa group includes patients already affected by early cachexia or that more precise criteria are needed to differentiate PCa from Ca patients. More studies are required to validate these findings. Copyright © 2016

  19. Booster Main Engine Selection Criteria for the Liquid Fly-Back Booster

    Science.gov (United States)

    Ryan, Richard M.; Rothschild, William J.; Christensen, David L.

    1998-01-01

    The Liquid Fly-Back Booster (LFBB) Program seeks to enhance the Space Shuttle system safety performance and economy of operations through the use of an advanced, liquid propellant Booster Main Engine (BME). There are several viable BME candidates that could be suitable for this application. The objective of this study was to identify the key criteria to be applied in selecting among these BME candidates. This study involved an assessment of influences on the overall LFBB utility due to variations in the candidate rocket engines' characteristics. This includes BME impacts on vehicle system weight, perfortnance,design approaches, abort modes, margins of safety, engine-out operations, and maintenance and support concepts. Systems engineering analyses and trade studies were performed to identify the LFBB system level sensitivities to a wide variety of BME related parameters. This presentation summarizes these trade studies and the resulting findings of the LFBB design teams regarding the BME characteristics that most significantly affect the LFBB system. The resulting BME choice should offer the best combination of reliability, performance, reusability, robustness, cost, and risk for the LFBB program.

  20. 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

  1. Application of risk-based multiple criteria decision analysis for selection of the best agricultural scenario for effective watershed management.

    Science.gov (United States)

    Javidi Sabbaghian, Reza; Zarghami, Mahdi; Nejadhashemi, A Pouyan; Sharifi, Mohammad Bagher; Herman, Matthew R; Daneshvar, Fariborz

    2016-03-01

    Effective watershed management requires the evaluation of agricultural best management practice (BMP) scenarios which carefully consider the relevant environmental, economic, and social criteria involved. In the Multiple Criteria Decision-Making (MCDM) process, scenarios are first evaluated and then ranked to determine the most desirable outcome for the particular watershed. The main challenge of this process is the accurate identification of the best solution for the watershed in question, despite the various risk attitudes presented by the associated decision-makers (DMs). This paper introduces a novel approach for implementation of the MCDM process based on a comparative neutral risk/risk-based decision analysis, which results in the selection of the most desirable scenario for use in the entire watershed. At the sub-basin level, each scenario includes multiple BMPs with scores that have been calculated using the criteria derived from two cases of neutral risk and risk-based decision-making. The simple additive weighting (SAW) operator is applied for use in neutral risk decision-making, while the ordered weighted averaging (OWA) and induced OWA (IOWA) operators are effective for risk-based decision-making. At the watershed level, the BMP scores of the sub-basins are aggregated to calculate each scenarios' combined goodness measurements; the most desirable scenario for the entire watershed is then selected based on the combined goodness measurements. Our final results illustrate the type of operator and risk attitudes needed to satisfy the relevant criteria within the number of sub-basins, and how they ultimately affect the final ranking of the given scenarios. The methodology proposed here has been successfully applied to the Honeyoey Creek-Pine Creek watershed in Michigan, USA to evaluate various BMP scenarios and determine the best solution for both the stakeholders and the overall stream health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Criteria for the Selection of Tourism Destinations by Students from Different Countries

    Directory of Open Access Journals (Sweden)

    Dębski Maciej

    2017-12-01

    Full Text Available The objective of this paper is to identify selected aspects of the management of information about prospective tourist destinations by young people (students from Canada, Poland, and Trinidad and Tobago. On the basis of a questionnaire study, the ranking of preferences of respondents (i.e., the main criteria of destination choice has been presented. Students were selected as respondents - as a “convenient sample” - in this privately funded study. A variety of aspects related to comfort (and convenience and attractiveness have been identified as most important to the choice of destination. These are also leading motives that may form a platform for advertising campaigns and suggestions for regional development. This examination has been done mainly with the use of analysis of averages, Spearman correlation coefficients, and various approaches to factor analysis. It turns out that despite very different characteristics of respondents from the three countries, both their preferences and motives for promotion of the destination are very similar. Conclusions can be helpful for travel agencies and those responsible for the development of tourism infrastructure, as well as for the organization of further studies on the subject. The combination of various statistical tools used when examining the subject and the finding - that is, the similarity of preferences between travelers - can be regarded as new value when examining the subject.

  3. The Criteria of Love: Trait Desirability of Filipino Youth on Mate Selection

    Directory of Open Access Journals (Sweden)

    Racidon P. Bernarte

    2016-08-01

    Full Text Available In choosing a life partner, making a ‘good match’ is what everyone hopes for. Usually we have the habit of thinking on how many potential mates are sitting around? And with that, how many would you be attracted and attached to, and how many person you’d probably never date? To find out the relevance of the claim, this quantitative study was designed to know the desirable traits being considered by the Filipino youth in selecting their potential mate, and how male and female differ in their preferences. A total of 400 Filipino university students with the age of 15 to 23 years old participated in the study through self-administered survey. General findings revealed that over the 6 trait dimensions: Physical Traits; Social Traits; Personality Traits; Skills; Achievements; and Spiritual Traits—male and female have significant difference in their trait preference in choosing their mate. Though there are traits that fall under the same degree of importance, women still have higher preference in mate selection criteria as compared to men in all traits. Overall, the trait preferences of the respondents were critically influenced by their sex. Nevertheless, this study clearly suggests the similarity that men and women put importance to traits which can help them develop and maintain an intimate and strong interpersonal relationship with their mate.

  4. Most Trial Eligibility Criteria and Patient Baseline Characteristics Do Not Modify Treatment Effect in Trials Using Targeted Therapies for Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Christensen, Anton Wulf; Tarp, Simon; Furst, Daniel E

    2015-01-01

    OBJECTIVE: To determine if variations in trial eligibility criteria and patient baseline characteristics could be considered effect modifiers of the treatment response when testing targeted therapies (biological agents and targeted synthetic disease modifying antirheumatic drugs (DMARDs....... Odds ratios (ORs) were calculated from the response rates and compared among the trial eligibility criteria/patient baseline characteristics of interest. Comparisons are presented as the Ratio of Odds Ratios (ROR). RESULTS: Sixty-two trials (19,923 RA patients) were included in the primary analyses...... using ACR20 response. Overall, targeted therapies constituted an effective treatment (OR 3.96 95% confidence interval (CI) 3.41 to 4.60). The majority of the trial eligibility criteria and patient baseline characteristics did not modify treatment effect. The added benefit of targeted therapies was lower...

  5. The criteria for selecting a method for unfolding neutron spectra based on the information entropy theory

    International Nuclear Information System (INIS)

    Zhu, Qingjun; Song, Fengquan; Ren, Jie; Chen, Xueyong; Zhou, Bin

    2014-01-01

    To further expand the application of an artificial neural network in the field of neutron spectrometry, the criteria for choosing between an artificial neural network and the maximum entropy method for the purpose of unfolding neutron spectra was presented. The counts of the Bonner spheres for IAEA neutron spectra were used as a database, and the artificial neural network and the maximum entropy method were used to unfold neutron spectra; the mean squares of the spectra were defined as the differences between the desired and unfolded spectra. After the information entropy of each spectrum was calculated using information entropy theory, the relationship between the mean squares of the spectra and the information entropy was acquired. Useful information from the information entropy guided the selection of unfolding methods. Due to the importance of the information entropy, the method for predicting the information entropy using the Bonner spheres' counts was established. The criteria based on the information entropy theory can be used to choose between the artificial neural network and the maximum entropy method unfolding methods. The application of an artificial neural network to unfold neutron spectra was expanded. - Highlights: • Two neutron spectra unfolding methods, ANN and MEM, were compared. • The spectrum's entropy offers useful information for selecting unfolding methods. • For the spectrum with low entropy, the ANN was generally better than MEM. • The spectrum's entropy was predicted based on the Bonner spheres' counts

  6. Scarab/Saffron Development Project Case study: Material Selection Criteria for the Monoethylene Glycol Recovery Package

    International Nuclear Information System (INIS)

    Moussa, A.M.; Habib, S.; Shinaishin, A.

    2004-01-01

    MEG Recovery Unit for Scarab/Saffron development project is the first application in gas production. The Mono Ethylene Glycol Recovery Unit (MEG) recovers MEG from Water/MEG stream and removes salts and other contaminants. MEG Recovery Unit Equipment Design Criteria were designed for two parallel trains A and B, each train is capable to treat 500 bbl MEG, 1500 bbl water and 9 ton salt. The MEG unit is a combination of two unit operations; MEG Recovery unit is normally applicable in the oil and gas industries that is applying distillation technique, while the new technology is salt treatment and handling. The MEG Unit material selection is made to be suitable for the entire design life which is 25 years, the materials for MEG Recovery Unit have been selected among the available corrosion resistance alloys, where requested by the service and ambient conditions. Therefore all. the parts of the MEG unit that are in saline service are in either (2205 duplex, AISI 316L) and in Inconel alloy 625 related to operating temperature. This case study focused at Inconel alloy 625, which is selected for salt service and their operation problem occurred during the construction and operating conditions

  7. Experimental Evaluation of Suitability of Selected Multi-Criteria Decision-Making Methods for Large-Scale Agent-Based Simulations.

    Science.gov (United States)

    Tučník, Petr; Bureš, Vladimír

    2016-01-01

    Multi-criteria decision-making (MCDM) can be formally implemented by various methods. This study compares suitability of four selected MCDM methods, namely WPM, TOPSIS, VIKOR, and PROMETHEE, for future applications in agent-based computational economic (ACE) models of larger scale (i.e., over 10 000 agents in one geographical region). These four MCDM methods were selected according to their appropriateness for computational processing in ACE applications. Tests of the selected methods were conducted on four hardware configurations. For each method, 100 tests were performed, which represented one testing iteration. With four testing iterations conducted on each hardware setting and separated testing of all configurations with the-server parameter de/activated, altogether, 12800 data points were collected and consequently analyzed. An illustrational decision-making scenario was used which allows the mutual comparison of all of the selected decision making methods. Our test results suggest that although all methods are convenient and can be used in practice, the VIKOR method accomplished the tests with the best results and thus can be recommended as the most suitable for simulations of large-scale agent-based models.

  8. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS).

    Science.gov (United States)

    Sieper, J; van der Heijde, D; Landewé, R; Brandt, J; Burgos-Vagas, R; Collantes-Estevez, E; Dijkmans, B; Dougados, M; Khan, M A; Leirisalo-Repo, M; van der Linden, S; Maksymowych, W P; Mielants, H; Olivieri, I; Rudwaleit, M

    2009-06-01

    Inflammatory back pain (IBP) is an important clinical symptom in patients with axial spondyloarthritis (SpA), and relevant for classification and diagnosis. In the present report, a new approach for the development of IBP classification criteria is discussed. Rheumatologists (n = 13) who are experts in SpA took part in a 2-day international workshop to investigate 20 patients with back pain and possible SpA. Each expert documented the presence/absence of clinical parameters typical for IBP, and judged whether IBP was considered present or absent based on the received information. This expert judgement was used as the dependent variable in a logistic regression analysis in order to identify those individual IBP parameters that contributed best to a diagnosis of IBP. The new set of IBP criteria was validated in a separate cohort of patients (n = 648). Five parameters best explained IBP according to the experts. These were: (1) improvement with exercise (odds ratio (OR) 23.1); (2) pain at night (OR 20.4); (3) insidious onset (OR 12.7); (4) age at onset validation cohort. This new approach with real patients defines a set of IBP definition criteria using overall expert judgement on IBP as the gold standard. The IBP experts' criteria are robust, easy to apply and have good face validity.

  9. Landfill Site Selection by AHP Based Multi-criteria Decision Making Tool: A Case Study in Kolkata, India

    Science.gov (United States)

    Majumdar, Ankush; Hazra, Tumpa; Dutta, Amit

    2017-09-01

    This work presents a Multi-criteria Decision Making (MCDM) tool to select a landfill site from three candidate sites proposed for Kolkata Municipal Corporation (KMC) area that complies with accessibility, receptor, environment, public acceptability, geological and economic criteria. Analytical Hierarchy Process has been used to solve the MCDM problem. Suitability of the three sites (viz. Natagachi, Gangajoara and Kharamba) as landfills as proposed by KMC has been checked by Landfill Site Sensitivity Index (LSSI) as well as Economic Viability Index (EVI). Land area availability for disposing huge quantity of Municipal Solid Waste for the design period has been checked. Analysis of the studied sites show that they are moderately suitable for landfill facility construction as both LSSI and EVI scores lay between 300 and 750. The proposed approach represents an effective MCDM tool for siting sanitary landfill in growing metropolitan cities of developing countries like India.

  10. Diagnosing ARVC in Pediatric Patients Applying the Revised Task Force Criteria: Importance of Imaging, 12-Lead ECG, and Genetics.

    Science.gov (United States)

    Steinmetz, Michael; Krause, Ulrich; Lauerer, Peter; Konietschke, Frank; Aguayo, Randolph; Ritter, Christian Oliver; Schuster, Andreas; Lotz, Joachim; Paul, Thomas; Staab, Wieland

    2018-05-12

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a potentially lethal disease that is well described in adults. In pediatric patients, however, identification of patients at risk of adverse events of ARVC remains a challenge. We aimed to determine which criteria of the revised Task Force Criteria (rTFC), alone or combined, have an impact on diagnosis of ARVC when compared to disease-specific genetic mutations in pediatric patients ≤ 18 years. Between September 2010 and December 2013, 48 consecutive young patients ≤ 18 years of age (mean 14, range of 12.9-15.1 years) underwent contrast-enhanced magnetic resonance imaging (CMR), genetic testing, and comprehensive clinical work-up for ARVC criteria to test for clinically suspected ARVC. As specified by the rTFC, patients were grouped into four categories: "definite," "borderline," "possible," and "none" ARVC. Of the 48 patients, 12 were found to have gene mutations of either the desmoplakin (9/12) or plakophilin (3/12) locus. According to rTFC 12/48 patients were considered as "definite" ARVC (25%), while 10/12 (83.3%) had an ARVC-specific gene mutation. Of the remaining 36 patients, 6 (12.5%) were grouped as "borderline" ARVC, 7 (14.6%) as "possible" ARVC (including the remaining two genetic mutations), and 22 (45.8%) as "none" ARVC, respectively. Statistical analysis of ARVC criteria in patients diagnosed with "definite" ARVC revealed high prevalence of positive findings by imaging (CMR and echocardiography) and positive genetics. The positive predictive value to detect "definite" ARVC by genotyping was 83.3%, while the negative predictive value was 94%. Logistic regression analyses for different criteria combinations revealed that imaging modalities (echo and CMR combined) and abnormalities of 12-lead ECG were significant markers (p < 0.01). Positive results of endomyocardial biopsies or arrhythmia on ECG or Holter as defined by the rTFC were not significant in this analysis. The rTFC for

  11. Computer code selection criteria for flow and transport code(s) to be used in undisturbed vadose zone calculations for TWRS environmental analyses

    International Nuclear Information System (INIS)

    Mann, F.M.

    1998-01-01

    The Tank Waste Remediation System (TWRS) is responsible for the safe storage, retrieval, and disposal of waste currently being held in 177 underground tanks at the Hanford Site. In order to successfully carry out its mission, TWRS must perform environmental analyses describing the consequences of tank contents leaking from tanks and associated facilities during the storage, retrieval, or closure periods and immobilized low-activity tank waste contaminants leaving disposal facilities. Because of the large size of the facilities and the great depth of the dry zone (known as the vadose zone) underneath the facilities, sophisticated computer codes are needed to model the transport of the tank contents or contaminants. This document presents the code selection criteria for those vadose zone analyses (a subset of the above analyses) where the hydraulic properties of the vadose zone are constant in time the geochemical behavior of the contaminant-soil interaction can be described by simple models, and the geologic or engineered structures are complicated enough to require a two-or three dimensional model. Thus, simple analyses would not need to use the fairly sophisticated codes which would meet the selection criteria in this document. Similarly, those analyses which involve complex chemical modeling (such as those analyses involving large tank leaks or those analyses involving the modeling of contaminant release from glass waste forms) are excluded. The analyses covered here are those where the movement of contaminants can be relatively simply calculated from the moisture flow. These code selection criteria are based on the information from the low-level waste programs of the US Department of Energy (DOE) and of the US Nuclear Regulatory Commission as well as experience gained in the DOE Complex in applying these criteria. Appendix table A-1 provides a comparison between the criteria in these documents and those used here. This document does not define the models (that

  12. 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.

  13. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.

    LENUS (Irish Health Repository)

    Hamilton, Hilary

    2011-06-13

    Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.

  14. Clinical value of DSM IV and DSM 5 criteria for diagnosing the most prevalent somatoform disorders in patients with medically unexplained physical symptoms (MUPS).

    Science.gov (United States)

    van Dessel, Nikki Claassen-; van der Wouden, Johannes C; Dekker, Joost; van der Horst, Henriette E

    2016-03-01

    This study aimed (1) to describe frequencies of DSM IV somatisation disorder, undifferentiated somatoform disorder and pain disorder versus DSM 5 somatic symptom disorder (SSD) in a multi-setting population of patients with medically unexplained physical symptoms (MUPS), (2) to investigate differences in sociodemographic and (psycho)pathological characteristics between these diagnostic groups and (3) to explore the clinical relevance of the distinction between mild and moderate DSM 5 SSD. We used baseline data of a cohort of 325 MUPS patients. Measurements included questionnaires about symptom severity, physical functioning, anxiety, depression, health anxiety and illness perceptions. These questionnaires were used as proxy measures for operationalization of DSM IV and DSM 5 diagnostic criteria. 92.9% of participants fulfilled criteria of a DSM IV somatoform disorder, while 45.5% fulfilled criteria of DSM 5 SSD. Participants fulfilling criteria of DSM 5 SSD suffered from more severe symptoms than those only fulfilling criteria of a DSM IV somatoform disorder(mean PHQ-15 score of 13.98 (SD 5.17) versus 11.23 (SD 4.71), P-valuephysical functioning was significantly lower. Compared to patients with mild SSD, patients with moderate SSD suffered from significantly lower physical functioning and higher levels of depression. Within a population of MUPS patients DSM 5 SSD criteria are more restrictive than DSM IV criteria for somatoform disorders. They are associated with higher symptom severity and lower physical functioning. However, further specification of the positive psychological criteria of DSM 5 SSD may improve utility in research and practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Diagnostic value of urodynamic bladder outlet obstruction to select patients for transurethral surgery of the prostate: Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Myong Kim

    Full Text Available To investigate the diagnostic value of urodynamic bladder outlet obstruction (BOO in the selection of patients for transurethral surgery of the prostate.We systematically searched online PubMed, Embase, and Cochrane Library databases from January 1989 to June 2014.A total of 19 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2321 patients with a median number of 92 patients per study (range: 12-437. Of the 19 studies, 15 conducted conventional transurethral prostatectomy (TURP, and 7 used other or multiple modalities. In urodynamic bladder outlet obstruction (BOO positive patients, the pooled mean difference (MD was significant for better improvement of the International Prostate Symptom Score (IPSS (pooled MD, 3.48; 95% confidence interval [CI], 1.72-5.24; p < 0.01; studies, 16; participants, 1726, quality of life score (QoL (pooled MD, 0.56; 95% CI, 0.14-1.02; p = 0.010; studies, 9; participants, 1052, maximal flow rate (Qmax (pooled MD, 3.86; 95% CI, 2.17-5.54; p < 0.01; studies, 17; participants, 1852, and post-void residual volume (PVR (pooled MD, 32.46; 95% CI, 23.34-41.58; p < 0.01; studies, 10; participants, 1219 compared with that in non-BOO patients. Some comparisons showed between-study heterogeneity despite the strict selection criteria of the included studies. However, there was no clear evidence of publication bias in this meta-analysis.Our meta-analysis results showed a significant association between urodynamic BOO and better improvements in all treatment outcome parameters. Preoperative UDS may add insight into postoperative outcomes after surgical treatment of benign prostatic hyperplasia.

  16. Real-life Use of Anticoagulants in Venous Thromboembolism With a Focus on Patients With Exclusion Criteria for Direct Oral Anticoagulants.

    Science.gov (United States)

    Moustafa, Farès; Pesavento, Raffaele; di Micco, Pierpaolo; González-Martínez, José; Quintavalla, Roberto; Peris, Maria-Luisa; Porras, José Antonio; Falvo, Nicolas; Baños, Pilar; Monreal, Manuel

    2018-04-01

    We assessed the real-life use of direct oral anticoagulants (DOACs) in patients with venous thromboembolism (VTE) and exclusion criteria for randomized trials. From 2013 to 2016, 3,578 of 18,853 patients (19%) had exclusion criteria. Irrespective of which anticoagulant was chosen, they had more VTE recurrences (hazard ratio (HR): 3.10; 95% confidence interval (CI): 2.47-3.88), major bleeds (HR: 4.10; 95% CI: 3.38-4.96), and deaths (HR: 9.47; 95% CI: 8.46-10.6) than those without exclusion criteria. During initial therapy, no patient with exclusion criteria on DOACs (n = 115) recurred, but those on rivaroxaban bled less often (adjusted HR: 0.18; 95% CI: 0.04-0.79) than those on unfractionated heparin (n = 224) and similar to those (n = 3,172) on low-molecular-weight (LMWH) heparin. For long-term therapy, patients on rivaroxaban (n = 151) had nonsignificantly fewer VTE recurrences (adjusted HR: 0.74; 95% CI: 0.08-1.32) and major bleeds (adjusted HR: 0.41; 95% CI: 0.15-1.15) than those on LMWH (n = 2,071). The efficacy and safety of DOACs were similar to standard therapy. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  17. 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.

  18. Criteria for Selecting a Monolingual Dictionary for Learners

    OpenAIRE

    Colin, Rogers

    2003-01-01

    There are a bewildering number of monolingual dictionaries on the market in Japan, including new learner dictionaries which give students a great deal of potentially useful information about how to use words. However it is essential to carefully evaluate dictionaries to ensure that they meet the needs of the learners who will use them. This article sets out some criteria to help make such decisions.

  19. A hybrid multi-criteria decision modeling approach for the best biodiesel blend selection based on ANP-TOPSIS analysis

    Directory of Open Access Journals (Sweden)

    G. Sakthivel

    2015-03-01

    Full Text Available The ever increasing demand and depletion of fossil fuels had an adverse impact on environmental pollution. The selection of appropriate source of biodiesel and proper blending of biodiesel plays a major role in alternate energy production. This paper describes an application of hybrid Multi Criteria Decision Making (MCDM technique for the selection of optimum fuel blend in fish oil biodiesel for the IC engine. The proposed model, Analytical Network Process (ANP is integrated with Technique for Order Performance by Similarity to Ideal Solution (TOPSIS and VlseKriterijumska Optimizacija I Kompromisno Resenje (in Serbian (VIKOR to evaluate the optimum blend. Evaluation of suitable blend is based on the exploratory analysis of the performance, emission and combustion parameters of the single cylinder, constant speed direct injection diesel engine at different load conditions. Here the ANP is used to determine the relative weights of the criteria, whereas TOPSIS and VIKOR are used for obtaining the final ranking of alternative blends. An efficient pair-wise comparison process and ranking of alternatives can be achieved for optimum blend selection through the integration of ANP with TOPSIS and VIKOR. The obtained preference order of the blends for ANP-VIKOR and ANP-TOPSIS are B20 > Diesel > B40 > B60 > B80 > B100 and B20 > B40 > Diesel > B60 > B80 > B100 respectively. Hence by comparing both these methods, B20 is selected as the best blend to operate the internal combustion engines. This paper highlights a new insight into MCDM techniques to evaluate the best fuel blend for the decision makers such as engine manufactures and R& D engineers to meet the fuel economy and emission norms to empower the green revolution.

  20. Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates.

    Science.gov (United States)

    Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

    2015-01-01

    Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1-62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4 risk factors for opioid dependence were similar. To our knowledge, this is one of the first studies to compare the final results for DSM-5 versus DSM-4 prescription opioid-use disorders among a high-risk patient population.

  1. The Association Between the STOPP/START Criteria and Gastro-Intestinal Track Bleedings in Elderly Patients

    NARCIS (Netherlands)

    Veldhuis, Anouk; Sent, Danielle; Bruin-Huisman, Linette; Beers, Erna; Abu-Hanna, Ameen

    2017-01-01

    Potentially inappropriate prescribing is a common problem, especially in elderly care. To tackle this problem, Irish medical experts have developed a list of criteria when medication should be added or omitted based upon the patient's physical condition and medication use, known as the STOPP and

  2. Political Criteria for Sustainable Development Goal (SDG Selection and the Role of the Urban Dimension

    Directory of Open Access Journals (Sweden)

    Manuel Rivera

    2013-11-01

    Full Text Available A flood of ideas and proposals on the shape and selection of Sustainable Development Goals (SDGs has begun to rise since 2012. This article looks at some of them, trying to understand which kind of “boundary work” between science and policy is done here. Starting with a reflection on the epistemological and practical implications of “discussing SDGs”, it primarily addresses scientists, but also decision makers and activists interested in the post-2015 debate. In practical terms of SDG selection, the argument goes in favor of a self-reflective “politization of science”; i.e., against claims for broad scientific comprehensiveness of SDGs and in favor of an “exemplary” selection of thematic areas and targets, which would combine aspects of (i political opportunity and (ii societal visibility. These criteria are only very partially met in the proposals the article looks at. By applying them, the article emphasizes the political importance of addressing, through SDGs, the subnational level directly, thus making the case for an SDG on cities. Such an SDG should, by the same logic, be rather focused and exemplary than all-encompassing. The recently employed formula of “resilient, inclusive and connected cities” is considered useful, when accompanied by tangible and communicable indicators.

  3. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    Science.gov (United States)

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  4. Evaluation Criteria of Noninvasive Telemonitoring for Patients With Heart Failure: Systematic Review.

    Science.gov (United States)

    Farnia, Troskah; Jaulent, Marie-Christine; Steichen, Olivier

    2018-01-16

    Telemonitoring can improve heart failure (HF) management, but there is no standardized evaluation framework to comprehensively evaluate its impact. Our objectives were to list the criteria used in published evaluations of noninvasive HF telemonitoring projects, describe how they are used in the evaluation studies, and organize them into a consistent scheme. Articles published from January 1990 to August 2015 were obtained through MEDLINE, Web of Science, and EMBASE. Articles were eligible if they were original reports of a noninvasive HF telemonitoring evaluation study in the English language. Studies of implantable telemonitoring devices were excluded. Each selected article was screened to extract the description of the telemonitoring project and the evaluation process and criteria. A qualitative synthesis was performed. We identified and reviewed 128 articles leading to 52 evaluation criteria classified into 6 dimensions: clinical, economic, user perspective, educational, organizational, and technical. The clinical and economic impacts were evaluated in more than 70% of studies, whereas the educational, organizational, and technical impacts were studied in fewer than 15%. User perspective was the most frequently covered dimension in the development phase of telemonitoring projects, whereas clinical and economic impacts were the focus of later phases. Telemonitoring evaluation frameworks should cover all 6 dimensions appropriately distributed along the telemonitoring project lifecycle. Our next goal is to build such a comprehensive evaluation framework for telemonitoring and test it on an ongoing noninvasive HF telemonitoring project. ©Troskah Farnia, Marie-Christine Jaulent, Olivier Steichen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.01.2018.

  5. Screening for Lynch syndrome using risk assessment criteria in patients with ovarian cancer.

    Science.gov (United States)

    Takeda, Takashi; Tsuji, Kosuke; Banno, Kouji; Yanokura, Megumi; Kobayashi, Yusuke; Tominaga, Eiichiro; Aoki, Daisuke

    2018-05-01

    Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM₅ were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM₅, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  6. MRI criteria for MS in patients with clinically isolated syndromes

    DEFF Research Database (Denmark)

    Montalban, X.; Tintore, M.; Swanton, J.

    2010-01-01

    neurologists and neuroradiologists. In some circumstances, several MRI examinations are needed to achieve an accurate and prompt diagnosis. This provides an incentive for continued efforts to refine the incorporation of MRI-derived information into the diagnostic workup of patients presenting with a clinically...... isolated syndrome. Within the European multicenter collaborative research network that studies MRI in MS (MAGNIMS), a workshop was held in London in November 2007 to review information that may simplify the existing MS diagnostic criteria, while maintaining a high specificity that is essential to minimize...... false positive diagnoses. New data that are now published were reviewed and discussed and together with a new proposal are integrated in this position paper. Neurology(R) 2010;74:427-434...

  7. Application of strict criteria in adrenal venous sampling increases the proportion of missed patients with unilateral disease who benefit from surgery for primary aldosteronism.

    Science.gov (United States)

    Kline, Gregory; Leung, Alexander; So, Benny; Chin, Alex; Harvey, Adrian; Pasieka, Janice L

    2018-06-01

    Adrenal vein sampling (AVS) is intended to confirm unilateral forms of primary aldosteronism, which are amenable to surgical cure. Excessively strict AVS criteria to define lateralization may result in many patients incorrectly categorized as bilateral primary aldosteronism and opportunity for surgical cure missed. Retrospective review of an AVS-primary aldosteronism database in which surgical cases are verified by standardized outcomes. Having used 'less strict' AVS criteria for lateralization, we examined the distribution of AVS lateralization indices in our confirmed unilateral primary aldosteronism cases both with and without cosyntropin stimulation. The proportion of proven unilateral cases that would have been missed with stricter AVS interpretation criteria was calculated. Particular focus was given to the proportion of missed cases according to use of international guidelines. False-positive lateralization with 'less strict' interpretation was also calculated. Of 80 surgical primary aldosteronism cases, 10-23% would have been missed with AVS lateralization indices of 3 : 1 to 5 : 1, with or without cosyntropin. If strict selectivity indices (for confirmation of catheterization) were combined with strict lateralization indices, up to 70% of unilateral primary aldosteronism cases could have been missed. Use of Endocrine Society AVS guidelines would have missed 21-43% of proven unilateral cases. 'Less strict' AVS interpretation yielded one case (1.2%) of false lateralization. Excessively strict AVS interpretation criteria will result in a high rate of missed unilateral primary aldosteronism with subsequent loss of opportunity for intervention. Use of more lenient lateralization criteria will improve the detection rate of unilateral primary aldosteronism with very low false-positive rate.

  8. Multi-criteria decision-making in the selection of a renewable energy project in spain: The Vikor method

    International Nuclear Information System (INIS)

    San Cristobal, J.R.

    2011-01-01

    One of the characteristics of the Spanish energy system is its high degree of dependence on imports. In 2005, the Spanish government approved the new Renewable Energy Plan in the following sectors: Windpower, Hydroelectric, Solar Thermal, Solar Thermo-electric, Photovoltaic, Biomass, Biogas and Biofuels. The aim of the Plan is to make it possible to reach the target of 12% of primary energy being met from renewable sources by 2010. When selecting one from various Renewable Energy investment projects different groups of decision-makers become involved in the process. Decision-making has to take into consideration several conflicting objectives because of the increasingly complex social, economic, technological, and environmental factors that are present. Traditional single-criterion decision-making is no longer able to handle these problems. The Compromise Ranking method, also known as the VIKOR method, introduces the Multi-criteria ranking index based on the particular measure of ''closeness'' to the ''ideal'' solution. In this paper, we apply the method in the selection of a Renewable Energy project corresponding to the Renewable Energy Plan launched by the Spanish Government. The method is combined with the Analytical Hierarchy Process method for weighting the importance of the different criteria, which allows decision-makers to assign these values based on their preferences. The results show that the Biomass plant option (Co-combustion in a conventional power plant) is the best choice, followed by the Wind power and Solar Thermo-electric alternatives. (author)

  9. 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.

  10. Selective chest imaging for blunt trauma patients: The national emergency X-ray utilization studies (NEXUS-chest algorithm).

    Science.gov (United States)

    Rodriguez, Robert M; Hendey, Gregory W; Mower, William R

    2017-01-01

    Chest imaging plays a prominent role in blunt trauma patient evaluation, but indiscriminate imaging is expensive, may delay care, and unnecessarily exposes patients to potentially harmful ionizing radiation. To improve diagnostic chest imaging utilization, we conducted 3 prospective multicenter studies over 12years to derive and validate decision instruments (DIs) to guide the use of chest x-ray (CXR) and chest computed tomography (CT). The first DI, NEXUS Chest x-ray, consists of seven criteria (Age >60years; rapid deceleration mechanism; chest pain; intoxication; altered mental status; distracting painful injury; and chest wall tenderness) and exhibits a sensitivity of 99.0% (95% confidence interval [CI] 98.2-99.4%) and a specificity of 13.3% (95% CI, 12.6%-14.0%) for detecting clinically significant injuries. We developed two NEXUS Chest CT DIs, which are both highly reliable in detecting clinically major injuries (sensitivity of 99.2%; 95% CI 95.4-100%). Designed primarily to focus on detecting major injuries, the NEXUS Chest CT-Major DI consists of six criteria (abnormal CXR; distracting injury; chest wall tenderness; sternal tenderness; thoracic spine tenderness; and scapular tenderness) and exhibits higher specificity (37.9%; 95% CI 35.8-40.1%). Designed to reliability detect both major and minor injuries (sensitivity 95.4%; 95% CI 93.6-96.9%) with resulting lower specificity (25.5%; 95% CI 23.5-27.5%), the NEXUS CT-All rule consists of seven elements (the six NEXUS CT-Major criteria plus rapid deceleration mechanism). The purpose of this review is to synthesize the three DIs into a novel, cohesive summary algorithm with practical implementation recommendations to guide selective chest imaging in adult blunt trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. A Fuzzy Multi-Criteria SWOT Analysis: An Application to Nuclear Power Plant Site Selection

    Directory of Open Access Journals (Sweden)

    Mehmet Ekmekcioglu

    2011-08-01

    Full Text Available SWOT (Strengths, Weaknesses, Opportunities and Threats analysis is a commonly used and an important technique for analyzing internal and external environments in order to provide a systematic approach and support for a decision making. SWOT is criticized mostly for considering only qualitative examination of environmental factors, no priority for various factors and strategies, and no vagueness of the factors under fuzziness. In this paper, fuzzy TOPSIS (Technique for Order Preference by Similarity to Ideal Solution integrated with fuzzy AHP (Analytical Hierarchy Process is used to develop fuzzy multi-criteria SWOT analysis in order to overcome these shortcomings. Nuclear power plant site selection, which is a strategic and important issue for Turkeyrs energy policy making, is considered as an application case study that demonstrated the applicability of the developed fuzzy SWOT model.

  12. The efficacy of cladribine tablets in CIS patients retrospectively assigned the diagnosis of MS using modern criteria: Results from the ORACLE-MS study.

    Science.gov (United States)

    Freedman, Mark S; Leist, Thomas P; Comi, Giancarlo; Cree, Bruce Ac; Coyle, Patricia K; Hartung, Hans-Peter; Vermersch, Patrick; Damian, Doris; Dangond, Fernando

    2017-01-01

    Multiple sclerosis (MS) diagnostic criteria have changed since the ORACLE-MS study was conducted; 223 of 616 patients (36.2%) would have met the diagnosis of MS vs clinically isolated syndrome (CIS) using the newer criteria. The objective of this paper is to assess the effect of cladribine tablets in patients with a first clinical demyelinating attack fulfilling newer criteria (McDonald 2010) for MS vs CIS. A post hoc analysis for subgroups of patients retrospectively classified as fulfilling or not fulfilling newer criteria at the first clinical demyelinating attack was conducted. Cladribine tablets 3.5 mg/kg ( n  = 68) reduced the risk of next attack or three-month confirmed Expanded Disability Status Scale (EDSS) worsening by 74% vs placebo ( n  = 72); p  = 0.0009 in patients meeting newer criteria for MS at baseline. Cladribine tablets 5.25 mg/kg ( n  = 83) reduced the risk of next attack or three-month confirmed EDSS worsening by 37%, but nominal significance was not reached ( p  = 0.14). In patients who were still CIS after applying newer criteria, cladribine tablets 3.5 mg/kg ( n  = 138) reduced the risk of conversion to clinically definite multiple sclerosis (CDMS) by 63% vs placebo ( n  = 134); p  = 0.0003. Cladribine tablets 5.25 mg/kg ( n  = 121) reduced the risk of conversion by 75% vs placebo ( n  = 134); p  ORACLE-MS study (NCT00725985).

  13. An evaluation of selection criteria on primary water chemistry parameters for SMART

    International Nuclear Information System (INIS)

    Choi, B. S.; Kim, S. H.; Yun, J. H.; Bae, Y. Y.; Gee, S. G.

    2003-01-01

    The selection criteria on the primary water chemistry of SMART by comparing the chemical design features with those of the current operating PWRs is analyzed. The most essential differences in water chemistry between the PWRs and SMART reactor is characterized by the presence of boron in water. SMART is boron free reactor, and the ammonia is used as a pH reagent. In SMART reactor hydrogen gas is not added to the primary coolant, but is normally generated from the radiolysis of ammonia of the coolant passes through the core. Ammonia is added once per shift because SMART reactor has no letdown and charging system during power operation. Because of these competing processes, the concentrations of hydrogen, nitrogen and ammonia in the primary coolant are steady state concentrations, which depend on the decomposition/combination rate of ammonia. Ammonia chemistry in SMART reactor has many advantages in that no hydrogen gas injection is needed to control the dissolved oxygen in primary coolant because of spontaneous generation of hydrogen and nitrogen produced by the reaction of ammonia decomposition

  14. Outcome Criteria for Discharging the Patient With a New Ostomy From Home Health Care: A WOCN Society Consensus Conference.

    Science.gov (United States)

    Colwell, Janice C; Kupsick, Phyllis T; McNichol, Laurie L

    2016-01-01

    The Wound, Ostomy and Continence Nurses Society hosted a consensus panel of expert ostomy clinicians who were tasked with identifying minimal discharge criteria for home care patients with a new fecal or urinary diversion. Shortened hospital inpatient stays, higher patient acuity, and limited access to ostomy specialists send patients with new ostomies home with multiple educational and adjustment needs related to a new stoma. The Society recognized the lack of evidence-based ostomy practice and supported the work of the panel to develop statements that defined elements of the care plan for the patient or caregiver in home care who is adapting to living with a stoma. Eighteen statements were developed that provide minimum discharge criteria for the patient with a new ostomy in the home care setting. Support based upon current evidence as well as expert opinion with implementation strategies are offered for each statement.

  15. Echocardiography Criteria for Structural Heart Disease in Patients With End-Stage Renal Disease Initiating Hemodialysis.

    Science.gov (United States)

    Hickson, LaTonya J; Negrotto, Sara M; Onuigbo, Macaulay; Scott, Christopher G; Rule, Andrew D; Norby, Suzanne M; Albright, Robert C; Casey, Edward T; Dillon, John J; Pellikka, Patricia A; Pislaru, Sorin V; Best, Patricia J M; Villarraga, Hector R; Lin, Grace; Williams, Amy W; Nkomo, Vuyisile T

    2016-03-15

    Cardiovascular disease among hemodialysis (HD) patients is linked to poor outcomes. The Acute Dialysis Quality Initiative Workgroup proposed echocardiographic (ECHO) criteria for structural heart disease (SHD) in dialysis patients. The association of SHD with important patient outcomes is not well defined. This study sought to determine prevalence of ECHO-determined SHD and its association with survival among incident HD patients. We analyzed patients who began chronic HD from 2001 to 2013 who underwent ECHO ≤1 month prior to or ≤3 months following initiation of HD (n = 654). Mean patient age was 66 ± 16 years, and 60% of patients were male. ECHO findings that met 1 or more and ≥3 of the new criteria were discovered in 87% and 54% of patients, respectively. Over a median of 2.4 years, 415 patients died: 108 (26%) died within 6 months. Five-year mortality was 62%. Age- and sex-adjusted structural heart disease variables associated with death were left ventricular ejection fraction (LVEF) ≤45% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.20 to 1.83) and right ventricular (RV) systolic dysfunction (HR: 1.68; CI: 1.35 to 2.07). An additive of higher death risk included LVEF ≤45% and RV systolic dysfunction rather than neither (HR: 2.04; CI: 1.57 to 2.67; p = 0.53 for test for interaction). Following adjustment for age, sex, race, diabetic kidney disease, and dialysis access, RV dysfunction was independently associated with death (HR: 1.66; CI 1.34 to 2.06; p < 0.001). SHD was common in our HD study population, and RV systolic dysfunction independently predicted mortality. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. APPLICATION OF THE MODEL CERNE FOR THE ESTABLISHMENT OF CRITERIA INCUBATION SELECTION IN TECHNOLOGY BASED BUSINESSES : A STUDY IN INCUBATORS OF TECHNOLOGICAL BASE OF THE COUNTRY

    Directory of Open Access Journals (Sweden)

    Clobert Jefferson Passoni

    2017-03-01

    Full Text Available Business incubators are a great source of encouragement for innovative projects, enabling the development of new technologies, providing infrastructure, advice and support, which are key elements for the success of new business. The technology-based firm incubators (TBFs, which are 154 in Brazil. Each one of them has its own mechanism for the selection of the incubation companies. Because of the different forms of management of incubators, the business model CERNE - Reference Center for Support for New Projects - was created by Anprotec and Sebrae, in order to standardize procedures and promote the increase of chances for success in the incubations. The objective of this study is to propose selection criteria for the incubation, considering CERNE’s five dimensions and aiming to help on the decision-making in the assessment of candidate companies in a TBF incubator. The research was conducted from the public notices of 20 TBF incubators, where 38 selection criteria were identified and classified. Managers of TBF incubators validated 26 criteria by its importance via online questionnaires. As a result, favorable ratings were obtained to 25 of them. Only one criterion differed from the others, with a unfavorable rating.

  17. Substantial criteria of decision of the communities in the selection of a network operator in energy-related concession agreements; Materiellrechtliche Entscheidungskriterien der Gemeinden bei der Auswahl des Netzbetreibers in energiewirtschaftlichen Konzessionsvertraegen

    Energy Technology Data Exchange (ETDEWEB)

    Buedenbender, Ulrich [Technische Univ. Dresden (Germany). Lehrstuhl fuer Buergerliches Recht, Energiewirtschaft und Arbeitsrecht

    2011-07-01

    In light of the local roads authority, the communities decide on which partner adopts the operation of the local distribution network for electricity and gas. The question of the selection criteria has been neglected largely. The author of the book under consideration analyzes the relevant issues in energy law and antitrust law including european legal and constitutional issues. Several aspects to be considered in the rightful selection of the concession contract partner are shown. Legal consequences of disregarding the legally prescribed selection criteria are discussed.

  18. The DSM-5 effect: psychological characteristics of new patients affected by Binge Eating Disorder following the criteria of the DSM-5 in a sample of severe obese patients.

    Science.gov (United States)

    Vinai, Piergiuseppe; Da Ros, Annalisa; Cardetti, Silvia; Casey, Halpern; Studt, Stacia; Gentile, Nicola; Tagliabue, Anna; Vinai, Luisa; Vinai, Paolo; Bruno, Cecilia; Mansueto, Giovanni; Palmieri, Sara; Speciale, Maurizio

    2016-03-01

    The current study evaluated whether or not there were significant differences in psychopathological traits between three groups of individuals. The first was a group of patients seeking bariatric surgery diagnosed as being affected by Binge Eating Disorder (BED), according to the new criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. This group (NEW BED group) did not meet BED diagnosis following the previous criteria listed in the DSM-IV-TR. The second group of individuals was composed of severely obese patients seeking bariatric surgery not affected by an eating disorder, according to the diagnostic criteria of the DSM-5 (OB group). The third group was composed of individuals within a healthy weight range (Control group). 94 severely obese patients (33 in the NEW BED group and 61 in the OB group) were compared to the Control group including 41 participants on depression, anxiety and eating habits. The NEW BED scored significantly higher than the OB group on the Beck Depression Inventory, both the subscales of the State Trait Anxiety Inventory, on disinhibition and hunger subscales of the Three-Factor Eating Questionnaire and on many subscales of the Eating Disorders Inventory. The new, less restrictive diagnostic criteria for BED of the DSM-5 are useful in identifying obese patients affected by severe psychopathology and dysfunctional eating habits.

  19. Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

    Science.gov (United States)

    Marović, Ivan; Hanak, Tomaš

    2017-10-01

    In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

  20. Observation of patients with vesicoureteral reflux off antibiotic prophylaxis: physician bias on patient selection and risk factors for recurrent febrile urinary tract infection.

    Science.gov (United States)

    Drzewiecki, Beth A; Thomas, John C; Pope, John C; Adams, Mark C; Brock, John W; Tanaka, Stacy T

    2012-10-01

    Observation off continuous antibiotic prophylaxis is an option for vesicoureteral reflux. We evaluated the characteristics of patients observed off continuous antibiotic prophylaxis and risk factors for febrile urinary tract infection. We identified children 1 to 18 years old with primary vesicoureteral reflux between January 1, 2010 and December 31, 2010. We excluded patients with prior surgical correction from analysis. We recorded age, gender, race/ethnicity, primary language, insurance carrier, age at vesicoureteral reflux diagnosis, initial presentation and vesicoureteral reflux severity. We quantified bladder and bowel dysfunction with a validated questionnaire if toilet trained. We compared patients off vs on continuous antibiotic prophylaxis with the chi-square test for categorical variables and the Mann-Whitney U test for continuous variables. We used a univariate Cox proportional hazards model to assess predictors of febrile urinary tract infection during observation off continuous antibiotic prophylaxis. Of 529 eligible patients 224 were observed off continuous antibiotic prophylaxis. Patients off continuous antibiotic prophylaxis tended to be older (p urinary tract infection (p = 0.05), to have nondilating vesicoureteral reflux on most recent cystogram (p urinary tract infection developed in 19 (8.5%). Risk factors associated with febrile urinary tract infection included initial presentation of multiple febrile urinary tract infections (p = 0.03), older age at diagnosis (p = 0.03) and older age starting observation off continuous antibiotic prophylaxis (p = 0.0003). Criteria to select patients with vesicoureteral reflux for observation off continuous antibiotic prophylaxis remain poorly defined in the literature. Observation will fail in a subset of patients with vesicoureteral reflux. Physician biases regarding patient selection for observation off continuous antibiotic prophylaxis should be considered when interpreting studies that evaluate treatment

  1. Polymers for enhanced oil recovery: fundamentals and selection criteria.

    Science.gov (United States)

    Rellegadla, Sandeep; Prajapat, Ganshyam; Agrawal, Akhil

    2017-06-01

    With a rising population, the demand for energy has increased over the years. As per the projections, both fossil fuel and renewables will remain as major energy source (678 quadrillion BTU) till 2030 with fossil fuel contributing 78% of total energy consumption. Hence, attempts are continuously made to make fossil fuel production more sustainable and cheaper. From the past 40 years, polymer flooding has been carried out in marginal oil fields and have proved to be successful in many cases. The common expectation from polymer flooding is to obtain 50% ultimate recovery with 15 to 20% incremental recovery over secondary water flooding. Both naturally derived polymers like xanthan gum and synthetic polymers like partially hydrolyzed polyacrylamide (HPAM) have been used for this purpose. Earlier laboratory and field trials revealed that salinity and temperature are the major issues with the synthetic polymers that lead to polymer degradation and adsorption on the rock surface. Microbial degradation and concentration are major issues with naturally derived polymers leading to loss of viscosity and pore throat plugging. Earlier studies also revealed that polymer flooding is successful in the fields where oil viscosity is quite higher (up to 126 cp) than injection water due to improvement in mobility ratio during polymer flooding. The largest successful polymer flood was reported in China in 1990 where both synthetic and naturally derived polymers were used in nearly 20 projects. The implementation of these projects provides valuable suggestions for further improving the available processes in future. This paper examines the selection criteria of polymer, field characteristics that support polymer floods and recommendation to design a large producing polymer flooding.

  2. Will the right Robin patient rise, please? Definitions and criteria during management of Robin sequence patients in the Netherlands and Belgium.

    Science.gov (United States)

    Basart, Hanneke; Kruisinga, Frea H; Breugem, Corstiaan C; Don Griot, J Peter W; Hennekam, Raoul C; Van der Horst, Chantal M A M

    2015-01-01

    Robin Sequence (RS) is characterized by micrognathia and upper airway obstruction (UAO), with or without cleft palate, causing respiratory and feeding problems. Management options are: positioning; nasopharyngeal airway (NPA); tongue-lip adhesion (TLA); mandibular distraction (MDO); and tracheostomy. Controversy exists in literature regarding RS definition and management. Here we describe definitions, management strategies and criteria in opting for management strategies, used by Dutch and Belgian cleft teams. A specifically designed questionnaire was sent to members of all 16 Dutch and Belgian cleft teams. 14 cleft teams returned 35 questionnaires. All used micrognathia as definition criterion, 93.4% cleft palate, 51.5%glossoptosis and 45.7% UAO. Six different RS definitions were used; even within a single team >1 definition was used. All teams used different management strategies: all used positioning, 10 NPA, 6 TLA, 7 MDO, 8 tracheostomy, 5 refer patients with invasive treatment indication. Criteria in opting management modalities were: O2-saturation (89.3%), clinical presentation (86.2%), growth and feeding problems (69.0%), polysomnography (62.1%), and differed within teams. The Dutch and Belgian cleft teams use variable RS definitions, different management modalities and criteria in choosing management strategies. A single, strict definition and evidence-based management guidelines should be formulated for optimal patient care. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. Criteria for applying imaging diagnosis and initial management for pediatric head trauma

    International Nuclear Information System (INIS)

    Shiomi, Naoto; Okada, Michiko; Echigo, Tadashi; Oka, Hideki; Hino, Akihiko

    2010-01-01

    It may be difficult to perform CT for pediatric head trauma because of body movement and radiation exposure. Imaging application criteria were established, in which patients diagnosed as less likely to have an intracranial lesion meeting the criteria were not indicated for imaging and subjected to course observation at home, and this policy was explained to the parents. When consent was obtained, patients were followed up at home, and we checked on the condition by making a phone call 4-8 hours after injury. The patients were 103 infants aged 15 years or younger brought to the emergency medical care center of our hospital between May and August 2008. Imaging was basically indicated for cases of traffic accidents, falls from a high level, those brought in by ambulance, referred cases, and cases with disturbance of consciousness, neurologically abnormal findings, vomiting on examination, and trauma requiring X-ray examination in addition to that for the head. However, apart from these cases, imaging was not required. Imaging was not necessary for 94% of infant cases. The parents were convinced by the explanation and selected course observation at home in 94% of cases for which imaging was judged as unnecessary. None of the patients required re-examination based on the conditions reported in phone calls to homes. Imaging diagnosis for pediatric head trauma is not always necessary, and its application should be decided on after consultation. When no imaging is performed, this should be fully explained at the initial treatment before selecting course observation at home. Checking on the child's condition by making a phone call several hours after injury is useful for both patients and physicians. (author)

  4. Spot the difference. Impact of different selection criteria on observed properties of passive galaxies in zCOSMOS-20k sample

    Science.gov (United States)

    Moresco, M.; Pozzetti, L.; Cimatti, A.; Zamorani, G.; Bolzonella, M.; Lamareille, F.; Mignoli, M.; Zucca, E.; Lilly, S. J.; Carollo, C. M.; Contini, T.; Kneib, J.-P.; Le Fèvre, O.; Mainieri, V.; Renzini, A.; Scodeggio, M.; Bardelli, S.; Bongiorno, A.; Caputi, K.; Cucciati, O.; de la Torre, S.; de Ravel, L.; Franzetti, P.; Garilli, B.; Iovino, A.; Kampczyk, P.; Knobel, C.; Kovač, K.; Le Borgne, J.-F.; Le Brun, V.; Maier, C.; Pelló, R.; Peng, Y.; Perez-Montero, E.; Presotto, V.; Silverman, J. D.; Tanaka, M.; Tasca, L.; Tresse, L.; Vergani, D.; Barnes, L.; Bordoloi, R.; Cappi, A.; Diener, C.; Koekemoer, A. M.; Le Floc'h, E.; López-Sanjuan, C.; McCracken, H. J.; Nair, P.; Oesch, P.; Scarlata, C.; Scoville, N.; Welikala, N.

    2013-10-01

    Aims: We present the analysis of photometric, spectroscopic, and morphological properties for differently selected samples of passive galaxies up to z = 1 extracted from the zCOSMOS-20k spectroscopic survey. This analysis intends toexplore the dependence of galaxy properties on the selection criterion adopted, study the degree of contamination due to star-forming outliers, and provide a comparison between different commonly used selection criteria. This work is a first step to fully investigating the selection effects of passive galaxies for future massive surveys such as Euclid. Methods: We extracted from the zCOSMOS-20k catalog six different samples of passive galaxies, based on morphology (3336 "morphological" early-type galaxies), optical colors (4889 "red-sequence" galaxies and 4882 "red UVJ" galaxies), specific star-formation rate (2937 "quiescent" galaxies), a best fit to the observed spectral energy distribution (2603 "red SED" galaxies), and a criterion that combines morphological, spectroscopic, and photometric information (1530 "red & passive early-type galaxies"). For all the samples, we studied optical and infrared colors, morphological properties, specific star-formation rates (SFRs), and the equivalent widths of the residual emission lines; this analysis was performed as a function of redshift and stellar mass to inspect further possible dependencies. Results: We find that each passive galaxy sample displays a certain level of contamination due to blue/star-forming/nonpassive outliers. The morphological sample is the one that presents the higher percentage of contamination, with ~12-65% (depending on the mass range) of galaxies not located in the red sequence, ~25-80% of galaxies with a specific SFR up to ~25 times higher than the adopted definition of passive, and significant emission lines found in the median stacked spectra, at least for log (M/M⊙) contamination in color 10.25, very limited tails in sSFR, a median value ~20% higher than the

  5. 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

    assessed in three double-blind, placebo-controlled trials of 457 patients, and safety has been assessed in 1,254 patients overall, with severe chronic cancer, noncancer, and acquired immunodeficiency syndrome pain types. Both agents are highlighted as first-line intrathecal therapy for the management of neuropathic or nociceptive pain. The purpose of this review is to discuss practical considerations for intrathecal drug delivery, delineate criteria for the identification and selection of candidates for intrathecal drug delivery, and consider which agent may be more appropriate for individual patients. Keywords: review, patient selection, chronic pain, intrathecal, drug delivery

  6. [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.

  7. Platelet-rich preparations to improve healing. Part II: platelet activation and enrichment, leukocyte inclusion, and other selection criteria.

    Science.gov (United States)

    Davis, Vicki L; Abukabda, Alaeddin B; Radio, Nicholas M; Witt-Enderby, Paula A; Clafshenkel, William P; Cairone, J Vito; Rutkowski, James L

    2014-08-01

    Multiple platelet-rich preparations have been reported to improve wound and bone healing, such as platelet-rich plasma (PRP) and platelet rich fibrin (PRF). The different methods employed during their preparation are important, as they influence the quality of the product applied to a wound or surgical site. Besides the general protocol for preparing the platelet-rich product (discussed in Part 1 of this review), multiple choices need to be considered during its preparation. For example, activation of the platelets is required for the release and enmeshment of growth factors, but the method of activation may influence the resulting matrix, growth factor availability, and healing. Additionally, some methods enrich leukocytes as well as platelets, but others are designed to be leukocyte-poor. Leukocytes have many important roles in healing and their inclusion in PRP results in increased platelet concentrations. Platelet and growth factor enrichment reported for the different types of platelet-rich preparations are also compared. Generally, TGF-β1 and PDGF levels were higher in preparations that contain leukocytes compared to leukocyte-poor PRP. However, platelet concentration may be the most reliable criterion for comparing different preparations. These and other criteria are described to help guide dental and medical professionals, in large and small practices, in selecting the best procedures for their patients. The healing benefits of platelet-rich preparations along with the low risk and availability of simple preparation procedures should encourage more clinicians to incorporate platelet-rich products in their practice to accelerate healing, reduce adverse events, and improve patient outcomes.

  8. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection

    NARCIS (Netherlands)

    Rudwaleit, M.; van der Heijde, D.; Landewé, R.; Listing, J.; Akkoc, N.; Brandt, J.; Braun, J.; Chou, C. T.; Collantes-Estevez, E.; Dougados, M.; Huang, F.; Gu, J.; Khan, M. A.; Kirazli, Y.; Maksymowych, W. P.; Mielants, H.; Sørensen, I. J.; Ozgocmen, S.; Roussou, E.; Valle-Oñate, R.; Weber, U.; Wei, J.; Sieper, J.

    2009-01-01

    To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA). All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back pain of unknown

  9. Optimal Selection of Clustering Algorithm via Multi-Criteria Decision Analysis (MCDA for Load Profiling Applications

    Directory of Open Access Journals (Sweden)

    Ioannis P. Panapakidis

    2018-02-01

    Full Text Available Due to high implementation rates of smart meter systems, considerable amount of research is placed in machine learning tools for data handling and information retrieval. A key tool in load data processing is clustering. In recent years, a number of researches have proposed different clustering algorithms in the load profiling field. The present paper provides a methodology for addressing the aforementioned problem through Multi-Criteria Decision Analysis (MCDA and namely, using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS. A comparison of the algorithms is employed. Next, a single test case on the selection of an algorithm is examined. User specific weights are applied and based on these weight values, the optimal algorithm is drawn.

  10. A Sensor-based System for Monitoring Hard-shoulder Incursions: Review of Technologies and Selection Criteria

    Directory of Open Access Journals (Sweden)

    Michalaki Paraskevi

    2016-01-01

    Full Text Available According to safety observations from motorway operators in the United Kingdom, the hard-shoulder is occasionally violated by road users travelling in the nearside lane. These unintentional movements (hard-shoulder incursions can impose risk to operatives performing activities on the network. To further investigate these events, a sensor-based system can be used for monitoring them and collecting related data such as severity of incursion and vehicle classification. A review of vehicle detection technologies that could be applied for this purpose is presented, along with the criteria for selection of the most suitable technology and implementation sites. Two potential non-intrusive systems are also described, a laser- and a radar-based systems, which provide different levels of flexibility and data.

  11. Design Criteria, Operating Conditions, and Nickel-Iron Hydroxide Catalyst Materials for Selective Seawater Electrolysis.

    Science.gov (United States)

    Dionigi, Fabio; Reier, Tobias; Pawolek, Zarina; Gliech, Manuel; Strasser, Peter

    2016-05-10

    Seawater is an abundant water resource on our planet and its direct electrolysis has the advantage that it would not compete with activities demanding fresh water. Oxygen selectivity is challenging when performing seawater electrolysis owing to competing chloride oxidation reactions. In this work we propose a design criterion based on thermodynamic and kinetic considerations that identifies alkaline conditions as preferable to obtain high selectivity for the oxygen evolution reaction. The criterion states that catalysts sustaining the desired operating current with an overpotential seawater-mimicking electrolyte. The catalyst was synthesized by a solvothermal method and the activity, surface redox chemistry, and stability were tested electrochemically in alkaline and near-neutral conditions (borate buffer at pH 9.2) and under both fresh seawater conditions. The Tafel slope at low current densities is not influenced by pH or presence of chloride. On the other hand, the addition of chloride ions has an influence in the temporal evolution of the nickel reduction peak and on both the activity and stability at high current densities at pH 9.2. Faradaic efficiency close to 100 % under the operating conditions predicted by our design criteria was proven using in situ electrochemical mass spectrometry. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. A benefit/risk approach towards selecting appropriate pharmaceutical dosage forms - an application for paediatric dosage form selection.

    Science.gov (United States)

    Sam, Tom; Ernest, Terry B; Walsh, Jennifer; Williams, Julie L

    2012-10-05

    The design and selection of new pharmaceutical dosage forms involves the careful consideration and balancing of a quality target product profile against technical challenges and development feasibility. Paediatric dosage forms present particular complexity due to the diverse patient population, patient compliance challenges and safety considerations of this vulnerable population. This paper presents a structured framework for assessing the comparative benefits and risks of different pharmaceutical design options against pre-determined criteria relating to (1) efficacy, (2) safety and (3) patient access. This benefit/risk framework has then been applied to three hypothetical, but realistic, scenarios for paediatric dosage forms in order to explore its utility in guiding dosage form design and formulation selection. The approach allows a rigorous, systematic and qualitative assessment of the merits and disadvantages of each dosage form option and helps identify mitigating strategies to modify risk. The application of a weighting and scoring system to the criteria depending on the specific case could further refine the analysis and aid decision-making. In this paper, one case study is scored for illustrative purposes. However, it is acknowledged that in real development scenarios, the generation of actual data considering the very specific situation for the patient/product/developer would come into play to drive decisions on the most appropriate dosage form strategy. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Do Different Diagnostic Criteria Impact Polycystic Ovary Syndrome Diagnosis for Adolescents?

    Science.gov (United States)

    Akgül, Sinem; Düzçeker, Yasemin; Kanbur, Nuray; Derman, Orhan

    2018-06-01

    Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. Fifty-two patients aged 13-18 years with at least 2 of the following criteria were included in the study: (1) oligomenorrhea or amenorrhea; (2) Clinical or biochemical hyperandrogenism; and (3) polycystic ovaries on ultrasonography. Patients were then categorized according to the 6 different criteria for PCOS. National Institutes of Health, Rotterdam criteria, Androgen Excess Society, Amsterdam criteria, Endocrine Society criteria, and the Pediatric Endocrine Society criteria. The characteristics of adolescents who were diagnosed with PCOS were also evaluated. Forty-one patients out of 52 (78.8%) received diagnosis with National Institutes of Health and Endocrine Society criteria, all with Rotterdam criteria, 45/52 (86.5%) with Androgen Excess Society criteria, 36/52 (69.2%) with Amsterdam criteria and 34/52 (65.4%) with the Pediatric Endocrine Society criteria. This study shows that the choice of guideline used does have a great effect on whether an adolescent received the PCOS diagnosis or not. For physicians using the broader criteria, care should be taken to ensure the patient does not receive diagnosis because of the physiological changes seen during puberty, which might mimic PCOS. For those using stricter criteria, close monitoring of patients who do not receive diagnosis is necessary to prevent chronic complications. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. Diagnosing autoimmune pancreatitis with the Unifying-Autoimmune-Pancreatitis-Criteria.

    Science.gov (United States)

    Schneider, Alexander; Michaely, Henrik; Rückert, Felix; Weiss, Christel; Ströbel, Philipp; Belle, Sebastian; Hirth, Michael; Wilhelm, Torsten J; Haas, Stephan L; Jesenofsky, Ralf; Schönberg, Stefan; Marx, Alexander; Singer, Manfred V; Ebert, Matthias P; Pfützer, Roland H; Löhr, J Matthias

    We had developed the Unifying-Autoimmune-Pancreatitis-Criteria (U-AIP) to diagnose autoimmune pancreatitis (AiP) within the M-ANNHEIM classification of chronic pancreatitis. In 2011, International-Consensus-Diagnostic-Criteria (ICDC) to diagnose AiP have been published. We had applied the U-AIP long before the ICDC were available. The aims of the study were, first, to describe patients with AiP diagnosed by the U-AIP; second, to compare diagnostic accuracies of the U-AIP and other diagnostic systems; third, to evaluate the clinical applicability of the U-AIP. From 1998 until 2008, we identified patients with AiP using U-AIP, Japanese-, Korean-, Asian-, Mayo-HISORt-, Revised-Mayo-HISORt- and Italian-criteria. We retrospectively verified the diagnosis by ICDC and Revised-Japanese-2011-criteria, compared diagnostic accuracies of all systems and evaluated all criteria in consecutive patients with pancreatitis (2009 until 2010, Pancreas-Outpatient-Clinic-Cohort, n = 84). We retrospectively validated our diagnostic approach in consecutive patients with a pancreatic lesion requiring surgery (Surgical-Cohort, n = 98). Overall, we identified 21 patients with AiP. Unifying-Autoimmune-Pancreatitis-Criteria and ICDC presented the highest diagnostic accuracies (each 98.8%), highest Youden indices (each 0.95238), and highest proportions of diagnosed patients (each n = 20/21, U-AIP/ICDC vs. other diagnostic systems, p Pancreatitis-Criteria revealed a satisfactory clinical applicability and offered an additional approach to diagnose AiP. Copyright © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  15. A Study on the Basic Criteria for Selecting Heterogeneity Parameters of F18-FDG PET Images.

    Directory of Open Access Journals (Sweden)

    Attila Forgacs

    Full Text Available Textural analysis might give new insights into the quantitative characterization of metabolically active tumors. More than thirty textural parameters have been investigated in former F18-FDG studies already. The purpose of the paper is to declare basic requirements as a selection strategy to identify the most appropriate heterogeneity parameters to measure textural features. Our predefined requirements were: a reliable heterogeneity parameter has to be volume independent, reproducible, and suitable for expressing quantitatively the degree of heterogeneity. Based on this criteria, we compared various suggested measures of homogeneity. A homogeneous cylindrical phantom was measured on three different PET/CT scanners using the commonly used protocol. In addition, a custom-made inhomogeneous tumor insert placed into the NEMA image quality phantom was imaged with a set of acquisition times and several different reconstruction protocols. PET data of 65 patients with proven lung lesions were retrospectively analyzed as well. Four heterogeneity parameters out of 27 were found as the most attractive ones to characterize the textural properties of metabolically active tumors in FDG PET images. These four parameters included Entropy, Contrast, Correlation, and Coefficient of Variation. These parameters were independent of delineated tumor volume (bigger than 25-30 ml, provided reproducible values (relative standard deviation< 10%, and showed high sensitivity to changes in heterogeneity. Phantom measurements are a viable way to test the reliability of heterogeneity parameters that would be of interest to nuclear imaging clinicians.

  16. A Study on the Basic Criteria for Selecting Heterogeneity Parameters of F18-FDG PET Images

    Science.gov (United States)

    Forgacs, Attila; Pall Jonsson, Hermann; Dahlbom, Magnus; Daver, Freddie; D. DiFranco, Matthew; Opposits, Gabor; K. Krizsan, Aron; Garai, Ildiko; Czernin, Johannes; Varga, Jozsef; Tron, Lajos; Balkay, Laszlo

    2016-01-01

    Textural analysis might give new insights into the quantitative characterization of metabolically active tumors. More than thirty textural parameters have been investigated in former F18-FDG studies already. The purpose of the paper is to declare basic requirements as a selection strategy to identify the most appropriate heterogeneity parameters to measure textural features. Our predefined requirements were: a reliable heterogeneity parameter has to be volume independent, reproducible, and suitable for expressing quantitatively the degree of heterogeneity. Based on this criteria, we compared various suggested measures of homogeneity. A homogeneous cylindrical phantom was measured on three different PET/CT scanners using the commonly used protocol. In addition, a custom-made inhomogeneous tumor insert placed into the NEMA image quality phantom was imaged with a set of acquisition times and several different reconstruction protocols. PET data of 65 patients with proven lung lesions were retrospectively analyzed as well. Four heterogeneity parameters out of 27 were found as the most attractive ones to characterize the textural properties of metabolically active tumors in FDG PET images. These four parameters included Entropy, Contrast, Correlation, and Coefficient of Variation. These parameters were independent of delineated tumor volume (bigger than 25–30 ml), provided reproducible values (relative standard deviation< 10%), and showed high sensitivity to changes in heterogeneity. Phantom measurements are a viable way to test the reliability of heterogeneity parameters that would be of interest to nuclear imaging clinicians. PMID:27736888

  17. Assessment of hydrogen fuel cell applications using fuzzy multiple-criteria decision making method

    International Nuclear Information System (INIS)

    Chang, Pao-Long; Hsu, Chiung-Wen; Lin, Chiu-Yue

    2012-01-01

    Highlights: ► This study uses the fuzzy MCDM method to assess hydrogen fuel cell applications. ► We evaluate seven different hydrogen fuel cell applications based on 14 criteria. ► Results show that fuel cell backup power systems should be chosen for development in Taiwan. -- Abstract: Assessment is an essential process in framing government policy. It is critical to select the appropriate targets to meet the needs of national development. This study aimed to develop an assessment model for evaluating hydrogen fuel cell applications and thus provide a screening tool for decision makers. This model operates by selecting evaluation criteria, determining criteria weights, and assessing the performance of hydrogen fuel cell applications for each criterion. The fuzzy multiple-criteria decision making method was used to select the criteria and the preferred hydrogen fuel cell products based on information collected from a group of experts. Survey questionnaires were distributed to collect opinions from experts in different fields. After the survey, the criteria weights and a ranking of alternatives were obtained. The study first defined the evaluation criteria in terms of the stakeholders, so that comprehensive influence criteria could be identified. These criteria were then classified as environmental, technological, economic, or social to indicate the purpose of each criterion in the assessment process. The selected criteria included 14 indicators, such as energy efficiency and CO 2 emissions, as well as seven hydrogen fuel cell applications, such as forklifts and backup power systems. The results show that fuel cell backup power systems rank the highest, followed by household fuel cell electric-heat composite systems. The model provides a screening tool for decision makers to select hydrogen-related applications.

  18. The life cycle cost of a building from the point of view of environmental criteria of selecting the most beneficial offer in the area of competitive tendering

    Directory of Open Access Journals (Sweden)

    Grzyl Beata

    2017-01-01

    Full Text Available The article analyses environmental and ecological criteria of selecting the most beneficial offer in the aspect of LCC. Construction works contracts and the potential method of defining the above criteria, among others, is pondered on (for example by the recommendation of a material, which is supposed to be used, a ban on substances that are harmful for human health as well for the environment. In the relation to the above, it is necessary to define technical parameters that have an impact on the environment, for example the level of pollution and noise emission, electricity and water consumption, or stating the minimal involvement of a processed ingredient. In addition the article presents also an account of the life cycle cost of a building from the point of view of environmental criteria constituting an element of selecting the most beneficial offer in the area of competitive tendering.

  19. Severity assessment criteria recommended by the British Thoracic Society (BTS) for community-acquired pneumonia (CAP) and older patients. Should SOAR (systolic blood pressure, oxygenation, age and respiratory rate) criteria be used in older people? A compilation study of two prospective cohorts.

    Science.gov (United States)

    Myint, Phyo K; Kamath, Ajay V; Vowler, Sarah L; Maisey, David N; Harrison, Brian D W

    2006-05-01

    To assess the usefulness of the British Thoracic Society guidelines for severity assessment of community-acquired pneumonia (CAP) in predicting mortality and to explore alternative criteria which could be more useful in older patients. Compilation study of two prospective observational cohorts. A University hospital in Norfolk, UK with a catchment population of 568,000. Subjects were 195 patients (median age = 77 years) who were included in two prospective studies of CAP. All-cause mortality occurring within the 6 week follow-up. sensitivity, specificity, positive and negative predictive values for study outcome using CURB and CURB-65 were assessed in 189 patients, and CRB-65 in 192 patients out of a total of 195 patients. Our results were comparable with the original study by Lim et al. Although CURB-65 and CRB-65 included age criteria, in effect they did not materially improve the specificity in predicting high-risk patients in both studies. We found that oxygenation measured by ventilation perfusion mismatch (PaO2:FiO2) was the best predictor of outcome in this slightly older cohort [odds ratio (OR) = 0.99 (0.98-0.99), P = 0.0001]. We derived a new set of criteria; SOAR (systolic blood pressure, oxygenation, age and respiratory rate) based on our findings. Their sensitivity, specificity, positive and negative predictive values were 81.0% (58.1-94.6), 59.3% (49.6-68.4), 27.0% (16.6-39.7) and 94.4% (86.2-98.4), respectively, confirming their comparability with existing criteria. Our Study confirms the usefulness of currently recommended severity rules for CAP in this older cohort. SOAR criteria may be useful as alternative criteria for a better identification of severe CAP in advanced age where both raised urea level above 7 mmol/l and confusion are common.

  20. Development of site selection criteria for radioactive waste disposal in view of favourable geological settings in Germany

    Energy Technology Data Exchange (ETDEWEB)

    Baltes, B.; Brewitz, W. [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) mbH, Cologne (Germany)

    2001-07-01

    In Germany it is intended to dispose of all types of radioactive waste in deep geological formations. Since the government has doubts regarding the suitability of the Gorleben site, further sites in different host rock formations have to be investigated. This investigation process has to be carried out with respect to technical suitability and safety as well as to public acceptance. A Committee has been established whose mandate is to develop a comprehensible procedure for the selection of sites for radioactive waste disposal in Germany. The Committee developed an iterative procedure which provides, besides the increase of transparency, the necessary flexibility in dealing with assessment results. The method is governed by geo-scientific and social-scientific criteria that are presented in this paper. 7 steps have been identified in the procedure: 1) exclusion of areas with obviously unfavourable conditions, 2) identification of areas with favourable geological settings, 3) exclusion of areas for socio-scientific reasons, 4) identification of regions with favourable conditions and ranking of regions, 5) identification of sites for further identification, 6) above-ground site investigation and ranking of potentially suitable sites, and 7) identification of sites for suitability investigations. The first 3 steps give the remaining areas that meet the minimum requirements. The criteria of the first 3 steps are: extensive vertical movements, active disturbance zones, seismic activity and volcanic activity, as for the 4 last steps criteria are based on geo- and socio- scientific weighing, voluntariness and regional mediation. (A.C.)

  1. Development of site selection criteria for radioactive waste disposal in view of favourable geological settings in Germany

    International Nuclear Information System (INIS)

    Baltes, B.; Brewitz, W.

    2001-01-01

    In Germany it is intended to dispose of all types of radioactive waste in deep geological formations. Since the government has doubts regarding the suitability of the Gorleben site, further sites in different host rock formations have to be investigated. This investigation process has to be carried out with respect to technical suitability and safety as well as to public acceptance. A Committee has been established whose mandate is to develop a comprehensible procedure for the selection of sites for radioactive waste disposal in Germany. The Committee developed an iterative procedure which provides, besides the increase of transparency, the necessary flexibility in dealing with assessment results. The method is governed by geo-scientific and social-scientific criteria that are presented in this paper. 7 steps have been identified in the procedure: 1) exclusion of areas with obviously unfavourable conditions, 2) identification of areas with favourable geological settings, 3) exclusion of areas for socio-scientific reasons, 4) identification of regions with favourable conditions and ranking of regions, 5) identification of sites for further identification, 6) above-ground site investigation and ranking of potentially suitable sites, and 7) identification of sites for suitability investigations. The first 3 steps give the remaining areas that meet the minimum requirements. The criteria of the first 3 steps are: extensive vertical movements, active disturbance zones, seismic activity and volcanic activity, as for the 4 last steps criteria are based on geo- and socio- scientific weighing, voluntariness and regional mediation. (A.C.)

  2. MDS clinical diagnostic criteria for Parkinson's disease in China.

    Science.gov (United States)

    Li, Jun; Jin, Miao; Wang, Li; Qin, Bin; Wang, Kang

    2017-03-01

    The Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (MDS-PD Criteria) was introduced by the Movement Disorder Society in 2015 for research purposes. However, its use for clinical diagnosis of Parkinson disease still needs further revision. This study compares the UK-Criteria versus MDS-PD Criteria in the clinical diagnosis of Parkinson disease referred to the China-Japan Friendship Hospital of Beijing, China. To compare the MDS-PD Criteria with the UK-Criteria and discuss the feasibility of the clinical application of MDS-PD Criteria as a general guide to clinical diagnosis of PD in Chinese PD patients. 150 patients of neurology clinic of China-Japan Friendship Hospital of Beijing were recruited in our research. They were divided into three groups: UK-Criteria group, MDS-PD Criteria group and a combined group of UK and MDS-PD Criteria. Clinical history was collected while physical and auxiliary examinations were done by a trained neurologist according to the corresponding criteria. An interrater reliability analysis using the Kappa statistic claimed substantial agreement (κ = 0.626) between the MDS-PD Criteria and the UK-Criteria. The differences between the diagnostic results of these two criteria were statistically significant by paired Chi-square test (p = 0.000). It was found that levodopa-induced dyskinesia had a good positive predictive value, while early bulbar impairment and inspiratory dysfunction presented a negative predictive value. The MDS-PD Criteria emphasize the importance of non-motor symptoms, keeping the motor symptoms as the core for the clinical diagnosis of PD, and establish categories of diagnosis features and levels of certainty which are more complete and organized to be used and replicated by non specialized physicians to evaluated patients with Parkinsonism. The higher sensitivity of MDS-PD Criteria compared with UK-Criteria is worth being widely used in clinical work.

  3. Carotid Consensus Panel duplex criteria can replace modified University of Washington criteria without affecting accuracy.

    Science.gov (United States)

    Kim, Ann H; Augustin, Gener; Shevitz, Andrew; Kim, Hannah; Trivonovich, Michael R; Powell, Alexis R; Kumins, Norman; Tarr, Robert; Kashyap, Vikram S

    2018-04-01

    The decision to intervene for internal carotid stenosis often depends on the degree of stenosis seen on duplex ultrasound (US). The aim of this study is to compare the diagnostic accuracy of two criteria: modified University of Washington (UW) and 2003 Carotid Consensus Panel (CCP). All patients undergoing US in an accredited (IAC) vascular laboratory from January 2010 to June 2015 were reviewed ( n=18,772 US exams). Patients receiving a neck computed tomography angiography (CTA) within 6 months of the US were included in the study ( n=254). The degree of stenosis was determined by UW/CCP criteria and confirmed on CTA images using North American Symptomatic Carotid Endarterectomy Trial (NASCET)/European Carotid Surgery Trial (ECST) schema. Kappa analysis with 95% confidence intervals (CIs) were utilized to determine duplex-CTA agreement. A total of 417 carotid arteries from 221 patients were assessed in this study. The modified UW criteria accurately classified 266 (63.9%, kappa = 0.321, 95% CI 0.255 to 0.386) cases according to NASCET-derived measurements. The sensitivity, specificity, and accuracy at ≥ 60% stenosis were 65.7%, 81.3%, and 81.9%. The CCP criteria resulted in 296 (70.9%) accurate diagnoses (kappa = 0.359, 95% CI 0.280 to 0.437). At ≥ 70% stenosis, the sensitivity, specificity and accuracy were 38.8%, 91.6%, and 87.1% for NASCET. Comparison of the duplex results to ECST-derived CTA measurements revealed a similar trend (UW 53.1%, κ = 0.301 vs CCP 62.1%, κ = 0.315). The CCP criteria demonstrate a higher concordance rate with measurements taken from CTAs. The CCP criteria may be more sensitive in classifying clinically significant degrees of stenosis without a loss in diagnostic accuracy.

  4. 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

  5. Effect of the selective vasopressin V2 receptor antagonists in hepatic cirrhosis patients with ascites: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Shao-hui TANG

    2013-07-01

    Full Text Available Objective To evaluate the efficacy and safety of selective vasopressin V2 receptor antagonists in the treatment of hepatic cirrhosis patients with ascites. Methods PubMed, EMBASE, Web of Science, The Cochrane Central Register of Controlled Trials, Database for Chinese Technical Periodical (VIP, Chinese Journal Full-Text Database (CNKI, and Wan Fang Digital Journal Full-text Database were retrieved to collect clinical randomized controlled trials of hepatic cirrhosis with ascites treated by selective vasopressin V2 receptor antagonists. Meta analysis was performed by using Review Manager 5.0. Results Nine randomized controlled trials including 1884 patients met the inclusion criteria. Meta-analysis showed that: 1 The selective vasopressin V2 receptor antagonists were associated with a significant reduction in body weight compared with placebo (WMD=–1.98kg, 95%CI:–3.24-–0.72kg, P=0.002. Treatment with selective vasopressin V2 receptor antagonists was associated with an improvement of low serum sodium concentration compared to placebo (WMD=3.74mmol/L, 95%CI: 0.91-6.58mmol/L, P=0.01. The percentage of patients with worsening ascites was higher in the group of patients treated with placebo (RR=0.51, 95%CI: 0.34-0.77, P=0.001. 2 The amplitude of increased urine volume was obviously higher in selective vasopressin V2 receptor antagonists group than in placebo group (WMD=1437.65ml, 95%CI: 649.01-2226.30ml, P=0.0004. The difference of serum creatinine in the selective vasopressin V2 receptor antagonists group was not statistically significant compared with the control group (WMD=–3.49μmol/L, 95%CI: –12.54¬5.56μmol/L, P=0.45. 3 There was no statistical significance between the two groups in the heart rate, systolic pressure, diastolic pressure and mortality (P>0.05. The rate of other adverse reactions was higher in the selective vasopressin V2 receptor antagonists group compared with that of placebo group (P=0.003. Conclusion

  6. What are the qualifications and selection criteria for women to be appointed to society journal editorial boards?

    Science.gov (United States)

    Tomizawa, Yasuko

    2014-02-01

    Japan ranks extremely low in global ranking of gender equality. It is not easy for female doctors to acquire leadership positions in member societies of the Japanese Association of Medical Science (JAMS). Very few women are included on editorial boards of English medical journals in Japan. Furthermore, until last year, there had been no female editors in English language journals of surgical societies. The qualifications and criteria for selecting editorial board members of medical journals should be clarified. Medical journals in Japan would gain diversity by including women on editorial boards in the same proportion as women membership in the corresponding medical societies.

  7. GIS-based multi-criteria site selection for zebra mussel cultivation: Addressing end-of-pipe remediation of a eutrophic coastal lagoon ecosystem.

    Science.gov (United States)

    Bagdanavičiūtė, Ingrida; Umgiesser, Georg; Vaičiūtė, Diana; Bresciani, Mariano; Kozlov, Igor; Zaiko, Anastasija

    2018-04-11

    Farming of shellfish and seaweeds is a tested tool for mitigating eutrophication consequences in coastal environments, however as many other marine economic activities it should be a subject of marine spatial planning for designating suitable sites. The present study proposes site selection framework for provisional zebra mussel farming in a eutrophic lagoon ecosystem, aimed primarily at remediation purposes. GIS-based multi-criteria approach was applied, combining data from empirical maps, numerical models and remote sensing to estimate suitability parameters. Site selection and prioritisation of suitable areas considered 15 environmental and socio-economic criteria, which contributed to 4 optimisation models (settlement, growth and survival of mussels, environmental and socio-economic) and 3 predefined scenarios representing provisional goals of mussel cultivation: spat production, biomass production and bioremediation. The relative importance of each criterion was assessed utilizing the Analytical Hierarchy Process. Site suitability index was calculated and the final result of the site selection analysis was summarized for 3 scenarios and overall suitability map. Four suitability classes (unsuitable, least, moderately and most suitable) were applied, and 3 most suitable zones for provisional zebra mussel cultivation with 12 candidate sites were selected accordingly. The integrated approach presented in this study can be adjusted for designating zebra mussel farming sites in other estuarine lagoon ecosystems, or cultivation of other mussel species for bioremediation purposes. The analytical framework and the workflow designed in this study are also adoptable for addressing other aquaculture-related spatial planning issues. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Why do patients undergoing anterior cruciate ligament reconstruction in Brazil stay in hospital for longer periods than in other countries? Prospective evaluation of 30 patients and presentation of possible discharge criteria

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2013-08-01

    Full Text Available OBJECTIVE: Evaluate a better moment by the medical team and patient to be discharged and relate to possible medical discharge criteria. METHODS: 31 anterior cruciate ligament reconstructed patients under similar conditions prospectively evaluated about the possibility of discharge with 24 and 48 hours after surgery and possibles discharges criteria such as pain, range of motion and capacity quadriceps contraction, besides the use of a validated scale to measure the patient's functional independence. RESULTS: 50% and 6.4% of patients prefer remain hospitalized after 24 and 48 hours of surgery, respectively. The average of the visual analogue scale of pain was 2.63 and 1.76 points, and the range of motion of 79º and 86,7º after 24 and 48 hours, respectively. 100% of patients were able to quadriceps contraction in every evaluated moments. CONCLUSION: In Brazil, possible discharged criteria as pain, range of motion, quad contraction and motor independence motor function scale show that anterior cruciate reconstruction reconstructed patients could be discharged after 24 hours of surgery. However, 50% of patients still prefer to remain hospitalized for longer periods.

  9. Comparison of the thermodynamic and correlation criteria for internal standard selection in laser-induced breakdown spectrometry

    International Nuclear Information System (INIS)

    Labutin, Timur A.; Zaytsev, Sergey M.; Popov, Andrey M.; Seliverstova, Irina V.; Bozhenko, Sergey E.; Zorov, Nikita B.

    2013-01-01

    The use of the reference line of an internal standard in LIBS is a usual way to eliminate or reduce the fluctuations of plasma parameters from pulse to pulse as well as from sample to sample. Thermodynamic criterion, i.e. closeness of excitation potentials of the analytical line and the reference one, is often used to select an appropriate reference line. In this work, we propose an alternative criterion based on searching the best correlated pairs of lines under the variations of laser energy. Two criteria were compared for high-alloy steels and soils of different origins. The discrepancy among the values of plasma temperature calculated from Fe I, Mn I and Cr I transitions was found under the conditions of slightly changed laser fluence on steel samples. On the other hand, the agreement between plasma temperatures, obtained for Fe I and Mn I transitions, was demonstrated in plasma on soil samples. Calibration results obtained for manganese in steels and lead in soils show that thermodynamic criterion can be an appropriate way for choosing an internal standard only under LTE conditions. Two lines of Mn I at 403.07 nm and 404.14 nm and Pb I at 405.78 nm were the analytical lines for the quantification of manganese in steels and lead in soils, respectively. The use of the correlative criterion seems to be suitable for internal standardization under LTE or non-LTE conditions. Probable limitations of the correlative criterion and its possibilities to identify weak lines are discussed in the article. - Highlights: • Novel criterion for internal standard selection, based on the correlation of analytical line and reference one • Comparison of correlation and thermodynamic criteria • Correlation analysis of the spectrum can be useful for atomic line identification. • Correlation approach can be used in LTE and non-LTE conditions

  10. [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.

  11. A heuristic approach using multiple criteria for environmentally benign 3PLs selection

    Science.gov (United States)

    Kongar, Elif

    2005-11-01

    Maintaining competitiveness in an environment where price and quality differences between competing products are disappearing depends on the company's ability to reduce costs and supply time. Timely responses to rapidly changing market conditions require an efficient Supply Chain Management (SCM). Outsourcing logistics to third-party logistics service providers (3PLs) is one commonly used way of increasing the efficiency of logistics operations, while creating a more "core competency focused" business environment. However, this alone may not be sufficient. Due to recent environmental regulations and growing public awareness regarding environmental issues, 3PLs need to be not only efficient but also environmentally benign to maintain companies' competitiveness. Even though an efficient and environmentally benign combination of 3PLs can theoretically be obtained using exhaustive search algorithms, heuristics approaches to the selection process may be superior in terms of the computational complexity. In this paper, a hybrid approach that combines a multiple criteria Genetic Algorithm (GA) with Linear Physical Weighting Algorithm (LPPW) to be used in efficient and environmentally benign 3PLs is proposed. A numerical example is also provided to illustrate the method and the analyses.

  12. Comparative analysis of objective techniques for criteria weighing in two MCDM methods on example of an air conditioner selection

    Directory of Open Access Journals (Sweden)

    Vujičić Momčilo D.

    2017-01-01

    Full Text Available This paper deals with comparative analysis of two different types of objective techniques for criteria weighing: Entropy and CRITIC and two MCDM methods: MOORA and SAW on example of an air conditioner selection. We used six variants for calculation of normalized performance ratings. Results showed that the decision of the best air conditioner was basically independent of the MCDM method used, despite the applied technique for determination of criteria weights. Complete ranking within all of the combinations of methods and techniques with diverse ratio calculation variants showed that the best ranked air conditioner was A7, while the worst ones were A5 and A9. Significant positive correlation was obtained for almost all the pairs of variants in all the combinations except for the MOORA - CRITIC combination with SAW - Entropy combination to have the highest correlations between variants (p < 0.01.

  13. Multi criteria analysis in environmental management: Selecting the best stormwater erosion and sediment control measure in Malaysian construction sites

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hadu, Ibrahiem Abdul Razak; Sidek, Lariyah Mohd; Desa, Mohamed Nor Mohamed [Civil Engineering, Universiti Tenga Nasional, Kajang, Selangor (Malaysia); Basri, Noor Ezlin Ahmad [Civil and Structural Engineering, Universiti Kebangsaan Malyasia, Bangi, Selangor (Malaysia)

    2011-07-01

    Malaysia located in a tropical region which is interested with a heavy rainfall through the whole seasons of the year. Construction stages usually associated with soil disturbing due to land clearing and grading activities, this combined with the tropical climate in Malaysia, will generate an enormous amount of soil to be eroded and then deposited in the adjacent water bodies. There are many kinds of mitigation measures used so as to reduce the impact of erosion and sedimentation that are generated due to the stormwater in construction sites. This paper presents the application of Multi Criteria Analysis (MCA) tool in choosing the best stormwater control measure by depending on specified criteria and criterion weight. The results obtained from the application of MCA in stormwater pollution control have many benefits to the contractors, consultants and decision makers by making them able to select the best control measure for every stage of construction.

  14. DSM disorders and their criteria: how should they inter-relate?

    Science.gov (United States)

    Kendler, K S

    2017-09-01

    While the changes in psychiatric diagnosis introduced by Diagnostic and Statistical Manual third edition (DSM-III) have had major benefits to the field of psychiatry, the reification of its diagnostic criteria and the widespread adoption of diagnostic literalism have been problematic. I argue that, at root, these developments can be best understood by contrasting two approaches to the relationship between DSM disorders and their criteria. In a constitutive relationship, criteria definitively define the disorder. Having a disorder is nothing more than meeting the criteria. In an indexical relationship, the criteria are fallible indices of a disorder understood as a hypothetical, tentative diagnostic construct. I trace the origins of the constitutive model to the philosophical theory of operationalism. I then examine a range of historical and empirical results that favor the indexical over the constitutive position including (i) evidence that individual criteria for DSM-III were selected from a broader pool of possible symptoms/signs, (ii) revisions of DSM have implicitly assumed an indexical criteria-disorder relationship, (iii) the indexical position allows DSM criteria to be wrong and misdiagnose patients while such a result is incoherent for a constitutive model, an implausible position, (iv) we assume an indexical criteria-scale relationships for many personality and symptom measures commonly used in psychiatric practice and research, and (v) empirical studies suggesting similar performance for DSM and non-DSM symptoms for major depression. I then review four reasons for the rise of the constitutive position: (i) the 'official' nature of the DSM criteria, (ii) the strong investment psychiatry has had in the DSM manual and its widespread use and success, iii) lack of a clear pathophysiology for our disorders, and (iv) the absence of informative diagnostic signs of minimal clinical importance. I conclude that the constitutive position is premature and reflects a

  15. Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice.

    Science.gov (United States)

    Segall, Liviu; Nistor, Ionuţ; Pascual, Julio; Mucsi, Istvan; Guirado, Lluis; Higgins, Robert; Van Laecke, Steven; Oberbauer, Rainer; Van Biesen, Wim; Abramowicz, Daniel; Gavrilovici, Cristina; Farrington, Ken; Covic, Adrian

    2016-10-01

    During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.

  16. Importance of cerebrospinal fluid analysis in the era of McDonald 2010 criteria: a German-Austrian retrospective multicenter study in patients with a clinically isolated syndrome.

    Science.gov (United States)

    Huss, André M; Halbgebauer, Steffen; Öckl, Patrick; Trebst, Corinna; Spreer, Annette; Borisow, Nadja; Harrer, Andrea; Brecht, Isabel; Balint, Bettina; Stich, Oliver; Schlegel, Sabine; Retzlaff, Nele; Winkelmann, Alexander; Roesler, Romy; Lauda, Florian; Yildiz, Özlem; Voß, Elke; Muche, Rainer; Rauer, Sebastian; Bergh, Florian Then; Otto, Markus; Paul, Friedemann; Wildemann, Brigitte; Kraus, Jörg; Ruprecht, Klemens; Stangel, Martin; Buttmann, Mathias; Zettl, Uwe K; Tumani, Hayrettin

    2016-12-01

    The majority of patients presenting with a first clinical symptom suggestive of multiple sclerosis (MS) do not fulfill the MRI criteria for dissemination in space and time according to the 2010 revision of the McDonald diagnostic criteria for MS and are thus classified as clinically isolated syndrome (CIS). To re-evaluate the utility of cerebrospinal fluid (CSF) analysis in the context of the revised McDonald criteria from 2010, we conducted a retrospective multicenter study aimed at determining the prevalence and predictive value of oligoclonal IgG bands (OCBs) in patients with CIS. Patients were recruited from ten specialized MS centers in Germany and Austria. We collected data from 406 patients; at disease onset, 44/406 (11 %) fulfilled the McDonald 2010 criteria for MS. Intrathecal IgG OCBs were detected in 310/362 (86 %) of CIS patients. Those patients were twice as likely to convert to MS according to McDonald 2010 criteria as OCB-negative individuals (hazard ratio = 2.1, p = 0.0014) and in a shorter time period of 25 months (95 % CI 21-34) compared to 47 months in OCB-negative individuals (95 % CI 36-85). In patients without brain lesions at first attack and presence of intrathecal OCBs (30/44), conversion rate to MS was 60 % (18/30), whereas it was only 21 % (3/14) in those without OCBs. Our data confirm that in patients with CIS the risk of conversion to MS substantially increases if OCBs are present at onset. CSF analysis definitely helps to evaluate the prognosis in patients who do not have MS according to the revised McDonald criteria.

  17. User perspectives on relevance criteria

    DEFF Research Database (Denmark)

    Maglaughlin, Kelly L.; Sonnenwald, Diane H.

    2002-01-01

    , partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance......This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant...... matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially...

  18. Patients Suspected of Irritable Bowel Syndrome-Cross-Sectional Study Exploring the Sensitivity of Rome III Criteria in Primary Care

    DEFF Research Database (Denmark)

    Engsbro, Anne Line; Begtrup, Luise Mølenberg; Kjeldsen, Jens

    2013-01-01

    The Rome III criteria for irritable bowel syndrome (IBS) are recommended by guidelines to help identify the syndrome. The majority of IBS patients are managed in primary care, where a pragmatic approach to diagnosis is usually adopted, using clinical judgment and knowledge about the patient. Many...

  19. Proposed radiological criteria for pre-operative determination of resectability in peritoneal-based malignancies

    International Nuclear Information System (INIS)

    Tan, Grace Hwei Ching; Chanyaputhipong, Jendana; Teo, Melissa Ching Ching; Kwek, Jin Wei; Hosseini, Reza; Tham, Chee Kian; Soo, Khee Chee

    2016-01-01

    The selection of patients for cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy infusion (HIPEC) is important, and relies heavily on imaging. However, it has been reported that Computer Tomographic (CT) scans may only achieve a low sensitivity of 33% for peritoneal disease. We propose a set of radiological criteria for pre-operative determination of resectability of peritoneal disease in peritoneal-based malignancies and validate this in our cohort of patients. A retrospective review of all patients who underwent laparotomy with a view for CRS and HIPEC, at the National Cancer Centre Singapore from January 2000 to April 2010, was performed. Intra-operative Peritoneal Cancer Index (PCI) scores were recorded. The pre-operative imaging was reviewed with a senior radiologist who was blinded, and recorded the radiological PCI scores (CT-PCI) and eight additional CT prognostic factors (CT-PF). The CT-PCI and CT-PF scores were then compared with the intra-operative findings to determine the radiological accuracy. The scores and the individual prognostic factors were then evaluated for their predictive ability for unresectability. Comparison of the CT-PCI and PCI scores showed a concordance correlation coefficient at 0.52 (95% CI 0.34–0.7). Accuracy was increased with the addition CT-PF. The presence of omental caking and ascites were predictors of unresectability. We propose a scoring system which is able to predict for unresectable disease with a specificity of 80% and a sensitivity of 62%. With our proposed criteria, and scoring system, the selection of patients for CRS and HIPEC can be improved, and unnecessary exploratory operations avoided.

  20. The safety and clinical outcomes of chemoembolization in child-pugh class C patients with hepatocellular carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Won; Kim, Hyo Cheol; Lee, Jeong Hoon; Yu, Su Jong; Kang, Beom Sik; Hur, Sae Beom; Lee, Myung Su; Jae, Hwan Jun; Chung, Jin Wook [Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-12-15

    To evaluate the safety and clinical outcomes of chemoembolization in Child-Pugh class C patients with hepatocellular carcinomas (HCC). The study comprised 55 patients with HCC who were classified as Child-Pugh class C and who underwent initial chemoembolization between January 2003 and December 2012. Selective chemoembolization was performed in all technically feasible cases to minimize procedure-related complications. All adverse events within 30 days were recorded using the Common Terminology Criteria for Adverse Events (CTCAE). The tumor response to chemoembolization was evaluated using the modified Response Evaluation Criteria In Solid Tumors. Thirty (54.5%) patients were within the Milan criteria, and 25 (45.5%) were beyond. The mortality of study subjects at 30 days was 5.5%. Major complications were observed in five (9.1%) patients who were all beyond the Milan criteria: two hepatic failures, one hepatic encephalopathy, and two CTCAE grade 3 increases in aspartate aminotransferase/alanine aminotransferase abnormality. The mean length of hospitalization was 6.3 ± 8.3 days (standard deviation), and 18 (32.7%) patients were discharged on the next day after chemoembolization. The tumor responses of the patients who met the Milan criteria were significantly higher (p = 0.014) than those of the patients who did not. The overall median survival was 7.1 months (95% confidence interval: 4.4-9.8 months). Even in patients with Child-Pugh class C, chemoembolization can be performed safely with a selective technique in selected cases with a small tumor burden.